Neural imbalance between feedback sensitivity and inhibitory control in compulsivity and negative urgency

Compulsivity and emotional impulsivity (negative urgency) are considered transdiagnostic risk factors for compulsive-impulsive psychopathology that is linked to a neural imbalance between executive and motivational-emotional systems. However, existing evidence does not derive from within-subjects designs, leaving it unclear whether imbalance occurs with high expressions in compulsivity and negative urgency. To address this gap, we conducted a preregistered analysis to examine how feedback sensitivity and inhibitory control interact as a function of compulsivity and negative urgency.Participants (n = 205; collected 2018-2019) expressing a wide range in compulsivity and impulsivity performed two inhibition and two feedback tasks during electroencephalography. We examined how the relationship between neural correlates of inhibition (nogo/stop>go) and feedback sensitivity (loss>gain) was moderated by compulsivity and negative urgency. Compulsivity emerged as the most robust moderator. Across multiple tasks, feedback sensitivity was associated with inhibitory activity in participants with low, but not high, compulsivity. A similar, less pronounced effect was observed in low versus high negative urgency. However, the effect of negative urgency did not remain significant after controlling for compulsivity, whereas the moderation by compulsivity remained when controlling for negative urgency. These results suggest a neural imbalance between systems tied to executive functioning and feedback sensitivity in transdiagnostic risk. This imbalance manifests such that strong motivational-emotional sensitivity is insufficiently compensated by inhibitory resources. It could drive repetitive or rash behaviors in response to distress in compulsivity and negative urgency, respectively. Whereas shared mechanisms may underlie compulsivity and negative urgency, the current interactions appear most relevant to compulsive psychopathology.