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Despite the prevalence and clinical impact of these behaviors, knowledge regarding the psychological risk markers for PB among individuals with NGDs is currently lacking. To fill this gap, we explored the relative contributions of key developmental (age, speech production) and clinical (emotion regulation, anxiety, sensory sensitivity, social communication) characteristics as predictors of unique PB subdomains in a sample of 255 individuals with NGDs (<jats:italic>M<\/jats:italic><jats:sub>age<\/jats:sub>\u2009=\u200914.16; SD<jats:sub>age<\/jats:sub>\u2009=\u200910.45; 51.0% male). Emotion dysregulation was a strong predictor of all subdomains of PB and the strongest predictor of aggression, conduct problems, and property destruction, after controlling for speech level and other clinical features. Lower social communication was the strongest predictor of elopement and self\u2010injury. Distinct facets of anxiety showed unique patterns of associations with PB subdomains, such that higher physiological anxiety was significantly associated with elopement and aggression, while lower worry was associated with elopement. Speech level was a significant negative predictor of conduct problems and elopement. Future research is needed to replicate reported findings and to understand the predictors, maintaining factors, and complex interplay between these factors in the occurrence of PB subdomains among individuals with NGDs.<\/jats:p>","DOI":"10.1002\/ajmg.b.33049","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T13:05:42Z","timestamp":1755695142000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Challenging Behavior Domains in Individuals With Neurodevelopmental Genetic Syndromes: The Role of Psychological Features"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2771-6346","authenticated-orcid":false,"given":"Emily F.","family":"Ferguson","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Stanford University  Stanford California 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