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

Abstract

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.

Mapping data‐driven individualized neurobehavioral phenotypes in heavy alcohol drinkers

“…It is likely that differences in specific assessments contributed to the differences in the measurement structure of the model. Notably, our model of the emotionality factor is consistent with recent work that also found that depression and anxiety loaded together onto a negative emotionality factor (Votaw et al, 2020) providing further evidence for this factor structure. Importantly, our study utilized the DASS to assess depression, which is a self‐report assessment of depressive symptomology over the previous week.…”

“…In addition, it is unclear how this framework functions to predict current levels of alcohol consumption. While a detailed study of the negative emotionality domain has shown that this factor is related to reasons for drinking and to drinking patterns, this was not compared across factors (Votaw et al, 2020). Given this, the purpose of the current study was 2-fold.…”

The Neurosciences of Health Communication: An fNIRS Analysis of Prefrontal Cortex and Porn Consumption in Young Women for the Development of Prevention Health Programs

“…There are multiple studies based on knowledge of substance-related addictions ( Addicott, 2020 ; Votaw et al, 2020 ), however, research related to behavioral addiction is much more scarce, highlighting those focused on understanding the relationship between addictive behavior and activation of the Dorsolateral Prefrontal Cortex and its effects on working memory and inhibition of the control of impulsive responses ( Alizadehgoradel et al, 2020 ; Maheux-Caron et al, 2020 ). One of the behavioral addictions that has attracted the most attention in recent years is pornography addiction.…”

Anger and substance abuse: a systematic review and meta-analysis

“…65 Still considering the changes in the brain induced by PSU, dopaminergic dysfunction in reward circuits seems to lead to dysfunctions in the orbitofrontal cortex. 35 This region has been implicated in the impulsivity observed in psychoactive substance users, 66 as ascertained in many studies in subjects with high anger scores. This is particularly interesting in understanding these results, as the orbitofrontal cortex is anatomically connected to sensory, limbic, and prefrontal cortical regions 67 -areas affected by drug use and which mediate executive function.…”