The dimensionality of alcohol use disorders and alcohol consumption in a cross-national perspective
The dimensionality of alcohol use disorders and alcohol consumption in a cross-national perspective
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DOI：
10.1111/j.1360-0443.2009.02778.x
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发表时间：
2010-02-01
期刊：
影响因子：
6
通讯作者：
Rubio-Stipec, Maritza
中科院分区：
文献类型：
--
作者：
Borges, Guilherme;Ye, Yu;Rubio-Stipec, Maritza
目的复制酒精使用障碍存在单一维度特征的发现，并测试男性通常的5+饮料和女性的4+饮料以及其他酒精消费措施是否有助于改善四个国家急诊科（ED）的一系列不同患者的酒精使用障碍标准。对18岁及以上的患者进行横断面调查，反映连续到达ED。使用复合国际诊断访谈核心来获得DSM-IV酒精依赖和酒精滥用的诊断;过去一年中饮酒和醉酒的数量和频率以及通常的饮酒量。SettingParticipants是在四个国家参加七个ED的5195名受伤和非受伤患者：阿根廷、墨西哥、波兰和美国（1995-2001年）。结果使用探索性因素分析，酒精使用障碍可以被描述为一个单一的，在所有场所，依赖和滥用标准之间没有任何明确的区分。项目反应理论分析的结果表明，目前的DSM-IV标准在酒精使用障碍连续体的中高端挖掘人们。酒精消费（使用量和频率）可以用于所有ED与当前的DSM-IV诊断标准，以帮助挖掘这个连续体的中下部分。即使一些特定的诊断标准和一些酒精消费量变量显示不同的项目功能跨网站，测试响应曲线不变的艾德网站和他们的列入将不会影响最终（总）性能的诊断system. ConclusionsDSM-IV滥用和依赖形成一个一维连续的艾德患者，无论国家的调查。如果增加酒精消费变量，将有助于挖掘更中度严重的患者。酒精使用障碍的DSM诊断系统表现出不变性，并在这些样本中表现非常好。
AimsTo replicate the finding that there is a single dimension trait in alcohol use disorders and to test whether the usual 5+ drinks for men and 4+ drinks for women and other measures of alcohol consumption help to improve alcohol use disorder criteria in a series of diverse patients from emergency departments (EDs) in four countries.DesignCross-sectional surveys of patients aged 18 years and older that reflected consecutive arrival at the ED. The Composite International Diagnostic Interview Core was used to obtain a diagnosis of DSM-IV alcohol dependence and alcohol abuse; quantity and frequency of drinking and drunkenness as well as usual number of drinks consumed during the last year.SettingParticipants were 5195 injured and non-injured patients attending seven EDs in four countries: Argentina, Mexico, Poland and the United States (between 1995-2001).FindingsUsing exploratory factor analyses alcohol use disorders can be described as a single, unidimensional continuum without any clear-cut distinction between the criteria for dependence and abuse in all sites. Results from item response theory analyses showed that the current DSM-IV criteria tap people in the middle-upper end of the alcohol use disorder continuum. Alcohol consumption (amount and frequency of use) can be used in all EDs with the current DSM-IV diagnostic criteria to help tap the middle-lower part of this continuum. Even though some specific diagnostic criteria and some alcohol consumption variables showed differential item function across sites, test response curves were invariant for ED sites and their inclusion would not impact the final (total) performance of the diagnostic system.ConclusionsDSM-IV abuse and dependence form a unidimensional continuum in ED patients regardless of country of survey. Alcohol consumption variables, if added, would help to tap patients with more moderate severity. The DSM diagnostic system for alcohol use disorders showed invariance and performed extremely well in these samples.