Item Response Theory Analysis of Binge Drinking and Its Relationship to Lifetime Alcohol Use Disorder Symptom Severity in an American Indian Community Sample
Item Response Theory Analysis of Binge Drinking and Its Relationship to Lifetime Alcohol Use Disorder Symptom Severity in an American Indian Community Sample
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DOI：
10.1111/j.1530-0277.2010.01429.x
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发表时间：
2011-05-01
影响因子：
3.2
通讯作者：
Ehlers, Cindy L.
中科院分区：
文献类型：
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作者：
Gilder, David A.;Gizer, Ian R.;Ehlers, Cindy L.
背景：项目反应理论(IRT)已被用来检验酒精使用障碍(AUD)症状及其心理测量学特性，但尚未被应用于美国印第安人样本中的AUD症状。方法：对530名美国印第安人参与者进行终生DSM-IV AUD症状和酗酒(5+饮酒男性/4+饮酒女性)在终生饮酒最多时期的狂饮标准评估。采用探索性因素分析方法，对10种AUD症状和各饮酒标准的因子结构进行检验。两参数IRT模型为10个DSM-IV AUD症状和每个消费标准产生了区分(A)和阈值(B)参数的边际最大似然估计。结果：AUD症状以“戒断”和“放弃活动”最为严重。“宽容”和“社会/人际问题”是最不严重的。所有的AUD症状都落在严重程度连续体的中等程度上，除了“戒断”，它落在严重程度的较低端。5+/4+(男性/女性)每月8次的消费标准界定了AUD症状开始出现的概率为50%的严重程度连续体的部分。DIF分析显示，在“危险使用”、“耐受性”和“放弃活动”方面，访问时的性别和年龄有显著差异，但在其他AUD症状上没有显著差异。结论：在这个美国印第安人社区样本中，酗酒和依赖并不代表明显的障碍。在AUD严重程度连续体的中等范围之外，仅发现一种AUD症状。在一生中饮酒最多的时期，以每月8次的频率饮用5+/4+(男性/女性)饮料被发现是终生DSM-IV AUD的一种风险和诊断标准。目前评估的DSM-IV AUD症状标准在捕捉AUDS的所有症状严重性方面的能力可能有限，至少在这一高危人群中是如此。
Background:Item response theory (IRT) has been used to examine alcohol use disorder (AUD) symptoms and their psychometric properties but has not been previously applied to AUD symptoms from an American Indian sample.Methods:Lifetime DSM-IV AUD symptoms and binge drinking (5+ drinks men/4+ drinks women) at >= 1, >= 4, >= 8, and >= 15 days per month during the period of heaviest lifetime drinking criteria were assessed in 530 American Indian participants. Exploratory factor analysis was used to examine the factor structure of the 10 AUD symptoms and each alcohol consumption criterion. Two-parameter IRT models generated marginal maximum likelihood estimates for discrimination (a) and threshold (b) parameters for 10 DSM-IV AUD symptoms and each consumption criterion. Differential item functioning (DIF) analysis was used to assess AUD symptom severity in groups defined by gender and age at interview.Results:The AUD symptoms of "Withdrawal" and "Activities Given Up" were the most severe symptoms. "Tolerance" and "Social/Interpersonal Problems" were the least severe. All AUD symptoms fell on the moderate portion of the severity continuum, except "Withdrawal," which fell at the lower end of the severe portion. The consumption criterion of 5+/4+ (male/female) at >= 8 times per month demarcated the portion of the severity continuum where AUD symptoms began to occur at a probability of 50%. DIF analysis showed significant gender and age at interview differences for "Hazardous Use,""Tolerance," and "Activities Given Up," but not for the other AUD symptoms.Conclusions:In this American Indian community sample, alcohol abuse and dependence did not represent distinct disorders. Only one AUD symptom was found outside the moderate portion of the underlying AUD severity continuum. Drinking 5+/4+ (male/female) drinks at a frequency of >= 8 times per month during the period of heaviest lifetime drinking was found to function well as both a risk and a diagnostic criterion for lifetime DSM-IV AUD. DSM-IV AUD symptom criteria, as currently assessed, may be limited in their ability to capture the full range of symptom severity of AUDs, at least in this high-risk population.