Towards the characterization and validation of alcohol use disorder subtypes: integrating consumption and symptom data.
Towards the characterization and validation of alcohol use disorder subtypes: integrating consumption and symptom data.
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DOI：
10.1017/s0033291713000573
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发表时间：
2014-01
影响因子：
6.9
通讯作者：
Sher KJ
中科院分区：
文献类型：
--
作者：
Jackson KM;Bucholz KK;Wood PK;Steinley D;Grant JD;Sher KJ
有证据表明，酒精消费、依赖和滥用的衡量标准是衡量酒精参与的不同性质亚型的有效指标，但也沿着一个连续统一体。本研究试图解决酒精参与的变化在何种程度上反映了种类与程度的差异。数据来自2001-2002年全国酒精及相关疾病流行病学调查。样本（51%男性; 72%白色/非西班牙裔）包括在两个波中报告过去12个月饮酒的受访者（波1：n=33644;波2：n=25186）。我们比较了因素混合模型（FRESH），一个混合的共同因素分析（FA）和潜在类分析（LCA），对FA和LCA模型使用过去12个月的酒精使用障碍（AUD）的标准和五个指标的酒精消费反映的频率和饮酒量。模型比较显示，在第一波最适合的模型是一个单因素四类FMM，类主要是依赖和消费指数不同。使用第2波数据复制该模型，并对AUD和依赖诊断进行验证。波1至波2的类别稳定性是中等的，与不经常饮酒的类别最一致。在潜在的潜在因素类内协会也显示随着时间的推移适度的协议。有证据表明，酒精参与可以被认为是分类和连续的，与反应减少到四个模式，定量变化沿着一个单一的维度。疾病学家可能会考虑混合方法，涉及消费模式和依赖性疾病学以及组内严重程度变化的群体。
There is evidence that measures of alcohol consumption, dependence and abuse are valid indicators of qualitatively different subtypes of alcohol involvement yet also fall along a continuum. The present study attempts to resolve the extent to which variations in alcohol involvement reflect a difference in kind versus a difference in degree. Data were taken from the 2001–2002 National Epidemiologic Survey of Alcohol and Related Conditions. The sample (51% male; 72% white/non-Hispanic) included respondents reporting past 12-month drinking at both waves (wave 1: n=33644; wave 2: n=25186). We compared factor mixture models (FMMs), a hybrid of common factor analysis (FA) and latent class analysis (LCA), against FA and LCA models using past 12-month alcohol use disorder (AUD) criteria and five indicators of alcohol consumption reflecting frequency and heaviness of drinking. Model comparison revealed that the best-fitting model at wave 1 was a one-factor four-class FMM, with classes primarily varying across dependence and consumption indices. The model was replicated using wave 2 data, and validated against AUD and dependence diagnoses. Class stability from waves 1 to 2 was moderate, with greatest agreement for the infrequent drinking class. Within-class associations in the underlying latent factor also revealed modest agreement over time. There is evidence that alcohol involvement can be considered both categorical and continuous, with responses reduced to four patterns that quantitatively vary along a single dimension. Nosologists may consider hybrid approaches involving groups that vary in pattern of consumption and dependence symptomatology as well as variation of severity within group.