Factor and item-response analysis DSM-IV criteria for abuse of and dependence on cannabis, cocaine, hallucinogens, sedatives, stimulants and opioids
Factor and item-response analysis DSM-IV criteria for abuse of and dependence on cannabis, cocaine, hallucinogens, sedatives, stimulants and opioids
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DOI：
10.1111/j.1360-0443.2007.01804.x
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发表时间：
2007-06-01
期刊：
影响因子：
6
通讯作者：
Kendler, Kenneth S.
中科院分区：
文献类型：
--
作者：
Gillespie, Nathan A.;Neale, Michael C.;Kendler, Kenneth S.
本研究以男性为样本，探讨了药物滥用和药物依赖标准的因子结构，并利用项目反应理论（IRT）对这些标准在不同药物类别中的表现进行了定性比较。设计采用边际最大似然法探讨各药物类别中各标准的因素结构，采用双参数IRT模型确定各药物类别中个别标准的难易程度和区别程度的差异。共有4234名男性，出生于1940年至1974年，来自以人口为基础的弗吉尼亚双胞胎登记处。DSM-IV大麻、镇静剂、兴奋剂、可卡因和阿片类药物使用、滥用和依赖标准。对于每一类药物，以开始和使用为条件的滥用和依赖的个别标准的认可模式可以用一个因素来最好地解释。不同物质的单项表现在项目难度和辨别力方面存在较大差异。可卡因使用者更有可能遇到法律、社会、身体和心理上的后果。结论：DSM-IV的滥用和依赖标准，在每个药物类别中，并不是截然不同的，但最好的描述是一个单一的潜在的连续风险。由于在IRT分析中不同物质的个别标准表现非常不同，因此假设这些项目在不同物质之间以相同的歧视衡量同等的严重程度或责任水平是不可持续的。与其他药物相比，可卡因的使用会带来更多的有害影响和负面后果，而大麻和致幻剂的影响似乎危害较小。讨论了对其他药物类别的影响。
Aims This paper explored, in a population-based sample of males, the factorial structure of criteria for substance abuse and dependence, and compared qualitatively the performance of these criteria across drug categories using item-response theory (IRT). Design Marginal maximum likelihood was used to explore the factor structure of criteria within drug classes, and a two-parameter IRT model was used to determine how the difficulty and discrimination of individual criteria differ across drug classes. Participants A total of 4234 males born from 1940 to 1974 from the population-based Virginia Twin Registry were approached to participate. Measurements DSM-IV drug use, abuse and dependence criteria for cannabis, sedatives, stimulants, cocaine and opiates. Findings For each drug class, the pattern of endorsement of individual criteria for abuse and dependence, conditioned on initiation and use, could be best explained by a single factor. There were large differences in individual item performance across substances in terms of item difficulty and discrimination. Cocaine users were more likely to have encountered legal, social, physical and psychological consequences. Conclusions The DSM-IV abuse and dependence criteria, within each drug class, are not distinct but best described in terms of a single underlying continuum of risk. Because individual criteria performed very differently across substances in IRT analyses, the assumption that these items are measuring equivalent levels of severity or liability with the same discrimination across different substances is unsustainable. Compared to other drugs, cocaine usage is associated with more detrimental effects and negative consequences, whereas the effects of cannabis and hallucinogens appear to be less harmful. Implications for other drug classes are discussed.