The etiology and diagnosis of alcohol dependence: Differences in the professional literature.

Polcin, Douglas L.

doi:10.1037/h0087704

Cited by 16 publications

(4 citation statements)

References 45 publications

(64 reference statements)

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“…Many researchers argue that loss of control is a cardinal feature of AUD (Edwards & Gross, 1976; Koob & Volkow, 2016; cf., Hill, 1985), but several reviews failed to report specific empirical evidence in support of this position (Polcin, 1997; West, 2005). In general, the larger literature fails to distinguish between the inability to abstain and loss of control, making it difficult to characterize the literature in regard to how certain outcomes are related uniquely to loss of control.…”

Section: Resultsmentioning

confidence: 99%

The etiologic, theory-based, ontogenetic hierarchical framework of alcohol use disorder: A translational systematic review of reviews.

Boness¹,

Watts²,

Moeller³

et al. 2021

Psychological Bulletin

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Modern nosologies (e.g., International Classification of Diseases, 11th edition [ICD-11], Diagnostic and Statistical Manual of Mental Disorders, 5th edition [DSM–5]) for alcohol use disorder (AUD) and dependence prioritize reliability and clinical presentation over etiology, resulting in a diagnosis that is not always strongly grounded in basic theory and research. Within these nosologies, DSM–5 AUD is treated as a discrete, largely categorical, but graded, phenomenon, which results in additional challenges (e.g., significant phenotypic heterogeneity). Efforts to increase the compatibility between AUD diagnosis and modern conceptualizations of alcohol dependence, which describe it as dimensional and partially overlapping with other psychopathology (e.g., other substance use disorders), will inspire a stronger scientific framework and strengthen AUD’s validity. We conducted a systematic review of 144 reviews to integrate addiction constructs and theories into a comprehensive framework to identify fundamental mechanisms implicated in AUD. The product of this effort was the Etiologic, Theory-based, Ontogenetic Hierarchical Framework (ETOH Framework) of AUD mechanisms, which outlines superdomains of cognitive control, reward, and negative valence and emotionality, each of which subsume narrower, hierarchically organized components. We also outline opponent processes and self-awareness as key moderators of AUD mechanisms. In contrast with other frameworks, we recommend an increased conceptual role for negative valence and compulsion in AUD. The ETOH framework serves as a critical step toward conceptualizations of AUD as dimensional and heterogeneous. It has the potential to improve AUD assessment and aid in the development of evidence-based diagnostic measures that focus on key mechanisms in AUD, consequently facilitating precision medicine.

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Section: Resultsmentioning

confidence: 99%

The etiologic, theory-based, ontogenetic hierarchical framework of alcohol use disorder: A translational systematic review of reviews.

Boness¹,

Watts²,

Moeller³

et al. 2021

Psychological Bulletin

View full text Add to dashboard Cite

show abstract

“…Many researchers argue that loss of control is a cardinal feature of AUD (Edwards & Gross, 1976;Koob & Volkow, 2016;c.f., Hill, 1985) but several reviews failed to report specific empirical evidence in support of this position (Polcin, 1997;West, 2005). In general, the larger literature fails to distinguish between the inability to abstain and loss of control, making it difficult to characterize the literature in regard to how certain outcomes are related uniquely to loss of control.…”

Section: Cognitive Control: Impulsivitymentioning

confidence: 99%

The Etiologic, Theory-based, Ontogenetic Hierarchical Framework of Alcohol Use Disorder: A translational systematic review of reviews

Boness¹,

Watts²,

Moeller³

et al. 2021

Preprint

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Modern nosologies (e.g., ICD-11, DSM-5) for alcohol use disorder (AUD) and dependence prioritize reliability and clinical presentation over etiology, resulting in a diagnosis that is not always strongly grounded in basic theory and research. Within these nosologies, DSM-5 AUD is treated as a discrete, largely categorical, but graded, phenomenon, which results in additional challenges (e.g., significant phenotypic heterogeneity). Efforts to increase the compatibility between AUD diagnosis and modern conceptualizations of alcohol dependence, which describe it as dimensional and partially overlapping with other psychopathology (e.g., other substance use disorders) will inspire a stronger scientific framework and strengthen AUD’s validity. We conducted a systematic review of 144 reviews to integrate addiction constructs and theories into a comprehensive framework with the aim of identifying fundamental mechanisms implicated in AUD. The product of this effort was the Etiologic, Theory-Based, Ontogenetic Hierarchical Framework (ETOH Framework) of AUD mechanisms, which outlines superdomains of cognitive control, reward, as well as negative valence and emotionality, each of which subsume narrower, hierarchically-organized components. We also outline opponent processes and self-awareness as key moderators of AUD mechanisms. In contrast with other frameworks, we recommend an increased conceptual role for negative valence and compulsion in AUD. The ETOH framework serves as a critical step towards conceptualizations of AUD as dimensional and heterogeneous. It has the potential to improve AUD assessment and aid in the development of evidence-based diagnostic measures that focus on key mechanisms in AUD, consequently facilitating treatment matching.

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“…Many experienced clinicians, particularly those who treat addiction, have been trained in a unidimensional model of addiction etiology. Traditional views of addiction tend to derive from theoretical positions that conceptualize excessive behaviors as the result of a single primary cause, such as moral weakness, disease process, behavioral or learning factors, self-medication, neurobiological factors, unresolved emotional confl icts, and others ( Marlatt, Baer, Donovan, & Kivlahan, 1988 ;Polcin, 1997 ). Some unidimensional views apply well to a given client but can restrict clinicians in terms of case formulation and treatment planning, limiting the clients they can serve and their effectiveness in general.…”

Section: Experienced Cliniciansmentioning

confidence: 99%

Clinical supervision and addiction treatment.

Madson¹,

Green²

2012

APA Addiction Syndrome Handbook, Vol. 2: Recovery, Prevention, and Other Issues.

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Clinical supervision is increasingly becoming one of the most prominent roles among psychologists ( Goodyear & Bernard, 1998 ;Goodyear & Guzzardo, 2000 ;Watkins, 1997 ). Supervision has a signifi cant infl uence on a clinician ' s training and professional development; it has an impact on the development of knowledge, skills, and competencies and promotes clinical effi cacy ( Cashwell & Dooley, 2001 ). Additionally, supervision is the central method used to ensure that clinicians provide quality care. Through training, support, consultation, and evaluation, clinical supervisors ensure that those entering psychology have the ability and values to perform competently. With the importance placed on supervision in provision of clinical services, it is important for psychologists to understand what supervision is and how it differs from psychotherapy and administration, the various roles involved in supervising clinicians, and the critical trends that will infl uence the conduct of supervision. Our goal for this chapter is to provide an overview of supervision and supervisory roles, the application of clinical supervision to the treatment of addiction, supervisory issues associated with diverse addiction treatment settings, and the provision of supervision within the addiction syndrome framework.

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The etiology and diagnosis of alcohol dependence: Differences in the professional literature.

Cited by 16 publications

References 45 publications

The etiologic, theory-based, ontogenetic hierarchical framework of alcohol use disorder: A translational systematic review of reviews.

The etiologic, theory-based, ontogenetic hierarchical framework of alcohol use disorder: A translational systematic review of reviews.

The Etiologic, Theory-based, Ontogenetic Hierarchical Framework of Alcohol Use Disorder: A translational systematic review of reviews

Clinical supervision and addiction treatment.

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