Using Factor Mixture Models to Evaluate the Type A/B Classification of Alcohol Use Disorders in a Heterogeneous Treatment Sample
Hildebrandt, Tom ; Epstein, Elizabeth E ; Sysko, Robyn ; Bux, Donald A. Jr
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Abstract
BACKGROUND: The type A/B classification model for alcohol use disorders (AUDs) has received considerable empirical support. However, few studies examine the underlying latent structure of this subtyping model, which has been challenged as a dichotomization of a single drinking severity dimension. Type B, relative to type A, alcoholics represent those with early age of onset, greater familial risk, and worse outcomes from alcohol use.
METHOD: We examined the latent structure of the type A/B model using categorical, dimensional, and factor mixture models in a mixed gender community treatment-seeking sample of adults with an AUD.
RESULTS: Factor analytic models identified 2-factors (drinking severity/externalizing psychopathology and internalizing psychopathology) underlying the type A/B indicators. A factor mixture model with 2-dimensions and 3-classes emerged as the best overall fitting model. The classes reflected a type A class and two type B classes (B1 and B2) that differed on the respective level of drinking severity/externalizing pathology and internalizing pathology. Type B1 had a greater prevalence of women and more internalizing pathology and B2 had a greater prevalence of men and more drinking severity/externalizing pathology. The 2-factor, 3-class model also exhibited predictive validity by explaining significant variance in 12-month drinking and drug use outcomes.
CONCLUSIONS: The model identified in the current study may provide a basis for examining different sources of heterogeneity in the course and outcome of AUDs.
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Alcohol Clin Exp Res. 2017 Mar 1. doi: 10.1111/acer.13367, https://doi.org/10.1111/acer.13367.
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This is the authors' peer reviewed version of the following article: Alcohol Clin Exp Res. 2017 Mar 1. doi: 10.1111/acer.13367, which is posted with a 12 month embargo and has been published in final form at https://doi.org/10.1111/acer.13367.