1
|
Shmulewitz D, Budney AJ, Borodovsky JT, Bujno JM, Walsh CA, Struble CA, Livne O, Habib MI, Aharonovich E, Hasin DS. Dimensionality and differential functioning of DSM-5 cannabis use disorder criteria in an online sample of adults with frequent cannabis use. J Psychiatr Res 2023; 163:211-221. [PMID: 37224773 PMCID: PMC10330577 DOI: 10.1016/j.jpsychires.2023.05.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 05/02/2023] [Accepted: 05/15/2023] [Indexed: 05/26/2023]
Abstract
The DSM-5 criteria for cannabis use disorder (CUD) combine DSM-IV dependence and abuse criteria (without legal problems) and new withdrawal and craving criteria. Information on dimensionality, internal reliability, and differential functioning of the DSM-5 CUD criteria is lacking. Additionally, dimensionality of the DSM-5 withdrawal items is unknown. This study examined the psychometric properties of the DSM-5 CUD criteria among adults who used cannabis in the past 7 days (N = 5,119). Adults with frequent cannabis use were recruited from the US general population through social media and filled in a web-based survey about demographics and cannabis use behaviors. Factor analysis was used to assess dimensionality, and item response theory analysis models were used to explore relationships between the criteria and the underlying latent trait (CUD), and whether each criterion and the criteria set functioned differently by demographic and clinical characteristics: sex, age, state-level cannabis laws, reasons for cannabis use, and frequency of use. The DSM-5 CUD criteria showed unidimensionality and provided information about the CUD latent trait across the severity spectrum. The cannabis withdrawal items indicated one underlying latent factor. While some CUD criteria functioned differently in specific subgroups, the criteria set as a whole functioned similarly across subgroups. In this online sample of adults with frequent cannabis use, evidence supports the reliability, validity, and utility of the DSM-5 CUD diagnostic criteria set, which can be used for determining a major risk of cannabis use, i.e., CUD, to inform cannabis policies and public health messaging, and for developing intervention strategies.
Collapse
Affiliation(s)
- Dvora Shmulewitz
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA.
| | - Alan J Budney
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, 46 Centerra Pkwy, Lebanon, NH, 03766, USA; Department of Biomedical Data Science, Dartmouth Geisel School of Medicine, 1 Rope Ferry Road, Hanover, NH, 03755, USA.
| | - Jacob T Borodovsky
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, 46 Centerra Pkwy, Lebanon, NH, 03766, USA; Department of Biomedical Data Science, Dartmouth Geisel School of Medicine, 1 Rope Ferry Road, Hanover, NH, 03755, USA.
| | - Julia M Bujno
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA.
| | - Claire A Walsh
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA.
| | - Cara A Struble
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, 46 Centerra Pkwy, Lebanon, NH, 03766, USA; Department of Biomedical Data Science, Dartmouth Geisel School of Medicine, 1 Rope Ferry Road, Hanover, NH, 03755, USA.
| | - Ofir Livne
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA; Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, 10032, USA.
| | - Mohammad I Habib
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, 46 Centerra Pkwy, Lebanon, NH, 03766, USA.
| | - Efrat Aharonovich
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA.
| | - Deborah S Hasin
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA; Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, 10032, USA.
| |
Collapse
|
2
|
Verweij KJH, Vink JM, Abdellaoui A, Gillespie NA, Derks EM, Treur JL. The genetic aetiology of cannabis use: from twin models to genome-wide association studies and beyond. Transl Psychiatry 2022; 12:489. [PMID: 36411281 PMCID: PMC9678872 DOI: 10.1038/s41398-022-02215-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 09/26/2022] [Accepted: 10/03/2022] [Indexed: 11/22/2022] Open
Abstract
Cannabis is among the most widely consumed psychoactive substances worldwide. Individual differences in cannabis use phenotypes can partly be explained by genetic differences. Technical and methodological advances have increased our understanding of the genetic aetiology of cannabis use. This narrative review discusses the genetic literature on cannabis use, covering twin, linkage, and candidate-gene studies, and the more recent genome-wide association studies (GWASs), as well as the interplay between genetic and environmental factors. Not only do we focus on the insights that these methods have provided on the genetic aetiology of cannabis use, but also on how they have helped to clarify the relationship between cannabis use and co-occurring traits, such as the use of other substances and mental health disorders. Twin studies have shown that cannabis use is moderately heritable, with higher heritability estimates for more severe phases of use. Linkage and candidate-gene studies have been largely unsuccessful, while GWASs so far only explain a small portion of the heritability. Dozens of genetic variants predictive of cannabis use have been identified, located in genes such as CADM2, FOXP2, and CHRNA2. Studies that applied multivariate methods (twin models, genetic correlation analysis, polygenic score analysis, genomic structural equation modelling, Mendelian randomisation) indicate that there is considerable genetic overlap between cannabis use and other traits (especially other substances and externalising disorders) and some evidence for causal relationships (most convincingly for schizophrenia). We end our review by discussing implications of these findings and suggestions for future work.
