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Karlsson P, Callinan S, Gmel G, Raninen J. How well do DSM-5 criteria measure alcohol use disorder in the general population of older Swedish adolescents? An item response theory analysis. Addict Behav 2024; 154:108007. [PMID: 38460492 DOI: 10.1016/j.addbeh.2024.108007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 03/04/2024] [Accepted: 03/05/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND This study assesses the psychometric properties of DSM-5 criteria of AUD in older Swedish adolescents using item response theory models, focusing specifically on the precision of the scale at the cut-offs for mild, moderate, and severe AUD. METHODS Data from the second wave of Futura01 was used. Futura01 is a nationally representative cohort study of Swedish people born 2001 and data for the second wave was collected when participants were 17/18 years old. This study included only participants who had consumed alcohol during the past 12 months (n = 2648). AUD was measured with 11 binary items. A 2-parameter logistic item response theory model (2PL) estimated the items' difficulty and discrimination parameters. RESULTS 31.8% of the participants met criteria for AUD. Among these, 75.6% had mild AUD, 18.3% had moderate, and 6.1% had severe AUD. A unidimensional AUD model had a good fit and 2PL models showed that the scale measured AUD over all three cut-offs for AUD severity. Although discrimination parameters ranged from moderate (1.24) to very high (2.38), the more commonly endorsed items discriminated less well than the more difficult items, as also reflected in less precision of the estimates at lower levels of AUD severity. The diagnostic uncertainty was pronounced at the cut-off for mild AUD. CONCLUSION DSM-5 criteria measure AUD with better precision at higher levels of AUD severity than at lower levels. As most older adolescents who fulfil an AUD diagnosis are in the mild category, notable uncertainties are involved when an AUD diagnosis is set in this group.
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Affiliation(s)
- Patrik Karlsson
- Department of Social Work, Stockholm University, Stockholm, Sweden.
| | - Sarah Callinan
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Gerhard Gmel
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 23A, 1011 Lausanne, Switzerland; Research Department, Addiction Switzerland, Avenue Louis-Ruchonnet 14, 1003 Lausanne, Switzerland; Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 250 College Street, Toronto, ON M5T 1R8, Canada; Alcohol and Research Unit, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, UK
| | - Jonas Raninen
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia; Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden
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Takahashi T, Lapham G, Chavez LJ, Lee AK, Williams EC, Richards JE, Greenberg D, Rubinsky A, Berger D, Hawkins EJ, Merrill JO, Bradley KA. Comparison of DSM-IV and DSM-5 criteria for alcohol use disorders in VA primary care patients with frequent heavy drinking enrolled in a trial. Addict Sci Clin Pract 2017; 12:17. [PMID: 28716049 PMCID: PMC5514480 DOI: 10.1186/s13722-017-0082-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 05/25/2017] [Indexed: 12/04/2022] Open
Abstract
Background Criteria for alcohol use disorders (AUD) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) were intended to result in a similar prevalence of AUD as DSM-IV. We evaluated the prevalence of AUD using DSM-5 and DSM-IV criteria, and compared characteristics of patients who met criteria for: neither DSM-5 nor DSM-IV AUD, DSM-5 alone, DSM-IV alone, or both, among Veterans Administration (VA) outpatients in the Considering Healthier drinking Options In primary CarE (CHOICE) trial. Methods VA primary care patients who reported frequent heavy drinking and enrolled in the CHOICE trial were interviewed at baseline using the DSM-IV Mini International Neuropsychiatric Interview for AUD, as well as questions about socio-demographics, mental health, alcohol craving, and substance use. We compared characteristics across 4 mutually exclusive groups based on DSM-5 and DSM-IV criteria. Results Of 304 participants, 13.8% met criteria for neither DSM-5 nor DSM-IV AUD; 12.8% met criteria for DSM-5 alone, and 73.0% met criteria for both DSM-IV and DSM-5. Only 1 patient (0.3%) met criteria for DSM-IV AUD alone. Patients meeting both DSM-5 and DSM-IV criteria had more negative drinking consequences, mental health symptoms and self-reported readiness to change compared with those meeting DSM-5 criteria alone or neither DSM-5 nor DSM-IV criteria. Conclusions In this sample of primary care patients with frequent heavy drinking, DSM-5 identified 13% more patients with AUD than DSM-IV. This group had a lower mental health symptom burden and less self-reported readiness to change compared to those meeting criteria for both DSM-IV and DSM-5 AUD. Trial Registration ClinicalTrials.gov NCT01400581. 2011 February 17 Electronic supplementary material The online version of this article (doi:10.1186/s13722-017-0082-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Traci Takahashi
- Department of Veterans Affairs Puget Sound Health Care System, General Medicine Services, 1660 South Columbian Way (S-152), Seattle, WA, 98108, USA. .,Department of Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA.
