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Chapron SA, Kervran C, Da Rosa M, Fournet L, Shmulewitz D, Hasin D, Denis C, Collombat J, Monsaingeon M, Fatseas M, Gatta-Cherifi B, Serre F, Auriacombe M. Does food use disorder exist? Item response theory analyses of a food use disorder adapted from the DSM-5 substance use disorder criteria in a treatment seeking clinical sample. Drug Alcohol Depend 2023; 251:110937. [PMID: 37666092 DOI: 10.1016/j.drugalcdep.2023.110937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Increased consumption of food that are high in energy and sugar have been pointed as a major factor in the obesity epidemic. Impaired control of food intake and the concept of food addiction has been developed as a potential contributor. Our objective was to evaluate the dimensionality and psychometric validity of diagnostic criteria for food addiction adapted from the 11 DSM-5 substance use disorder (SUD) criteria (i.e.: Food Use Disorder (FUD) criteria), and to evaluate the influence of age, gender, and body mass index (BMI). METHODS Cross-sectional observational study including 508 participants (56.1% male; mean age 42.2) from outpatient treatment clinics for obesity or addiction disorders at time of admission. FUD diagnostic criteria were analyzed using confirmatory factor and 2-parameter item response theory analyses. Differential Item and Test Functioning analyses were performed across age, gender, and BMI. RESULTS We demonstrated the one-factor dimensionality of the criteria set. The criterion "craving" presented the strongest factor loading and discrimination parameter and the second-lowest difficulty. We found some significant uniform differential item functioning for body mass index. We found some differential test functioning for gender and BMI. CONCLUSIONS This study reports, for the first time, the validity of a potential Food Use Disorder (derived from the 11 DSM-5 SUD criteria adapted to food) in a sample of treatment seeking adults. This has great implications both at the clinical level and in terms of public health policy in the context of the global obesity epidemic.
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Affiliation(s)
- Sophie-Athéna Chapron
- University of Bordeaux, Bordeaux, France; SANPSY Sleep, Addiction and Neuropsychiatry, Centre national de la recherche scientifique CNRS UMR 6033 and University of Bordeaux, Bordeaux, France; Addiction Clinic (Pôle Interétablissement d'Addictologie), CH Charles Perrens and CHU de Bordeaux, Bordeaux, France
| | - Charlotte Kervran
- University of Bordeaux, Bordeaux, France; SANPSY Sleep, Addiction and Neuropsychiatry, Centre national de la recherche scientifique CNRS UMR 6033 and University of Bordeaux, Bordeaux, France; Addiction Clinic (Pôle Interétablissement d'Addictologie), CH Charles Perrens and CHU de Bordeaux, Bordeaux, France
| | - Marco Da Rosa
- University of Bordeaux, Bordeaux, France; SANPSY Sleep, Addiction and Neuropsychiatry, Centre national de la recherche scientifique CNRS UMR 6033 and University of Bordeaux, Bordeaux, France; Center for Drug and Alcohol Research, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Lucie Fournet
- University of Bordeaux, Bordeaux, France; SANPSY Sleep, Addiction and Neuropsychiatry, Centre national de la recherche scientifique CNRS UMR 6033 and University of Bordeaux, Bordeaux, France; Addiction Clinic (Pôle Interétablissement d'Addictologie), CH Charles Perrens and CHU de Bordeaux, Bordeaux, France
| | - Dvora Shmulewitz
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA; Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA
| | - Deborah Hasin
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA; Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA
| | - Cécile Denis
- SANPSY Sleep, Addiction and Neuropsychiatry, Centre national de la recherche scientifique CNRS UMR 6033 and University of Bordeaux, Bordeaux, France; Department of psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Julie Collombat
- SANPSY Sleep, Addiction and Neuropsychiatry, Centre national de la recherche scientifique CNRS UMR 6033 and University of Bordeaux, Bordeaux, France; Addiction Clinic (Pôle Interétablissement d'Addictologie), CH Charles Perrens and CHU de Bordeaux, Bordeaux, France
| | - Maude Monsaingeon
- Obesity Clinic, Haut-Leveque Hospital, CHU de Bordeaux, Bordeaux, France
| | - Mélina Fatseas
- University of Bordeaux, Bordeaux, France; SANPSY Sleep, Addiction and Neuropsychiatry, Centre national de la recherche scientifique CNRS UMR 6033 and University of Bordeaux, Bordeaux, France; Addiction Clinic (Pôle Interétablissement d'Addictologie), CH Charles Perrens and CHU de Bordeaux, Bordeaux, France; INCIA, UMR 5287, Bordeaux, France
| | - Blandine Gatta-Cherifi
- University of Bordeaux, Bordeaux, France; Obesity Clinic, Haut-Leveque Hospital, CHU de Bordeaux, Bordeaux, France; Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, Institut National de la Santé et de la Recherche Médicale (INSERM), Unité 1215, Bordeaux, 33076 France
| | - Fuschia Serre
- University of Bordeaux, Bordeaux, France; SANPSY Sleep, Addiction and Neuropsychiatry, Centre national de la recherche scientifique CNRS UMR 6033 and University of Bordeaux, Bordeaux, France; Addiction Clinic (Pôle Interétablissement d'Addictologie), CH Charles Perrens and CHU de Bordeaux, Bordeaux, France
| | - Marc Auriacombe
- University of Bordeaux, Bordeaux, France; SANPSY Sleep, Addiction and Neuropsychiatry, Centre national de la recherche scientifique CNRS UMR 6033 and University of Bordeaux, Bordeaux, France; Addiction Clinic (Pôle Interétablissement d'Addictologie), CH Charles Perrens and CHU de Bordeaux, Bordeaux, France; Department of psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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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.
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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.
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Shmulewitz D, Stohl M, Greenstein E, Roncone S, Walsh C, Aharonovich E, Wall MM, Hasin DS. Validity of the DSM-5 craving criterion for alcohol, tobacco, cannabis, cocaine, heroin, and non-prescription use of prescription painkillers (opioids). Psychol Med 2023; 53:1955-1969. [PMID: 35506791 PMCID: PMC9096712 DOI: 10.1017/s0033291721003652] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Although the DSM-5 was adopted in 2013, the validity of the new substance use disorder (SUD) diagnosis and craving criterion has not been investigated systematically across substances. METHODS Adults (N = 588) who engaged in binge drinking or illicit drug use and endorsed at least one DSM-5 SUD criterion were included. DSM-5 SUD criteria were assessed for alcohol, tobacco, cannabis, cocaine, heroin, and opioids. Craving was considered positive if "wanted to use so badly that could not think of anything else" (severe craving) or "felt a very strong desire or urge to use" (moderate craving) was endorsed. Baseline information on substance-related variables and psychopathology was collected, and electronic daily assessment queried substance use for the following 90 days. For each substance, logistic regression estimated the association between craving and validators, i.e. variables expected to be related to craving/SUD, and whether association with the validators differed for DSM-5 SUD diagnosed with craving as a criterion v. without. RESULTS Across substances, craving was associated with most baseline validators (p values<0.05); neither moderate nor severe craving consistently showed greater associations. Baseline craving predicted subsequent use [odds ratios (OR): 4.2 (alcohol) - 234.3 (heroin); p's ⩽ 0.0001], with stronger associations for moderate than severe craving (p's < 0.05). Baseline DSM-5 SUD showed stronger associations with subsequent use when diagnosed with craving than without (p's < 0.05). CONCLUSION The DSM-5 craving criterion as operationalized in this study is valid. Including craving improves the validity of DSM-5 SUD diagnoses, and clinical relevance, since craving may cause impaired control over use and development and maintenance of SUD.
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Affiliation(s)
- D Shmulewitz
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Dr, New York, NY 10032, USA
- New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA
| | - M Stohl
- New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA
| | - E Greenstein
- New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA
| | - S Roncone
- New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA
| | - C Walsh
- New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA
| | - E Aharonovich
- New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA
| | - MM Wall
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Dr, New York, NY 10032, USA
- New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA
- Department of Biostatistics, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY, 10032, USA
| | - DS Hasin
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Dr, New York, NY 10032, USA
- New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY, 10032, USA
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Gauld C, Baillet E, Micoulaud-Franchi JA, Kervran C, Serre F, Auriacombe M. The centrality of craving in network analysis of five substance use disorders. Drug Alcohol Depend 2023; 245:109828. [PMID: 36868091 DOI: 10.1016/j.drugalcdep.2023.109828] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 01/26/2023] [Accepted: 02/22/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND AND AIMS Among the 11 current diagnostic criteria, craving is a potential central marker for understanding and for treatment of Substance Use Disorders (SUD). Our objective was to explore craving centrality across SUD based on the study of symptom interactions in cross-sectional network analyses of DSM-5 SUD diagnostic criteria. We hypothesized the centrality of "Craving" in SUD across substance types. DESIGN Participants from the ADDICTAQUI clinical cohort with regular use (2 times per week threshold for a substance) and at least one DSM-5 SUD. SETTING Outpatient substance use treatment services in Bordeaux, France. PARTICIPANTS The sample of 1359 participants, had a mean age of 39 years old and 67% were males. The prevalence of SUD over the time course of the study was: 93% for alcohol, 98% for opioids, 94% for cocaine, 94% for cannabis and 91% tobacco. MEASUREMENTS Construction of a Symptom Network Model conducted on the DSM-5 SUD criteria evaluated over the past 12 months for Alcohol-, Cocaine-, Tobacco-, Opioid- and Cannabis Use disorder. FINDINGS The only symptom that consistently remained in terms of centrality was "Craving" [3.96 - 6.17] (z-scores), indicating that it exhibits a high degree of connections in the entire symptom network regardless of the substance. CONCLUSION Identifying craving as central in SUD symptoms network confirms the role of craving as a marker of addiction. This constitutes a major avenue in the understanding of the mechanisms of addiction, with implications to ameliorate diagnostic validity and clarify treatment targets.
