title: Towards the characterization and validation of alcohol use disorder subtypes: integrating consumption and symptom data.
abstract: BACKGROUND
  There is evidence that measures of alcohol consumption, dependence and abuse are valid indicators of qualitatively different subtypes of alcohol involvement yet also fall along a continuum. The present study attempts to resolve the extent to which variations in alcohol involvement reflect a difference in kind versus a difference in degree.
  
  
  METHODS
  Data were taken from the 2001-2002 National Epidemiologic Survey of Alcohol and Related Conditions. The sample (51% male; 72% white/non-Hispanic) included respondents reporting past 12-month drinking at both waves (wave 1: n = 33644; wave 2: n = 25186). We compared factor mixture models (FMMs), a hybrid of common factor analysis (FA) and latent class analysis (LCA), against FA and LCA models using past 12-month alcohol use disorder (AUD) criteria and five indicators of alcohol consumption reflecting frequency and heaviness of drinking.
  
  
  RESULTS
  Model comparison revealed that the best-fitting model at wave 1 was a one-factor four-class FMM, with classes primarily varying across dependence and consumption indices. The model was replicated using wave 2 data, and validated against AUD and dependence diagnoses. Class stability from waves 1 to 2 was moderate, with greatest agreement for the infrequent drinking class. Within-class associations in the underlying latent factor also revealed modest agreement over time.
  
