Cross-cultural invalidity of alcohol dependence measurement across Hispanics and Caucasians in 2001 and 2002.

AIMS: Do assessments of alcohol dependence demonstrate similarly validity across Hispanics and non-Hispanic Caucasians? This investigation examined this question.
METHOD: It employed confirmatory factor analyses for ordered-categorical measures to search for measurement bias on the AUDADIS, a standardized measure of alcohol dependence, across Hispanic (n=4819) and non-Hispanic Caucasians (n=16, 109) in a nationally representative survey of alcohol use in the United States conducted in 2001 and 2002. MEASUREMENT: Analyses considered whether 27 items operationalizing the DSM-IV alcohol dependence construct provided equivalent measurement. FINDINGS AND
CONCLUSIONS: Nine items revealed statistically significant bias, suggesting strong caution regarding the cross-ethnic validity of alcohol dependence. Sensitivity analyses established that item level differences erroneously impact alcohol dependence estimates among the 2001-2002 US Hispanic population. Biased measurement underestimates differences between Hispanics and non-Hispanic Caucasians, underestimates Hispanics' true use levels, and falsely minimizes current increases in drinking behavior evidenced among Hispanics. Findings urge improved public health efforts among the Hispanic community and underscore the necessity for cultural sensitivity when generalizing measures and constructs developed in the majority to Hispanic individuals.