Are Some Alcohol Use Disorder Criteria More (or Less) Externalizing than Others? Distinguishing Alcohol Use Symptomatology from General Externalizing Psychopathology.
Alcohol Use Disorder Criteria
Comorbidity
Externalizing Behavior
Journal
Alcoholism, clinical and experimental research
ISSN: 1530-0277
Titre abrégé: Alcohol Clin Exp Res
Pays: England
ID NLM: 7707242
Informations de publication
Date de publication:
03 2019
03 2019
Historique:
received:
11
06
2018
accepted:
02
01
2019
pubmed:
9
1
2019
medline:
12
5
2020
entrez:
9
1
2019
Statut:
ppublish
Résumé
The externalizing spectrum contains a range of disinhibition-related conditions, such as conduct disorder, antisocial personality disorder, and substance use disorders. Comorbidity among externalizing disorders is commonly investigated at the syndromal and trait level precluding insight into the relationship of symptoms across externalizing disorders. It is unknown whether comorbidity across externalizing disorders holds constant across highly varied, individual alcohol use disorder (AUD) criteria. AUD criteria range from symptoms reflecting neuroadaptation (e.g., tolerance) to symptoms reflecting behavioral problems (e.g., social problems). The present study aimed to determine the degree to which individual AUD criteria are associated with symptomatology from other externalizing disorders. Characterization of the degree to which AUD criteria reflect neuroadaptation versus behavioral problems can be used to identify symptom profiles, which, in turn, can be used to inform diagnostic and treatment approaches. Data from 2 large nationally representative samples were used to examine associations between AUD criteria and externalizing behavior. Psychometric inquiries via multivariate and factor analytic approaches estimated relative associations of externalizing behavior and AUD criteria endorsement, as compared to alcohol consumption. Our results indicate differential relations of externalizing behavior and AUD criteria endorsement. For example, social problems and role interference criteria were most strongly associated with externalizing behavior across analytic approaches, with general and unique associations with externalizing behavior. Additionally, tolerance was most weakly associated with externalizing behavior across approaches. Results highlight potential etiological heterogeneity among AUD criteria that could guide future diagnostic refinements and aid in the identification of treatment targets.
Sections du résumé
BACKGROUND
The externalizing spectrum contains a range of disinhibition-related conditions, such as conduct disorder, antisocial personality disorder, and substance use disorders. Comorbidity among externalizing disorders is commonly investigated at the syndromal and trait level precluding insight into the relationship of symptoms across externalizing disorders. It is unknown whether comorbidity across externalizing disorders holds constant across highly varied, individual alcohol use disorder (AUD) criteria. AUD criteria range from symptoms reflecting neuroadaptation (e.g., tolerance) to symptoms reflecting behavioral problems (e.g., social problems). The present study aimed to determine the degree to which individual AUD criteria are associated with symptomatology from other externalizing disorders. Characterization of the degree to which AUD criteria reflect neuroadaptation versus behavioral problems can be used to identify symptom profiles, which, in turn, can be used to inform diagnostic and treatment approaches.
METHODS
Data from 2 large nationally representative samples were used to examine associations between AUD criteria and externalizing behavior. Psychometric inquiries via multivariate and factor analytic approaches estimated relative associations of externalizing behavior and AUD criteria endorsement, as compared to alcohol consumption.
RESULTS
Our results indicate differential relations of externalizing behavior and AUD criteria endorsement. For example, social problems and role interference criteria were most strongly associated with externalizing behavior across analytic approaches, with general and unique associations with externalizing behavior. Additionally, tolerance was most weakly associated with externalizing behavior across approaches.
CONCLUSIONS
Results highlight potential etiological heterogeneity among AUD criteria that could guide future diagnostic refinements and aid in the identification of treatment targets.
Identifiants
pubmed: 30620411
doi: 10.1111/acer.13952
pmc: PMC6397083
mid: NIHMS1005710
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
483-496Subventions
Organisme : NIAAA NIH HHS
ID : K05 AA017242
Pays : United States
Organisme : NIAAA NIH HHS
ID : T32 AA013526
Pays : United States
Organisme : NIAAA NIH HHS
ID : R01 AA024133
Pays : United States
Informations de copyright
© 2019 by the Research Society on Alcoholism.
