• Brain stimulation
• Decision-making
• Gambling
• Impulsivity
• Risk

• Humans
• Impulsive Behavior/physiology
• Gambling/physiopathology
• Gambling/psychology
• Transcranial Direct Current Stimulation/methods
• Male
• Prefrontal Cortex/physiology
• Prefrontal Cortex/physiopathology
• Female
• Adult
• Cross-Over Studies
• Young Adult
• Dorsolateral Prefrontal Cortex/physiology

• California
• HIV
• USA: binge drinking
• alcohol
• alcohol consumption
• alcohol dependence
• alcohol use
• alcohol use disorder
• alcoholic
• clinical
• cross-sectional study
• drinking
• herbal
• herbal supplements
• logistic regression
• men
• social
• supplement

• Humans
• Male
• Cross-Sectional Studies
• Adult
• Dietary Supplements
• Homosexuality, Male/statistics & numerical data
• Homosexuality, Male/psychology
• San Francisco/epidemiology
• Middle Aged
• Alcoholism/epidemiology
• Alcoholism/drug therapy
• Sexual and Gender Minorities/statistics & numerical data
• Sexual and Gender Minorities/psychology
• Alcohol Drinking/epidemiology
• Young Adult

• Alcohol dependence
• community care
• community-based treatment
• mental health camp
• substance use

• D43 TW009120 FIC NIH HHS

• borderline intellectual functioning
• cognitive impairment
• learning impairment
• mental health
• parents

• Adult
• Humans
• Female
• Mental Health
• Psychotic Disorders
• Stress Disorders, Post-Traumatic
• Surveys and Questionnaires
• Intellectual Disability/epidemiology
• Learning Disabilities/psychology

• Alcohol Drinking/epidemiology
• Erectile dysfunction
• Sexual dysfunction

• COSMIN
• alcohol
• methodological quality
• psychometric property
• scale
• validity

• Humans
• Alcoholism/diagnosis
• Alcoholism/epidemiology
• Surveys and Questionnaires
• Ethanol
• Alcohol Drinking
• Psychometrics/methods

Measurement of externalizing disorders such as antisocial disorders, attention-deficit/hyperactivity disorder or borderline disorder have relevant implications for the daily lives of people with these disorders. While the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD) have provided the diagnostic framework for decades, recent dimensional frameworks question the categorical approach of psychopathology, inherent in traditional nosotaxies. Tests and instruments develop under the DSM or ICD framework preferentially adopt this categorical approach, providing diagnostic labels. In contrast, dimensional measurement instruments provide an individualized profile for the domains that comprise the externalizing spectrum, but are less widely used in practice. Current paper aims to review the operational definitions of externalizing disorders defined under these different frameworks, revise the different measurement alternatives existing, and provide an integrative operational definition. First, an analysis of the operational definition of externalizing disorders among the DSM/ICD diagnostic systems and the recent Hierarchical Taxonomy of Psychopathology (HiTOP) model is carried out. Then, in order to analyze the coverage of operational definitions found, a description of measurement instruments among each conceptualization is provided. Three phases in the development of the ICD and DSM diagnosis systems can be observed with direct implications for measurement. ICD and DSM versions have progressively introduced systematicity, providing more detailed descriptions of diagnostic criteria and categories that ease the measurement instrument development. However, it is questioned whether the DSM/ICD systems adequately modelize externalizing disorders, and therefore their measurement. More recent theoretical approaches, such as the HiTOP model seek to overcome some of the criticism raised towards the classification systems. Nevertheless, several issues concerning this model raise mesasurement challenges. A revision of the instruments underneath each approach shows incomplete coverage of externalizing disorders among the existing instruments. Efforts to bring nosotaxies together with other theoretical models of psychopathology and personality are still needed. The integrative operational definition of externalizing disorders provided may help to gather clinical practice and research.

• Externalizing disorders
• Measurement
• Diagnostic and Statistical Manual of Mental Disorders
• International Classification of Diseases
• Hierarchical Taxonomy of Psychopathology
• Psychopathology

