Measurement and Multimethod Validation of Alcohol Use Disorder Etiologic Mechanisms

酒精使用障碍病因机制的测量和多方法验证

• 批准号: 10504509
• 负责人: Cassandra Lee Boness
• 金额: $ 20.37万
• 依托单位: UNIVERSITY OF NEW MEXICO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-10 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10504509
• 关键词: Address; Alcohol consumption; Alcohol dependence; Alcoholic beverage heavy drinker; Alcohols; Calibration; Categories; Clinical; Communities; Consultations; DSM-V; Data; Data Collection; Development; Diagnosis; Diagnostic; Dimensions; Discrimination; Ecological momentary assessment; Emotional; Ensure; Etiology; Evaluation; Factor Analysis; Gender; Goals; Heterogeneity; Hour; Individual; International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10); Intervention; Interview; Laboratories; Literature; Manuals; Measurement; Measures; Modeling; Modernization; Mood Disorders; National Institute on Alcohol Abuse and Alcoholism; Participant; Pathology; Patient Self-Report; Persons; Phenotype; Population Heterogeneity; Prevention; Property; Psychometrics; Psychopathology; Public Health; Reduce health disparities; Research; Research Domain Criteria; Rewards; SET Domain; Sampling; Services; Severities; Strategic Planning; Structure; Testing; Time; Validation; Work; addiction; alcohol abuse therapy; alcohol testing; alcohol use disorder; base; behavioral pharmacology; clinical decision-making; clinical practice; cognitive control; cognitive interview; community based participatory research; community setting; comorbidity; computerized; disease classification; evidence base; experience; follow up assessment; follow-up; improved; improved outcome; indexing; mental disorder prevention; multimodality; novel; optimal treatments; patient population; practice setting; precision medicine; response; sex; substance use; theories; uptake

PROJECT SUMMARY Alcohol use disorder (AUD) is a significant public health problem, yet treatments demonstrate only modest efficacy, likely due to the the profound phenotypic heterogeneity of AUD. In order to improve the efficacy of AUD treatments, it is imperative to better characterize this heterogeneity which may, in turn, elucidate clearer treatment targets for precision medicine approaches. This likely requires shifting conceptualizations of AUD away from clinical description and towards etiologic mechanisms, an approach embodied by the goals of some modern conceputalizations of AUD, such as the Addiction Research Domain Criteria (AARDoC) and Addictions Neuroclinical Assessment (ANA). However, current research suggests that AARDoC and ANA suffer from important shortcomings, including limited clinical efficiency, and may therefore benefit from further development, refinement, and validation. To address these shortcomings, the proposed project aims to (a) empirically test the models articulated by modern conceptual AUD etiological frameworks, including the ANA, and (b) derive a mechanism-based computerized adaptive test (CAT) assessment of AUD developed using principles of objective test construction and community-based participatory research strategies. First, a candidate set of self-report items indexing 13 etiologic domains articulated by the Etiologic, Theory-Based, Ontogenetic Hierarchical (ETOH) framework of AUD mechanisms, which serves as a recent extension of AARDoC/ANA, will be derived from the literature and two rounds of cognitive interviews will be used to refine the item set among a diverse group of participants (N = 50) with hazardous or harmful alcohol use. Next, items will be administered to a combined community and clinical sample (N = 1,200) to empirically test the structure of items and determine the best-fitting model. Item response theory will then be used to calibrate the items for the purpose of building a CAT for each of the domains identified (e.g., reward, cognitive control, negative emotionality). Using the refined and calibrated item set and domain-specific CATs, data will be collected from an additional independent sample of heavy drinkers (N = 100). Ecological momentary assessment over 14 days and a follow-up assessment will also be conducted with the goal of evaluating the psychometric properties of the CATs in ecologically valid contexts and over time. Specifically, to determine if the domain-specific CATs demonstrate validity (e.g., convergent, discriminant, predictive) and reliability (e.g., test-retest) across diverse patient populations and sex/gender groups. All research aims will be conducted alongside and in consultation with individuals with lived experience of AUD to ensure the measure is acceptable, feasible, and adequately contextualized. This project is consistent with NIAAA's Strategic Plan, specifically Goal 1 (Identify mechanisms of alcohol-related pathology) and Goal 2 (Improve diagnosis and tracking of AUD). The resulting measure also has the potential to support progress towards Goal 4 (Develop and improve treatments for AUD) by facilitating the assessment of mechanisms that may serve as viable targets in AUD treatments, including behavioral and pharmacological interventions.

项目摘要 酒精使用障碍（AUD）是一个重大的公共卫生问题，但治疗仅表明 功效，可能是由于AUD的深刻表型异质性。为了提高AUD的功效 治疗方法，必须更好地表征这种异质性，而这种异质性又可能阐明更清晰 精确医学方法的治疗目标。这可能需要改变AUD的概念化 从临床描述到病因机制，这种方法由某些现代的目标体现 AUD的自我评估，例如成瘾研究领域标准（AARDOC）和成瘾 神经临床评估（ANA）。但是，当前的研究表明，Aardoc和Ana遭受了 重要的缺点，包括有限的临床效率，因此可能受益于进一步的发展， 改进和验证。为了解决这些缺点，拟议的项目旨在（a）经验测试 包括ANA在内的现代概念AUD病因框架所阐明的模型，（b）得出A 基于机制的计算机自适应测试（CAT）评估AUD的评估使用客观原理开发 测试建筑和基于社区的参与性研究策略。首先，一组自我报告 基于病因，基于理论的，个体发育等级（ETOH）表达的13个病因学领域的项目。 AUD机制的框架是AARDOC/ANA的最新扩展的框架，将源自 文学和两轮认知访谈将用于完善各种各样的项目 参与者（n = 50）有危险或有害饮酒。接下来，将项目管理到合并 社区和临床样本（n = 1,200）以经验测试项目的结构并确定最合适的 模型。然后，项目响应理论将用于校准项目，以便为每种猫建造一只猫 确定的领域（例如，奖励，认知控制，负面情绪）。使用精制和校准 物品集和特定于域的猫，将从其他重量的独立样本中收集数据 饮酒者（n = 100）。在14天内的生态瞬时评估，随访评估也将是 进行的目的是评估猫在生态有效的环境中的心理测量特性和 随着时间的推移。具体而言，确定域特异性猫是否表现出有效性（例如，收敛性， 歧视，预测性）和可靠性（例如，重新测试）跨多种患者人群和性别/性别 组。所有研究目标都将与具有生活经验的人一起进行并协商 确保该措施是可以接受，可行和充分背景的AUD。这个项目是一致的 有了NIAAA的战略计划，特别是目标1（确定与酒精相关病理的机制）和目标2 （改善AUD的诊断和跟踪）。最终的措施也有可能支持进步 迈向目标4（通过促进评估机制的评估 可以作为AUD处理的可行靶标，包括行为和药理干预措施。