  
  CONCLUSIONS
  There is evidence that alcohol involvement can be considered both categorical and continuous, with responses reduced to four patterns that quantitatively vary along a single dimension. Nosologists may consider hybrid approaches involving groups that vary in pattern of consumption and dependence symptomatology as well as variation of severity within group.
authors.affiliation: Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA.
authors.forename: K M
authors.initials: KM
authors.lastname: Jackson
authors.forename: K K
authors.initials: KK
authors.lastname: Bucholz
authors.forename: P K
authors.initials: PK
authors.lastname: Wood
authors.forename: D
authors.initials: D
authors.lastname: Steinley
authors.forename: J D
authors.initials: JD
authors.lastname: Grant
authors.forename: K J
authors.initials: KJ
authors.lastname: Sher
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking; D019973:Alcohol-Related Disorders / Q000145:classification; D000437:Alcoholism / Q000145:classification*; D002492:Central Nervous System Depressants / Q000009:adverse effects; D000431:Ethanol / Q000009:adverse effects; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D012309:Risk-Taking; D012720:Severity of Illness Index; D013375:Substance Withdrawal Syndrome / Q000209:etiology; D055815:Young Adult
chemical_list: D002492:Central Nervous System Depressants; D000431:Ethanol
references.citation: Exp Clin Psychopharmacol. 2000 Nov;8(4):493-508
references.pmid: 11127421
references.citation: Struct Equ Modeling. 2013 Oct 1;20(4):
references.pmid: 24302849
references.citation: Drug Alcohol Depend. 2008 Jan 11;93(1-2):111-20
references.pmid: 17964082
references.citation: Drug Alcohol Depend. 2007 Jun 15;89(1):82-92
references.pmid: 17240085
references.citation: Alcohol Clin Exp Res. 2009 Apr;33(4):663-73
references.pmid: 19183135
references.citation: J Abnorm Psychol. 1999 Aug;108(3):430-2
references.pmid: 10466265
references.citation: Addict Behav. 2006 Jun;31(6):1050-66
references.pmid: 16675147
references.citation: Exp Clin Psychopharmacol. 2006 May;14(2):228-44
references.pmid: 16756427
references.citation: Psychol Methods. 2005 Mar;10(1):21-39
references.pmid: 15810867
references.citation: Alcohol Clin Exp Res. 2009 May;33(5):761-71
references.pmid: 19298332
references.citation: Alcohol Clin Exp Res. 1996 Nov;20(8):1462-71
references.pmid: 8947326
references.citation: J Abnorm Psychol. 2012 May;121(2):511-23
references.pmid: 22060948
references.citation: Arch Gen Psychiatry. 1992 Aug;49(8):599-608
references.pmid: 1637250
references.citation: Psychol Rev. 1992 Apr;99(2):232-47
references.pmid: 1594724
references.citation: J Abnorm Psychol. 2010 Nov;119(4):650-61
references.pmid: 20853915
references.citation: J Stud Alcohol. 1998 Jan;59(1):122-4
references.pmid: 9498324
references.citation: J Abnorm Psychol. 2008 Aug;117(3):561-75
references.pmid: 18729609
references.citation: Arch Gen Psychiatry. 1987 Jun;44(6):573-88
references.pmid: 3579504
references.citation: Soc Dev. 2010 Aug;19(3):470-493
references.pmid: 24489441
references.citation: Psychol Med. 2011 Mar;41(3):653-64
references.pmid: 20459887
references.citation: J Stud Alcohol Drugs. 2010 May;71(3):418-23
references.pmid: 20409436
references.citation: Arch Gen Psychiatry. 1981 Aug;38(8):861-8
references.pmid: 7259422
references.citation: J Stud Alcohol Drugs. 2009 Nov;70(6):829-38
references.pmid: 19895759
references.citation: Psychol Med. 2006 Jul;36(7):931-41
references.pmid: 16563205
references.citation: Alcohol Clin Exp Res. 2010 Jun;34(6):1073-83
references.pmid: 20374206
references.citation: Addiction. 2006 Mar;101(3):385-92
references.pmid: 16499511
references.citation: Drug Alcohol Depend. 2009 Apr 1;101(1-2):53-61
references.pmid: 19095379
references.citation: Alcohol Clin Exp Res. 2006 Jul;30(7):1165-75
references.pmid: 16792564
references.citation: Annu Rev Clin Psychol. 2010;6:551-75
references.pmid: 20192786
references.citation: Addiction. 2010 Jul;105(7):1246-53
references.pmid: 20491729
references.citation: Addiction. 2001 Jan;96(1):103-14
references.pmid: 11177523
references.citation: Psychol Methods. 2003 Sep;8(3):338-63
references.pmid: 14596495
references.citation: Addiction. 2011 May;106(5):866-7
references.pmid: 21477226
references.citation: Behav Genet. 2009 Jan;39(1):101-22
references.pmid: 19009342
references.citation: J Abnorm Psychol. 2004 Feb;113(1):72-80
references.pmid: 14992659
references.citation: Drug Alcohol Depend. 2005 Nov 1;80(2):191-200
references.pmid: 15894432
references.citation: Nebr Symp Motiv. 1986;34:27-83
references.pmid: 3498124
references.citation: Alcohol Alcohol. 2007 Mar-Apr;42(2):57-63
references.pmid: 17307789
references.citation: Am J Psychiatry. 2010 Oct;167(10):1158-60
references.pmid: 20889660
references.citation: Addiction. 2010 Feb;105(2):240-54
references.pmid: 20078482
references.citation: Psychol Assess. 2004 Jun;16(2):107-19
references.pmid: 15222807
references.citation: Drug Alcohol Depend. 2006 Jan 4;81(1):21-6
references.pmid: 16005578
references.citation: Psychol Methods. 2011 Mar;16(1):63-79
references.pmid: 21319900
references.citation: Psychol Addict Behav. 2012 Mar;26(1):68-77
references.pmid: 22082343
references.citation: Alcohol Alcohol. 2011 May-Jun;46(3):333-41
references.pmid: 21310744
references.citation: Drug Alcohol Depend. 2008 Nov 1;98(1-2):105-14
references.pmid: 18586414
references.citation: J Stud Alcohol. 1981 Nov;42(11):925-37
references.pmid: 7038311
references.citation: J Consult Clin Psychol. 2000 Oct;68(5):799-809
references.pmid: 11068966
references.citation: Alcohol Clin Exp Res. 2001 Dec;25(12):1734-42
references.pmid: 11781506
references.citation: Annu Rev Psychol. 2008;59:29-53
references.pmid: 18154498
references.citation: Drug Alcohol Depend. 2008 Jan 11;93(1-2):1-11
references.pmid: 17935914
references.citation: Addiction. 2006 Sep;101 Suppl 1:6-16
references.pmid: 16930156