Using Symptom Network Models to Translate Theory to Clinical Applications

项目摘要/摘要 广泛/长期目标：拟议的研究有两个广泛目标：改善诊断 采用更符合当代的以症状为中心的方法来概念化AUD 成瘾的理论模型(例如，异位作用)；并确定这种方法可以达到的程度 转化为临床应用。 具体目标：拟议项目的目标是：描述个别AUD症状如何独一无二 预测其他症状的开始、持续和复发(过程)；解决诊断异质性和 通过检查先验和经验派生的子组中的症状结构来改进分类；并分析 不同症状和症状亚组通过不同形式预测临床结果的程度 关于治疗的问题。 研究设计和方法：该项目将包括使用两个波的二次数据分析 全国酒精及相关疾病流行病学调查(NESARC)、联合研究和项目 匹配。在NESARC中，症状网络建模(SNM)将被用来识别预测 其他症状的病程，并确定症状亚组的核心特征。该项目还将比较 根据病因(如品行障碍、酗酒模式)风险因素和 通过聚类分析经验得出的症状特征亚组。在匹配和组合中，一般混合 将应用模型和组因素分析来分析症状特征、治疗之间的交互作用 病情和治疗结果。 意义：这个项目将促进对AUD诊断标准如何反映内源性 现代成瘾理论提出的过程，有助于解决诊断异质性，并改善 诊断效度。此外，该项目的成果将有助于更有效地调整和实施 有重点的评估和确定潜在的治疗目标。 培训计划和环境：培训计划旨在为申请者提供量化的、 实质性和实践性培训，以促进独立调查员的成功职业生涯。申请人 将接受高级多元统计学培训，将成瘾理论模型应用于临床 成果、开放的科学实践和一般科学写作。培训将在华盛顿大学进行 密苏里州心理科学部，该部门有一个出色的成瘾培训计划 由NIAAA培训补助金(T32 AA013526；PI：Kenneth Sher)提供。指导团队由以下方面的专家组成 对澳元的定量研究(斯坦利博士、伍德博士)和实质性研究(谢尔博士、维基维茨博士)。成员： 该团队有着悠久的学院历史，为申请者提供了协同培训体验。

PROJECT SUMMARY/ABSTRACT Broad/Long Term Objectives: The proposed research has two broad goals: to improve diagnostic conceptualization of AUD by adopting a symptom-focused approach that is more consistent with contemporary theoretical models of addiction (e.g., allostasis); and to ascertain the extent to which this approach can be translated into clinical applications. Specific Aims: The aims of the proposed project are to: characterize how individual AUD symptoms uniquely predict the onset, persistence, and recurrence (course) of other symptoms; resolve diagnostic heterogeneity and improve classification by examining symptom structure in a priori and empirically derived subgroups; and analyze the extent to which different symptoms and symptom subgroups predict clinical outcomes across different forms of treatment. Research Design and Method: The project will consist of secondary data analysis using both waves of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), the COMBINE study, and Project MATCH. In NESARC, symptom network modelling (SNM) will be used to identify key symptoms predicting the course of the other symptoms and identify core features of symptom subgroups. The project will also compare a priori subgroups based on etiologic (e.g., Conduct Disorder, heavy drinking patterns) risk factors and subgroups of symptom profiles empirically derived via cluster analysis. In MATCH and COMBINE, general mixed models and group factor analysis will be applied analyze the interaction between symptom profile, treatment condition, and treatment outcomes. Significance: This project will advance the understanding of how AUD diagnostic criteria reflect the endogenous processes proposed by modern addiction theories, help resolve diagnostic heterogeneity, and improve diagnostic validity. Additionally, the results of the project will allow for more effective tailoring and implementation of focused assessment and identification of potential targets for treatment. Training Plan and Environment: The training plan is designed to provide the applicant with quantitative, substantive, and practical training to facilitate a successful career as an independent investigator. The applicant will receive training in advanced multivariate statistics, application of theoretical models of addiction to clinical outcomes, open sciences practices, and general scientific writing. Training will take place at the University of Missouri’s Department of Psychological Sciences, which has an outstanding addiction training program funded by an NIAAA training grant (T32 AA013526; PI: Kenneth Sher). The mentoring team consists of experts in quantitative (Dr. Steinley, Dr. Wood) and substantive (Dr. Sher, Dr. Witkiewitz) research on AUD. Members of the team have a long collegial history, providing a synergistic training experience for the applicant.