Toward DSM-V: an item response theory analysis of the diagnostic process for DSM-IV alcohol abuse and dependence in adolescents.
paper
Cited
Public
- Authors
- Gelhorn, Heather; Hartman, Christie; Sakai, Joseph; Stallings, Michael; Young, Susan; Rhee, Soo Hyun; Corley, Robin; Hewitt, John; Hopfer, Christian; Crowley, Thomas
- Year
- 2008
- Journal
- Journal of the American Academy of Child and Adolescent Psychiatry
- PMID
- 18827724
- DOI
- 10.1097/CHI.0b013e318184ff2e
- PMCID
- PMC2800944
OBJECTIVE: Item response theory analyses were used to examine alcohol abuse and dependence symptoms and diagnoses in adolescents. Previous research suggests that the DSM-IV alcohol use disorder (AUD) symptoms in adolescents may be characterized by a single dimension. The present study extends prior research with a larger and more comprehensive sample and an examination of an alternative diagnostic algorithm for AUDs. METHOD: Approximately 5,587 adolescents between the ages of 12 and 18 years from adjudicated, clinical, and community samples were administered structured clinical interviews. Analyses were conducted to examine the severity of alcohol abuse and dependence symptoms and the severity of alcohol use problems (AUDs) within the diagnostic categories created by the DSM-IV. RESULTS: Although the DSM-IV diagnostic categories differ in severity of AUDs, there is substantial overlap and inconsistency in AUD severity of persons across these categories. Item Response Theory-based AUD severity estimates suggest that many persons diagnosed with abuse have AUD severity greater than persons with dependence. Similarly, many persons who endorse some symptoms but do not qualify for a diagnosis (i.e., diagnostic orphans) have more severe AUDs than persons with an abuse diagnosis. Additionally, two dependence items, "tolerance" and "larger/longer," show differences in severity between samples. CONCLUSIONS: The distinction between DSM-IV abuse and dependence based on severity can be improved using an alternative diagnostic algorithm that considers all of the alcohol abuse and dependence symptoms conjointly.
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| Name | Type |
|---|---|
| Abuse threshold local | phenotype |
| Adjudicated adolescents local | cohort |
| Adjudicated cohort local | cohort |
| Adjudicated sample local | cohort |
| Adjudicated Sample local | cohort |
| adolescents | cohort |
| Adoption Sample local | cohort |
| adults | cohort |
| alcohol | phenotype |
| alcohol abuse | phenotype |
| Alcohol Abuse (DSM-IV) local | phenotype |
| alcohol dependence | phenotype |
| Alcohol Dependence Symptoms | phenotype |
| Alcohol Problems | phenotype |
| alcohol-related problems | phenotype |
| Alcohol Use Disorder | phenotype |
| Alcohol Use Disorder Severity local | phenotype |
| alternative algorithm local | cohort |
| Alternative diagnostic algorithm local | cohort |
| AUD | phenotype |
| AUD severity local | phenotype |
| cannabis use | phenotype |
| cannabis use disorder | phenotype |
| Center for Antisocial Drug Dependence local | cohort |
| Clinical adolescents local | cohort |
| clinical cohort | cohort |
| clinical samples | cohort |
| Colorado Adjudicated Youth Study local | cohort |
| Colorado adolescent cohort local | cohort |
| Colorado Adoption Project local | cohort |
| Colorado Twin Registry | cohort |
| community | cohort |
| Community adolescents local | cohort |
| Community cohort local | cohort |
| community sample | cohort |
| conduct disorder | phenotype |
| Continuous phenotypes local | phenotype |
| Dependence threshold local | phenotype |
| Diagnostic categories local | phenotype |
| diagnostic orphans | phenotype |
| DSM-IV | phenotype |
| DSM-IV abuse and dependence symptoms local | phenotype |
| DSM-IV alcohol symptom local | phenotype |
| DSM-IV alcohol symptoms local | phenotype |
| DSM-IV algorithm local | cohort |
| DSM-IV diagnostic algorithm local | cohort |
| DSM-IV diagnostic system local | cohort |
| DSM-IV diagnostic system local | phenotype |
| DSM-IV marijuana symptoms local | phenotype |
| DSM-V local | cohort |
| Family Control Sample local | cohort |
| Genetic studies | cohort |
| Giving up activities | phenotype |
| IRT-based severity estimate local | phenotype |
| larger/longer | phenotype |
| Neglect Roles local | phenotype |
| other drug use | phenotype |
| Quit/Control local | phenotype |
| race/ethnicity | phenotype |
| sex | phenotype |
| social problems | phenotype |
| state juvenile justice records local | cohort |
| substance abuse | phenotype |
| substance use | phenotype |
| symptom count | phenotype |
| Time Spent | phenotype |
| tolerance | phenotype |
| Total Alcohol Symptom Count local | phenotype |
| treatment response | phenotype |
| Twin cohort | cohort |
| withdrawal | phenotype |
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