The dimensionality of alcohol abuse and dependence:: A multivariate analysis of DSM-IV symptom items in the National Longitudinal Survey of Youth
The dimensionality of alcohol abuse and dependence:: A multivariate analysis of DSM-IV symptom items in the National Longitudinal Survey of Youth
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DOI：
10.15288/jsa.2001.62.150
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发表时间：
2001-03-01
期刊：
影响因子：
--
通讯作者：
Muthén, BO
中科院分区：
文献类型：
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作者：
Harford, TC;Muthén, BO
目的：检验用于构建DSM-IV(精神疾病诊断与统计手册第四版)酒精滥用和依赖标准的22个症状条目的因子结构，并将其与背景特征联系起来。方法：本研究的数据来源于全国青年劳动力市场经验纵向研究(NLSY)。采用结构方程模型统计技术，将症状项与协变量联系起来，推广到二分法的结果。本模型是结构方程模型的特例，是一个多原因多指标(MIMIC)模型，其中一个或多个潜在变量(如酗酒和依赖)介入一组预测一组观察反应变量(即DSM-IV症状项)的观察背景变量之间。尽管双因素维度与DSM-IV关于滥用和依赖的概念有很大的相似之处，但每个维度的症状项目的项目内容都有显著差异。依赖方面借鉴了与继续饮酒的滥用标准有关的项目，尽管存在社会问题和反复饮酒，导致未能履行角色义务。滥用方面借鉴了与危险饮酒的滥用标准和长期大量饮酒的依赖标准有关的项目。这两个因素与背景变量有不同的关系。酒依赖电视与家族酗酒史、文化程度有关。年龄与酒精依赖无关，而与酒精滥用呈负相关。结论：本研究的结果重复了其他研究中发现的DSM-IV标准的二维模型，为酒精依赖在一般人群样本中的有效性提供了进一步的支持。本研究中因素结构的一个主要含义是，如果不按照DSM-IV标准对病例进行不同的分类。这些偏离被证明影响滥用，它只保留了DSM-IV诊断的40%，比依赖更强烈，后者保留了DSM-IV诊断的91%。
Objective: This article examines the factor structure of 22 symptom items used to configure the criteria of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) alcohol abuse and dependence and relates the factor structure to background characteristics.Method: Data for this study were drawn from the National Longitudinal Study of Labor Market Experience in Youth (NLSY). The symptom items were related to the covariates using the statistical technique of structural equation modeling generalized to dichotomous outcomes. The present model is a special case of structural equation modeling, a multiple causes and multiple indicators (MIMIC) model, in which one or more latent variables (i.e., alcohol abuse and dependence) intervene between a set of observed background variables predicting a set of observed response variables (i.e., DSM-IV symptom items).Results: The results of the structural equation analysis provide further support for two dimensions underlying the DSM-IV symptom items. Although the two-factor dimension bore a strong resemblance to the DSM-IV conceptions of abuse and dependence, there were notable differences in the item content of the symptom items for each dimension. The dependence dimension drew upon items related to the abuse criteria for continued drinking despite social problems and recurrent drinking resulting in failure to fulfill role obligations. The abuse dimension drew upon items related to the abuse criterion for hazardous drinking and the dependence criterion for larger amounts over time. The two factors were shown to have different relationships to the background variables. Alcohol dependence tvas related to family history of alcoholism and educational status. Age was not related to dependence and inversely related to alcohol abuse.Conclusions: Findings from this study replicate the two-dimensional model for DSM-IV criteria found in other studies and provide further support for the validity of alcohol dependence in general population samples. A major implication of the factor structure in the present study relates to the different classification of cases that would otherwise be obtained with DSM-IV criteria. These departures were shown to affect abuse, which retained only 40% of DSM-IV diagnoses, more strongly than dependence, which retained 91% of DSM-IV diagnoses.