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

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 for assessing individual variability within AUD across three domains corresponding to the proposed stages of the addiction cycle: reward (binge-intoxication stage), negative emotionality (withdrawal-negative affect stage), and cognitive control (preoccupation-anticipation stage). Recent work has evaluated the ANA's three-factor structure and construct validity, primarily in treatment-seekers with AUD. We extended this research by examining the factor structure, bias across alcohol use severity, longitudinal invariance, and concurrent and predictive validity of a novel assessment of the ANA domains in adults with past 12-month regular (10 + alcohol units/week) alcohol use. Participants recruited from Prolific (N = 732), a crowdsourced data collection platform, completed various self-report measures. A test-retest subsample (n = 234) completed these measures 30 days later. Split-half exploratory factor analysis and confirmatory factor analysis supported the three-factor structure of the ANA. The overall factor structure was invariant across 30 days. Concurrently and prospectively, ANA domains demonstrated convergent validity concerning theoretically aligned alcohol-related, psychological, and personality measures. However, there was evidence of poor discriminant validity, and several cognitive control and reward items demonstrated bias across alcohol use severity. Future research is needed to improve the measurement of ANA domains using multimodal indicators, examine longitudinal changes in domains and their relationship with alcohol use severity, characterize phenotypic subgroups based on relative levels of domains, and compare the utility of the ANA with other proposed frameworks for measuring AUD heterogeneity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Motives for Substance Use in Daily Life: A Systematic Review of Studies Using Ecological Momentary Assessment.

The motivational model of substance use posits four motive subtypes (coping, enhancement, social, conformity) dynamically interact with contextual factors to impact decisions about substance use. Yet, prior studies assessing the motivational model have relied on between-person, cross-sectional evaluations of trait motives. We systematically reviewed ecological momentary assessments (EMA) studies (N=64) on motives for substance use to examine: methodological features of EMA studies examining the motivational model, support for the motivational model between and within individuals, and associations between trait motives and daily processes. Results of the reviewed studies provide equivocal support for the motivational model, and suggest that EMA measures and trait measures of motives might not reflect the same construct. The reviewed body of research indicates most studies have not examined the momentary and dynamic nature of the motivational model and more research is needed to inform interventions that address heterogeneous reasons for substance use in daily life.

Validity and measurement invariance of the Addictions Neuroclinical Assessment incentive salience domain among treatment-seekers with alcohol use disorder.

Incentive salience, or the attribution of motivational value to stimuli, is a biopsychological process that is disrupted in alcohol use disorder (AUD). The Addictions Neuroclinical Assessment (ANA) is a framework to characterize heterogeneity in addiction and establish a common assessment battery for research and clinical use. The ANA framework hypothesizes three constructs that correspond to processes in the etiology, course, and treatment of addiction: incentive salience, negative emotionality, and executive function. The current study extends prior findings on the ANA by validating the incentive salience construct among participants (n = 563) in a multisite prospective study of individuals entering treatment for AUD. We used confirmatory factor analysis to test a one-factor model of incentive salience. Indicators included items assessing perception of urges to drink from the Alcohol Dependence Scale, Impaired Control Scale, and Marlatt Relapse Interview. Results indicated the one-factor model fit the data well (χ2 (12) = 19.42, p = .08; RMSEA = 0.034 [90% CI: 0.000, 0.060], CFI = 0.992) and was measurement invariant across sex. Incentive salience was associated with drinking patterns (e.g., drinks per day, r = 0.447 [95% CI: 0.379, 0.514]); reasons for drinking (urges/temptation r = 0.529 [95% CI: 0.460, 0.599]); testing personal control, r = 0.384 (95% CI: 0.308, 0.461); social pressure, r = 0.549 (95% CI: 0.481, 0.617); and family history of AUD, r = 0.134. The incentive salience factor demonstrated greater predictive validity for drinking outcomes compared to alternative preexisting scales. Overall, this study provides support for the construct validity and measurement invariance of the ANA incentive salience construct in a sample of individuals seeking AUD treatment.

The Addictions Neuroclinical Assessment Negative Emotionality Domain Among Treatment-Seekers with Alcohol Use Disorder: Construct Validity and Measurement Invariance.

BACKGROUND: The Addictions Neuroclinical Assessment (ANA), a framework for measuring heterogeneity in alcohol use disorder (AUD), focuses on 3 domains that reflect neurobiological dysfunction in addiction and correspond to the cycles of addiction: executive function, incentive salience, and negative emotionality. Kwako and colleagues (Am J Psychiatry 176:744, 2019) validated a 3-factor model of the ANA with neuropsychological and self-report indicators among treatment-seekers and non-treatment-seekers with and without AUD. The present analysis replicated and extended these findings in a treatment-seeking sample, focusing on the negative emotionality domain. METHODS: Participants (n = 563; 58.8% male; mean age = 34.3) were part of a multisite prospective study of individuals entering AUD treatment. We examined the factor structure of the negative emotionality domain at the baseline, 6-month follow-up, and 12-month follow-up assessments. The Beck Depression Inventory, Beck Anxiety Inventory, State-Trait Anger Expression Inventory-Trait Anger Subscale, and 3 Drinker Inventory of Consequences items assessing negative affective consequences were indicators in the model. RESULTS: Results indicated that a 1-factor model was an excellent fit at all assessments and that the negative emotionality domain was time and gender invariant. Furthermore, negative emotionality was associated with drinking patterns and reasons for alcohol use (i.e., drinking because of negative emotions and urges/withdrawal) at all assessments. CONCLUSIONS: This analysis provides evidence for the construct validity and measurement invariance of the ANA negative emotionality domain among AUD treatment-seekers. Future studies are needed to evaluate prospective associations between negative emotionality and specific treatment modalities, and whether individuals with greater negative emotionality are more likely to respond to treatment that targets drinking to relieve negative affective states.