Alcohol craving and the dimensionality of alcohol disorders.
Alcohol craving and the dimensionality of alcohol disorders.
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DOI：
10.1017/s003329171000053x
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发表时间：
2011-03
影响因子：
6.9
通讯作者：
Hasin, D. S.
中科院分区：
文献类型：
--
作者：
Keyes, K. M.;Krueger, R. F.;Grant, B. F.;Hasin, D. S.
ICD-10包括酒精依赖的渴望标准，而DSM-IV则没有。对于渴望是否符合或改善DSM-IV酒精使用障碍的标准，我们知之甚少。数据来自1991-92年全国纵向酒精流行病学调查（NLAES）中的当前饮酒者（N= 18，352），这是一项对美国17岁以上成年人的全国代表性调查。AUDADIS用于评估DSM-IV的11个依赖和滥用标准以及酒精渴望。探索性因素，项目反应理论和回归分析被用来评估心理测量学特性和并发效度的DSM为基础的酒精障碍标准，增加了酒精渴望。过去12个月的渴求患病率为1.3%。渴望形成了一个unideminsional潜在变量，包括现有的DSM-IV标准的一部分。渴望表现出高度严重的酒精使用障碍的连续性，导致在一个改进的维度模型，更大的区分能力相比，目前的DSM-IV标准。诊断的相关性没有改变，加上渴望，过去12个月的渴望与先前的酒精依赖，抑郁症，酒精障碍发作的年龄较早的那些与目前的DSM-IV酒精依赖。在现有的DSM-IV标准中增加渴望产生了一种连续的测量方法，可以更好地区分沿着酒精使用障碍连续体有和没有酒精问题的个体。很少有人被新诊断为酒精依赖，因为除了渴望，表明结构效度，但冗余与现有的标准。
ICD-10 includes a craving criterion for alcohol dependence while DSM-IV does not. Little is known about whether craving fits with or improves the DSM-IV criteria set for alcohol use disorders. Data were derived from current drinkers (N=18,352) in the 1991–92 National Longitudinal Alcohol Epidemiologic Survey (NLAES), a nationally representative survey of US adults >17 years of age. The AUDADIS was used to assess the eleven DSM-IV dependence and abuse criteria, and alcohol craving. Exploratory factor, Item Response Theory, and regression analyses were used to evaluate the psychometric properties and concurrent validity of DSM-based alcohol disorder criteria with the addition of alcohol craving. The past-12 month prevalence of craving was 1.3%. Craving formed part of a unideminsional latent variable that included existing DSM-IV criteria. Craving demonstrated high severity on the alcohol use disorder continuum, resulting in an improved dimensional model with greater discriminatory ability compared to current DSM-IV criteria. Correlates of the diagnosis did not change with the addition of craving, and past-12 month craving was associated with prior alcohol dependence, depression, and earlier age of alcohol disorder onset among those with current DSM-IV alcohol dependence. The addition of craving to the existing DSM-IV criteria yields a continuous measure that better differentiates individuals with and without alcohol problems along the alcohol use disorder continuum. Few individuals are newly diagnosed with alcohol dependence given the addition of craving, indicating construct validity but redundancy with existing criteria.