Although previous research in alcohol dependent populations identified alterations within local structures of the addiction ‘reward’ circuitry, there is limited research into global features of this network, especially in early recovery. Transcranial magnetic stimulation (TMS) is capable of non‐invasively perturbing the brain network while electroencephalography (EEG) measures the network response. The current study is the first to apply a TMS inhibitory paradigm while utilising network science (graph theory) to quantify network anomalies associated with alcohol dependence. Eleven individuals with alcohol‐dependence (ALD) in early recovery and 16 healthy controls (HC) were administered 75 single pulses and 75 paired‐pulses (inhibitory paradigm) to both the left and right prefrontal cortex (PFC). For each participant, Pearson cross‐correlation was applied to the EEG data and correlation matrices constructed. Global network measures (mean degree, clustering coefficient, local efficiency and global efficiency) were extracted for comparison between groups. Following administration of the inhibitory paired‐pulse TMS to the left PFC, the ALD group exhibited altered mean degree, clustering coefficient, local efficiency and global efficiency compared to HC. Decreases in local efficiency increased the prediction of being in the ALD group, while all network metrics (following paired‐pulse left TMS) were able to adequately discriminate between the groups. In the ALD group, reduced mean degree and global clustering was associated with increased severity of past alcohol use. Our study provides preliminary evidence of altered network topology in patients with alcohol dependence in early recovery. Network anomalies were predictive of high alcohol use and correlated with clinical features of alcohol dependence. Further research using this novel brain mapping technique may identify useful network biomarkers of alcohol dependence and recovery.

• alcohol dependence
• brain stimulation
• electroencephalography
• global connectivity
• long-interval cortical inhibition
• network analysis
• transcranial magnetic stimulation

Substance abuse or drug dependence is a prevalent phenomenon, and is on the rise in United States. Important contributing factors for the prevalence are the addictive nature of certain medicinal/prescriptive drugs, individual dispositions (biological, physiological, and psychological), and other external influences (e.g., pharmaceutical advertising campaigns). However, currently there is no comprehensive computational or machine learning framework that allows systematic studies of substance abuse and its factors with majority of the works using subjective surveys questionnaires and focusing on classification techniques. Lacking standardized methods and/or measures to prescribe medication and to study substance abuse makes it difficult to advance through collective research efforts. Thus, in this paper, we propose to test the feasibility of developing a, objective substance effect index, SEI, that can measure the tendency of an individual towards substance abuse. To that end, we combine the benefits of Electronics Medical Records (EMR) with machine learning technology by defining SEI as a function of EMR data and using logistics regression to obtain a closed form expression for SEI. We conduct various evaluations to validate the proposed model, and the results show that further work towards the development of SEI will not only provide researchers with standard computational measure for substance abuse, but may also allow them to study certain attribute interactions to gain further insights into substance abuse tendencies.

• logistic regression
• machine learning
• medicinal drug dependence
• standard measure
• substance abuse
• substance effect index

• alcohol comorbidity
• alcohol liaison team
• alcohol-related brain injury

• Adult
• Alcoholism/pathology
• Brain Injuries/chemically induced
• Hospitalization
• Humans
• Inpatients
• Mental Status and Dementia Tests

• MR/S000607/1 Medical Research Council

• addiction
• neuroscience

• Administration, Oral
• Adult
• Alcoholism/metabolism
• Brain/drug effects
• Brain/metabolism
• Dextroamphetamine/administration & dosage
• Dextroamphetamine/pharmacology
• Fentanyl/administration & dosage
• Fentanyl/metabolism
• Humans
• Male
• Middle Aged
• Opioid Peptides/metabolism
• Positron-Emission Tomography
• Receptors, Opioid, mu/agonists
• Receptors, Opioid, mu/metabolism

• G0400575 Medical Research Council
• G1002226 Medical Research Council
• MR/N00616X/1 Medical Research Council
• Department of Health
• Medical Research Council (MRC)

To detect the individual’s severity of alcohol use disorder (AUD) in an effective and accurate manner, this study aimed to build an item bank for AUD screening and derive the computerized adaptive testing (CAT) version of AUD (CAT-AUD).

The initial CAT-AUD item bank was selected from the Chinese version of the questionnaires related to AUD according to the DSM-5 criteria. Then 915 valid Chinese samples, covering the healthy individuals and the AUD high-risk individuals, completed the initial CAT-AUD item bank. By testing the unidimensionality, test fit, item fit, discrimination parameter and differential item functioning of the initial item bank, the final CAT-AUD item bank confirming to the requirements of the item response theory (IRT) were obtained. Subsequently, the CAT-AUD simulation study based on the real data of the final item bank conducted to detect characteristics, reliability, validity, and predictive utility (sensitivity and specificity) of CAT-AUD.

The CAT-AUD item bank meeting the IRT psychometric measurement requirements could be well geared into the graded response model. The Pearson’s correlation between the estimated theta via CAT-AUD and the estimated theta via the full-length item bank reached 0.95, and the criterion-related validity was 0.63. CAT-AUD can provide highly reliable test results for subjects whose theta above −0.8 with an average of 16 items. Besides, the predictive utility of CAT-AUD was better than AUDIT and AUDIT-C.