Collapse
Affiliation(s)
- Karin J. H. Verweij
- grid.7177.60000000084992262Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands
| | - Jacqueline M. Vink
- grid.5590.90000000122931605Behavioural Science Institute, Radboud University Nijmegen, Thomas van Aquinostraat 4, 6525 GD Nijmegen, The Netherlands
| | - Abdel Abdellaoui
- grid.7177.60000000084992262Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands
| | - Nathan A. Gillespie
- grid.224260.00000 0004 0458 8737Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, 800 East Leigh St, Suite 100, Richmond, VA 23219 USA
| | - Eske M. Derks
- grid.1049.c0000 0001 2294 1395Translational Neurogenomics, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006 Australia
| | - Jorien L. Treur
- grid.7177.60000000084992262Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands
| |
Collapse
|
3
|
Thomas NS, Salvatore JE, Gillespie NA, Aliev F, Ksinan AJ, Dick DM. Cannabis use in college: Genetic predispositions, peers, and activity participation. Drug Alcohol Depend 2021; 219:108489. [PMID: 33373877 PMCID: PMC8369492 DOI: 10.1016/j.drugalcdep.2020.108489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 11/10/2020] [Accepted: 11/22/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Among adult college students in the US, cannabis use is common and associated with considerable negative consequences to health, cognition, and academic functioning, underscoring the importance of identifying risk and protective factors. Cannabis use is influenced by genetic factors, but genetic risk is not determinative. Accordingly, it is critical to identify environments that reduce risk among those who are at elevated genetic risk. This study examined the impact of polygenic scores for cannabis initiation, various forms of social activity participation, and peer deviance on recent cannabis use. Our aim was to test whether these environments moderate genetic risk for cannabis use. METHODS Data came from a longitudinal sample of undergraduate college students of European American (EA; NEA = 750) and African American (AA; NAA = 405) ancestry. Generalized estimating equations with a logit link function were used to examine main effects and two-way interactions. RESULTS Engagement with church activities was associated with lower probability of cannabis use. Peer deviance was associated with higher probability of cannabis use. Engagement with community activities moderated the influence of the polygenic risk score in the EA sample, such that PRS was associated with recent cannabis use among those who never engaged in community activities. This effect did not replicate in AAs, which may have been due to the portability of PRS based on EA discovery samples. CONCLUSIONS Results suggest that community activities may limit the influence of genetic risk, as associations between PRS and cannabis use were only observed among individuals who never engaged in community activities.
Collapse
Affiliation(s)
- Nathaniel S Thomas
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA, 23284-2018, United States; College Behavioral and Emotional Health Institute, Virginia Commonwealth University, Box 843092, Richmond, VA, 23284-3092, United States.
| | - Jessica E Salvatore
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA, 23284-2018, United States; Virginia Institute for Psychiatric and Behavioral Genetics, Box 980126, Richmond, VA, 23298-0126, United States
| | - Nathan A Gillespie
- Department of Psychiatry, Virginia Commonwealth University, Box 980308, Richmond, VA, 23219-1359, United States; Virginia Institute for Psychiatric and Behavioral Genetics, Box 980126, Richmond, VA, 23298-0126, United States; Genetic Epidemiology, QIMR Berghofer Medical Research Institute, Locked Bag 2000, Royal Brisbane Hospital, QLD, 4029, Brisbane, Australia
| | - Fazil Aliev
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA, 23284-2018, United States; Karabuk University, Faculty of Business, Turkey
| | - Albert J Ksinan
- Department of Health Behavior and Policy, Virginia Commonwealth University, 830 E Main St., Richmond, VA, 23219, United States
| | - Danielle M Dick
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA, 23284-2018, United States; College Behavioral and Emotional Health Institute, Virginia Commonwealth University, Box 843092, Richmond, VA, 23284-3092, United States; Department of Human & Molecular Genetics, Virginia Commonwealth University, Box 980033, Richmond, VA, 23298-0033, United States.
