Are Differences in Social Drive in Childhood and Adolescence Diagnosis Specific? A Multimeasurement Subtyping Approach

Objective: Altered social drive is a common feature across psychiatric disorders and is embedded in multiple diagnostic criteria, underscoring the need for a transdiagnostic approach. However, the extent to which social drive alterations vary across diagnoses and clinical presentations remains poorly characterized. This study examined whether distinct social drive profiles-defined by differences in social reticence, seeking, and maintaining challenges-relate to variations in clinical features and show specificity to particular neurodevelopmental and neuropsychiatric conditions. Method: Data were drawn from the Healthy Brain Network (N = 2,380; ages 5-21 years, mean [SD] age = 10.27 [3.39] years; 68% male) and included youth with attention-deficit/hyperactivity disorder, anxiety disorders, autism spectrum disorder, oppositional defiant/conduct disorder, depressive disorders, obsessive-compulsive disorder, and tic disorders. Latent profile analysis identified distinct social drive profiles based on constellations of social reticence, seeking, and maintaining challenges. Profiles were compared across demographic, social functioning, and clinical measures, and the distribution of diagnostic categories within each profile was assessed. Results: Five profiles emerged: engaged (n = 1,530), inhibited (n = 477), aloof (n = 189), avoidant (n = 143), and constrained (n = 50). Profile differences were evident in demographic factors, social functioning, and clinical features. No single diagnosis mapped exclusively onto any profile; rather, participants with distinct neurodevelopmental or neuropsychiatric diagnoses were distributed across all 5 profiles. Conclusion: Psychiatric diagnoses alone may not fully capture alterations in social drive, which appear to transcend diagnostic boundaries. These findings support a transdiagnostic framework and challenge disorder-specific models of social drive differences.