In brief, the CAT-AUD developed in this study can effectively screen the AUD high-risk group and accurately measure the AUD severity of individuals.

• Alcohol-induced sexual dysfunction
• international index of erectile function-15
• sociodemography

• Alcohol dependence
• Detoxification
• Quality of life
• Treatment outcomes

• Alcohol dependence
• craving
• early relapse

• Alcohol dependence
• alcohol cirrhosis
• severity of drinking

• Alcohol abuse
• Alcohol dependence
• Everyday memory
• Patient–proxy agreement
• Prospective and Retrospective Memory Questionnaire

• Alcohol use disorders
• ICF
• alcohol dependence
• assessment
• clinical practice guidelines
• functioning
• standardized instruments

• Humor
• Marital Quality
• Rebounding
• Resilience
• Self-determination
• Self-efficacy
• Severity of Alcohol Dependence
• Wives of Alcoholics

• H.3.3. Information Storage and Retrieval
• H.5.m. Information Interfaces and Presentation (e.g., HCI)
• Information Storage and Retrieval
• Miscellaneous
• behavior
• health
• hierarchical classification
• natural language processing
• social media

• Alcohol dependence
• harm reduction
• harmful drinking
• hazardous drinking
• physical and mental health
• systematic review

A pilot randomized controlled trial (RCT) to assess the feasibility and potential efficacy of assertive community treatment (ACT) in adults with alcohol dependence.

Single blind, individually randomized, pilot RCT of 12 months of ACT plus treatment as usual (TAU) versus TAU alone in adults (age 18+ years) with alcohol dependence and a history of previous unsuccessful alcohol treatment attending specialist community alcohol treatment services. ACT aimed to actively engage participants for 12 months with assertive, regular, minimum weekly contact. ACT was combined with TAU. TAU comprised access to the full range of services provided by the community teams. Primary outcome is mean drinks per drinking day and percent days abstinent at 12 months follow up. Analysis of covariance was conducted using 80% confidence intervals, appropriate in the context of a pilot trial.

A total of 94 participants were randomized, 45 in ACT and 49 in TAU. Follow-up was achieved with 98 and 88%, respectively at 12 months. Those in ACT had better treatment engagement, and were more often seen in their homes or local community than TAU participants. At 12 months the ACT group had more problems related to drinking and lower quality of life than TAU but no differences in drinking measures. The ACT group had a higher percentage of days abstinent but lower quality of life at 6 months. The ACT group had less unplanned healthcare use than TAU.

An trial of ACT was feasible to implement in an alcohol dependent treatment population.

ISRCTN22775534

• Alcohol-related liver disease
• Alcohol-use disorder
• Baclofen

• Alcohol
• Dependence
• Disorder
• Neuropsychology
• Psychometry
• Psychotic

• Adult
• Alcoholism/complications
• Alcoholism/diagnosis
• Alcoholism/physiopathology
• Alcoholism/psychology
• Cognition/physiology
• Cognitive Dysfunction/complications
• Cognitive Dysfunction/diagnosis
• Cognitive Dysfunction/physiopathology
• Cognitive Dysfunction/psychology
• Cross-Sectional Studies
• Female
• Humans
• Male
• Memory, Short-Term/physiology
• Mental Recall/physiology
• Neuropsychological Tests
• Psychiatric Status Rating Scales
• Psychometrics
• Psychotic Disorders/complications
• Psychotic Disorders/diagnosis
• Psychotic Disorders/physiopathology
• Psychotic Disorders/psychology
• South Africa

• Harry Crossley Foundation

• alcohol
• ambivalence
• approach
• avoidance
• implicit cognition

• Adult
• Alcoholism/physiopathology
• Alcoholism/psychology
• Alcoholism/therapy
• Cues
• Female
• Humans
• Male
• Middle Aged
• Outcome Assessment, Health Care
• Predictive Value of Tests
• Prognosis
• Surveys and Questionnaires/standards

• 068247/Z/08/Z Wellcome Trust

• Alcohol-dependent syndrome
• explicit gambling task
• gambling paradigm
• siblings of alcohol dependents

Real-time functional magnetic resonance imaging (rtfMRI) is used for neurofeedback training (NFT). Preliminary results suggest that it can help patients to control their symptoms. This study uses rtfMRI NFT for relapse prevention in alcohol dependence.

