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Chronic Intermittent Ethanol Vapor Exposure Paired with Two-Bottle Choice to Model Alcohol Use Disorder
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Alcohol use disorder criteria exhibit different comorbidity patterns.

Ashley L Watts1, David Watson2, Andrew C Heath3

  • 1Department of Psychological Sciences, University of Missouri, Columbia, MO, USA.

Addiction (Abingdon, England)
|January 6, 2023
PubMed
Summary

Different alcohol use disorder (AUD) symptom patterns relate to distinct externalizing and internalizing psychopathology dimensions. Understanding these symptom clusters is key to addressing AUD and comorbid conditions effectively.

Keywords:
alcohol use disordercomorbidityexternalizingheterogeneityinternalizingsymptoms

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Addiction Research

Background:

  • Alcohol use disorder (AUD) frequently co-occurs with other mental health conditions, including externalizing disorders like conduct disorder and internalizing disorders such as depression and anxiety.
  • Current research often treats AUD criteria as uniform indicators of psychopathology, overlooking the varied domains encompassed by AUD criteria.
  • Emerging evidence suggests specific symptom clusters within AUD may differentially relate to external criteria like psychopathology and personality traits (e.g., impulsivity).

Purpose of the Study:

  • To investigate the relationship between individual alcohol use disorder criteria and internalizing and externalizing dimensions of psychopathology.
  • To explore whether specific symptom combinations within AUD predict distinct patterns of comorbidity.

Main Methods:

  • Utilized multivariate and factor analytical modeling on data from two large, nationally representative samples of past-year drinkers in the United States.
  • Assessed psychopathology using the Alcohol Use Disorder and Associated Disabilities Interview Schedule, capturing AUD criteria, internalizing diagnoses, and externalizing diagnoses/symptoms.
  • Measured alcohol consumption via past-year drinking frequency, usual amount consumed, binge drinking, intoxication frequency, and maximum drinks per day.

Main Results:

  • Identified four distinct patterns of association between AUD criteria and psychopathology.
  • Found that several AUD criteria showed weak associations with both externalizing and internalizing dimensions.
  • Observed that alcohol withdrawal was linked to internalizing conditions, but not specifically to distress; recurrent hazardous use correlated with higher externalizing and lower internalizing tendencies.

Conclusions:

  • Different combinations of alcohol use disorder symptoms manifest in disorder-specific ways or reflect broader externalizing or internalizing tendencies.
  • This suggests that AUD is not a monolithic disorder, and its symptom heterogeneity is associated with distinct patterns of comorbidity.
  • Findings highlight the importance of examining individual AUD criteria to better understand its relationship with other psychopathology.