Constructs Derived From the Addiction Cycle Predict Alcohol Use Disorder Treatment Outcomes and Recovery 3 Years Following Treatment

Katie Witkiewitz, Elena R. Stein, Victoria R. Votaw, Kevin A. Hallgren, Benjamin C. Gibson, Cassandra L. Boness, Matthew R. Pearson, Stephen A. Maisto

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Objective: The addiction cycle has been proposed as a framework for understanding the progression of alcohol use disorder (AUD) in terms of psychological and biological domains, including reward drinking/incentive salience, relief drinking/negative emotionality, and loss of control/executive functioning impairment. To have utility in clinical practice, self-report measures of these domains that are applicable across sociodemographic groups and associated with clinical outcomes are needed. This study sought to validate domains from self-report measures and to testwhether domains aremeasurement invariant across sociodemographic groups and associated with treatment outcomes. Method: Secondary analysis of individuals with AUD (n = 3,092) who participated in two alcohol clinical trials, Project Matching Alcohol Treatment to Client Heterogeneity (MATCH) and COMBINE. Factor analytic methods were used to derive addiction cycle domains at baseline. These domains were then examined as predictors of outcomes. Results: Fifteen self-report items were used as indicators of the addiction cycle domains, with sociodemographic differences in measurement by sex, age, race, education, and AUD symptoms. Relief/negative emotionality and reward/incentive salience were significantly associated with outcomes at 1 and 3 years following treatment, and executive functioning also predicted nonabstinent recovery at 3 years. Conclusions: The results support the utility of domains relevant to the addiction cycle in predictingAUD treatment outcomes and recovery among individuals who sought treatment for AUD. The addiction cycle domains were more strongly associated with outcomes than other measures clinicians might use to predict outcomes (e.g., AUD symptoms). Future research should continue to develop and refine the items and test whether the addiction cycle domains can inform treatment planning.

Original languageEnglish (US)
Pages (from-to)376-389
Number of pages14
JournalPsychology of Addictive Behaviors
Issue number3
StatePublished - Aug 11 2022


  • Addictions Neuroclinical Assessment
  • Alcohol and Addiction Research Domain Criteria
  • addiction cycle
  • alcohol use disorder
  • recovery

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology
  • Medicine (miscellaneous)


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