Participants are alcohol-dependent patients who have completed a detoxification programme within the past 6 months and have remained abstinent. Potential participants are screened for eligibility, and those who are eligible are randomly assigned to the treatment group (receiving rtfMRI NFT in addition to treatment as usual) or the control group (receiving only treatment as usual). Participants in both groups are administered baseline assessments to measure their alcohol consumption and severity of dependence and a variety of psychological and behavioural characteristics that are hypothesised to predict success with rtfMRI NFT. During the following 4 months, experimental participants are given six NFT sessions, and before and after each session various alcohol-related measures are taken. Participants in the control group are given the same measures to coincide with their timing in the experimental group. Eight and 12 months after the baseline assessment, both groups are followed up with a battery of measures. The primary research questions are whether NFT can be used to teach participants to down-regulate their brain activation in the presence of alcohol stimuli or to up-regulate their brain activation in response to pictures related to healthy goal pursuits, and, if so, whether this translates into reductions in alcohol consumption. The primary outcome measures will be those derived from the functional brain imaging data. We are interested in improvements (i.e., reductions) in participants’ alcohol consumption from pretreatment levels, as indicated by three continuous variables, not simply whether or not the person has remained abstinent. The indices of interest are percentage of days abstinent, drinks per drinking day, and percentage of days of heavy drinking. General linear models will be used to compare the NFT group and the control group on these measures.

Relapse in alcohol dependence is a recurring problem, and the present evaluation of the role of rtfMRI in its treatment holds promise for identifying a way to prevent relapse.

ClinicalTrials.gov Identifier: NCT02486900, registered on 26 June 2015.

The online version of this article (doi:10.1186/s13063-016-1607-7) contains supplementary material, which is available to authorized users.

• Alcohol dependence
• Functional magnetic resonance imaging
• Neurofeedback training
• Randomised controlled trial
• Relapse prevention

• alcohol dependence
• cortical inhibition
• dorsolateral prefrontal cortex
• electroencephalography
• transcranial magnetic stimulation

In 1987, Cloninger proposed a clinical description and classification of different personality traits genetically defined and independent from each other. Moreover, he elaborated a specific test the TCI to investigate these traits/states. The study of craving in Alcohol Use Disorder (AUD) assumed a greater significance, since ever more data seems to suggest a direct correlation between high levels of craving and a higher risk of relapse in alcoholics. Thus, our study aim is to explore the possible correlations among TCI linked molecular neurobiological pattern (s), craving and alcohol addiction severity measures in a sample of Italian alcoholics.

191 alcoholics were recruited in a Day Hospital (DH) setting at the Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome. After 7 days detoxification treatment a psychodiagnostic protocol was administered, including TCI, VAS-C, ASI and SADQ. All patients signed an Institutional Review Board (IRB) approved informed consent.

Principally, we detected a significant positive correlation between HA-scale scores and the VAS scale: increasing in HA-scale corresponds to an increase in craving perception for both intensity (r=0.310; p ≤ 0.001) and frequency (r=0.246; p ≤ 0.001). Moreover, perception of dependence severity, measured with SADQ was also found to be significantly associated positively to both HA-scale (r=0.246; p ≤ 0.001) and NS-scale (r=0.224; p ≤ 0.01). While, for character scales, Persistence (r=−0.195; p=.008) and Self-directedness (r=−0.294; p ≤ 0.001) was negatively associated with ASI linked to alcohol problems. Self-directedness was also negatively correlated with ASI linked to family and social problems (r=−0.349; p ≤ 0.001), employment and support problems (r=−0.220; p=0.003) and psychiatric problems (r=−0.358; p ≤ 0.001). Cooperativeness was a negative correlate with Legal Problems (r=−0.173; p=0.019). and Self-Transcendence was positive correlated with Medical Problems (r=0.276; p ≤ 0.001)

In view of recent addiction neurobiological theories, such as the “Reward Deficiency Syndrome (RDS)” and the Koob model, our data could suggest that our cohort of patients could possibly be in a particular stage of the course of their addiction history. Thus, if our hypothesis will be confirmed, the TCI-based assessment of alcoholics would allow an optimization of the treatment. Clinicians understanding these newer concepts will be able to translate this information to their patients and potentially enhance clinical outcome (s), because it could suggest a functional hypothesis of neurotransmitter circuits that helps to frame the patient in his/her history of addiction.