| | - Gwen Lapham
- Health Services Research and Development (HSR&D), Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, 1660 S. Columbian Way, Seattle, WA, 98108, USA.,Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, Ste. 1600, Seattle, WA, 98101, USA
| | - Laura J Chavez
- Health Services Research and Development (HSR&D), Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, 1660 S. Columbian Way, Seattle, WA, 98108, USA.,Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, USA.,Center for Innovation in Pediatric Practice, Nationwide Children's Hospital, Columbus, OH, USA
| | - Amy K Lee
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, Ste. 1600, Seattle, WA, 98101, USA
| | - Emily C Williams
- Health Services Research and Development (HSR&D), Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, 1660 S. Columbian Way, Seattle, WA, 98108, USA.,Department of Health Services, University of Washington, 1959 Pacific Street, Seattle, WA, 98195, USA
| | - Julie E Richards
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, Ste. 1600, Seattle, WA, 98101, USA.,Department of Health Services, University of Washington, 1959 Pacific Street, Seattle, WA, 98195, USA
| | - Diane Greenberg
- Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.,Department of Veterans Affairs Puget Sound Health Care System, Mental Health Service, 1660 South Columbian Way (S-152), Seattle, WA, 98108, USA
| | - Anna Rubinsky
- Health Services Research and Development (HSR&D), Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, 1660 S. Columbian Way, Seattle, WA, 98108, USA.,Center of Excellence in Substance Abuse Treatment and Education (CESATE), Veterans Affairs (VA) Puget Sound Health Care System, S-123-PCC, 1660 S. Columbian Way, Seattle, WA, 98108, USA.,The Kidney Health Research Collaborative, San Francisco and San Francisco VA Medical Center, University of California, 4150 Clement Street (111A1), San Francisco, CA, 94121, USA
| | - Douglas Berger
- Department of Veterans Affairs Puget Sound Health Care System, General Medicine Services, 1660 South Columbian Way (S-152), Seattle, WA, 98108, USA.,Department of Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA
| | - Eric J Hawkins
- Health Services Research and Development (HSR&D), Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, 1660 S. Columbian Way, Seattle, WA, 98108, USA.,Center of Excellence in Substance Abuse Treatment and Education (CESATE), Veterans Affairs (VA) Puget Sound Health Care System, S-123-PCC, 1660 S. Columbian Way, Seattle, WA, 98108, USA.,Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Joseph O Merrill
- Department of Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA
| | - Katharine A Bradley
- Health Services Research and Development (HSR&D), Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, 1660 S. Columbian Way, Seattle, WA, 98108, USA.,Center of Excellence in Substance Abuse Treatment and Education (CESATE), Veterans Affairs (VA) Puget Sound Health Care System, S-123-PCC, 1660 S. Columbian Way, Seattle, WA, 98108, USA.,Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, Ste. 1600, Seattle, WA, 98101, USA.,Department of Health Services, University of Washington, 1959 Pacific Street, Seattle, WA, 98195, USA.,Department of Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA
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