| |
Collapse
|
4
|
Butelman ER, Chen CY, Fry RS, Kimani R, Levran O, Ott J, Correa da Rosa J, Kreek MJ. Re-evaluation of the KMSK scales, rapid dimensional measures of self-exposure to specific drugs: Gender-specific features. Drug Alcohol Depend 2018; 190:179-187. [PMID: 30041093 DOI: 10.1016/j.drugalcdep.2018.05.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/14/2018] [Accepted: 05/30/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND The Kreek-McHugh-Schluger-Kellogg (KMSK) scales provide a rapid assessment of maximal self-exposure to specific drugs and can be used as a dimensional instrument. This study provides a re-evaluation of the KMSK scales for cannabis, alcohol, cocaine, and heroin in a relatively large multi-ethnic cohort, and also the first systematic comparison of gender-specific profiles of drug exposure with this scale. METHODS This was an observational study of n = 1,133 consecutively ascertained adult volunteers. The main instruments used were the SCID-I interview (DSM-IV criteria) and KMSK scales for cannabis, alcohol, cocaine, and heroin. RESULTS Participants were 852 volunteers (297 female) with specific DSM-IV abuse or dependence diagnoses, and 281 volunteers without any drug diagnoses (154 female). Receiver operating characteristic (ROC) curves were calculated for concurrent validity of KMSK scores with the respective DSM-IV dependence diagnoses. The areas under the ROC curves for men and women combined were 99.5% for heroin, 97% for cocaine, 93% for alcohol, and 85% for cannabis. Newly determined optimal KMSK "cutpoint" scores were identical for men and women for cocaine and heroin dependence diagnoses, but were higher in men than in women, for cannabis and alcohol dependence diagnoses. CONCLUSIONS This study confirms the scales' effectiveness in performing rapid dimensional analyses for cannabis, alcohol, cocaine, and heroin exposure, in a cohort larger than previously reported, with "cutpoints" changed from initial determinations, based on this larger sample. The KMSK scales also detected gender differences in self-exposure to alcohol and cannabis that are associated with the respective dependence diagnoses.
Collapse
Affiliation(s)
- Eduardo R Butelman
- Laboratory of the Biology of Addictive Diseases, The Rockefeller University, 1230 York Avenue, New York, NY, 10065, USA.
| | - Carina Y Chen
- Laboratory of the Biology of Addictive Diseases, The Rockefeller University, 1230 York Avenue, New York, NY, 10065, USA
| | - Rebecca S Fry
- Laboratory of the Biology of Addictive Diseases, The Rockefeller University, 1230 York Avenue, New York, NY, 10065, USA
| | - Rachel Kimani
- Laboratory of the Biology of Addictive Diseases, The Rockefeller University, 1230 York Avenue, New York, NY, 10065, USA
| | - Orna Levran
- Laboratory of the Biology of Addictive Diseases, The Rockefeller University, 1230 York Avenue, New York, NY, 10065, USA
| | - Jürg Ott
- Laboratory of Statistical Genetics, The Rockefeller University, 1230 York Avenue, New York, NY, 10065, USA
| | - Joel Correa da Rosa
- Center for Clinical and Translational Science, The Rockefeller University Hospital, 1230 York Avenue, New York, NY, 10065, USA
| | - Mary Jeanne Kreek
- Laboratory of the Biology of Addictive Diseases, The Rockefeller University, 1230 York Avenue, New York, NY, 10065, USA
| |
Collapse
|
5
|
Gillespie NA, Aggen SH, Neale MC, Knudsen GP, Krueger RF, South SC, Czajkowski N, Nesvåg R, Ystrom E, Kendler KS, Reichborn-Kjennerud T. Associations between personality disorders and cannabis use and cannabis use disorder: a population-based twin study. Addiction 2018; 113:1488-1498. [PMID: 29500852 PMCID: PMC6043378 DOI: 10.1111/add.14209] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/26/2016] [Accepted: 02/23/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND AIMS Individual differences in DSM-IV personality disorders (PDs) are associated with increased prevalence of substance use disorders. Our aims were to determine which combination of PDs trait scores best predict cannabis use (CU) and cannabis use disorder (CUD), and to estimate the size and significance of genetic and environmental risks in PD traits shared with CU and CUD. DESIGN Linear mixed-effects models were used to identify PD traits for inclusion in twin analyses to explore the genetic and environmental associations between the traits and cannabis use. SETTING Cross-sectional data were obtained from Norwegian adult twins in a face-to-face interview in 1999-2004 as part of a population-based study of mental health. PARTICIPANTS Subjects were 1419 twins (μage = 28.2 years, range = 19-36) from the Norwegian Institute of Public Health Twin Panel with complete PD and cannabis data. MEASUREMENTS PD traits were assessed using DSM-IV criteria. Life-time CU and CUD were based on DSM-IV abuse and dependence criteria, including withdrawal and craving. FINDINGS After adjusting for age and sex, antisocial [β = 0.23, 95% confidence interval (CI) = 0.19-0.28] and borderline PDs (β = 0.20, 95% CI = 0.14-0.26) were associated strongly with CU. Antisocial (β = 0.26, 95% CI = 0.21-0.31) and borderline PDs (β = 0.12, 95% CI = 0.06-0.18) were also linked strongly to CUD. Genetic risks in antisocial and borderline PD traits explained 32-60% of the total variance in CU and CUD. Dependent and avoidant PDs explained 11 and 16% of the total variance in CU and CUD, respectively. CONCLUSIONS Individual differences in the liability to cannabis use and cannabis use disorder appear to be linked to genetic risks correlated with antisocial and borderline personality disorder traits.