• Addiction
• Alcohol Dependence (ADD)
• Craving
• Reward Deficiency Syndrome (RDS)
• TCI

• Alcohol dependence
• Asia
• executive function
• neuropsychological tests
• treatment outcome

• Alcohol dependence syndrome
• Alcohol treatment
• Alcohol use disorder
• Integrative data analysis
• Moderated nonlinear factor analysis

• Adult
• Alcoholism/diagnosis
• Alcoholism/epidemiology
• Clinical Trials as Topic/methods
• Clinical Trials as Topic/standards
• Diagnostic and Statistical Manual of Mental Disorders
• Female
• Humans
• Male
• Middle Aged
• Reproducibility of Results
• Statistics as Topic/methods
• Statistics as Topic/standards
• Surveys and Questionnaires/standards
• Young Adult

• R01 AA022328 NIAAA NIH HHS
• 1T32 AA007455-32 NIAAA NIH HHS
• 1R01 AA022328 NIAAA NIH HHS
• T32 AA007455 NIAAA NIH HHS
• K05 AA016928 NIAAA NIH HHS
• 2K05 AA16928 NIAAA NIH HHS

• Age of onset
• Alcohol Use Disorder Identification Test
• Severity of Alcohol Dependence Questionnaire
• behavioral
• biomarkers
• family history of alcoholism
• liver function tests
• severity of alcoholism

• Adolescent
• Adult
• Alcohol-Related Disorders/psychology
• Alcohol-Related Disorders/therapy
• Bibliotherapy
• Female
• Humans
• Internet
• Male
• Middle Aged
• Motivation
• Pilot Projects
• Smartphone
• Treatment Outcome
• Young Adult

• RC2 AA019422 NIAAA NIH HHS
• RC2AA019422 NIAAA NIH HHS

Despite its success with compliant or supervised patients, disulfiram has been a controversial medication in the treatment of alcoholism. Often, study designs did not recognize a pivotal factor in disulfiram research, the importance of an open-label design. Our objectives are: (1) to analyze the efficacy and safety of disulfiram in RCTs in supporting abstinence and (2) to compare blind versus open-label studies, hypothesizing that blinded studies would show no difference between disulfiram and control groups because the threat would be evenly spread across all groups.

We searched PubMed, EMBASE and the Cochrane Central Register for RCTs on disulfiram use with alcoholics in comparison to any alcoholic control group. The primary outcome was defined by the authors of each trial. Additional analyses included: blind vs. open-label, with or without supervision, cocaine study or not, and type of control.

Overall, the 22 included studies showed a higher success rate of disulfiram compared to controls Hedges'g = .58 (95%CI = .35–.82). When comparing blind and open-label RCTs, only open-label trials showed a significant superiority over controls g = .70 (95%CI = .46–.93). RCTs with blind designs showed no efficacy of disulfiram compared to controls. Disulfiram was also more effective than the control condition when compared to naltrexone g = .77, 95%CI = .52–1.02, to acamprosate g = .76, 95%CI = .04–1.48, and to the no disulfiram groups g = .43, 95%CI = .17–.69.

Limits include: (1) a population of 89% male subjects and (2) a high but unavoidable heterogeneity of the studies with a substantial I-square in most subgroups of studies.

Blinded studies were incapable of distinguishing a difference between treatment groups and thus are incompatible with disulfiram research. Based on results with open-label studies, disulfiram is a safe and efficacious treatment compared to other abstinence supportive pharmacological treatments or to no disulfiram in supervised studies for problems of alcohol abuse or dependence.

• Adolescent
• Adult
• Aged
• Alcohol Deterrents/adverse effects
• Alcohol Deterrents/therapeutic use
• Alcoholism/drug therapy
• Case-Control Studies
• Cocaine/adverse effects
• Disulfiram/adverse effects
• Disulfiram/therapeutic use
• Endpoint Determination
• Female
• Humans
• Male
• Middle Aged
• Randomized Controlled Trials as Topic
• Treatment Outcome

• Alcohol dependence
• Attentional control
• Cognitive recovery
• Craving
• Frontostriatal dysfunction
• Neurocognitive deficits

• Acoustic Stimulation
• Adult
• Alcoholism/genetics
• Alcoholism/physiopathology
• Alcoholism/psychology
• Blinking/physiology
• Case-Control Studies
• Cues
• Electromyography
• Female
• Genetic Predisposition to Disease
• Humans
• Male
• Middle Aged
• Multivariate Analysis
• Photic Stimulation
• Punishment/psychology
• Reflex, Startle/drug effects
• Reflex, Startle/physiology
• Regression Analysis
• Reward
• Self Report
• Severity of Illness Index
• Sex Characteristics
• Temperance

• Abstinence
• alcohol dependence
• quality of life
• treatment outcome