The alcohol and addiction research domain criteria (AARDoC) has been proposed to provide a framework for understanding the nature of alcohol use disorder (AUD) in terms of psychological and biological constructs that can be traced to a specific behavioral function with an underlying biological basis (e.g., neural dysfunction). The AARDoC proposes that AUD develops, progresses, and is maintained because of heightened incentive salience for alcohol, greater negative emotionality, and/or impairments in executive functioning and impulsivity. AARDoC was proposed in 2015 with the goal of improving efforts at precision medicine for AUD. As such, it is critically important that clinical assessments based on the AARDoC framework be studied and validated in order to inform clinical decision making and precision medicine initiatives for AUD. The AARDoC may also have utility in predicting AUD treatment outcomes and AUD recovery. There is an accumulation of evidence that drinking reductions are both achievable and associated with improvements in functioning among individuals with AUD. Examining whether drinking reductions can be associated with meaningful recovery of functioning is critically important because many individuals do not seek treatment because they do not want to abstain from alcohol, yet treatment systems are mostly focused on abstinence as a necessary and sufficient condition for recovery. Expanding the definition of recovery to include non-abstinent recoveries and other functional outcomes could increase acceptability of non-abstinent treatment goals among providers, increase treatment seeking among those with AUD who are not willing to abstain completely, and ultimately reduce the public health burden of untreated AUD. To address these gaps in understanding, this study will build an empirical knowledge base regarding clinical assessments that could be used to identify the AARDoC constructs and will examine whether the AARDoC constructs are associated with a novel typology of alcohol recovery, defined by consumption and functioning, among individuals who receive alcohol treatment. To achieve the study aims, integrative data analysis of AARDoC constructs among more than 3600 individuals (n = 3,672) who participated in three publicly funded alcohol treatment studies will be examined. This research will examine a broad definition of recovery and prediction of AUD recovery up to 10 years following an AUD treatment episode. The results from this study will be directly applicable to clinical practice and future research on AUD precision medicine. Project Relevance This study seeks to gain a better understanding of variability among individuals with alcohol use disorder who are seeking treatment and predictors of recovery from alcohol use disorder. The results will build a scientific knowledge base that will help guide future precision medicine initiatives, alcohol treatment planning, and decision-making among clients, clinicians, program evaluators, and policy makers, which may ultimately improve clinical outcomes and decrease the public health burden of alcohol use disorder.

Public Health Relevance

Project Relevance This study seeks to gain a better understanding of variability among individuals with alcohol use disorder who are seeking treatment and predictors of recovery from alcohol use disorder. The results will build a scientific knowledge base that will help guide future precision medicine initiatives, alcohol treatment planning, and decision-making among clients, clinicians, program evaluators, and policy makers, which may ultimately improve clinical outcomes and decrease the public health burden of alcohol use disorder.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
2R01AA022328-04
Application #
9760851
Study Section
National Institute on Alcohol Abuse and Alcoholism Initial Review Group (AA)
Program Officer
Hagman, Brett Thomas
Project Start
2013-08-05
Project End
2023-03-31
Budget Start
2019-04-15
Budget End
2020-03-31
Support Year
4
Fiscal Year
2019
Total Cost
Indirect Cost
Name
University of New Mexico
Department
Miscellaneous
Type
Organized Research Units
DUNS #
868853094
City
Albuquerque
State
NM
Country
United States
Zip Code
87106
Mann, Karl; Roos, Corey R; Hoffmann, Sabine et al. (2018) Precision Medicine in Alcohol Dependence: A Controlled Trial Testing Pharmacotherapy Response Among Reward and Relief Drinking Phenotypes. Neuropsychopharmacology 43:891-899
Witkiewitz, Katie; Kranzler, Henry R; Hallgren, Kevin A et al. (2018) Drinking Risk Level Reductions Associated with Improvements in Physical Health and Quality of Life Among Individuals with Alcohol Use Disorder. Alcohol Clin Exp Res 42:2453-2465
Witkiewitz, Katie; Vowles, Kevin E (2018) Alcohol and Opioid Use, Co-Use, and Chronic Pain in the Context of the Opioid Epidemic: A Critical Review. Alcohol Clin Exp Res 42:478-488
Witkiewitz, Katie; Roos, Corey R; Tofighi, Davood et al. (2018) Broad Coping Repertoire Mediates the Effect of the Combined Behavioral Intervention on Alcohol Outcomes in the COMBINE Study: An Application of Latent Class Mediation. J Stud Alcohol Drugs 79:199-207
Robinson, Charles S H; Fokas, Kathryn; Witkiewitz, Katie (2018) Relationship between empathic processing and drinking behavior in project MATCH. Addict Behav 77:180-186
Hallgren, Kevin A; Wilson, Adam D; Witkiewitz, Katie (2018) Advancing Analytic Approaches to Address Key Questions in Mechanisms of Behavior Change Research. J Stud Alcohol Drugs 79:182-189
Witkiewitz, Katie; Kirouac, Megan; Roos, Corey R et al. (2018) Abstinence and low risk drinking during treatment: Association with psychosocial functioning, alcohol use, and alcohol problems 3 years following treatment. Psychol Addict Behav 32:639-646
Mechanisms of Behavior Change Satellite Committee (2018) Novel Approaches to the Study of Mechanisms of Behavior Change in Alcohol and Other Drug Use Disorders. J Stud Alcohol Drugs 79:159-162
Kirouac, Megan; Witkiewitz, Katie (2018) Revisiting the Drinker Inventory of Consequences: An extensive evaluation of psychometric properties in two alcohol clinical trials. Psychol Addict Behav 32:52-63
Maisto, Stephen A; Hallgren, Kevin A; Roos, Corey R et al. (2018) Course of remission from and relapse to heavy drinking following outpatient treatment of alcohol use disorder. Drug Alcohol Depend 187:319-326

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