Dimensionality of DSM-IV nicotine dependence in a national sample: An item response theory application

• Published in: Drug and alcohol dependence Vol. 108; no. 1; pp. 21 - 28
• Main Authors: Saha, Tulshi D, Compton, Wilson M, Pulay, Attila J, Stinson, Frederick S, Ruan, W. June, Smith, Sharon M, Grant, Bridget F
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.04.2010; Elsevier
• Subjects: Addictive behaviors; Adult; Adult and adolescent clinical studies; Age Factors; Aged; Biological and medical sciences; Consumption; Drug addiction; Drug dependency; DSM-V revision; Ethnic Groups; Factor Analysis, Statistical; Female; Humans; Item response theory; Male; Medical sciences; Middle Aged; Models, Statistical; Nicotine; Nicotine dependence; Nicotine use criterion; Psychiatric assessment; Psychiatric Status Rating Scales; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Severity; Sex Factors; Smoking; Smoking - psychology; Socioeconomic Factors; Tobacco smoking; Tobacco Use Disorder - epidemiology; Tobacco Use Disorder - psychology; Tobacco, tobacco smoking; Toxicology; United States - epidemiology; United States; DSM-V revision; Nicotine use criterion; Item response theory; Psychiatric assessment; Nicotine dependence; Human; Drug addiction; Sample; Use; Tobacco smoking; Alkaloid; Addiction; Revision; Criterion; Diagnostic and Statistical Manual V; Dependence; Diagnostic and Statistical Manual IV; Application; Psychiatry; Nicotine
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2009.11.012

Abstract Background Research focusing on the development of a dimensional representation of DSM-IV nicotine dependence is scarce and prior research has not assessed the role of nicotine use criteria in that a dimensional representation, nor the invariance of the DSM-IV nicotine dependence criteria across important population subgroups. Methods Using a large, representative sample of the U.S. population, this study utilized item response theory (IRT) analyses to explore the dimensionality of DSM-IV nicotine dependence criteria and several candidate criteria for cigarette use among past-year cigarette smokers ( n = 10,163). Results Factor analyses demonstrated the unidimensionality of nicotine dependence criteria and IRT analyses demonstrated good fit of the observed responses and the underlying, unobserved latent trait of dependence severity. The model containing all seven DSM-IV dependence criteria, along with the consumption criterion of smoking at least a quarter of a pack of cigarettes in a day in the past year, was identified as the best-fitting model. No differential criterion functioning was shown across sex, race-ethnicity, and age subgroups. Discussion Major implications of this study are discussed in terms of the addition of a dimensional representation of nicotine dependence to pre-existing categorical representations of the disorder in the DSM-V, and the need for a nicotine consumption criterion to improve representations of nicotine dependence severity.