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Affiliation(s)
- Christophe Gauld
- Department of Child Psychiatry, CHU de Lyon, F-69000 Lyon, France; Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS & Université Claude Bernard Lyon 1, F-69000 Lyon, France
| | - Emmanuelle Baillet
- University of Bordeaux, F-33076 Bordeaux, France; SANPSY, CNRS, UMR 6033, F-33076 Bordeaux, France; Pôle Interétablissement d'Addictologie, CH Ch. Perrens and CHU de Bordeaux, F-33076 Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- University of Bordeaux, F-33076 Bordeaux, France; SANPSY, CNRS, UMR 6033, F-33076 Bordeaux, France; University Sleep Clinic, University Hospital of Bordeaux (CHU Bordeaux), Place Amélie Raba-Leon, F-33076 Bordeaux, France
| | - Charlotte Kervran
- University of Bordeaux, F-33076 Bordeaux, France; I-prev, MéRISP/PHARES, CIC 1401, Inserm U1219, Bordeaux Population Health Research Center (BPH), F-33076 Bordeaux, France
| | - Fuschia Serre
- University of Bordeaux, F-33076 Bordeaux, France; SANPSY, CNRS, UMR 6033, F-33076 Bordeaux, France; Pôle Interétablissement d'Addictologie, CH Ch. Perrens and CHU de Bordeaux, F-33076 Bordeaux, France
| | - Marc Auriacombe
- University of Bordeaux, F-33076 Bordeaux, France; SANPSY, CNRS, UMR 6033, F-33076 Bordeaux, France; Pôle Interétablissement d'Addictologie, CH Ch. Perrens and CHU de Bordeaux, F-33076 Bordeaux, France.
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Schiestl ET, Wolfson JA, Gearhardt AN. The qualitative evaluation of the Yale Food addiction scale 2.0. Appetite 2022; 175:106077. [PMID: 35537659 PMCID: PMC9663207 DOI: 10.1016/j.appet.2022.106077] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 04/07/2022] [Accepted: 05/02/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND The Yale Food Addiction Scale 2.0 (YFAS 2.0) operationalizes food addiction (FA) by applying the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM 5) criteria for substance use disorder (SUD) to the overconsumption of highly processed foods. The YFAS 2.0 has been quantitatively validated across numerous populations, but has never undergone qualitative analysis. AIMS Using qualitative methods we aimed to determine if the interpretation YFAS 2.0 is aligned with the DSM 5 conceptualization of SUD, to determine if any items are perceived as irrelevant to the lived-experience of FA, and to determine if there are constructs central to the lived-experience of FA that are not captured by the scale. METHODS We interviewed 16 participants who met criteria for FA on the modified YFAS 2.0 using semi-structured interviews to understand each participants' interpretation of items on the scale and their perceptions of how the scale matched their lived-experience of FA. Reflexive thematic analysis was used to code responses and identify themes. RESULTS Most interpretations aligned with the DSM 5 conceptualization of SUDs. Withdrawal and tolerance-related items were subject to some misinterpretations. Participants viewed problem-focused symptoms (e.g., interpersonal problems) as the least relevant to their lived-experience. Novel themes not included on the YFAS 2.0 (e.g., emotional eating) emerged. SUMMARY Our study supports the validity of the YFAS 2.0 by showing consistency with the DSM 5 conceptualization of SUDs and consistency with the lived-experience of individuals who endorse FA. Future research should explore the novel themes that emerged in this study.
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Affiliation(s)
| | - Julia A Wolfson
- Department of International Health, Ann Arbor, USA; Department of Health Policy and Management, USA
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Boudard M, Alexandre JM, Kervran C, Jakubiec L, Shmulewitz D, Hasin D, Fournet L, Rassis C, Claverie P, Serre F, Auriacombe M. Item Response Theory Analyses of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Criteria Adapted to Screen Use Disorder: Exploratory Survey. J Med Internet Res 2022; 24:e31803. [PMID: 35896018 PMCID: PMC9377463 DOI: 10.2196/31803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 02/26/2022] [Accepted: 06/08/2022] [Indexed: 11/23/2022] Open
Abstract
Background Screen use is part of daily life worldwide and morbidity related to excess use of screens has been reported. Some use of screens in excess could indicate a screen use disorder (ScUD). An integrative approach to ScUD could better fit the polymodal reality of screens, and concurrent problems with screens, than a split approach, activity by activity. In that paradigm, a pragmatic and operationalized approach to study a potential ScUD requires the use of common criteria, for all screens and activities done on screens, in a single questionnaire. Objective Our goals were (1) to describe screen uses in a general population sample and (2) to test the unidimensionality, local independence, and psychometric properties of the 9 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) internet gaming disorder (IGD) criteria adapted to screen use in a community sample. We hypothesized that the 9 DSM-5 IGD criteria adapted to ScUD would show unidimensionality, local independence, and good discrimination, with criteria distributed on the severity continuum. Methods This cross-sectional survey in a French suburban city targeted adults and adolescents. A self-administered questionnaire covered the main types of screens used and their use for various activities in the past month. Presence of ScUD diagnostic criteria in past 12 months was also self-evaluated in the questionnaire. Factor and 2-parameter Item Response Theory analysis were used to investigate the dimensionality, local independence, and psychometric properties of the ScUD criteria. Results Among the 300 participants, 171 (57.0%) were female (mean age 27 years), 297 (99.0%) used screens, 134 (44.7%) reported at least one criterion (potential problem users), and 5 (1.7%) reported 5 or more criteria and endorsed an ScUD. The most endorsed criteria were loss of control (60/300, 20.0%) and preoccupation (52/300, 17.3%). Screen types used and screen activities differed between participants with no ScUD criteria and those with at least one ScUD criterion. The latter were more likely to have a computer as the most used screen type, and more video gaming, communication/social network, and watching news and research of information as activities. Unidimensionality was confirmed by all fit indices. Local independence was confirmed by the absence of residual correlation between the items. Criteria had relatively high factor loading, with loss of interest in other recreational activities having the highest. However, criteria with the lowest factor loading all remained above the cut-offs, sanctioning unidimensionality. Most discriminating criteria were loss of interests, preoccupation, deceive/cover up, and risk/lose relationship/opportunities, which also provided the most information on the measurement of the latent trait. Conclusions We described screen uses in a French community sample and have shown that the adaptation of the DSM-5 IGD to “ScUD” has good psychometric validity and is discriminating, confirming our hypothesis. We suggest to use those criteria to assess potential “ScUD.” Further studies should determine if all criteria are needed and whether others should be added.