Références
Arch Gen Psychiatry. 1992 Aug;49(8):599-608
pubmed: 1637250
Behav Brain Res. 2011 Oct 1;223(2):255-61
pubmed: 21507334
Trends Cogn Sci. 2012 Jan;16(1):81-91
pubmed: 22155014
J Stud Alcohol Drugs. 2011 Jul;72(4):685-6
pubmed: 21683051
J Abnorm Psychol. 1994 Feb;103(1):92-102
pubmed: 8040486
Am J Psychiatry. 2010 Jun;167(6):630-9
pubmed: 20516163
Am J Psychiatry. 2002 Nov;159(11):1882-8
pubmed: 12411223
Arch Gen Psychiatry. 1999 Oct;56(10):921-6
pubmed: 10530634
Science. 1987 Apr 24;236(4800):410-6
pubmed: 2882604
Alcohol Clin Exp Res. 1988 Aug;12(4):494-505
pubmed: 3056070
Addiction. 2014 Nov;109(11):1773-8
pubmed: 24913314
Alcohol Clin Exp Res. 2016 Aug;40(8):1691-9
pubmed: 27339661
J Abnorm Psychol. 2005 Nov;114(4):537-50
pubmed: 16351376
Br J Psychiatry. 1971 May;118(546):525-31
pubmed: 5580368
J Stud Alcohol. 2000 May;61(3):431-8
pubmed: 10807215
Am J Psychiatry. 2013 Aug;170(8):834-51
pubmed: 23903334
Am J Psychiatry. 2010 Jul;167(7):748-51
pubmed: 20595427
Addict Behav. 2016 Aug;59:95-9
pubmed: 27082748
J Abnorm Psychol. 2017 May;126(4):454-477
pubmed: 28333488
Am J Ment Defic. 1981 Sep;86(2):127-37
pubmed: 7315877
J Stud Alcohol Drugs. 2009 Mar;70(2):157-68
pubmed: 19261227
Alcohol Clin Exp Res. 2014 Feb;38(2):489-500
pubmed: 24033811
J Abnorm Child Psychol. 2013 Feb;41(2):223-37
pubmed: 22936218
J Consult Clin Psychol. 2012 Dec;80(6):1052-1061
pubmed: 22774792
Annu Rev Clin Psychol. 2013;9:91-121
pubmed: 23537483
Drug Alcohol Depend. 1995 Oct;39(3):197-206
pubmed: 8556968
Can Med Assoc J. 1960 Dec 24;83:1341-5
pubmed: 13789799
Psychol Addict Behav. 2011 Sep;25(3):390-404
pubmed: 21823762
Clin Psychol Sci. 2014 Mar;2(2):119-137
pubmed: 25360393
J Abnorm Psychol. 2007 Nov;116(4):645-66
pubmed: 18020714
Alcohol Clin Exp Res. 2018 Jun;42(6):1073-1083
pubmed: 29570805
Dev Psychopathol. 2013 Aug;25(3):739-54
pubmed: 23880389
Mol Psychiatry. 2012 Dec;17(12):1306-15
pubmed: 22105626
BMC Med. 2013 May 14;11:126
pubmed: 23672542
Psychol Bull. 1979 Mar;86(2):420-8
pubmed: 18839484
J Atten Disord. 2010 Jul;14(1):7-14
pubmed: 19794136
BMC Psychiatry. 2011 Apr 11;11:57
pubmed: 21481227
J Clin Psychiatry. 2005 Jun;66(6):677-85
pubmed: 15960559
J Abnorm Psychol. 2004 Feb;113(1):72-80
pubmed: 14992659
Psychol Med. 2006 May;36(5):699-710
pubmed: 16438742
Nebr Symp Motiv. 1986;34:27-83
pubmed: 3498124
Addict Behav. 1998 Nov-Dec;23(6):893-907
pubmed: 9801724
Alcohol Health Res World. 1996;20(1):46-54
pubmed: 31798164
Alcohol Clin Exp Res. 2011 Mar;35(3):550-8
pubmed: 21143251
J Abnorm Psychol. 2009 Nov;118(4):699-710
pubmed: 19899840
Alcohol Clin Exp Res. 2015 Apr;39(4):579-84
pubmed: 25833016
Drug Alcohol Depend. 2002 Dec 1;68(3):299-307
pubmed: 12393224
J Abnorm Psychol. 1996 Aug;105(3):299-312
pubmed: 8772001
J Pers. 1999 Feb;67(1):39-65
pubmed: 10030020
Psychol Med. 2010 Jun;40(6):899-909
pubmed: 19719899
Brain Res Brain Res Rev. 1993 Sep-Dec;18(3):247-91
pubmed: 8401595