Characterizing patterns and predictors of recovery from alcohol use disorders: A genetically informed, longitudinal design

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PROJECT SUMMARY Alcohol use disorders (AUD) are one of the leading causes of premature death and disability. Approximately 40-65% of affected individuals remit from AUD; however, compared to the study of the development of alcohol problems, much less is known about factors that contribute to recovery. Recovery is now understood as a dynamic process of holistic improvement in physical, psychological, and social wellbeing through abstinence or controlled alcohol use without problems. The path to AUD recovery is increasingly recognized as heterogeneous, such that individuals in recovery may experience more or less improvement across some domains of functioning compared to others. However, few studies have systematically examined patterns and predictors of functioning in recovery. Another gap in the field is that although it has become clear that understanding AUD necessitates a genetically informed perspective, this has not been integrated into the study of recovery. Twin and family studies suggest that the development of AUD is heritable. The profound and ubiquitous influence of genetic factors on diverse behavioral outcomes suggests differential patterns of recovery may also be genetically influenced. The overall goal of this NRSA proposal is to characterize and predict patterns of functioning in AUD recovery using a genetically informed, longitudinal design, which will be accomplished through secondary analysis of the Collaborative Study on the Genetics of Alcoholism (COGA) Prospective Study dataset (N = 3,129; U10AA008401). The applicant will investigate profiles of heterogeneous functioning among individuals in remission from AUD. Next, the applicant will test whether behavioral characteristics, precipitating environmental factors, and genetic influences (measured via genome-wide polygenic risk scores) predict recovery functioning profile membership. The proposed research will advance the burgeoning field of recovery science by contributing to a better understanding of the genetic and environmental influences on individual differences in AUD recovery processes. Findings can inform the development of treatment interventions that foster sustained recovery, one of five key goals outlined in NIAAA's current strategic plan. Additionally, the protected time and training opportunities afforded by the NRSA fellowship will help the applicant to: 1) develop an understanding of recovery science and individual differences in AUD recovery processes; 2) gain deeper experience in the use and interpretation of (a) advanced, person- centered statistical techniques and (b) statistical genetic methods for complex traits; and 3) cultivate professional development skills. These training activities will help the applicant launch a career as an independent researcher specializing in the genetic and environmental factors contributing to substance use disorders and recovery using person-centered, community-engaged approaches.