Delineating the Longitudinal Associations Between Somatic Symptoms, Negative Urgency, and Lack of Perseverance During Preadolescent Development

Abstract

Functional somatic symptoms affect a substantial proportion of youth during the preadolescent to later adolescent stages, posing a risk for maladaptive behaviors such as substance misuse. Our previous work demonstrated that these associations were mediated by dimensions of impulsivity (negative urgency and lack of perseverance), suggesting a combined internalizing/externalizing pathway to risk-taking behaviors. The present study sought to better delineate the directionality of associations between these endophenotypes within youth enrolled in the Adolescent Brain Cognitive Development study, using cross-lagged analysis. Further, we aimed to characterize the neural mechanisms underpinning these relationships through mediation analysis, accounting for sex differences. Our findings suggest that somatic symptoms precede impulsive behaviors in females, starting a cycle of lacking perseverance and increased somatic symptoms later in development. We failed to identify connectivity mediators driving these associations, possibly due to pubertal and environmental events conflating findings. Future work should employ more advanced statistical procedures and mixed-methods approaches to better describe the biological nature of this risk-pathway.