Toward DSM-V: An Item Response Theory Analysis of the Diagnostic Process for DSM-IV Alcohol Abuse and Dependence in Adolescents
Clinical interviews of approximately 5,587 adolescents revealed that DSM-IV diagnostic categories were found to be different in terms of the severity of alcohol use disorders (AUDs). However, a substantial inconsistency and overlap was found in severity of AUDs across categories. The need for an alt...
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| Published in | Journal of the American Academy of Child and Adolescent Psychiatry Vol. 47; no. 11; pp. 1329 - 1339 |
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| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Lippincott Williams & Wilkins
01.11.2008
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| Subjects | |
| Online Access | Get more information |
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| Abstract | Clinical interviews of approximately 5,587 adolescents revealed that DSM-IV diagnostic categories were found to be different in terms of the severity of alcohol use disorders (AUDs). However, a substantial inconsistency and overlap was found in severity of AUDs across categories. The need for an alternative diagnostic algorithm which considers all of the alcohol dependence and abuse symptoms is discussed. |
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| AbstractList | Clinical interviews of approximately 5,587 adolescents revealed that DSM-IV diagnostic categories were found to be different in terms of the severity of alcohol use disorders (AUDs). However, a substantial inconsistency and overlap was found in severity of AUDs across categories. The need for an alternative diagnostic algorithm which considers all of the alcohol dependence and abuse symptoms is discussed. 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. 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. 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. 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. |
| Author | Rhee, So Hyun Young, Susan Hopger, Christian Sakai, Joseph Hewitt, John Hartman, Christie Stallings, Michael Corley, Robin Gelhorn, Heather Crowley, Thomas D |
| Author_xml | – sequence: 1 fullname: Gelhorn, Heather – sequence: 2 fullname: Hartman, Christie – sequence: 3 fullname: Sakai, Joseph – sequence: 4 fullname: Stallings, Michael – sequence: 5 fullname: Young, Susan – sequence: 6 fullname: Rhee, So Hyun – sequence: 7 fullname: Corley, Robin – sequence: 8 fullname: Hewitt, John – sequence: 9 fullname: Hopger, Christian – sequence: 10 fullname: Crowley, Thomas D |
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| SubjectTerms | Adolescent Adolescents Alcohol Abuse Alcoholism - classification Alcoholism - diagnosis Alcoholism - rehabilitation Algorithms Antisocial Personality Disorder - classification Antisocial Personality Disorder - diagnosis Antisocial Personality Disorder - rehabilitation Child Classification Clinical Diagnosis Colorado Conduct Disorder - classification Conduct Disorder - diagnosis Conduct Disorder - rehabilitation Diagnostic and Statistical Manual of Mental Disorders Disability Identification Drinking Female Humans Item Response Theory Juvenile Delinquency - legislation & jurisprudence Juvenile Delinquency - psychology Male Psychometrics - statistics & numerical data Reproducibility of Results Sensitivity and Specificity Severity (of Disability) Symptoms (Individual Disorders) |
| Title | Toward DSM-V: An Item Response Theory Analysis of the Diagnostic Process for DSM-IV Alcohol Abuse and Dependence in Adolescents |
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