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Affiliation(s)
- Mathieu Boudard
- Sanpsy (Sleep Addiction and Neuropsychiatry), CNRS (Centre National de la Recherche Scientifique), UMR (Unité Mixte de Recherche) 6033, University of Bordeaux, Bordeaux, France.,Pôle Interétablissement d'Addictologie, Centre Hospitalier Charles Perrens and Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Jean-Marc Alexandre
- Sanpsy (Sleep Addiction and Neuropsychiatry), CNRS (Centre National de la Recherche Scientifique), UMR (Unité Mixte de Recherche) 6033, University of Bordeaux, Bordeaux, France.,Pôle Interétablissement d'Addictologie, Centre Hospitalier Charles Perrens and Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Charlotte Kervran
- Sanpsy (Sleep Addiction and Neuropsychiatry), CNRS (Centre National de la Recherche Scientifique), UMR (Unité Mixte de Recherche) 6033, University of Bordeaux, Bordeaux, France.,MéRISP (Methods for population health intervention research), BPH (Bordeaux Population Health), INSERM (Institut National de la Santé et de la Recherche Médicale) Unité 1219, University of Bordeaux, Bordeaux, France
| | - Louise Jakubiec
- Sanpsy (Sleep Addiction and Neuropsychiatry), CNRS (Centre National de la Recherche Scientifique), UMR (Unité Mixte de Recherche) 6033, University of Bordeaux, Bordeaux, France.,Pôle Interétablissement d'Addictologie, Centre Hospitalier Charles Perrens and Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Dvora Shmulewitz
- Department of Psychiatry, Columbia University, New York, NY, United States
| | - Deborah Hasin
- Department of Psychiatry, Columbia University, New York, NY, United States
| | - Lucie Fournet
- Sanpsy (Sleep Addiction and Neuropsychiatry), CNRS (Centre National de la Recherche Scientifique), UMR (Unité Mixte de Recherche) 6033, University of Bordeaux, Bordeaux, France.,Pôle Interétablissement d'Addictologie, Centre Hospitalier Charles Perrens and Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Christophe Rassis
- Sanpsy (Sleep Addiction and Neuropsychiatry), CNRS (Centre National de la Recherche Scientifique), UMR (Unité Mixte de Recherche) 6033, University of Bordeaux, Bordeaux, France.,Pôle Interétablissement d'Addictologie, Centre Hospitalier Charles Perrens and Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | | | - Fuschia Serre
- Sanpsy (Sleep Addiction and Neuropsychiatry), CNRS (Centre National de la Recherche Scientifique), UMR (Unité Mixte de Recherche) 6033, University of Bordeaux, Bordeaux, France.,Pôle Interétablissement d'Addictologie, Centre Hospitalier Charles Perrens and Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Marc Auriacombe
- Sanpsy (Sleep Addiction and Neuropsychiatry), CNRS (Centre National de la Recherche Scientifique), UMR (Unité Mixte de Recherche) 6033, University of Bordeaux, Bordeaux, France.,Pôle Interétablissement d'Addictologie, Centre Hospitalier Charles Perrens and Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
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7
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Kervran C, Shmulewitz D, Serre F, Denis C, Roux P, Jauffret-Roustide M, Lalanne L, Hasin D, Auriacombe M. Do DSM-5 substance use disorder criteria differ by user care settings? An item response theory analysis approach. Addict Behav 2021; 116:106797. [PMID: 33450665 DOI: 10.1016/j.addbeh.2020.106797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 11/07/2020] [Accepted: 12/20/2020] [Indexed: 01/05/2023]
Abstract
AIM To examine differences in the psychometric characteristics of diagnostic criteria for Substance Use Disorders (SUD) between substance users in harm reduction settings (HR) and substance users seeking treatment (Tx). METHODS Differential Item and Test Functioning (DIF & DTF) analysis were performed to examine differences in the difficulty of endorsement and in discrimination of the 11 diagnostic criteria and to test if the criteria set as a whole (the "test") functioned differently by care settings (Tx vs. HR) for alcohol, cocaine, cannabis, opiates and tobacco. To test uniform and nonuniform DIF, multiple indicator multiple cause (MIMIC) structural equation models were used. RESULTS Regardless of the substance, the DSM-5 criteria "craving", "large amount", "time spent", "tolerance" and "activities given up" had similar functioning by care settings. Little evidence for DIF was found for other criteria. The criteria set as a whole did not function differently by care settings for alcohol, cocaine and tobacco. At the same trait severity, compared to HR, the Tx subgroup had a greater number of endorsed criteria for cannabis and a smaller number of endorsed criteria for opioids. CONCLUSION The unidimensionality of the 11 DSM-5 criteria and applicability of all criteria and diagnosis was confirmed in this large sample of problematic substance users. While the majority of the criteria related to loss of control of substance use, functioned well in both care settings, the criteria related to consequences of substance use had several differential functioning.
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Affiliation(s)
- C Kervran
- University of Bordeaux, Addiction Team, Sleep Addiction and Neuropsychiatry Laboratory (SANPSY), Bordeaux, France; USR CNRS 3413, Bordeaux, France; Pôle Addictologie, CH Ch. Perrens and CHU de Bordeaux, Bordeaux, France
| | - D Shmulewitz
- New York State Psychiatric Institute, New York, NY, United States; Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
| | - F Serre
- University of Bordeaux, Addiction Team, Sleep Addiction and Neuropsychiatry Laboratory (SANPSY), Bordeaux, France; USR CNRS 3413, Bordeaux, France; Pôle Addictologie, CH Ch. Perrens and CHU de Bordeaux, Bordeaux, France
| | - C Denis
- University of Bordeaux, Addiction Team, Sleep Addiction and Neuropsychiatry Laboratory (SANPSY), Bordeaux, France; USR CNRS 3413, Bordeaux, France; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - P Roux
- Aix Marseille University, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France
| | - M Jauffret-Roustide
- Cermes3, Inserm U988, CNRS UMR 8236, Université de Paris, EHESS, Paris, France; British Columbia Centre on Substance Use (BCCSU), Vancouver, Canada; Baldy Center for Law and Social Policy, Buffalo University of Social Sciences, Buffalo, NY, United States
| | - L Lalanne
- INSERM 1114, Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - D Hasin
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - M Auriacombe
- University of Bordeaux, Addiction Team, Sleep Addiction and Neuropsychiatry Laboratory (SANPSY), Bordeaux, France; USR CNRS 3413, Bordeaux, France; Pôle Addictologie, CH Ch. Perrens and CHU de Bordeaux, Bordeaux, France; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
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8
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Borges G, Orozco R, Benjet C, Mart´ınez KIM, Contreras EV, P´erez ALJ, Cedr´es AJP, Uribe PCH, Couder MACD, Gutierrez-Garcia RUA, Ch´avez GEQ, Albor Y, Mendez E, Medina-Mora ME, Mortier P, Ayuso-Mateos JL. (Internet) Gaming Disorder in DSM-5 and ICD-11: A Case of the Glass Half Empty or Half Full: (Internet) Le trouble du jeu dans le DSM-5 et la CIM-11: Un cas de verre à moitié vide et à moitié plein. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2021; 66:477-484. [PMID: 32806957 PMCID: PMC8107956 DOI: 10.1177/0706743720948431] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Diagnostic and Statistical Manual of Mental Disorders (DSM-5) included in 2013 Internet gaming disorder (IGD) as a condition for further study, and in 2018, the World Health Organization included gaming disorder (GD) as a mental disorder in the International Classification of Disease (ICD-11). We aim to compare disorders of gaming in both diagnostic systems using a sample of young adults in Mexico. METHODS Self-administered survey to estimate the prevalence of DSM-5 IGD and ICD-11 GD in 5 Mexican universities; 7,022 first-year students who participated in the University Project for Healthy Students, part of the World Health Organization World Mental Health International College Student Initiative. Cross-tabulation, logistic regression, and item response theory were used to inform on 12- month prevalence of DSM-5 IGD and ICD-11 GD, without and with impairment. RESULTS The 12-month prevalence of DSM-5 IGD was 5.2% (95% CI, 4.7 to 5.8), almost twice as high as the prevalence using the ICD-11 GD criteria (2.7%; 95% CI, 2.4 to 3.1), and while adding an impairment requirement diminishes both estimates, prevalence remains larger in DSM-5. We found that DSM-5 cases detected and undetected by ICD-11 criteria were similar in demographics, comorbid mental disorders, service use, and impairment variables with the exception that cases detected by ICD-11 had a larger number of symptoms and were more likely to have probable drug dependence than undetected DSM-5 cases. CONCLUSION DSM-5 cases detected by ICD-11 are mostly similar to cases undetected by ICD-11. By using ICD-11 instead of DSM-5, we may be leaving (similarly) affected people underserved. It is unlikely that purely epidemiological studies can solve this discrepancy and clinical validity studies maybe needed.
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Affiliation(s)
- Guilherme Borges
- Instituto Nacional de Psiquiatría Ramón de la Fuente
Muñiz, Ciudad de México, México
- Guilherme Borges, Instituto Nacional de
Psiquiatría Ramon de la Fuente Muñiz, Calzada México Xochimilco No. 101, Col.
San Lorenzo Huipulco, CP, 14370 CDMX, México. Emails:
;
| | - Ricardo Orozco
- Instituto Nacional de Psiquiatría Ramón de la Fuente
Muñiz, Ciudad de México, México
| | - Corina Benjet
- Instituto Nacional de Psiquiatría Ramón de la Fuente
Muñiz, Ciudad de México, México
| | | | | | | | | | | | | | | | | | - Yesica Albor
- Universidad Cuauhtémoc plantel
Aguascalientes, México
| | - Enrique Mendez
- Instituto Nacional de Psiquiatría Ramón de la Fuente
Muñiz, Ciudad de México, México
| | - Maria Elena Medina-Mora
- Center of Global Mental Health Research, Instituto Nacional de Psiquiatría Ramón de la Fuente
Muñiz, Ciudad de México, México
| | - Philippe Mortier
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), CIBER en
Epidemiología y Salud Pública (CIBERESP), Center for Public Health Psychiatry, KU
Leuven, Belgium
| | - Jos´e Luis Ayuso-Mateos
- Departamento de Psiquiatría, Universidad Autónoma de
Madrid, CIBER en Salud Mental (CIBERSAM), Spain
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9
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Kervran C, Shmulewitz D, Serre F, Stohl M, Denis C, Hasin D, Auriacombe M. Item Response Theory analyses of DSM-5 substance use disorder criteria in French outpatient addiction clinic participants. How much is craving special? Drug Alcohol Depend 2020; 212:108036. [PMID: 32464467 DOI: 10.1016/j.drugalcdep.2020.108036] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 04/15/2020] [Accepted: 04/16/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND To evaluate the dimensionality and psychometric validity of the 11 DSM-5 criteria for 5 substance use disorders, with a focus on craving, and taking into account age, gender and psychiatric comorbidities in a French sample of subjects seeking addiction treatment. METHODS This cross-sectional study, included participants with DSM-5 substance use disorders that sought treatment for at least one addiction from outpatient clinics. Diagnostic criteria were evaluated with the Mini international Neuropsychiatric Interview. In Current regular user (2 times per week), factor and 2-parameter IRT analysis was used to investigate the dimensionality and psychometric properties of the 11 DSM-5 SUD criteria. Differential Item and Test functioning (DIF and DTF) analysis were performed across sociodemographic characteristics and psychiatric disorders. RESULTS 1359 participants (alcohol n = 787, opiates n = 131, cocaine n = 141, tobacco n = 1014, cannabis n = 504), were included (68% male; mean age 38.7). One-factor dimensionality was confirmed, except for tobacco. Craving criterion had the strongest factor loadings, lower difficulty (range, -1.29 to -0.67) and higher discrimination (range, 2.11-3.05), and no DIF compared to other criteria. The tobacco criteria set functioned differently by mood and anxiety disorders. CONCLUSIONS We confirmed the unidimensionality of the 11 SUD DSM-5 criteria and furthermore that craving was the most selective criterion because of its psychometric properties and no DIF compared to other criteria, regardless of the substance in this adult clinical sample. Unidimensionality of tobacco criteria was not confirmed, suggesting DSM-IV abuse criteria limitations as indicators of the construct.
