ONSET AND STAGING OF DSM-IV ALCOHOL DEPENDENCE USING MEAN AGE AND SURVIVAL-HAZARD METHODS
ONSET AND STAGING OF DSM-IV ALCOHOL DEPENDENCE USING MEAN AGE AND SURVIVAL-HAZARD METHODS
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DOI：
10.1037/0021-843x.104.2.346
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发表时间：
1995-05-01
影响因子：
4.6
通讯作者：
CHUNG, T
中科院分区：
文献类型：
--
作者：
LANGENBUCHER, JW;CHUNG, T
精神症状的有序发作对病例检测和基础疾病的结构效度都有影响。使用平均年龄和生存风险技术研究了从异质区域样本中抽取的369例临床病例的酒精滥用和依赖（定义见1994年美国精神病学协会《精神疾病诊断和统计手册》第4版）。这些方法提供了类似的症状排序的一般模式，尽管只有生存风险分析描述了酒精中毒在3个离散阶段的间断发作：酒精滥用、依赖和适应疾病。该模型通过了严格的拟合优度测试程序，并描述了大多数样本，支持了酒精滥用作为离散的第一疾病阶段和依赖作为一组与随后的滥用不同的核心结构的结构有效性。本文讨论了生存风险分析作为一种研究工具在疾病分期研究中的优势。
Orderly onset of psychiatric symptoms has implications for both case detection and the construct validity of the underlying illness. Mean age and survival-hazard techniques were used to study the onset of alcohol abuse and dependence ( as defined in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association, 1994) in 369 clinical cases drawn from a heterogeneous regional sample. The methods provided a similar general pattern of symptom sequencing, though only survival-hazard analysis described a punctuated onset of alcoholism in 3 discrete stages: alcohol abuse, dependence, and accommodation to the illness. This model survived a rigorous program of tests for goodness of fit and described the majority of the sample, supporting the construct validity of both alcohol abuse as a discrete first illness phase and of dependence as a set of core constructs distinct from and succeeding abuse. The specific strengths of survival-hazard analysis as a research tool in illness staging research are discussed.