{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T08:31:09Z","timestamp":1789979469289,"version":"4.0.1"},"reference-count":41,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["K24AA022136"],"award-info":[{"award-number":["K24AA022136"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["R01AA025849"],"award-info":[{"award-number":["R01AA025849"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alcohol, Clinical and Experimental Research"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Definitions of alcohol use disorder (AUD) \u201crecovery\u201d abound, but the National Institute on Alcohol Abuse and Alcoholism (NIAAA) was the first to offer an operational definition (\u201cAUD remission with no heavy drinking\u201d). Little is known about this definition or how it compares to others. Greater knowledge would inform its clinical and public health utility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>\n                      Multisite, single\u2010group, prospective study of individuals beginning a new AUD recovery attempt (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009442) assessed at baseline, 3, 6, 9, and 12\u2009months on AUD symptoms, alcohol use, and functioning\/well\u2010being. Hidden Markov models (HMMs) estimated NIAAA\u2010defined recovery status and other recovery group statuses\/transitions. Regressions tested group membership predictors; linear mixed models examined functioning\/well\u2010being.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Participants were classified into four groups depending on remission status and level of alcohol use: (i) Remission\u2009+\u2009abstinence (R\u2009+\u2009A;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009102); (ii) Remission\u2009+\u2009low\u2010risk drinking (R\u2009+\u2009LRD;\n                      <jats:italic>n<\/jats:italic>\n                      =51); (iii) Remission\u2009+\u2009higher\u2010risk drinking (R\u2009+\u2009HRD;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200970); (iv) No remission (NR;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009219). During follow\u2010up, groups 1\u2009+\u20092 (NIAAA definition) were quite prevalent (34.6%), evincing patterns of larger psychosocial improvements compared with NR and R\u2009+\u2009HRD. R\u2009+\u2009A and R\u2009+\u2009LRD, however, differed on baseline characteristics, with R\u2009+\u2009A, similar to NR, being more severe on AUD\u2010related metrics, whereas both remitted but still drinking groups (R\u2009+\u2009LRD, R\u2009+\u2009HRD) were less severe. Of note, R\u2009+\u2009A was the most stably remitted group; R\u2009+\u2009LRD and R\u2009+\u2009HRD were less stable, moving increasingly into NR. Unlike R\u2009+\u2009HRD, who, similar to NR, exhibited persistent lower levels of self\u2010esteem and happiness, NIAAA\u2010defined groups were associated with widespread improvements.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The NIAAA recovery definition was consistent with empirical outcomes exhibited by the R\u2009+\u2009A and R\u2009+\u2009LRD profiles, with both showing large psychosocial improvements, but who may represent different AUD phenotypes\/stages. Despite R\u2009+\u2009A exhibiting a pattern of historically greater clinical severity, they demonstrated more stable remission compared with both the NIAAA recovery definition\u2010inclusive R\u2009+\u2009LRD, but especially R\u2009+\u2009HRD. Ongoing alcohol use appears to destabilize remission, with heavier use associated with less psychosocial improvement and AUD reinstatement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acer.70172","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T14:25:26Z","timestamp":1758723926000},"page":"2579-2591","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Prevalence, predictors, correlates, and dynamic changes in the NIAAA\u2010defined \u201crecovery\u201d definition"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6915-0750","authenticated-orcid":false,"given":"John F.","family":"Kelly","sequence":"first","affiliation":[{"name":"Psychiatry in Addiction Medicine Harvard Medical School  Boston Massachusetts USA"},{"name":"Recovery Research Institute Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5403-9531","authenticated-orcid":false,"given":"Kyla L.","family":"Belisario","sequence":"additional","affiliation":[{"name":"Peter Boris Center for Addiction Research McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8695-1071","authenticated-orcid":false,"given":"James","family":"MacKillop","sequence":"additional","affiliation":[{"name":"Peter Boris Center for Addiction Research McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/16066359.2018.1515352"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v081.i04"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v067.i01"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41562\u2010017\u20100189\u2010z"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psc.2022.04.006"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2007.06.001"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1037\/0893-164X.17.4.328"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.53.2.189"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530\u20100277.2007.00536.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530\u20100277.2011.01729.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/00273171.2017.1370364"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsa.1994.55.141"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.14765"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360\u20100443.1986.tb00313.x"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.14192"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/alcalc\/agae088"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(20)30752\u20102"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.21090963"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000759"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2013.06.010"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.14067"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.3109\/16066359.2014.930132"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.2105\/9780875533452ch15"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010pharmtox\u2010031323\u2010115847"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606.x"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572\u2010022\u201000406\u20101"},{"key":"e_1_2_9_28_1","doi-asserted-by":"crossref","unstructured":"McCabe R. 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