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Affiliation(s)
- Charlotte Kervran
- University of Bordeaux, Phenomenology and Determinants of Appetitive Behaviors (Addiction Team), Sleep, Addiction and Neuropsychiatry Laboratory (SANPSY), USR CNRS 3413, 146 Bis Rue Léo Saignat, 33076, Bordeaux, France; Pôle Addictologie, CH Ch. Perrens and CHU de Bordeaux, 121 Rue De La Béchade, 33076, Bordeaux, France
| | - Dvora Shmulewitz
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA; Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA
| | - Fuschia Serre
- University of Bordeaux, Phenomenology and Determinants of Appetitive Behaviors (Addiction Team), Sleep, Addiction and Neuropsychiatry Laboratory (SANPSY), USR CNRS 3413, 146 Bis Rue Léo Saignat, 33076, Bordeaux, France; Pôle Addictologie, CH Ch. Perrens and CHU de Bordeaux, 121 Rue De La Béchade, 33076, Bordeaux, France
| | - Malki Stohl
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
| | - Cécile Denis
- Center for Studies of Addiction, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market St, Suite 4000, Philadelphia, PA 19104, USA; University of Bordeaux, Phenomenology and Determinants of Appetitive Behaviors (Addiction Team), Sleep, Addiction and Neuropsychiatry Laboratory (SANPSY), USR CNRS 3413, 146 Bis Rue Léo Saignat, 33076, Bordeaux, France
| | - Deborah Hasin
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA; Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA; Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, USA
| | - Marc Auriacombe
- University of Bordeaux, Phenomenology and Determinants of Appetitive Behaviors (Addiction Team), Sleep, Addiction and Neuropsychiatry Laboratory (SANPSY), USR CNRS 3413, 146 Bis Rue Léo Saignat, 33076, Bordeaux, France; Pôle Addictologie, CH Ch. Perrens and CHU de Bordeaux, 121 Rue De La Béchade, 33076, Bordeaux, France; Center for Studies of Addiction, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market St, Suite 4000, Philadelphia, PA 19104, USA.
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10
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Borges G, Orozco R, Benjet C, Martínez Martínez KI, Contreras EV, Jiménez Pérez AL, Peláez Cedrés AJ, Hernández Uribe PC, Díaz Couder MAC, Gutierrez-Garcia RA, Quevedo Chavez GE, Albor Y, Mendez E, Medina-Mora ME, Mortier P, Rumpf HJ. DSM-5 Internet gaming disorder among a sample of Mexican first-year college students. J Behav Addict 2019; 8:714-724. [PMID: 31830812 PMCID: PMC7044582 DOI: 10.1556/2006.8.2019.62] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND AIMS DSM-5 includes Internet gaming disorder (IGD) as a condition for further study. While online and offline gaming may produce undesired negative effects on players, we know little about the nosology of IGD and its prevalence, especially in countries with emerging economies. METHODS A self-administered survey has been employed to estimate prevalence of DSM-5 IGD and study the structure and performance of an instrument in Spanish to measure DSM-5 IGD among 7,022 first-year students in 5 Mexican universities that participated in the University Project for Healthy Students (PUERTAS), part of the World Health Organization's World Mental Health International College Student Initiative. RESULTS The scale for IGD showed unidimensionality with factor loadings between 0.694 and 0.838 and a Cronbach's α = .816. Items derived from gaming and from substance disorders symptoms mixed together. We found a 12-month prevalence of IGD of 5.2% in the total sample; prevalence was different for males (10.2%) and females (1.2%), but similar for ages 18-19 years (5.0%) and age 20+ (5.8%) years. Among gamers, the prevalence was 8.6%. Students with IGD were more likely to report lifetime psychological or medical treatment [OR = 1.8 (1.4-2.4)] and any severe role impairment [OR = 2.4 (1.7-3.3)]. Adding any severe role impairment to the diagnostic criteria decreased the 12-month prevalence of IGD to 0.7%. DISCUSSION AND CONCLUSIONS Prevalence of DSM-5 IGD and the performance of diagnostic criteria in this Mexican sample were within the bounds of what is reported elsewhere. Importantly, about one in every seven students with IGD showed levels of impairment that would qualify them for treatment under DSM-5.
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Affiliation(s)
- Guilherme Borges
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico,Corresponding author: Guilherme Borges; Instituto Nacional de Psiquiatría Ramon de la Fuente Muñiz, Calzada México Xochimilco No. 101, Col. San Lorenzo Huipulco, CP: 14370, CDMX, México; E-mail: ;
| | - Ricardo Orozco
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Corina Benjet
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | | | | | | | | | | | | | | | | | - Yesica Albor
- Universidad Cuauhtémoc Plantel Aguascalientes, Aguascalientes, Mexico
| | - Enrique Mendez
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Maria Elena Medina-Mora
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico,Center of Global Mental Health Research, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Philippe Mortier
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Hans-Juergen Rumpf
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lubeck, Germany
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11
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The latent trait of ICD-11 nicotine dependence criteria: Dimensional and categorical phenotypes. Psychiatry Res 2018; 266:275-283. [PMID: 29605101 DOI: 10.1016/j.psychres.2018.03.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 12/22/2017] [Accepted: 03/05/2018] [Indexed: 12/11/2022]
Abstract
We aimed to identify phenotypes of DSM-ICD nicotine dependence among a representative sample of lifetime weekly smokers in the largest metropolitan area in South America. Data came from 1,387 lifetime weekly smokers in the São Paulo Megacity Mental Health Survey. We used exploratory factor analysis (EFA) and latent class analysis (LCA) on ICD-11 nicotine dependence proposed criteria to explore dimensionality and phenotypes profiles, followed by logistic regression models to examine the association between latent classes and socio-demographic, psychiatric and chronic medical conditions. Analyses were performed using Mplus taking into account the complex survey design features. An unidimensional model had the best EFA fit with high loadings on all criteria. Response patterns detected by LCA indicated class differences based on severity continuum: a "non-symptomatic class" (32.0%), a "low-moderate symptomatic class" (34.9%)-with high probability of the criterion "use in larger amounts", and a "high-moderate symptomatic class" (33.1%). We found an association between high-income and the intermediate class that differs from findings in high-income countries, and high likelihood of psychiatric comorbidity among the most symptomatic smokers. The best dimensional model that pulled together nicotine dependence criteria supported a single factor, in concordance with the changes proposed for ICD-11.
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12
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Hoertel N, Peyre H, Lavaud P, Blanco C, Guerin-Langlois C, René M, Schuster JP, Lemogne C, Delorme R, Limosin F. Examining sex differences in DSM-IV-TR narcissistic personality disorder symptom expression using Item Response Theory (IRT). Psychiatry Res 2018; 260:500-507. [PMID: 29291575 PMCID: PMC6002876 DOI: 10.1016/j.psychres.2017.12.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 10/25/2017] [Accepted: 12/12/2017] [Indexed: 12/30/2022]
Abstract
The limited published literature on the subject suggests that there may be differences in how females and males experience narcissistic personality disorder (NPD) symptoms. The aim of this study was to use methods based on item response theory to examine whether, when equating for levels of NPD symptom severity, there are sex differences in the likelihood of reporting DSM-IV-TR NPD symptoms. We conducted these analyses using a large, nationally representative sample from the USA (n=34,653), the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). There were statistically and clinically significant sex differences for 2 out of the 9 DSM-IV-TR NPD symptoms. We found that males were more likely to endorse the item 'lack of empathy' at lower levels of narcissistic personality disorder severity than females. The item 'being envious' was a better indicator of NPD severity in males than in females. There were no clinically significant sex differences on the remaining NPD symptoms. Overall, our findings indicate substantial sex differences in narcissistic personality disorder symptom expression. Although our results may reflect sex-bias in diagnostic criteria, they are consistent with recent views suggesting that narcissistic personality disorder may be underpinned by shared and sex-specific mechanisms.
