Using Factor Mixture Models to Evaluate the Type A/B Classification of Alcohol Use Disorders in a Heterogeneous Treatment Sample.
Using Factor Mixture Models to Evaluate the Type A/B Classification of Alcohol Use Disorders in a Heterogeneous Treatment Sample.
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DOI：
10.1111/acer.13367
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发表时间：
2017-05
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影响因子：
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通讯作者：
Bux DA Jr
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文献类型：
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作者：
Hildebrandt T;Epstein EE;Sysko R;Bux DA Jr
酒精使用障碍(AUD)的A/B型分类模型得到了相当大的经验支持。然而，很少有研究检验这种亚型模型的潜在结构，它被挑战为单一饮酒严重程度维度的二分法。B型，相对于A型，酗酒者代表起病年龄较早、家庭风险较大、饮酒后果较差的人。我们使用范畴模型、维度模型和因素混合模型对AUD成人寻求治疗的混合性别社区样本的A/B型模型的潜在结构进行了检验。因素分析模型确定了A/B型指标背后的2个因素(饮酒严重程度/外化精神病理学和内化精神病理学)。2维3分类的因子混合模型是最好的总体拟合模型。这些类别反映了一个A类和两个B类(B1和B2)，它们在饮酒严重程度/外化病理和内化病理的各自水平上存在差异。B1型有较高的女性患病率和更多的内化病理，而B2型有更多的男性患病率和更多的饮酒严重程度/外化病理。通过解释12个月饮酒和吸毒结果的显著差异，2因素3类模型也显示出预测有效性。本研究中确定的模型可能为检验AUDS过程和结果中不同来源的异质性提供基础。
The type A/B classification model for alcohol use disorders (AUDs) has received considerable empirical support. However, few studies examine the underlying latent structure of this subtyping model, which has been challenged as a dichotomization of a single drinking severity dimension. Type B, relative to type A, alcoholics represent those with early age of onset, greater familial risk, and worse outcomes from alcohol use. We examined the latent structure of the type A/B model using categorical, dimensional, and factor mixture models in a mixed gender community treatment-seeking sample of adults with an AUD. Factor analytic models identified 2-factors (drinking severity/externalizing psychopathology and internalizing psychopathology) underlying the type A/B indicators. A factor mixture model with 2-dimensions and 3-classes emerged as the best overall fitting model. The classes reflected a type A class and two type B classes (B1 and B2) that differed on the respective level of drinking severity/externalizing pathology and internalizing pathology. Type B1 had a greater prevalence of women and more internalizing pathology and B2 had a greater prevalence of men and more drinking severity/externalizing pathology. The 2-factor, 3-class model also exhibited predictive validity by explaining significant variance in 12-month drinking and drug use outcomes. The model identified in the current study may provide a basis for examining different sources of heterogeneity in the course and outcome of AUDs.