Using Symptom Network Models to Translate Theory to Clinical Applications

项目总结/摘要 广泛/长期目标：拟议的研究有两个广泛的目标：提高诊断 澳元的概念化，采用一种更符合当代 成瘾的理论模型（例如，（1）确定这种方法在多大程度上可以 转化为临床应用。 具体目标：拟议项目的目标是：描述个体AUD症状的独特性 预测其他症状的发作、持续和复发（病程）;解决诊断异质性， 通过检查先验和经验导出亚组中的症状结构来改进分类;以及分析 不同症状和症状亚组预测不同形式临床结局的程度 的治疗。 研究设计和方法：该项目将包括二次数据分析，使用两个波的 全国酒精及相关疾病流行病学调查（NESARC）、联合收割机研究和项目 匹配.在NESARC中，将使用症状网络模型（SNM）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 基于病因的先验亚组（例如，行为障碍，酗酒模式）的风险因素和 通过聚类分析根据经验得出的症状特征的亚组。在MATCH和联合收割机中，一般混合 模型和组因素分析将被应用于分析症状特征、治疗 条件和治疗结果。 意义：本项目将促进对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， 诊断效度此外，该项目的成果将有助于更有效地调整和执行 重点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人提供定量， 实质性和实用的培训，以促进作为一名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，开放科学实践和一般科学写作。培训将在哥伦比亚大学进行。 密苏里州的心理科学部，它有一个杰出的成瘾训练计划资助 通过NIAAA培训补助金（T32 AA 013526; PI：Kenneth Sher）。指导小组由以下方面的专家组成： 定量（Steinley博士，Wood博士）和实质性（Sher博士，Witkiewitz博士）研究AUD。成员 该团队有着悠久的学院历史，为申请人提供了协同培训经验。

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.