Collapse
Affiliation(s)
- Nathan A Gillespie
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Steven H Aggen
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Michael C Neale
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
- Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Gun Peggy Knudsen
- Department of Mental Disorders, Norwegian Institute of Public Health, Norway
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Susan C South
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - Nikolai Czajkowski
- Department of Mental Disorders, Norwegian Institute of Public Health, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Ragnar Nesvåg
- Department of Mental Disorders, Norwegian Institute of Public Health, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Eivind Ystrom
- Department of Mental Disorders, Norwegian Institute of Public Health, Norway
- Section of Health, Developmental and Personality Psychology, Department of Psychology, University of Oslo, Norway
- PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy, University of Oslo, Norway
| | - Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
- Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Ted Reichborn-Kjennerud
- Department of Mental Disorders, Norwegian Institute of Public Health, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
6
|
Hodgins DC, Stea JN. Insights from individuals successfully recovered from cannabis use disorder: natural versus treatment-assisted recoveries and abstinent versus moderation outcomes. Addict Sci Clin Pract 2018; 13:16. [PMID: 30056804 PMCID: PMC6065061 DOI: 10.1186/s13722-018-0118-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 07/14/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Increasing understanding of the pathways and processes of recovery from cannabis use disorder may help in designing effective and attractive interventions to promote recovery. We report insights from individuals who had successfully recovered from cannabis use disorder with a variety of pathways. Recovered individuals describe their perceptions of why they developed the problem, why they were successful in recovering, and the advice they would offer to individuals with similar problems. METHODS Media announcements were used to recruit 119 volunteers who met lifetime but not past year criteria for cannabis use disorder. Participants were asked open-ended questions which were content analyzed and compared between individuals who whose recoveries were treatment-assisted (45%) versus natural (55%) and between individuals who were abstinent (57%) versus those who continued non-problematic consumption (43%). RESULTS Participants most frequently described their problems as having developed due to the use of cannabis to cope, because of environmental and social influences, and enjoyment of the positive effects. Success in recovery was attributed to focusing on reasons for change, goal commitment to change, and conquering denial/self-deception. Treatment-assisted participants were more likely to perceive that they overcame their cannabis problem due to treatment/self-help and conquering underlying issues, whereas naturally recovered participants were more likely to describe focusing on reasons for change, will power, and lost enjoyment/lifestyle change. Treatment-assisted participants were more likely to recommend seeking help/social support and naturally recovered participants were more likely to endorse reflecting on reasons for change, engaging in hobbies/distracting activities, and stimulus control/avoidance/change social environment. The majority recommended professional treatment (79.1%) and self-help materials (76.9%), and a little over half (53.2%) would also recommend natural recovery. CONCLUSIONS These insights from people with lived experience further support previous research that treatment-assisted and natural recoveries are for the most part similar with respect to the recovery process. However, participants, whether or not they had had treatment involvement, recommended the use of treatment and self-help materials to sharpen their focus on the reasons to change and to enhance their commitment to change. At the same time, they saw value in the efforts of individuals to recovery without help.
