[Epub ahead of print]

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

Murat Yücel, Erin Oldenhof, Serge H. Ahmed, David Belin, Joel Billieux, Henrietta Bowden-Jones, Adrian Carter, Samuel R. Chamberlain, Luke Clark, Jason Connor, Mark Daglish, Geert Dom, Pinhas Dannon, Theodora Duka, Maria Jose Fernandez-Serrano, Matt Field, Ingmar Franken, Rita Z. Goldstein, Raul Gonzalez, Anna E. Goudriaan, Jon E. Grant, Matthew J. Gullo, Robert Hester, David C. Hodgins, Bernard Le Foll, Rico S. C. Lee, Anne Lingford-Hughes, Valentina Lorenzetti, Scott J. Moeller, Marcus R. Munafò, Brian Odlaug, Marc N. Potenza, Rebecca Segrave, Zsuzsika Sjoerds, Nadia Solowij, Wim van den Brink, Ruth J. van Holst, Valerie Voon, Reinout Wiers, Leonardo F. Fontenelle, Antonio Verdejo-Garcia
Addiction. 2018-10-05; :
DOI: 10.1111/add.14424

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

Yücel M(1), Oldenhof E(1), Ahmed SH(2), Belin D(3), Billieux J(4), Bowden-Jones
H(5), Carter A(1), Chamberlain SR(6), Clark L(7), Connor J(8), Daglish M(9), Dom
G(10), Dannon P(11), Duka T(12), Fernandez-Serrano MJ(13), Field M(14), Franken
I(15), Goldstein RZ(16), Gonzalez R(17), Goudriaan AE(18), Grant JE(19), Gullo
MJ(20), Hester R(21), Hodgins DC(22), Le Foll B(23)(24), Lee RSC(1),
Lingford-Hughes A(25), Lorenzetti V(26), Moeller SJ(27), Munafò MR(28), Odlaug
B(29)(30), Potenza MN(31), Segrave R(1), Sjoerds Z(32)(33), Solowij N(34)(35),
van den Brink W(36), van Holst RJ(36), Voon V(37), Wiers R(38), Fontenelle LF(1),
Verdejo-Garcia A(1).

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,
(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,
(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,
(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,
(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.

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.

© 2018 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of
Society for the Study of Addiction.

DOI: 10.1111/add.14424
PMID: 30133930

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