Process-Based Psychological Processes in Alcohol Use Disorder: A Case-Control Study Using PBAT, PHQ-9, and GAD-7

The present study is grounded in the process-based approach to psychopathology, which emphasizes the identification and modification of core psychological processes underlying mental disorders, rather than focusing exclusively on categorical diagnoses.

A central theoretical framework guiding this approach is the Extended Evolutionary Meta-Model (EEMM), which conceptualizes psychological functioning and psychopathology through evolutionary principles:

• Variation - the ability to generate flexible and adaptive behavioral responses
• Selection - the capacity to choose behaviors aligned with personal goals and contextual demands
• Retention - the maintenance and consolidation of adaptive behaviors over time
• Context - sensitivity to environmental and situational factors influencing behavior

According to this model, psychopathology (including Alcohol Use Disorder) is characterized by psychological inflexibility, maladaptive behavioral selection, and poor retention of functional strategies, often in interaction with contextual insensitivity.

These processes operate across multiple domains, including affect, cognition, attention, motivation, self, and overt behavior.

Inclusion criteria

• age ≥18, the ability to provide informed consent, no psychiatric diagnosis (for the control group).

Exclusion criteria

• severe cognitive impairment, psychosis, inability to complete questionnaires.