Examining the Validity of the Addictions Neuroclinical Assessment Domains in a Crowdsourced Sample of Adults with Current Alcohol Use

Abstract

Several dimensional frameworks for classifying 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 that correspond 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. The current study aimed to extend this research by examining the factor structure, concurrent and predictive validity, and longitudinal invariance of a novel assessment of the ANA domains in adults with past-12-month alcohol use recruited from Prolific (N=732), a crowdsourced data collection platform. Participants completed various self-report measures (e.g., items assessing ANA domains; alcohol-related, psychological, and personality measures), and 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, and this 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 divergent validity, as ANA domains were associated with these measures to a similar extent. Future research is needed to improve the measurement of ANA domains using multimodal indicators, identify phenotypic subgroups based on relative levels of ANA domains, and compare the utility of the ANA with other recently proposed frameworks for measuring heterogeneity within AUD.