Reward‐network connectivity in childhood predicts multi‐domain dysregulation in adolescence

Background Multi‐domain dysregulation in adolescence, indexed by co‐occurring affective, cognitive, and behavioural difficulties, is a robust transdiagnostic risk factor. However, its developmental course and neural antecedents are poorly understood. Given heightened emotional reactivity and impulsivity in adolescence, alterations in reward‐network connectivity may represent an early neural marker of risk. Methods Adolescents completed four assessments approximately two years apart between ages 9–13 and 15–18 years. Multi‐domain dysregulation was assessed at each wave using the Youth Self‐Report Dysregulation Profile (YSR‐DP), computed as the sum of the anxious/depressed, aggressive behaviour, and attention problems subscales. Resting‐state fMRI was acquired at baseline ( M age = 11.34 years). Piecewise linear mixed‐effects models ( N = 211) characterized trajectories of YSR‐DP scores across adolescence. Principal component scores indexing a Latent Dysregulation Factor were used to derive residualised change in dysregulation, and regression analyses ( N = 94) tested whether baseline reward‐network connectivity predicted this change. Results YSR‐DP scores declined from late childhood to early adolescence, increased from early to mid‐adolescence, and then stabilized in late adolescence. Weaker connectivity within the reward network in late childhood predicted greater increases in the latent dysregulation factor from early to mid‐adolescence, above and beyond baseline dysregulation. Connectivity in seven large‐scale control networks did not predict changes in dysregulation. Conclusions Multi‐domain dysregulation follows a nonlinear trajectory across adolescence, and weaker reward‐network connectivity in childhood prospectively predicts subsequent escalation of this phenotype. Prevention and intervention efforts may benefit from targeting reward processing and regulatory skills in late childhood and early adolescence.