Collapse
Affiliation(s)
- David C Hodgins
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
| | - Jonathan N Stea
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| |
Collapse
|
7
|
Wildes JE, Forbush KT, Hagan KE, Marcus MD, Attia E, Gianini LM, Wu W. Characterizing severe and enduring anorexia nervosa: An empirical approach. Int J Eat Disord 2017; 50:389-397. [PMID: 27991694 PMCID: PMC5386793 DOI: 10.1002/eat.22651] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 11/11/2016] [Accepted: 11/11/2016] [Indexed: 11/07/2022]
Abstract
Targeted approaches for the treatment of severe and enduring anorexia nervosa (SE-AN) have been recommended, but there is no consensus definition of SE-AN to inform research and clinical practice. This study aimed to take initial steps toward developing an empirically based definition of SE-AN by characterizing associations among putative indicators of severity and chronicity in eating disorders. Patients with AN (N = 355) completed interviews and questionnaires at treatment admission and discharge; height and weight were assessed to calculate body mass index (BMI). Structural equation mixture modeling was used to test whether associations among potential indicators of SE-AN (illness duration, treatment history, BMI, binge eating, purging, quality-of-life) formed distinct subgroups, a single group with one or more dimensions, or a combination of subgroups and dimensions. A three-factor (dimensional), two-profile (categorical) mixture model provided the best fit to the data. Factor 1 included eating disorder behaviors; Factor 2 comprised quality-of-life domains; Factor 3 was characterized by illness duration, number of hospitalizations, and admission BMI. Profiles differed on eating disorder behaviors and quality-of-life, but not on indicators of chronicity or BMI. Factor scores, but not profile membership, predicted outcome at discharge from treatment. Data suggest that patients with AN can be classified on the basis of eating disorder behaviors and quality-of-life, but there was no evidence for a chronic subgroup of AN. Rather, indices of chronicity varied dimensionally within each class. Given that current definitions of SE-AN rely on illness duration, these findings have implications for research and clinical practice.
Collapse
Affiliation(s)
- Jennifer E. Wildes
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA
| | | | - Kelsey E. Hagan
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Marsha D. Marcus
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Evelyn Attia
- Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Loren M. Gianini
- Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Wei Wu
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| |
Collapse
|
8
|
Choo EK, Emery SL. Clearing the haze: the complexities and challenges of research on state marijuana laws. Ann N Y Acad Sci 2016; 1394:55-73. [PMID: 27723946 DOI: 10.1111/nyas.13093] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
As states increasingly liberalize marijuana laws, high-quality research is needed that will inform the public and policymakers about the health and societal impact of these laws. However, there are many challenges to studying marijuana policy, including the heterogeneity of the drug and its use, the variability in the laws and their implementation from state to state, the need to capture a wide variety of relevant outcomes, and the poorly understood influence of marijuana commercialization. Furthermore, current instruments generally fail to distinguish between types of users and lack accurate and detailed measures of use. This review provides a background on marijuana laws in the United States and an overview of existing policy research, discusses methodological considerations when planning analysis of state marijuana laws, and highlights specific topics needing further development and investigation.
