Investigating dimensionality and measurement bias of DSM-5 alcohol use disorder in a representative sample of the largest metropolitan area in South America.
Investigating dimensionality and measurement bias of DSM-5 alcohol use disorder in a representative sample of the largest metropolitan area in South America.
复制标题
DOI：
10.1016/j.drugalcdep.2015.04.024
复制
发表时间：
2015-07-01
影响因子：
4.2
通讯作者：
Andrade LH
中科院分区：
文献类型：
--
作者：
Castaldelli-Maia JM;Wang YP;Borges G;Silveira CM;Siu ER;Viana MC;Andrade AG;Martins SS;Andrade LH
鉴于最近推出了针对酒精使用障碍 (AUD) 的新诊断分类 (DSM-5)，我们旨在研究其维度以及非美国样本中可能存在的测量偏差。目前的分析仅限于 5,037 名个体样本中的 948 名受试者，这些受试者在过去一年中每周至少饮酒 1 杯。数据来自 2005 年至 2007 年收集的圣保罗特大城市项目（世界心理健康调查的一部分）。首先，进行探索性因素分析 (EFA)，以测试 DSM-5-AUD 标准的最佳维度结构。然后，使用项目反应理论（IRT）来研究DSM-5-AUD每个标准的严重性和区分属性。最后，通过社会人口统计学（收入、性别、年龄、就业状况、婚姻状况和教育程度）对差别标准功能（DCF）进行了调查。所有分析均在 Mplus 软件中进行，考虑到复杂的调查设计特征。最好的 EFA 模型是一维模型。 IRT 结果显示，“花费时间”和“放弃”标准具有最高的歧视性和严重性属性，而“较大/较长”标准具有最低的严重性值，但歧视性平均值。只有女性在标准和因子水平上都具有 DCF，从而导致测量偏差。这项研究强化了南美洲最大都市区中 DSM-5-AUD 连续体的存在，包括以前饮酒率较高（教育/收入水平较低）的亚组。女性的 DSM-5-AUD 分数较低。
Given the recent launch of a new diagnostic classification (DSM-5) for alcohol use disorders (AUD), we aimed to investigate its dimensionality and possible measurement bias in a non-U.S. sample. The current analyses were restricted to 948 subjects who endorsed drinking at least 1 drink per week in the past year from a sample of 5,037 individuals. Data came from São Paulo Megacity Project (which is part of World Mental Health Surveys) collected between 2005–2007. First, exploratory factor analysis (EFA) was carried out to test for the best dimensional structure for DSM-5-AUD criteria. Then, item response theory (IRT) was used to investigate the severity and discrimination properties of each criterion of DSM-5-AUD. Finally, differential criteria functioning (DCF) were investigated by sociodemographics (income, gender, age, employment status, marital status and education). All analyses were performed in Mplus software taking into account complex survey design features. The best EFA model was a one-dimensional model. IRT results showed that the criteria “Time Spent” and “Given Up” have the highest discrimination and severity properties, while the criterion “Larger/Longer” had the lowest value of severity, but an average value of discrimination. Only female gender had DCF both at criterion- and factor-level, rendering measurement bias. This study reinforces the existence of a DSM-5-AUD continuum in the largest metropolitan area of South America, including subgroups that had previously higher rates of alcohol use (lower educational/income levels). Lower DSM-5-AUD scores were found in women.