Furthermore, our analysis was limited in that it did not differentiate participants who had different patterns of shifts in AD status. For example, participants who did not meet AD criteria at one assessment might never had AD or be in remission; participants who met AD criteria at one assessment could be having AD for the first time or be in relapse. Individuals with different patterns of shifts in AD status were likely to be at different stages in the addiction process and the effect of positive and negative reinforcement on alcohol consumption may differ between them. In addition, although our results provide support for the multistage model of addiction, we note that this theoretical model does not take into account potential heterogeneity in pathways of risk to AD. Future research is warranted to examine potential differences in the effects of positive and negative reinforcement associated with alcohol consumption across the addiction process among individuals with heterogeneous pathways of developing AD. Lastly, due to the characteristics of our sample, generalizability of findings from this study may be limited. Our sample is