Collapse
Affiliation(s)
- Esther K Choo
- Department of Emergency Medicine, Center for Policy and Research in Emergency Medicine, Oregon Health & Science University, Portland, Oregon
| | | |
Collapse
|
9
|
Malone M, Hoffmann N. A Comparison of DSM-IV Versus DSM-5 Substance Use Disorder Diagnoses in Adolescent Populations. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2016. [DOI: 10.1080/1067828x.2015.1049679] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
10
|
Kirisci L, Tarter RE, Reynolds M, Vanyukov MM. Item Response Theory Analysis to Assess Dimensionality of Substance Use Disorder Abuse and Dependence Symptoms. INTERNATIONAL JOURNAL OF PERSON CENTERED MEDICINE 2016; 6:260-273. [PMID: 28944002 PMCID: PMC5606209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Item response theory (IRT) based studies conducted on diverse samples showed a single dominant factor for DSM-III-R and DSM-IV substance use disorder (SUD) abuse and dependence symptoms of alcohol, cannabis, sedative, cocaine, stimulants, and opiates use disorders. IRT provides the opportunity, within a person-centered framework, to accurately gauge each person's severity of disorder that, in turn, informs required intensiveness of treatment. OBJECTIVES The aim of this study was to determine whether the SUD symptoms indicate a unidimensional trait or instead need to be conceptualized and quantified as a multidimensional scale. METHODS The sample was composed of families of adult SUD+ men (n=349), and SUD+ women (n=173), who qualified for DSM-III-R diagnosis of substance use disorder (abuse or dependence) and families of adult men and women who did not qualify for a SUD diagnosis (SUD- men: n=190, SUD- women: n=133). An expanded version of the Structured Clinical Interview for DSM-III-R (SCID) was administered to characterize lifetime and current substance use disorders. Item response theory methodology was used to assess the dimensionality of DSM-III-R SUD abuse and dependence symptoms. RESULTS A bi-factor model provided the optimal representation of the factor structure of SUD symptoms in males and females. SUD symptoms are scalable as indicators of a single common factor, corresponding to general (non-drug-specific, common) liability to addiction, combined with drug-specific liabilities. CONCLUSIONS IRT methodology used to quantify the continuous general liability to addiction (GLA) latent trait in individuals having SUD symptoms was found effective for accurately measuring SUD severity in men and women. This may be helpful for person-centered medicine approaches to effectively address intensity of treatment.
Collapse
Affiliation(s)
- Levent Kirisci
- Department of Pharmaceutical Sciences, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ralph E. Tarter
- Department of Pharmaceutical Sciences, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Maureen Reynolds
- Department of Pharmaceutical Sciences, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA
| | - Michael M. Vanyukov
- Department of Pharmaceutical Sciences, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| |
Collapse
|
11
|
Fairman BJ. Cannabis problem experiences among users of the tobacco-cannabis combination known as blunts. Drug Alcohol Depend 2015; 150:77-84. [PMID: 25746234 PMCID: PMC4387065 DOI: 10.1016/j.drugalcdep.2015.02.014] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 02/11/2015] [Accepted: 02/12/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND In most of the world, cannabis smokers mix loose tobacco inside a joint, pipe, spliff, or cone. More recently, a 'blunt' formulation combines these two drugs by inserting cannabis into a hollowed-out cigar. Epidemiological research linking simultaneous use of these two drugs and the development of cannabis use disorders (CUD) remains unclear. This study estimates associations linking blunt smoking with levels and subtypes of cannabis problems. METHODS Cross-sectional data on 27,767 past-year cannabis users were analyzed from the US National Survey on Drug Use and Health (NSDUH) conducted from 2009 to 2012. Ten self-reported items of DSM-IV CUD features elicited a single latent trait of cannabis problem (CP) severity, which was then regressed on past-year blunt smoking and past-month blunt frequency measures within the context of a conceptual model. Differential item functioning (DIF) analysis evaluated potential bias in CP feature response by blunt smoking history. RESULTS Past-year blunt smoking was associated with higher CP severity compared to cannabis users who did not smoke blunts. Days of blunt smoking in the past month also predicted higher CP severity than less frequent blunt use. Those smoking blunts experienced more subjectively felt tolerance and having spent more time obtaining or using cannabis, but were less likely to experience other problems, even at the same level of CP severity. CONCLUSIONS These findings suggest smoking blunts might promote the development of problematic cannabis use. Responses to cannabis problems differed by history of blunt smoking, possibly implicating an influence of tobacco on measurement of cannabis use disorders.
