Tulshi D Saha1, Frederick S Stinson, Bridget F Grant. 1. Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-9304, United States.
Abstract
BACKGROUND: Item response theory (IRT) was used to determine whether DSM-IV alcohol abuse and dependence and consumption criteria were arrayed along a continuum of severity. METHODS: Data came from a large, nationally representative sample of the U.S. adult population. RESULTS: DSM-IV alcohol abuse and dependence criteria formed a continuum of alcohol use disorder severity along with the drinking 5+/4+ at least once a week in the past year criterion. Criteria were invariant across sex, race-ethnicity, and age subgroups. CONCLUSION: The drinking 5+/4+ high-risk drinking pattern was identified as a suitable criterion for future classifications of DSM-IV alcohol use disorder. Some dependence criteria were among the least severe criteria, and some abuse criteria were among the most severe, findings that question the validity of DSM-IV abuse and dependence categories as distinct entities and that do not support the assumption of abuse as prodromal to dependence. Physical dependence and addiction were identified as defining elements of the continuum. Further research examining their dimensional properties and relationships to high-risk drinking patterns appears warranted. An approach highlighting a more important role of consumption in future classifications of alcohol use disorder defined broadly to encompass all alcohol-related harm, including addiction and physical dependence, is discussed.
BACKGROUND: Item response theory (IRT) was used to determine whether DSM-IV alcohol abuse and dependence and consumption criteria were arrayed along a continuum of severity. METHODS: Data came from a large, nationally representative sample of the U.S. adult population. RESULTS: DSM-IV alcohol abuse and dependence criteria formed a continuum of alcohol use disorder severity along with the drinking 5+/4+ at least once a week in the past year criterion. Criteria were invariant across sex, race-ethnicity, and age subgroups. CONCLUSION: The drinking 5+/4+ high-risk drinking pattern was identified as a suitable criterion for future classifications of DSM-IV alcohol use disorder. Some dependence criteria were among the least severe criteria, and some abuse criteria were among the most severe, findings that question the validity of DSM-IV abuse and dependence categories as distinct entities and that do not support the assumption of abuse as prodromal to dependence. Physical dependence and addiction were identified as defining elements of the continuum. Further research examining their dimensional properties and relationships to high-risk drinking patterns appears warranted. An approach highlighting a more important role of consumption in future classifications of alcohol use disorder defined broadly to encompass all alcohol-related harm, including addiction and physical dependence, is discussed.
Authors: B Ustün; W Compton; D Mager; T Babor; O Baiyewu; S Chatterji; L Cottler; A Göğüş; V Mavreas; L Peters; C Pull; J Saunders; R Smeets; M R Stipec; R Vrasti; D Hasin; R Room; W Van den Brink; D Regier; J Blaine; B F Grant; N Sartorius Journal: Drug Alcohol Depend Date: 1997-09-25 Impact factor: 4.492
Authors: Vivia V McCutcheon; Arpana Agrawal; Andrew C Heath; Howard J Edenberg; Victor M Hesselbrock; Marc A Schuckit; John R Kramer; Kathleen K Bucholz Journal: Alcohol Clin Exp Res Date: 2011-06-01 Impact factor: 3.455
Authors: Brian E Perron; Michael G Vaughn; Matthew O Howard; Amy Bohnert; Erick Guerrero Journal: J Stud Alcohol Drugs Date: 2010-07 Impact factor: 2.582
Authors: Paul A Pilkonis; Lan Yu; Nathan E Dodds; Kelly L Johnston; Suzanne M Lawrence; Thomas F Hilton; Dennis C Daley; Ashwin A Patkar; Dennis McCarty Journal: Drug Alcohol Depend Date: 2015-09-21 Impact factor: 4.492