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Affiliation(s)
- Nicolas Hoertel
- Assistance Publique Hôpitaux de Paris (APHP), Western Paris University Hospitals, Department of Psychiatry, 92130 Issy-les-Moulineaux, France; INSERM UMR 894, Psychiatry and Neurosciences Center, Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France.
| | - Hugo Peyre
- Assistance Publique Hôpitaux de Paris (APHP), Robert Debré Hospital, Child and Adolescent Psychiatry Department, Paris, France; Cognitive Sciences and Psycholinguistic Laboratory, Ecole Normale Supérieure, Paris, France
| | - Pierre Lavaud
- Assistance Publique Hôpitaux de Paris (APHP), Western Paris University Hospitals, Department of Psychiatry, 92130 Issy-les-Moulineaux, France
| | - Carlos Blanco
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, ML, USA
| | - Christophe Guerin-Langlois
- Assistance Publique Hôpitaux de Paris (APHP), Western Paris University Hospitals, Department of Psychiatry, 92130 Issy-les-Moulineaux, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Margaux René
- Assistance Publique Hôpitaux de Paris (APHP), Western Paris University Hospitals, Department of Psychiatry, 92130 Issy-les-Moulineaux, France
| | - Jean-Pierre Schuster
- Assistance Publique Hôpitaux de Paris (APHP), Western Paris University Hospitals, Department of Psychiatry, 92130 Issy-les-Moulineaux, France; Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | - Cédric Lemogne
- Assistance Publique Hôpitaux de Paris (APHP), Western Paris University Hospitals, Department of Psychiatry, 92130 Issy-les-Moulineaux, France; INSERM UMR 894, Psychiatry and Neurosciences Center, Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Richard Delorme
- Assistance Publique Hôpitaux de Paris (APHP), Robert Debré Hospital, Child and Adolescent Psychiatry Department, Paris, France
| | - Frédéric Limosin
- Assistance Publique Hôpitaux de Paris (APHP), Western Paris University Hospitals, Department of Psychiatry, 92130 Issy-les-Moulineaux, France; INSERM UMR 894, Psychiatry and Neurosciences Center, Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France
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13
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Shmulewitz D, Meyers JL, Wall MM, Aharonovich E, Frisch A, Spivak B, Weizman A, Edenberg HJ, Gelernter J, Hasin DS. CHRNA5/A3/B4 Variant rs3743078 and Nicotine-Related Phenotypes: Indirect Effects Through Nicotine Craving. J Stud Alcohol Drugs 2016; 77:227-37. [PMID: 26997181 DOI: 10.15288/jsad.2016.77.227] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Nicotine craving is considered an important element in the persistence of cigarette smoking, but little is known about the role of craving in the widely recognized association between variants mapped to the neuronal nicotinic acetylcholine receptor (CHRN) genes on chromosome 15 and nicotine phenotypes. METHOD The associations between CHRNA5-CHRNA3-CHRNB4 variants and cigarettes per day (CPD), the Fagerström Test for Nicotine Dependence (FTND), and craving were analyzed in data from 662 lifetime smokers from an Israeli adult Jewish household sample. Indirect effects of genotype on nicotine phenotypes through craving were formally tested using regression and bootstrapping procedures. RESULTS At CHRNA3, allele G of rs3743078 was associated with increased craving, CPD, and FTND scores: Participants with one or two copies of the G allele had, on average, higher scores on the craving scale (p = .0025), more cigarettes smoked (p = .0057), and higher scores on the FTND (p =.0024). With craving in the model, variant rs3743078 showed a significant indirect effect through craving on CPD (p = .0026) and on FTND score (p = .0024). A sizeable proportion of the total rs3743078 effect on CPD (56.4%) and FTND (65.2%) was indirect through craving. CONCLUSIONS These results suggest that nicotine craving may play a central role in nicotine use disorders and may have utility as a therapeutic target.
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Affiliation(s)
- Dvora Shmulewitz
- Department of Psychiatry, Columbia University, NewYork, NewYork.,NewYork State Psychiatric Institute, NewYork, NewYork
| | - Jacquelyn L Meyers
- Department of Epidemiology, Mailman School of Public Health, Columbia University, NewYork, NewYork
| | - Melanie M Wall
- Department of Psychiatry, Columbia University, NewYork, NewYork.,NewYork State Psychiatric Institute, NewYork, NewYork.,Department of Biostatistics, Mailman School of Public Health, Columbia University, NewYork, NewYork
| | - Efrat Aharonovich
- Department of Psychiatry, Columbia University, NewYork, NewYork.,NewYork State Psychiatric Institute, NewYork, NewYork
| | - Amos Frisch
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Felsenstein Medical Research Center, Petach Tikva, Israel
| | - Baruch Spivak
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Abraham Weizman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Felsenstein Medical Research Center, Petach Tikva, Israel.,Research Unit, Geha Mental Health Center, Petach Tikva, Israel
| | - Howard J Edenberg
- Departments of Biochemistry and Molecular Biology and Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Joel Gelernter
- Departments of Psychiatry and Genetics and Neurobiology, Yale University School of Medicine, New Haven, Connecticut
| | - Deborah S Hasin
- Department of Psychiatry, Columbia University, NewYork, NewYork.,NewYork State Psychiatric Institute, NewYork, NewYork.,Department of Epidemiology, Mailman School of Public Health, Columbia University, NewYork, NewYork
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14
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Shmulewitz D, Greene ER, Hasin D. Commonalities and Differences Across Substance Use Disorders: Phenomenological and Epidemiological Aspects. Alcohol Clin Exp Res 2015; 39:1878-900. [PMID: 26332166 DOI: 10.1111/acer.12838] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 07/07/2015] [Indexed: 01/18/2023]
Abstract
BACKGROUND Although psychoactive substances vary in many ways, they have important commonalties, particularly in their ability to lead to an addiction syndrome. The field lacks an updated review of the commonalities and differences in the phenomenology of alcohol, cannabis, tobacco, stimulants, opioids, hallucinogens, sedatives/tranquilizers, and inhalants and their related substance use disorders (SUDs). METHODS DSM-IV and DSM-5 SUD diagnostic criteria were reviewed, as was evidence from recent epidemiological and clinical research: psychometric studies (test-retest reliability, latent trait analysis); physiological indicators (tolerance, withdrawal); prevalence and age of onset. Information was incorporated from previous reviews, PubMed and Scopus literature searches, and data from large U.S. national surveys. RESULTS Empirical evidence in the form of test-retest reliability and unidimensionality supports use of the same DSM-IV dependence or DSM-5 SUD diagnostic criteria across substances. For most substances, the criteria sets were generally most informative in general population samples at moderate-to-severe levels of SUD. Across substances, 2 criteria (tolerance and use in hazardous situations) were identified as functioning differently in population subgroups. Since substances have different pharmacological effects, withdrawal is assessed using substance-specific symptoms, while tolerance is not; issues remain with the assessment of tolerance. Alcohol, tobacco, and cannabis were consistently identified as the substances with earliest onset of use, highest prevalence of lifetime use, and highest prevalence of lifetime disorder. CONCLUSIONS Despite differences between psychoactive substances, the generic DSM criteria set appears equally applicable across substances. Additional studies of tolerance and hazardous use will be useful for future nosologies. Alcohol, cannabis, and tobacco are the substances with the greatest public health impact due to the high prevalence and early onset of their use, and the potential all 3 substances have to lead to addiction.
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Affiliation(s)
- Dvora Shmulewitz
- Department of Psychiatry, Columbia University, New York City, New York.,New York State Psychiatric Institute, New York City, New York
| | - Emily R Greene
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York
| | - Deborah Hasin
- Department of Psychiatry, Columbia University, New York City, New York.,New York State Psychiatric Institute, New York City, New York.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York
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15
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Meyers JL, Shmulewitz D, Elliott JC, Thompson RG, Aharonovich E, Spivak B, Weizman A, Frisch A, Grant BF, Hasin DS. Parental alcohol history differentially predicts offspring disorders in distinct subgroups in Israel. J Stud Alcohol Drugs 2015; 75:859-69. [PMID: 25208204 DOI: 10.15288/jsad.2014.75.859] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The association between alcoholism in parents and related disorders in their offspring is well established in cultures with intermediate/high alcohol consumption, but not in those with low consumption, such as Israel. This study investigated differences in parental transmission of alcohol problems and related psychopathology between immigrants from the former Soviet Union (FSU) to Israel and other Israelis-two Israeli subgroups with differing alcohol consumption behaviors and social norms. METHOD A total of 1,347 adults from a household sample were interviewed. Regression analyses were used to examine associations between parental alcohol problems and participant disorders: alcohol, nicotine, and cannabis use disorders (AUD, NUD, CUD); antisocial personality disorder (ASPD); major depressive disorder (MDD); and posttraumatic stress disorder (PTSD). We also examined the associations of parental alcohol problems with participant disorders characterized with two latent factors: externalizing (EXT: AUD, NUD, CUD, ASPD) and internalizing (INT: MDD, PTSD). Differential parental transmission of alcohol problems in FSU (n = 315) and non-FSU (n = 1,032) Israelis was examined with statistical interaction. RESULTS Among emigrants from the FSU, parental alcohol problems predicted AUD, NUD, CUD, ASPD, PTSD, EXT, and INT (mean ratios = 1.38-4.83). In non-FSU Israelis, parental alcohol problems predicted only ASPD and PTSD (mean ratios = 1.08-4.09). Significant interactions were observed for AUD, CUD, PTSD, and EXT; each relationship was stronger in FSU Israelis and null (AUD, CUD, EXT) or less robust (PTSD) in other Israelis. CONCLUSIONS Parental alcohol problems were related to substance use and psychiatric disorders differently in FSU and other Israelis, two groups with different alcohol consumption levels and drinking norms. We propose that, in social contexts that vary in the degree to which they constrain alcohol behavior, underlying genetic predispositions may manifest as different disorders.
