What were they thinking? Adolescents' interpretations of DSM-IV alcohol dependence symptom queries and implications for diagnostic validity
What were they thinking? Adolescents' interpretations of DSM-IV alcohol dependence symptom queries and implications for diagnostic validity
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DOI：
10.1016/j.drugalcdep.2005.03.023
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发表时间：
2005-11-01
影响因子：
4.2
通讯作者：
Martin, CS
中科院分区：
文献类型：
--
作者：
Chung, T;Martin, CS
目的：DSM-IV酒精依赖标准的酒精耐受性和饮酒时间超过预期在青少年中具有相对较高的患病率，并且可能容易出现假阳性症状分配，从而降低诊断的有效性。我们对DSM-IV症状查询进行了方法学研究，用于评估酒精耐受性和饮酒控制受损，以确定测量误差的潜在来源。方法：从成瘾治疗中招募的青少年参加焦点小组（n = 9）或个人访谈（n =41），以提供他们对半结构化诊断访谈中选定项目的解释数据。结果：当酒精耐受性被操作性地定义为获得相同效果的量的变化时，代表高水平耐受性的量的变化的巨大个体差异限制了该操作性定义作为依赖指标的效用。“饮酒过量或饮酒时间超过预期”的症状包含了一种根深蒂固的假设，即已经设定了饮酒限制。然而，青少年通常是想喝醉，而不是保持饮酒的极限。结论：青少年对症状问题的理解表明，如何通过更多地关注影响评估的发育因素来提高DSM-IV酒精症状和诊断的有效性。2005爱思唯尔爱尔兰有限公司版权所有。
Objective: DSM-IV alcohol dependence criteria of tolerance to alcohol and drinking more or longer than intended have relatively high prevalence among youth, and may be vulnerable to false positive symptom assignments that degrade diagnostic validity. We conducted a methodological study of DSM-IV symptom queries used to assess alcohol tolerance and impaired control over drinking to determine potential sources of measurement error.Method: Adolescents recruited from addictions treatment participated in either a focus group (n = 9) or an individual interview (n =41) to provide data on their interpretation of selected items contained in a semi-structured diagnostic interview.Results: When alcohol tolerance is operationally defined as a change in quantity to obtain the same effect, large individual differences in the change in quantity that represents a high level of tolerance limit the Utility of this operational definition as an indicator of dependence. The symptom "drinking more or longer than intended", includes the embedded assumption that a limit on use had been set. Teens, however, typically intended to become intoxicated, rather than to keep to a limit.Conclusions: Adolescents' understanding of symptom queries suggests how validity of DSM-IV alcohol symptoms and diagnoses can be improved through greater attention to developmental considerations affecting assessment. (c) 2005 Elsevier Ireland Ltd. All rights reserved.