New approaches to deep phenotyping in addictions.

Psychology of Addictive Behaviors, Journal Year: 2022, Volume and Issue: 37(3), P. 361 - 375

Published: Sept. 29, 2022

The causes of substance use disorders (SUDs) are largely unknown and the effectiveness their treatments is limited. One crucial impediment to research treatment progress surrounds how SUDs classified diagnosed. Given substantial heterogeneity among individuals diagnosed with a given SUD (e.g., alcohol disorder [AUD]), identifying novel targets developing new study designs daunting.

Language: Английский

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Diagnostic Criteria for Identifying Individuals at High Risk of Progression From Mild or Moderate to Severe Alcohol Use Disorder

JAMA Network Open, Journal Year: 2023, Volume and Issue: 6(10), P. e2337192 - e2337192

Published: Oct. 10, 2023

Importance Current Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) ( DSM-5 ) diagnoses substance use disorders rely on criterion count–based approaches, disregarding severity grading indexed by individual criteria. Objective To examine correlates alcohol disorder (AUD) across count-based groups (ie, mild, moderate, mild-to-moderate, severe), identify specific diagnostic criteria indicative greater severity, evaluate whether within mild-to-moderate AUD differentiate relevant manifest in hazards severe development. Design, Setting, Participants This cohort study involved 2 cohorts from the family-based Collaborative Study Genetics Alcoholism (COGA) with 7 sites United States: cross-sectional (assessed 1991-2005) longitudinal 2004-2019). analyses were conducted December 2022 to June 2023. Main Outcomes Measures Sociodemographic, alcohol-related, psychiatric comorbidity, brain electroencephalography (EEG), polygenic score measures as levels severe) severity–defined low-risk vs high-risk mild-to-moderate). Results A total 13 110 individuals COGA (mean [SD] age, 37.8 [14.2] years) 2818 baseline 16.1 [3.2] included. Associations psychiatric, EEG, reinforced role increasing counts indexing severity. Yet (2-5 criteria), presence (eg, withdrawal) identified a group reporting heavier drinking comorbidity even after accounting for count differences. In analyses, prior characterized endorsement at least 1 was associated more accelerated progression (adjusted hazard ratio [aHR], 11.62; 95% CI, 7.54-17.92) compared without (aHR, 5.64; 3.28-9.70), independent count. Conclusions Relevance this combined 15 928 individuals, findings suggested that simple approaches estimating vulnerability, which ignore heterogeneity among criteria, may be improved emphasizing Such emphasis allow better focus greatest risk improve understanding development AUD.

Language: Английский

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Exploratory Bifactor Analysis of Symptoms and Traits Highlights Aspects of Psychopathology Inaccessible by Other Methods

Clinical Psychological Science, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 26, 2025

Bifactor analysis has the distinct ability to model general versus specific psychopathology liabilities and extent which these are involved in manifest symptoms. However, overreliance on confirmatory models of diagnostic covariance hampers substantive implications. We undertook an exploratory bifactor approach symptom-level epidemiological data ( N = 8,405) critically examine known issues contribute development more finely grained models. The resulting included Distress, Harmful Alcohol Use, Antisocial Behavior, Attention Seeking, Social Alienation, Psychosis factors. Within categories, symptoms showed substantial heterogeneity regarding their degree generality specificity primary loadings Results clarify shortcomings persist beyond limitations diagnosis-level and/or methods. These findings suggest additional layers complexity nuance quantitative dimensional taxonomies offer new insights into critical debates literature.

Language: Английский

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A Hierarchical Model of the Symptom-Level Structure of Psychopathology in Youth

Clinical Psychological Science, Journal Year: 2024, Volume and Issue: unknown

Published: Aug. 7, 2024

More comprehensive modeling of psychopathology in youth is needed to facilitate a developmentally informed expansion the Hierarchical Taxonomy Psychopathology (HiTOP) model. In this study, we examined symptom-level model structure children and adolescents—most aged 11 17 years—bringing together data from large clinical, community, representative samples ( N = 18,290) covering nearly all major forms mental disorders related content domains (e.g., aggression). The resulting hierarchical dimensional was based on points convergence among three statistical approaches included 15 narrow dimensions nested under four broad (a) internalizing, (b) externalizing, (c) eating pathology, (d) uncontrollable worry, obsessions, compulsions. We position these findings within context existing literature articulate implications for future research. Ultimately, add rapidly growing move step closer toward quantifying (dis)continuities psychopathology’s across life span.

Language: Английский

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Understanding alcohol use and alcohol use disorders from a developmental psychopathology perspective: Research advances, challenges, and future directions

Development and Psychopathology, Journal Year: 2024, Volume and Issue: unknown, P. 1 - 15

Published: April 24, 2024

Abstract As part of the special issue Development and Psychopathology honoring remarkable contributions Dr Dante Cicchetti, current paper attempts to describe recent that a developmental psychopathology perspective has made in understanding development alcohol use alcohol-related problems over lifespan. The also identifies some future challenges research directions. Because scope this task far exceeds confines journal length article does not attempt comprehensive review. Rather, it builds on an earlier review commentary was published 2013, with similar goal.)Building work updating its conclusions suggestions for directions, emphasizes findings from areas were identified further study 2013 have been since time.

