Oddo Lauren E, Acuff Samuel F, Arenson Melanie B, Oshri Assaf, Chronis-Tuscano Andrea, MacKillop James, Murphy James G
Department of Psychology, University of Maryland, 4094 Campus Dr, College Park, MD 20742, USA.
Department of Psychology, University of Memphis, 400 Innovation Dr, Memphis, TN 38111, USA.
Alcohol Alcohol. 2022 Jul 9;57(4):452-459. doi: 10.1093/alcalc/agab070.
Contemporary theories of attention-deficit/hyperactivity disorder (ADHD) and alcohol use disorder (AUD) emphasize core dysfunctions in reward-related processes and behaviors as pathognomonic characteristics. However, to date, it is unclear which domains of reward functioning are unique to ADHD versus AUD symptom dimensions, and which represent underlying shared correlates.
The current study employed secondary data analyses from a large community sample of emerging adults (N = 602; 57.3% female) and novel transdiagnostic modeling (i.e. bi-factor confirmatory factor analyses and structural equation modeling) of ADHD, AUD and shared symptom dimensions to identify unique and common reward-related dimensions: environmental suppressors, reward probability, hedonic capacity, proportionate substance-related reinforcement and delay discounting.
The presence of environmental suppressors was the only reward-related construct that correlated with the underlying ADHD-AUD shared dimension. The AUD symptom dimension was uniquely associated with proportionate substance-related reinforcement, whereas the ADHD symptom dimension was uniquely associated with limited reward probability. No significant associations were found for delay discounting or hedonic capacity.
These novel findings highlight specific aspects of reward-related functioning in ADHD, AUD and shared symptom dimensions. In so doing, this work meaningfully advances theoretical conceptualizations of these two commonly co-occurring presentations and suggests future directions for research on transdiagnostic correlates. Future longitudinal studies should include clinical samples with diagnoses of AUD and ADHD to further identify underlying correlates over time.
注意缺陷多动障碍（ADHD）和酒精使用障碍（AUD）的当代理论强调奖励相关过程和行为中的核心功能障碍是其特征性表现。然而，迄今为止，尚不清楚奖励功能的哪些领域是ADHD与AUD症状维度所特有的，哪些代表潜在的共同关联因素。
本研究采用对大量新兴成年人社区样本（N = 602；57.3%为女性）的二次数据分析，以及对ADHD、AUD和共同症状维度进行新的跨诊断建模（即双因素验证性因素分析和结构方程建模），以确定独特且与奖励相关的维度：环境抑制因素、奖励概率、享乐能力、成比例的物质相关强化和延迟折扣。
环境抑制因素的存在是唯一与ADHD - AUD潜在共同维度相关的奖励相关结构。AUD症状维度与成比例的物质相关强化独特相关，而ADHD症状维度与有限的奖励概率独特相关。未发现延迟折扣或享乐能力有显著关联。
这些新发现突出了ADHD、AUD和共同症状维度中奖励相关功能的特定方面。通过这样做，这项工作有力地推进了对这两种常见共现表现的理论概念化，并为跨诊断关联研究提出了未来方向。未来的纵向研究应纳入患有AUD和ADHD诊断的临床样本，以进一步确定随时间推移的潜在关联因素。