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Affiliation(s)
- Jacquelyn L Meyers
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Dvora Shmulewitz
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, New York State Psychiatric Institute, New York, New York
| | - Jennifer C Elliott
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Ronald G Thompson
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, New York State Psychiatric Institute, New York, New York
| | - Efrat Aharonovich
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, New York State Psychiatric Institute, New York, New York
| | - Baruch Spivak
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Abraham Weizman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, Felsenstein Medical Research Center, Petah Tikva, Israel, Research Unit, Geha Mental Health Center, Petah Tikva, Israel
| | - Amos Frisch
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, Felsenstein Medical Research Center, Petah Tikva, Israel
| | - Bridget F Grant
- Laboratory of Epidemiology and Biometry, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland
| | - Deborah S Hasin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, New York State Psychiatric Institute, New York, New York
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Hoertel N, Peyre H, Wall MM, Limosin F, Blanco C. Examining sex differences in DSM-IV borderline personality disorder symptom expression using Item Response Theory (IRT). J Psychiatr Res 2014; 59:213-9. [PMID: 25258339 DOI: 10.1016/j.jpsychires.2014.08.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 08/20/2014] [Accepted: 08/28/2014] [Indexed: 10/24/2022]
Abstract
Limited literature suggests that there may be differences in how women and men experience borderline personality disorder (BPD) symptoms. The aim of the current study was to use methods based on item response theory (IRT) to examine whether, when equating for levels of BPD symptom severity, there are sex differences in the likelihood of reporting DSM-IV BPD symptoms. We conducted these analyses using a large, nationally representative sample from the USA (n = 34,653), the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Data from women and men were compared. There were statistically and clinically significant sex differences for 3 out of the 9 DSM-IV BPD symptoms. We found that women were more likely to experience suicidal/self-mutilation behavior, affective instability and chronic feelings of emptiness and tended to be less likely to endorse impulsivity at lower levels of borderline personality disorder severity than men, while affective instability and chronic feelings of emptiness appeared to be significantly less discriminant in terms of severity in men than in women. There were no significant differences between women and men on the remaining DSM-IV symptoms. Overall, our findings indicate substantial sex differences in borderline personality disorder symptom expression. Although our results may reflect sex-bias in diagnostic criteria, they are in keeping with recent arguments suggesting that BPD could be understood as a clinical phenomenon that may partially differ in men and women.
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Affiliation(s)
- Nicolas Hoertel
- Department of Psychiatry, New York State Psychiatric Institute/ Columbia University, New York, USA; Assistance Publique-Hôpitaux de Paris (APHP), Corentin Celton Hospital, Department of Psychiatry, 92130 Issy-les-Moulineaux, France; Paris Descartes University, PRES Sorbonne Paris Cité, Paris, France; INSERM UMR 894, Psychiatry and Neurosciences Center, Paris Descartes University, PRES Sorbonne Paris Cité, Paris, France.
| | - Hugo Peyre
- Assistance Publique Hôpitaux de Paris (APHP), Robert Debré Hospital, Child and Adolescent Psychiatry Department, Paris, France; Cognitive Sciences and Psycholinguistic Laboratory, Ecole Normale Supérieure, CNRS, EHESS, Paris, France
| | - Melanie M Wall
- Department of Psychiatry, New York State Psychiatric Institute/ Columbia University, New York, USA; Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, USA
| | - Frédéric Limosin
- Assistance Publique-Hôpitaux de Paris (APHP), Corentin Celton Hospital, Department of Psychiatry, 92130 Issy-les-Moulineaux, France; Paris Descartes University, PRES Sorbonne Paris Cité, Paris, France; INSERM UMR 894, Psychiatry and Neurosciences Center, Paris Descartes University, PRES Sorbonne Paris Cité, Paris, France
| | - Carlos Blanco
- Department of Psychiatry, New York State Psychiatric Institute/ Columbia University, New York, USA
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Walsh K, Elliott JC, Shmulewitz D, Aharonovich E, Strous R, Frisch A, Weizman A, Spivak B, Grant BF, Hasin D. Trauma exposure, posttraumatic stress disorder and risk for alcohol, nicotine, and marijuana dependence in Israel. Compr Psychiatry 2014; 55:621-30. [PMID: 24387979 PMCID: PMC3965593 DOI: 10.1016/j.comppsych.2013.11.016] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 11/18/2013] [Accepted: 11/20/2013] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Substance dependence is more common among trauma-exposed individuals; however, most studies suggest that Posttraumatic Stress Disorder (PTSD) accounts for the link between trauma exposure (TE) and substance dependence. OBJECTIVES This study examined associations between TE and substance dependence (alcohol, nicotine, and marijuana), and whether PTSD accounted for this association. METHOD 1317 Jewish Israeli household residents completed in-person structured interviews assessing TE, PTSD, and substance (alcohol, nicotine, marijuana) dependence between 2007 and 2009. Regression analyses examined associations among TE, PTSD, and substance dependence. RESULTS In the full sample, mean number of traumatic events was 2.7 (sd=2.2), with 83.7% experiencing at least one event. In the full sample, mean number of PTSD symptoms was 2.5 (sd=3.4), with 13.5% meeting PTSD diagnostic criteria. Prevalence of alcohol dependence was 13.4%; nicotine dependence 52.8%; and marijuana dependence 12.1%. Number of traumatic events was associated with increased odds of alcohol (OR=1.3; 95% CI=1.2-1.4) and nicotine (OR=1.2; 95% CI=1.1-1.3) dependence. Similarly, any traumatic event exposure was associated with increased odds of alcohol (OR=3.1; 95% CI=1.6-6.0) and nicotine (OR=1.9; 95% CI=1.2-2.9) dependence. PTSD symptoms were associated with increased odds of alcohol (OR=1.2; 95% CI=1.1-1.3), nicotine (OR=1.1; 95% CI=1.1-1.2), and marijuana (OR=1.1; 95% CI=1.04-1.2) dependence; similarly, a PTSD diagnosis was associated with increased odds of alcohol (OR=3.4; 95% CI=2.1-5.5), nicotine (OR=2.2; 95% CI=1.4-3.4), and marijuana (OR=2.6; 95% CI=1.2-5.9) dependence. PTSD symptoms accounted for a sizeable proportion of the TE effect on alcohol (46%) and nicotine dependence (31%). CONCLUSION Individuals with more traumatic events had heightened risk for alcohol and nicotine dependence, and PTSD symptoms partially accounted for this risk. However, marijuana dependence was only significantly related to PTSD symptoms. Clinicians and researchers should separately assess different types of dependence among trauma-exposed individuals both with and without PTSD symptoms.
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Affiliation(s)
- Kate Walsh
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York 10032, USA
| | - Jennifer C. Elliott
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York 10032, USA
| | - Dvora Shmulewitz
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA,New York State Psychiatric Institute, New York, New York 10032, USA
| | - Efrat Aharonovich
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA,New York State Psychiatric Institute, New York, New York 10032, USA
| | - Rael Strous
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, 69978
| | - Amos Frisch
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, 69978,Felsenstein Medical Research Center, Petach Tikva, Israel, 49100
| | - Abraham Weizman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, 69978,Felsenstein Medical Research Center, Petach Tikva, Israel, 49100,Research Unit, Geha Mental Health Center, Petach Tikva, Israel, 49100
| | - Baruch Spivak
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, 69978
| | - Bridget F. Grant
- Laboratory of Epidemiology and Biometry, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland, USA
| | - Deborah Hasin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York 10032, USA; Department of Psychiatry, Columbia University Medical Center, New York, New York 10032, USA; New York State Psychiatric Institute, New York, New York 10032, USA.
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18
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Murphy CM, Stojek MK, Few LR, Rothbaum AO, Mackillop J. Craving as an alcohol use disorder symptom in DSM-5: an empirical examination in a treatment-seeking sample. Exp Clin Psychopharmacol 2014; 22:43-9. [PMID: 24490710 PMCID: PMC4105007 DOI: 10.1037/a0034535] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Craving has been added as an alcohol use disorder (AUD) symptom in DSM-5 but relatively few nosological studies have directly examined the empirical basis for doing so. The current study investigated the validity of craving as an AUD symptom in a sample of heavy drinking treatment-seeking individuals. Using a semistructured clinical interview, individuals (N = 104; 62% male) were assessed for symptoms of DSM-IV AUD. The extent to which individuals endorsed pathological levels of craving in comparison with other AUD symptoms was investigated as was the association between craving and several aspects of problematic alcohol involvement. Factor analysis was utilized to examine whether craving and other AUD symptoms comprised a unidimensional syndrome. Results indicated that craving was significantly positively correlated with AUD severity, quantitative indices of drinking, and adverse consequences of alcohol abuse. In terms of frequency of endorsement, craving was present in 47% of the sample and was the 8th most frequent of the 12 symptoms evaluated. When considered with the DSM-IV AUD criteria, craving aggregated with other symptoms to form a unidimensional syndrome. Extending previous findings from epidemiological samples, these data suggest that, in a clinical sample, many relevant aspects of craving aggregate to form a diagnostic criterion that functions similarly to other AUD symptoms and is related to diverse aspects of alcohol-related impairment.
