An Item-Response Theory Analysis of DSM-IV Alcohol-Use Disorder Criteria and "Binge" Drinking in Undergraduates
An Item-Response Theory Analysis of DSM-IV Alcohol-Use Disorder Criteria and "Binge" Drinking in Undergraduates
复制标题
DOI：
10.15288/jsad.2010.71.418
复制
发表时间：
2010-05-01
影响因子：
3.4
通讯作者：
Leeman, Robert F.
中科院分区：
文献类型：
--
作者：
Beseler, Cheryl L.;Taylor, Laura A.;Leeman, Robert F.
目的：本研究首次运用项目反应理论(IRT)对《精神疾病诊断与统计手册》第四版(DSM-IV)中的酒精使用障碍和重度间歇性(或酗酒)饮酒标准进行了研究。IRT有助于评估标准的严重性、区分风险最高和风险最低的人的能力，以及增加“狂欢”饮酒标准的价值。方法：在353名大学生饮酒者的样本中，我们进行了因素分析，以确定标准最适合单因素结构还是双因素结构。然后，我们进行了IRT分析，以获得项目特征曲线，表明在酒精使用障碍风险增加的水平上认可标准的可能性。这些分析首先包括当前(即过去一年)DSM-IV酒精使用障碍标准，然后重新运行添加每周一次的“狂欢”饮酒。结果：DSM-IV标准的单因素模型与双因素模型没有显著差异。在计入酗酒因素后，有两个因素比一个因素更符合数据，但只有一个因素占主导地位。戒断是最严重的标准，而耐受性和“更大/更长”是最不严重的。饮酒时间和社会/法律困难的综合标准最有能力区分那些酒精使用障碍风险最高和最低的人。“狂欢”饮酒表现出低辨别度和低严重性。结论：据我们所知，这是第一次使用IRT在大学生样本中检验DSM-IV标准的研究。在这个样本中，虐待和依赖在一个严重的连续体中混合在一起，而“酗酒”是最不严重的区域。(J.Stud.酒精类毒品，71,418-423,2010)
Objective: This is the first study to examine the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), criteria for alcohol-use disorders and heavy episodic (or "binge") drinking in a college sample using item-response theory (IRT) analysis. IRT facilitates assessment of the severity of the criteria, their ability to distinguish between those at greatest and lowest risk, and the value of adding a "binge" drinking criterion. Method: In a sample of undergraduate drinkers (n = 353), we conducted factor analyses to determine whether the criteria best fit a one- or two-factor structure. We then conducted IRT analyses to obtain item-characteristic curves indicating the probability of endorsing a criterion at increasing levels of alcohol-use-disorder risk. These analyses were first conducted including current (i.e., past-year) DSM-IV alcohol-use-disorder criteria only and then rerun adding weekly "binge" drinking. Results: A single-factor model of the DSM-IV criteria did not differ significantly from a two-factor model. After including "binge" drinking, two factors fit the data slightly better than one factor but with a dominant single factor. Withdrawal was the most severe criterion, whereas tolerance and "larger/longer" were the least severe. Time spent drinking and a combined social/legal difficulties criterion had the best ability to discriminate those at greatest and lowest risk for an alcohol-use disorder. "Binge" drinking showed both low discrimination and low severity. Conclusions: To our knowledge, this is the first study to examine DSM-IV criteria in an undergraduate sample using IRT. In this sample, abuse and dependence were intermixed on a continuum of severity, and "binge" drinking was in the least severe region. (J. Stud. Alcohol Drugs, 71, 418-423, 2010)