Reconciling neurocognitive and behavioral impulsivities through ecological assessment and multivariate modelling of cognitive control dynamics

Abstract Impulsivity is a core dimension of ADHD and a transdiagnostic risk factor for adverse outcomes. However, laboratory-based neurocognitive measures show weak convergence and limited prediction of real-world behavior. We tested whether repeated ecological assessment combined with response-time (RT) modeling improves impulsivity assessment. Sixty participants completed 1,347 smartphone-based Balloon Analogue Risk Task (D-BART) assessments alongside the Conners CPT-3. Linear mixed-effects models characterized RT as a function of objective risk and subjective uncertainty, while partial least squares identified shared D-BART/CPT-3 response patterns. RT slowed with increasing risk and uncertainty, distinguished clinical from control participants better than conventional metrics. D-BART latent scores predicted real-world hyperactivity/impulsivity with superior accuracy compered to CPT-3 scores. D-BART predictive accuracy further increased with repeated ecological sampling. These findings demonstrate that repeated ecological assessment combined with parsimonious RT modelling improves the construct validity, cross-paradigm convergence, and clinical relevance of neurocognitive measures of impulsivity beyond the current clinical gold standard.