Preclinical psychiatric symptomatology and “Diagnostic Criterion” of
pathological procrastination: A psychopathological connectome model
Abstract
Background Procrastination describes irrational delays of
scheduled tasks despite clear awareness of adverse consequences to do
so. Although procrastination is well-known to be linked to psychiatric
or pathological processes, insights into why procrastination may
contribute to psychopathological outcomes has not been fully explored.
The aim of the current study was to identify the criterion for
“pathological procrastination” and its preclinical correlates.
Methods This is a longitudinal and prospective observational
study with a five-year interval. Participants ( N = 464)
completed measures of trait procrastination in November 2018, with a
follow-up conducted in March 2023 ( N = 267) to collect
preclinical psychiatric symptoms via self-reported measures. A
constrained multivariate direct gradient model (cmDGM) was built to
prospectively fit procrastination to the preclinical psychiatric
symptomatology that formulated by DSM-5 framework. The 2-stage
psychopathological connectome model was further constructed to
constitute a “diagnostic criterion” reflecting “pathological
procrastination”. Results Procrastination prospectively
predicted severe preclinical psychiatric symptoms and unhealthy
lifestyles. Preclinical bridge hubs of “failure to self-regulate
delays”, “failure to control adverse consequences”, “useless to
self-change”, “out-of-control irruptions”, “poor sleep quality” and
“negative emotional reactions” were captured for highly local and
global disruptions in the psychopathological network of procrastination,
and thus constituted the 9-item pathological procrastination diagnostic
criterion (3PDC) with good diagnostic performance (AUC = 0.82, p
<.01). Conclusions The present study revealed the
predictive rol of procrastination for preclinical psychiatric
symptomatology, and further established the preclinical 3PDC to lay the
foundation for the “diagnostics of pathological procrastinators” by
both quantitative measurements and DSM-structured binary schemes.