Specific Aims The current proposal aims to integrate core AUD constructs and theories, including promising endophenotypes, into an RDoC framework. This systematic integration will be used to derive a set of construct valid AUD ?diagnostic criteria? that will be validated in a college, community, and treatment sample. The resulting measure will consist of phenotypic-based criteria that are well-suited for treatment purposes, given they match directly to individual treatment targets, consistent with the precision medicine approach. Method Towards these aims, a systematic review of reviews on the topics of AUD etiology, core theories, and important endophenotypes will be conducted. Seminal, replicable findings will be integrated into the RDoC matrix (Aim 1). Once the core AUD domains have been identified, a second review will be conducted with the goal of identifying existing questionnaire and interview items that address each addiction-related RDoC domain. The appropriateness of these item/domain categorizations will be evaluated by Dr. Sher and consultants in order to provide feedback on the validity of the categorizations (Aim 2). Lastly, the items identified in Aim 2 will be used to develop a diagnostic measure of AUD using advanced statistical methods such as IRT, using the help of Drs. Merkle and Bucholz (consultants) and Dr. Sher (sponsor;
Aim 3). An MTurk sample of participants (N = 1,000) will be used for the item evaluation stage of measure development, and a college student (N = 1,000), outpatient (N = 150), and treatment (N = 150) sample will be used for the clinical refinement and external validation stage. Long-Term Objectives The over-arching goal of the proposed project is to develop an objective measure of AUD that is informed by basic translational science, consistent with the RDoC framework. Through the systematic integration of seminal work on AUD etiology into an RDoC framework, which has not been previously accomplished, the current study is well-positioned to produce a construct-valid measure of AUD that can be used to inform clinical treatment decisions. The proposed project can contribute to the movement towards developing personalized AUD intervention efforts by focusing on the specific domains in which individuals are experiencing symptoms and therefore overcoming the current issues related to treatment of widely heterogeneous AUD presentation. Training Aims The current proposal will serve as an important starting place for my long-term objective of building a more reliable and construct-valid diagnostic framework for use in the assessment and treatment of AUDs. The proposal will allow the applicant to gain valuable experience in translational science and its application within an RDoC framework, plus knowledge in analysis of big data, test construction, and psychometric evaluation. The nature of these training experiences will provide me with an immersive experience through close collaboration with mentors and exposure to new research and statistical methods. Thus, successful completion of these training aims will provide the foundation for my career objective of obtaining a tenure-track research position investigating AUD nosology and assessment with the goal of using these findings to improve clinical outcomes.
The major innovation of the proposed project is the main objective of informing alcohol use disorder (AUD) diagnostic conceptualization, nosology, and assessment in a way that is consistent with theory, basic research on addiction and the Research Domain Criteria (RDoC), a major translational framework. RDoC has the major advantage of construct validity when compared to traditional psychiatric diagnostic criteria which are theoretically haphazard and not conceptually coherent. The development of a construct valid, objective measure of AUD could improve diagnosis, which is important for both treatment and etiological research.