Collapse
Affiliation(s)
- Brian J. Fairman
- Department of Mental Health, John Hopkins Bloomberg School of Public Health, 624 North Broadway, 8th Floor, Baltimore, MD 21205 , Phone: (410) 347-3211, Fax: (410) 614-7569
| |
Collapse
|
12
|
Sterba SK. Cautions on the Use of Multiple Imputation When Selecting Between Latent Categorical versus Continuous Models for Psychological Constructs. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2014; 45:167-75. [DOI: 10.1080/15374416.2014.958839] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
|
13
|
Comparing factor, class, and mixture models of cannabis initiation and DSM cannabis use disorder criteria, including craving, in the Brisbane longitudinal twin study. Twin Res Hum Genet 2014; 17:89-98. [PMID: 24588857 DOI: 10.1017/thg.2014.9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Accumulating evidence suggests that the Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic criteria for cannabis abuse and dependence are best represented by a single underlying factor. However, it remains possible that models with additional factors, or latent class models or hybrid models, may better explain the data. Using structured interviews, 626 adult male and female twins provided complete data on symptoms of cannabis abuse and dependence, plus a craving criterion. We compared latent factor analysis, latent class analysis, and factor mixture modeling using normal theory marginal maximum likelihood for ordinal data. Our aim was to derive a parsimonious, best-fitting cannabis use disorder (CUD) phenotype based on DSM-IV criteria and determine whether DSM-5 craving loads onto a general factor. When compared with latent class and mixture models, factor models provided a better fit to the data. When conditioned on initiation and cannabis use, the association between criteria for abuse, dependence, withdrawal, and craving were best explained by two correlated latent factors for males and females: a general risk factor to CUD and a factor capturing the symptoms of social and occupational impairment as a consequence of frequent use. Secondary analyses revealed a modest increase in the prevalence of DSM-5 CUD compared with DSM-IV cannabis abuse or dependence. It is concluded that, in addition to a general factor with loadings on cannabis use and symptoms of abuse, dependence, withdrawal, and craving, a second clinically relevant factor defined by features of social and occupational impairment was also found for frequent cannabis use.
Collapse
|
14
|
Jackson KM, Bucholz KK, Wood PK, Steinley D, Grant JD, Sher KJ. Towards the characterization and validation of alcohol use disorder subtypes: integrating consumption and symptom data. Psychol Med 2014; 44:143-159. [PMID: 23551901 PMCID: PMC3856175 DOI: 10.1017/s0033291713000573] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND There is evidence that measures of alcohol consumption, dependence and abuse are valid indicators of qualitatively different subtypes of alcohol involvement yet also fall along a continuum. The present study attempts to resolve the extent to which variations in alcohol involvement reflect a difference in kind versus a difference in degree. METHOD Data were taken from the 2001-2002 National Epidemiologic Survey of Alcohol and Related Conditions. The sample (51% male; 72% white/non-Hispanic) included respondents reporting past 12-month drinking at both waves (wave 1: n = 33644; wave 2: n = 25186). We compared factor mixture models (FMMs), a hybrid of common factor analysis (FA) and latent class analysis (LCA), against FA and LCA models using past 12-month alcohol use disorder (AUD) criteria and five indicators of alcohol consumption reflecting frequency and heaviness of drinking. RESULTS Model comparison revealed that the best-fitting model at wave 1 was a one-factor four-class FMM, with classes primarily varying across dependence and consumption indices. The model was replicated using wave 2 data, and validated against AUD and dependence diagnoses. Class stability from waves 1 to 2 was moderate, with greatest agreement for the infrequent drinking class. Within-class associations in the underlying latent factor also revealed modest agreement over time. CONCLUSIONS There is evidence that alcohol involvement can be considered both categorical and continuous, with responses reduced to four patterns that quantitatively vary along a single dimension. Nosologists may consider hybrid approaches involving groups that vary in pattern of consumption and dependence symptomatology as well as variation of severity within group.
Collapse
Affiliation(s)
- K. M. Jackson
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - K. K. Bucholz
- Washington University School of Medicine in St Louis, St Louis, MO, USA
- Midwest Alcoholism Research Center
| | - P. K. Wood
- Midwest Alcoholism Research Center
- University of Missouri-Columbia, Columbia, MO, USA
| | - D. Steinley
- Midwest Alcoholism Research Center
- University of Missouri-Columbia, Columbia, MO, USA
| | - J. D. Grant
- Washington University School of Medicine in St Louis, St Louis, MO, USA
- Midwest Alcoholism Research Center
| | - K. J. Sher
- Midwest Alcoholism Research Center
- University of Missouri-Columbia, Columbia, MO, USA
| |
Collapse
|