Addictions are linked but distinct: A transdiagnostic network analysis of concurrent disorder risk

Background and aims: Concurrent disorder refers to the co-occurrence of one or more addictive disorder(s) alongside one or more other mental health disorder(s). To identify psychotherapy targets most-closely related to concurrent disorders, we modeled addiction and mental health symptom severities alongside relevant cognitive psychological factors using pairwise Markov random fields. Methods: Canadian postsecondary students (N = 6,646) self-reported symptoms of addictive disorders related to legally-available products (alcohol, nicotine, cannabis, gambling, or video games), symptoms of commonly co-occurring mental health concerns (depression, anxiety, Post-Traumatic Stress Disorder, and attention-deficit/hyperactivity disorder), and correlated cognitive psychological factors identified by previous research (motives, impulsivity, emotion dysregulation, and those relating to difficult life events [resilience, self-efficacy, perceived social support, experiences of discrimination and adverse childhood experiences]). For these, network models were fit examining addiction symptoms jointly, individually, and separately for product types and classes. Results: Significant correlations between addiction and mental health symptoms were most often attributable to indirect links via psychological factors. Behavioural addiction symptoms were linked to mental health symptoms via psychological factors both shared (coping motives, impulsive urgency, and lack of social support) and not shared (e.g., discrimination, adverse childhood experiences) with substance-related addictions. Differences between addiction symptoms relevant to specific products varied more between individuals than between substances. Disorder symptom severities were differently accounted-for by network factors (R2adj = .13-.63). Discussion and Conclusions: Despite identifying several mechanisms of concurrence between mental health and addictions, modeled psychological factors do not account for most variability in addiction symptom severity.