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Keyes KM, Shmulewitz D, Greenstein E, McLaughlin K, Wall M, Aharonovich E, Weizman A, Frisch A, Spivak B, Grant BF, Hasin D. Exposure to the Lebanon War of 2006 and effects on alcohol use disorders: the moderating role of childhood maltreatment. Drug Alcohol Depend 2014; 134:296-303. [PMID: 24262650 PMCID: PMC3884580 DOI: 10.1016/j.drugalcdep.2013.10.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 10/21/2013] [Accepted: 10/22/2013] [Indexed: 12/20/2022]
Abstract
BACKGROUND Civilian populations now comprise the majority of casualties in modern warfare, but effects of war exposure on alcohol disorders in the general population are largely unexplored. Accumulating literature indicates that adverse experiences early in life sensitize individuals to increased alcohol problems after adult stressful experiences. However, child and adult stressful experiences can be correlated, limiting interpretation. We examine risk for alcohol disorders among Israelis after the 2006 Lebanon War, a fateful event outside the control of civilian individuals and uncorrelated with childhood experiences. Further, we test whether those with a history of maltreatment are at greater risk for an alcohol use disorder after war exposure compared to those without such a history. METHODS Adult household residents selected from the Israeli population register were assessed with a psychiatric structured interview; the analyzed sample included 1306 respondents. War measures included self-reported days in an exposed region. RESULTS Among those with a history of maltreatment, those in a war-exposed region for 30+ days had 5.3 times the odds of subsequent alcohol disorders compared to those exposed 0 days (95%C.I. 1.01-27.76), controlled for relevant confounders; the odds ratio for those without this history was 0.5 (95%C.I. 0.25-1.01); test for interaction: X(2)=5.28, df=1, P=0.02. CONCLUSIONS Experiencing a fateful stressor outside the control of study participants, civilian exposure to the 2006 Lebanon War, is associated with a heightened the risk of alcohol disorders among those with early adverse childhood experiences. Results suggest that early life experiences may sensitize individuals to adverse health responses later in life.
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Affiliation(s)
- Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA,Corresponding author at: Department of Epidemiology, Columbia University Department of Epidemiology, 722 West 168th Street, Suite 503, New York, NY 10032, USA. Tel.: +1 212 304 5652; fax: +1 212 543 5913. (K.M. Keyes)
| | - Dvora Shmulewitz
- New York State Psychiatric Institute, New York, NY 10032, USA,Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Eliana Greenstein
- New York State Psychiatric Institute, New York, NY 10032, USA,Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Kate McLaughlin
- Division of General Pediatrics, Children’s Hospital Boston, Harvard Medical School, Boston, MA 02115-6092, USA
| | - Melanie Wall
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Efrat Aharonovich
- New York State Psychiatric Institute, New York, NY 10032, USA,Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Abraham Weizman
- Felsenstein Medical Research Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Amos Frisch
- Felsenstein Medical Research Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Baruch Spivak
- Felsenstein Medical Research Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Bridget F. Grant
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Deborah Hasin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA,New York State Psychiatric Institute, New York, NY 10032, USA,Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
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Shoval G, Shmulewitz D, Wall MM, Aharonovich E, Spivak B, Weizman A, Hasin D. Alcohol dependence and suicide-related ideation/behaviors in an Israeli household sample, with and without major depression. Alcohol Clin Exp Res 2013; 38:820-5. [PMID: 24117756 DOI: 10.1111/acer.12290] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 08/29/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Suicide-related ideation and behaviors (SRIB) are associated with both alcohol disorders and major depressive disorder (MDD). The objective of this study was to evaluate the relationship of alcohol dependence (AD) and major depression to the risk for lifetime SRIB. METHODS Data from a community-based sample of 1,237 adult Israeli lifetime drinkers assessed with reliable diagnostic measures were analyzed using logistic regression. RESULTS Lifetime SRIB was reported in 4.7% and was more prevalent among participants with AD (9.0%) than among those without AD (4.1%); p-value = 0.01. Although both AD and major depression were associated with SRIB (AD: OR 2.2, 95% CI 1.1 to 4.4; MDD: OR 11.4, 95% CI = 6.4 to 20.4), joint analysis showed that AD without MDD increased risk for SRIB as compared to those without AD or MDD (OR 3.1, 95% CI 1.1 to 9.1), but AD did not increase risk among those with MDD (OR 1.1, 95% CI 0.4 to 2.7). Among those with AD, the severity of subclinical depressive symptoms was associated with increased SRIB. CONCLUSIONS These findings show that AD increases risk for SRIB among individuals without a history of major depression. Suicidal tendencies may be undetected and underdiagnosed in this group because of the absence of major depression and therefore left untreated. These findings should be considered when adopting suicide prevention or treatment strategies for this high-risk subpopulation.
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Affiliation(s)
- Gal Shoval
- Geha Mental Health Center, Petah Tiqva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Shmulewitz D, Wall M, Aharonovich E, Spivak B, Weizman A, Frisch A, Grant BF, Hasin D. Validity of proposed DSM-5 diagnostic criteria for nicotine use disorder: results from 734 Israeli lifetime smokers. Psychol Med 2013; 43:2179-2190. [PMID: 23312475 PMCID: PMC3767302 DOI: 10.1017/s0033291712002954] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The fifth edition of the diagnostic and statistical manual of mental disorders (DSM-5) proposes aligning nicotine use disorder (NUD) criteria with those for other substances, by including the current DSM fourth edition (DSM-IV) nicotine dependence (ND) criteria, three abuse criteria (neglect roles, hazardous use, interpersonal problems) and craving. Although NUD criteria indicate one latent trait, evidence is lacking on: (1) validity of each criterion ; (2) validity of the criteria as a set ; (3) comparative validity between DSM-5 NUD and DSM-IV ND criterion sets ; and (4) NUD prevalence. METHOD Nicotine criteria (DSM-IV ND, abuse and craving) and external validators (e.g., smoking soon after awakening, number of cigarettes per day) were assessed with a structured interview in 734 lifetime smokers from an Israeli household sample. Regression analysis evaluated the association between validators and each criterion. Receiver operating characteristic analysis assessed the association of the validators with the DSM-5 NUD set (number of criteria endorsed) and tested whether DSM-5 or DSM-IV provided the most discriminating criterion set. Changes in prevalence were examined. RESULTS Each DSM-5 NUD criterion was significantly associated with the validators, with strength of associations similar across the criteria. As a set, DSM-5 criteria were significantly associated with the validators, were significantly more discriminating than DSM-IV ND criteria, and led to increased prevalence of binary NUD (two or more criteria) over ND. CONCLUSIONS All findings address previous concerns about the DSM-IV nicotine diagnosis and its criteria and support the proposed changes for DSM-5 NUD, which should result in improved diagnosis of nicotine disorders.
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Affiliation(s)
- D. Shmulewitz
- New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - M.M. Wall
- New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - E. Aharonovich
- New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - B. Spivak
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A. Weizman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Felsenstein Medical Research Center, Petach Tikva, Israel
- Research Unit, Geha Mental Health Center, Petach Tikva, Israel
| | - A. Frisch
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Felsenstein Medical Research Center, Petach Tikva, Israel
| | - B. F. Grant
- Laboratory of Epidemiology and Biometry, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - D. Hasin
- New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Hasin DS, O’Brien CP, Auriacombe M, Borges G, Bucholz K, Budney A, Compton WM, Crowley T, Ling W, Petry NM, Schuckit M, Grant BF. DSM-5 criteria for substance use disorders: recommendations and rationale. Am J Psychiatry 2013; 170:834-51. [PMID: 23903334 PMCID: PMC3767415 DOI: 10.1176/appi.ajp.2013.12060782] [Citation(s) in RCA: 806] [Impact Index Per Article: 73.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Since DSM-IV was published in 1994, its approach to substance use disorders has come under scrutiny. Strengths were identified (notably, reliability and validity of dependence), but concerns have also arisen. The DSM-5 Substance-Related Disorders Work Group considered these issues and recommended revisions for DSM-5. General concerns included whether to retain the division into two main disorders (dependence and abuse), whether substance use disorder criteria should be added or removed, and whether an appropriate substance use disorder severity indicator could be identified. Specific issues included possible addition of withdrawal syndromes for several substances, alignment of nicotine criteria with those for other substances, addition of biomarkers, and inclusion of nonsubstance, behavioral addictions.This article presents the major issues and evidence considered by the work group, which included literature reviews and extensive new data analyses. The work group recommendations for DSM-5 revisions included combining abuse and dependence criteria into a single substance use disorder based on consistent findings from over 200,000 study participants, dropping legal problems and adding craving as criteria, adding cannabis and caffeine withdrawal syndromes, aligning tobacco use disorder criteria with other substance use disorders, and moving gambling disorders to the chapter formerly reserved for substance-related disorders. The proposed changes overcome many problems, while further studies will be needed to address issues for which less data were available.
