Format

Send to

Choose Destination
Addiction. 2019 Jun;114(6):1095-1109. doi: 10.1111/add.14424. Epub 2018 Oct 5.

A transdiagnostic dimensional approach towards a neuropsychological assessment for addiction: an international Delphi consensus study.

Author information

1
Brain and Mental Health Research Hub, Monash Institute of Cognitive and Clinical Neurosciences (MICCN) and School of Psychological Sciences, Monash University, Melbourne, Australia.
2
Institut des Maladies Neurodégénératives, Université de Bordeaux, Bordeaux, France.
3
Department of Psychology, University of Cambridge, Cambridge, UK.
4
Addictive and Compulsive Behaviours Laboratory (ACB-lab), Institute for Health and Behaviours, University of Luxembourg, Esch-sur-Alzette, Luxembourg.
5
Department of Medicine, Imperial College, London, UK.
6
Department of Psychiatry, University of Cambridge; and Cambridge and Peterborough NHS Foundation Trust (CPFT), Cambridge, UK.
7
Centre for Gambling Research at UBC, Department of Psychology, University of British Columbia, Vancouver, BC, Canada.
8
Discipline of Psychiatry, Faculty of Medicine, and Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, Australia.
9
Alcohol and Drug Service, Royal Brisbane and Women's Hospital, Metro North HHS, Queensland Health and Discipline of Psychiatry, The University of Queensland, Australia.
10
Antwerp University (UA), Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp, Belgium.
11
Department of Psychiatry, the Sackler School of Medicine and Tel Aviv University, Tel Aviv, Israel.
12
Sussex Addiction Research and Intervention Centre, School of Psychology, University of Sussex, Brighton, UK.
13
Departamento de Psicología, Universidad de Jaén, Spain.
14
Department of Psychology, University of Sheffield, Sheffield, UK.
15
Institute of Psychology, Erasmus School of Social Sciences and Behavioral Sciences, Erasmus University, Rotterdam, the Netherlands.
16
Department of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, NY, USA.
17
Center for Children and Families, Department of Psychology, Florida International University, Miami, FL.
18
Arkin Mental Health and Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam, Netherlands.
19
Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA.
20
Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, Australia.
21
School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
22
Department of Psychology, University of Calgary, Calgary, Canada.
23
Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Canada.
24
Department of Family and Community Medicine, Pharmacology and Toxicology, Psychiatry, University of Toronto, Toronto, Canada.
25
Neuropsychopharmacology Unit, Centre for Psychiatry, Division of Brain Sciences, Imperial College, London, UK.
26
School of Psychology, Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia.
27
Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY, USA.
28
MRC Integrative Epidemiology Unit at the University of Bristol and UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, UK.
29
Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
30
H. Lundbeck A/S, Valby, Denmark.
31
Departments of Psychiatry and Neuroscience, Child Study Center, Yale University School of Medicine and Connecticut Mental Health Center and Connecticut Council on Problem Gambling, New Haven, CT, USA.
32
Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
33
Cognitive Psychology Unit, Institute of Psychology, and Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands.
34
School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia.
35
The Australian Centre for Cannabinoid Clinical and Research Excellence (ACRE), New Lambton Heights NSW, Australia.
36
Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam, Netherlands.
37
Department of Psychiatry, University of Cambridge, Cambridge, UK.
38
Addiction, Development and Psychopathology (ADAPT)-lab, Deptartment of Psychology, University of Amsterdam, the Netherlands.

Abstract

BACKGROUND:

The US National Institutes of Mental Health Research Domain Criteria (RDoC) seek to stimulate research into biologically validated neuropsychological dimensions across mental illness symptoms and diagnoses. The RDoC framework comprises 39 functional constructs designed to be revised and refined, with the overall goal of improving diagnostic validity and treatments. This study aimed to reach a consensus among experts in the addiction field on the 'primary' RDoC constructs most relevant to substance and behavioural addictions.

METHODS:

Forty-four addiction experts were recruited from Australia, Asia, Europe and the Americas. The Delphi technique was used to determine a consensus as to the degree of importance of each construct in understanding the essential dimensions underpinning addictive behaviours. Expert opinions were canvassed online over three rounds (97% completion rate), with each consecutive round offering feedback for experts to review their opinions.

RESULTS:

Seven constructs were endorsed by ≥ 80% of experts as 'primary' to the understanding of addictive behaviour: five from the Positive Valence System (reward valuation, expectancy, action selection, reward learning, habit); one from the Cognitive Control System (response selection/inhibition); and one expert-initiated construct (compulsivity). These constructs were rated to be related differentially to stages of the addiction cycle, with some linked more closely to addiction onset and others more to chronicity. Experts agreed that these neuropsychological dimensions apply across a range of addictions.

CONCLUSIONS:

The study offers a novel and neuropsychologically informed theoretical framework, as well as a cogent step forward to test transdiagnostic concepts in addiction research, with direct implications for assessment, diagnosis, staging of disorder, and treatment.

KEYWORDS:

Addiction; RDoC; assessment; cognition; compulsions; decision-making; habit; reward; transdiagnostic

Supplemental Content

Full text links

Icon for Wiley Icon for PubMed Central
Loading ...
Support Center