Cited by 396Substance Abuse Treatment and OutcomesNeurotransmitter Receptor Influence on BehaviorGambling Behavior and Treatments

The DOI matches its Crossref record; 147 of the 151 references it cites were found in a registry or an index.

Addictions Neuroclinical Assessment: A Neuroscience-Based Framework for Addictive Disorders

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Abstract

This paper proposes a heuristic framework for an Addictions Neuroclinical Assessment (ANA) that incorporates key functional domains derived from the neurocircuitry of addiction. We review how addictive disorders (AD) are presently diagnosed, and the need for new neuroclinical measures to differentiate patients who meet clinical criteria for addiction to the same agent while differing in etiology, prognosis and treatment response. The need for a better understanding of the mechanisms provoking and maintaining addiction, as evidenced by the limitations of current treatments and within-diagnosis clinical heterogeneity, is articulated. In addition, recent changes in the nosology of AD, challenges to current classification systems, and prior attempts to subtype individuals with AD are described. Complementary initiatives, including the Research Domain Criteria (RDoC) project, which have established frameworks for the neuroscience of psychiatric disorders, are discussed. Three domains, executive function, incentive salience, and negative emotionality, tied to different phases in the cycle of addiction, form the core functional elements of AD. Measurement of these domains in epidemiologic, genetic, clinical, and treatment studies will provide the underpinnings for an understanding of cross-population and temporal variation in addictions, shared mechanisms in addictive disorders, impact of changing environmental influences, and gene identification. Finally, we show that it is practical to implement such a deep neuroclinical assessment using a combination of neuroimaging and performance measures. Neuroclinical assessment is key to reconceptualizing the nosology of AD on the basis of process and etiology, an advance that can lead to improved prevention and treatment.

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Crossref · 10.1016/j.biopsych.2015.10.024

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Metadata

Authors
Kwako, L. E., Momenan, R., Litten, R. Z., Koob, G. F., & Goldman, D.
Affiliations
National Institutes of Health (US)
Corresponding author
Kwako, Laura E.
Venue
Biological Psychiatry
Publisher
Elsevier BV
Published
2016-08
Volume
80
Issue
3
Pages
179-189
ISSN
0006-3223 (ISSN-L)
OpenAlex
W2207035985
Cited by
395
References
151
Citations by year
2026: 48 · 2025: 32 · 2024: 46 · 2023: 38 · 2022: 43 · 2021: 47 · 2020: 38 · 2019: 46 · 2018: 24 · 2017: 27 · 2016: 6
FWCI
2.47
Type
journal article
Language
en
Open access
Locations
  • Biological Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health (Z99‐AA999999)
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
  • Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
Keywords
addiction, executive function, incentive salience, negative affectivity, addiction classification, Research Domain Criteria, neuroimaging, clinical heterogeneity, causes of addiction
MeSH terms
Emotions, Humans, Models, Psychological, Motivation, Neuropsychological Tests, Behavior, Addictive, Substance-Related Disorders, Executive Function, Neuroimaging

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