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Chung T, Martin CS, Maisto SA, Cornelius JR, Clark DB. Greater prevalence of proposed DSM-5 nicotine use disorder compared to DSM-IV nicotine dependence in treated adolescents and young adults. Addiction 2012; 107:810-8. [PMID: 22092543 PMCID: PMC3290741 DOI: 10.1111/j.1360-0443.2011.03722.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS Compared to DSM-IV nicotine dependence, proposed DSM-5 nicotine use disorder (NUD) would lower the threshold from three to two symptoms, and increase the number of criteria used for diagnosis from seven to 11. The impact of the proposed changes on nicotine disorder prevalence and the concurrent validity of diagnostic criteria were examined. DESIGN Cross-sectional survey to compare DSM-IV and proposed DSM-5 algorithms. SETTING AND PARTICIPANTS Adolescent (n = 179) and young adult (n = 292) past-year cigarette users recruited from addictions treatment. MEASUREMENTS Semi-structured clinical interview to evaluate DSM-IV nicotine dependence, and 10 of the 11 proposed DSM-5 NUD criteria; 30-day time-line follow-back; and the Fagerström Test for Nicotine Dependence (FTND). FINDINGS Prevalence of proposed DSM-5 NUD (two-symptom threshold) was much higher (adolescents: 68.7%, young adults: 86.0%) than DSM-IV nicotine dependence (33.0% and 59.6%, respectively), although prevalence of DSM-5 severe NUD (four-symptom threshold) was similar to DSM-IV nicotine dependence. Concurrent validity analyses in both samples indicated consistent support for DSM-5 severe NUD diagnosis (four symptoms) but not for the moderate NUD (two symptoms) diagnosis, which had modest relations with only FTND score. IRT analyses indicated strong support for the new craving item, but not for the proposed interpersonal problems and hazardous use items. CONCLUSIONS The proposed DSM-5 nicotine use disorder criteria have substantial limitations when applied to adolescents and young adults, and appear to have low concurrent validity.
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Affiliation(s)
- Tammy Chung
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, PA, USA.
| | - Christopher S. Martin
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, 3811 O’Hara Street, Pittsburgh, Pennsylvania 15213
| | | | - Jack R. Cornelius
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, 3811 O’Hara Street, Pittsburgh, Pennsylvania 15213
| | - Duncan B. Clark
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, 3811 O’Hara Street, Pittsburgh, Pennsylvania 15213
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Hasin DS, Fenton MC, Beseler C, Park JY, Wall MM. Analyses related to the development of DSM-5 criteria for substance use related disorders: 2. Proposed DSM-5 criteria for alcohol, cannabis, cocaine and heroin disorders in 663 substance abuse patients. Drug Alcohol Depend 2012; 122:28-37. [PMID: 21963333 PMCID: PMC3755770 DOI: 10.1016/j.drugalcdep.2011.09.005] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Revised: 08/31/2011] [Accepted: 09/02/2011] [Indexed: 11/15/2022]
Abstract
BACKGROUND A number of changes have been proposed and investigated in the criteria for substance use disorders in DSM-5. However, although clinical utility of DSM-5 is a high priority, relatively little of the empirical evidence supporting the changes was obtained from samples of substance abuse patients. METHODS Proposed changes were examined in 663 patients in treatment for substance use disorders, evaluated by experienced clinicians using the Psychiatric Research Interview for Substance and Mental Disorders (PRISM). Factor and item response theory analysis was used to investigate the dimensionality and psychometric properties of alcohol, cannabis, cocaine and heroin abuse and dependence criteria, and craving. RESULTS The seven dependence criteria, three of the abuse criteria (hazardous use; social/interpersonal problems related to use; neglect of roles to use), and craving form a unidimensional latent trait for alcohol, cannabis, cocaine and heroin. Craving did not add significantly to the total information offered by the dependence criteria, but adding the three abuse criteria and craving together did significantly increase total information for the criteria sets associated with alcohol, cannabis and heroin. CONCLUSION Among adult patients in treatment for substance disorders, the alcohol, cannabis, cocaine and heroin criteria for dependence, abuse (with the exception of legal problems), and craving measure a single underlying dimension. Results support the proposal to combine abuse and dependence into a single diagnosis in the DSM-5, omitting legal problems. Mixed support was provided for the addition of craving as a new criterion, warranting future studies of this important construct in substance use disorders.
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Affiliation(s)
- Deborah S. Hasin
- College of Physicians and Surgeons, Department of Psychiatry, Columbia University, New York, NY 10032, United States
,Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, NY 10032, United States
,New York State Psychiatric Institute, New York, NY 10032, United States
,Corresponding author at: College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive #123, New York, NY 10032, United States. Tel.: +1 212 543 5035; fax: +1 212 543 5913. (D.S. Hasin)
| | - Miriam C. Fenton
- Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, NY 10032, United States
| | - Cheryl Beseler
- College of Physicians and Surgeons, Department of Psychiatry, Columbia University, New York, NY 10032, United States
,Department of Psychology, Colorado State University, Fort Collins, CO 80523-1879, United States
| | - Jung Yeon Park
- New York State Psychiatric Institute, New York, NY 10032, United States
| | - Melanie M. Wall
- College of Physicians and Surgeons, Department of Psychiatry, Columbia University, New York, NY 10032, United States
,Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, NY 10032, United States
,New York State Psychiatric Institute, New York, NY 10032, United States
,Mailman School of Public Health, Department of Biostatistics, Columbia University, New York, NY 10032, United States
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Baker TB, Breslau N, Covey L, Shiffman S. DSM criteria for tobacco use disorder and tobacco withdrawal: a critique and proposed revisions for DSM-5. Addiction 2012; 107:263-75. [PMID: 21919989 PMCID: PMC3246568 DOI: 10.1111/j.1360-0443.2011.03657.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS This paper aims to identify appropriate criteria for tobacco dependence assessment, evaluate relevant research and suggest revisions that may be incorporated into DSM-5. METHODS Desirable conceptual and psychometric features of tobacco dependence assessments were identified, including the types of outcomes against which such assessment should be validated. DSM-IV criteria were matched against these criteria and compared with other dependence measures. RESULTS DSM-IV criteria were found to be ambiguous, little used in tobacco research, and have relatively low predictive validity. Other dependence measures were found to have greater validity in the prediction of important dependence features such as relapse likelihood. Strength of urges to smoke on typical smoking days and during abstinence, markers of nicotine intake or frequency of smoking and latency to smoke soon after waking were found to be useful dependence measures. CONCLUSION The use and utility of DSM-5 will be enhanced by eliminating most DSM-IV criteria and adding new ones based on smoking pattern, smoking heaviness, and the severity of craving during periods of smoking and withdrawal.
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Affiliation(s)
- Timothy B. Baker
- Department of Medicine, Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health
| | - Naomi Breslau
- Department of Epidemiology, Michigan State University
| | - Lirio Covey
- Professor of Clinical Psychology in Psychiatry, Columbia University Medical Center, Research Scientist, New York State Psychiatric Institute
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Kerridge BT, Saha TD, Smith S, Chou PS, Pickering RP, Huang B, Ruan JW, Pulay AJ. Dimensionality of hallucinogen and inhalant/solvent abuse and dependence criteria: implications for the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition. Addict Behav 2011; 36:912-8. [PMID: 21621334 DOI: 10.1016/j.addbeh.2011.04.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Revised: 03/31/2011] [Accepted: 04/28/2011] [Indexed: 01/16/2023]
Abstract
BACKGROUND Prior research has demonstrated the dimensionality of Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) alcohol, nicotine, cannabis, cocaine and amphetamine abuse and dependence criteria. The purpose of this study was to examine the dimensionality of hallucinogen and inhalant/solvent abuse and dependence criteria. In addition, we assessed the impact of elimination of the legal problems abuse criterion on the information value of the aggregate abuse and dependence criteria, another proposed change for DSM-IV currently lacking empirical justification. METHODS Factor analyses and item response theory (IRT) analyses were used to explore the unidimisionality and psychometric properties of hallucinogen and inhalant/solvent abuse and dependence criteria using a large representative sample of the United States (U.S.) general population. RESULTS Hallucinogen and inhalant/solvent abuse and dependence criteria formed unidimensional latent traits. For both substances, IRT models without the legal problems abuse criterion demonstrated better fit than the corresponding model with the legal problem abuse criterion. Further, there were no differences in the information value of the IRT models with and without the legal problems abuse criterion, supporting the elimination of that criterion. No bias in the new diagnoses was observed by sex, age and race-ethnicity. CONCLUSION Consistent with findings for alcohol, nicotine, cannabis, cocaine and amphetamine abuse and dependence criteria, hallucinogen and inhalant/solvent criteria reflect underlying dimensions of severity. The legal problems criterion associated with each of these substance use disorders can be eliminated with no loss in informational value and an advantage of parsimony. Taken together, these findings support the changes to substance use disorder diagnoses recommended by the DSM-V Substance and Related Disorders Workgroup, that is, combining DSM-IV abuse and dependence criteria and eliminating the legal problems abuse criterion.
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Affiliation(s)
- Bradley T Kerridge
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD 20740, United States
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