Language: Английский

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“General Addiction Liability” Revisited

Clinical Psychological Science, Journal Year: 2024, Volume and Issue: unknown

Published: May 25, 2024

Although substance use disorders are widely known to be influenced by myriad etiologic factors, recent research promotes the notion that liability toward addiction broadly construed can described a single, unitary dimension we term general liability. Here, revisit concept of placing it at greater theoretical and empirical risk. To do so, used data from two epidemiologic samples (ns 262-8552) employed varied quantitative methods examine associations between alcohol, cannabis, tobacco, opioid disorders. We did not find strong evidence for Nevertheless, consequence-based features (e.g., social/interpersonal harm, hazardous use) tended form cross-substance connections. contextualize our findings in broader literature on offer several explanations why others arrive competing conclusions with respect robustness nature

Language: Английский

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Association patterns of antisocial personality disorder across substance use disorders

Translational Psychiatry, Journal Year: 2024, Volume and Issue: 14(1)

Published: Aug. 28, 2024

There is a high prevalence of antisocial personality disorder (ASPD) in individuals affected by substance use disorders (SUD). However, there limited information on the specific patterns association ASPD with SUD severity and diagnostic criteria. We investigated alcohol, cannabis, cocaine, opioid, tobacco (AUD, CanUD, CocUD, OUD, TUD, respectively) 1660 6640 controls matched sex (24% female), age, racial/ethnic background sample ascertained for addiction-related traits. Generalized linear regressions were used to test respect five DSM-5 diagnoses, their (i.e., mild, moderate, severe), found that associated diagnosis AUD (Odds Ratio, ORs = 1.89 1.25), CanUD (ORs 2.13 1.32), TUD 1.50 1.21) (ps < 0.003). Of criteria, "hazardous use" criterion showed strongest across SUDs (from OR

Language: Английский

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Reconstructing Psychopathology: A Data-Driven Reorganization of the Symptoms in the Diagnostic and Statistical Manual of Mental Disorders

Clinical Psychological Science, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 17, 2024

In this study, we reduced the fifth edition of Diagnostic and Statistical Manual Mental Disorders ( DSM-5) to its constituent symptoms reorganized them based on patterns covariation in individuals’ N = 14,762) self-reported experiences form an empirically derived hierarchical framework clinical phenomena. Specifically, used points agreement among principal components analyses clustering as well between randomly split primary n 11,762) hold-out 3,000) samples identify robust constructs that emerged a hierarchy ranging from syndromes up very broad superspectra psychopathology. The resulting model had noteworthy convergence with upper levels Hierarchical Taxonomy Psychopathology (HiTOP) substantially expands HiTOP’s current coverage dissociative, elimination, sleep–wake, trauma-related, neurodevelopmental, neurocognitive disorder symptoms. We also mapped some exemplar DSM-5 disorders onto our hierarchy; formed coherent syndromes, whereas others were notably heterogeneous.

Language: Английский

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Reconstructing Psychopathology: A data-driven reorganization of the symptoms in the Diagnostic and Statistical Manual of Mental Disorders

Published: Nov. 30, 2023

In this study, we reduced the DSM-5 to its constituent symptoms and reorganized them based on patterns of covariation in individuals’ (n = 14,762) self-reported experiences form an empirically derived hierarchical framework clinical phenomena. Specifically, used points agreement among principal components analyses clustering, as well between randomly split primary 11,762) hold-out 3,000) samples, identify robust constructs that emerged a hierarchy ranging from syndromes up very broad superspectra psychopathology. The resulting model had noteworthy convergence with upper levels Hierarchical Taxonomy Psychopathology (HiTOP) substantially expands HiTOP’s current coverage dissociative, elimination, sleep-wake, trauma-related, neurodevelopmental, neurocognitive disorder symptoms. We also mapped some exemplar disorders onto our hierarchy; formed coherent syndromes, whereas others were notably heterogeneous.

Language: Английский

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Examining the validity of the addictions neuroclinical assessment domains in a crowdsourced sample of adults with current alcohol use.

Experimental and Clinical Psychopharmacology, Journal Year: 2023, Volume and Issue: 32(1), P. 68 - 83

Published: May 25, 2023

Several dimensional frameworks for characterizing heterogeneity in alcohol use disorder (AUD) have been proposed, including the Addictions Neuroclinical Assessment (ANA). The ANA is a framework assessing individual variability within AUD across three domains corresponding to proposed stages of addiction cycle: reward (binge-intoxication stage), negative emotionality (withdrawal-negative affect and cognitive control (preoccupation-anticipation stage). Recent work has evaluated ANA's three-factor structure construct validity, primarily treatment-seekers with AUD. We extended this research by examining factor structure, bias severity, longitudinal invariance, concurrent predictive validity novel assessment adults past 12-month regular (10 + units/week) use. Participants recruited from Prolific (

Language: Английский

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