Moving beyond mental disorders towards a transdiagnostic approach: The case of alcohol consumption

Introduction: Alcohol is a leading risk factor for global disease burden causing more than 3 million deaths, 5.3% of all deaths, worldwide in 2018. However, an increasing number of studies highlight that psychiatric gnosologies may no longer be fit for purpose in research and clinical practice. In this context, a “transdiagnostic” approach across traditional diagnostic boundaries may provide a new perspective into how to account for mental disorders. Unfortunately, the core transdiagnostic factors underlying mental disorders such as alcohol use disorders (AUD) remain understudied. Aim: The aim of this study is to carry out a critical review of the literature to identify the main transdiagnostic factors involved in alcohol use disorders and examine gender differences. Methodology: A literature review of studies published in the last 10 years was conducted using Web of Science, Semantic Scholar, Pubmed and Cochrane as main databases. Results and conclusions: Based on the evidence reviewed, the three main key transdiagnostic factors related to AUD and other mental health problems are: psychological stress, defined as the perception of lack of control and predictability over the results of our behavior; psychological inflexibility, defined as the tendency to avoid, suppress, or otherwise control the frequency or intensity of internal experiences, such as thoughts and feelings even when doing so causes behavioral harm, also known as experiential avoidance; and loneliness, understood as perceived social isolation. Discussion: Degree of overlap or distinction between these constructs, mediation and moderation relationships, and implications of transdiagnostic factors for prevention and treatment of people with alcohol abuse are further discussed.