Classification of substance use disorders in adolescents

描述(由申请人提供)：这一更新的R01申请建立在我们对物质使用障碍(SUDS)流行病学的富有成效的研究基础上。通过利用全国药物使用与健康调查(NSDUH)的多波数据，我们发表了一系列流行病学论文，涉及使用或滥用酒精、香烟、吸入剂、大麻、可卡因、海洛因、兴奋剂、阿片类药物和致幻剂/MDMA，以及与使用药物滥用治疗服务相关的因素。鉴于缺乏对新兴的DSM-V的青少年个体和共病SUD的经验分类的研究，这项应用利用我们对NSDUH的扎实知识作为基础，并扩展我们对物质使用和障碍的研究努力，以调查以前未解决的关于测量偏差和用于生成DSM-IV SUD的国家估计的DSM-IV诊断标准的潜在结构的问题。本申请旨在解决PA-08-124《药物滥用流行病学》建议的交叉问题，通过应用流行病学和几种潜在变量建模方法来分析已经收集的大量诊断数据，并对12-17岁青少年肥皂水的诊断评估和诊断分类的质量提出新的看法。研究的目的是：(1)确定依赖症状与滥用在10种物质类别中共存的程度；(2)评估每个SUD标准的维度和项目水平的心理测量学特性；(3)调查SUD评估中的项目反应偏差(测量误差)；(4)评估用于特定SUD分类的维度、分类以及综合维度和范畴方法；(5)检查每个SUD经验定义的诊断亚组的外部验证者变量；以及(6)使用新的诊断分类方法识别经验定义的共生SUD亚型，并评估经验性定义的共生SUD亚型的外部验证变量。 公共卫生相关性：正在进行的《全国药物使用与健康调查》是记录国家药物使用障碍统计数据的主要来源。这项拟议研究的结果将对该领域作出非常及时和具有高度影响力的贡献，因为它阐明了用于生成青少年物质使用障碍国家估计的诊断标准的质量或测量偏差，并提供了与新出现的DSM-V和ICD-11物质使用障碍分类的经验基础相关的新发现。

DESCRIPTION (provided by applicant): This renewal R01 application builds on our productive research on the epidemiology of substance use disorders (SUDs). By capitalizing on multiple waves of data from the National Survey on Drug Use and Health (NSDUH), we have published a series of epidemiological papers related to the use or abuse of alcohol, cigarettes, inhalants, marijuana, cocaine, heroin, stimulants, opioids, and hallucinogens/MDMA, as well as the factors associated with the utilization of substance abuse treatment services. In light of the lack of research on the empirical classification of individual and comorbid SUDs in adolescents for the emerging DSM-V, this application utilizes our solid knowledge of the NSDUH as a foundation and expands our research efforts on substance use and disorders to investigate previously unaddressed questions regarding measurement bias and latent constructs of DSM-IV diagnostic criteria used to generate national estimates of DSM-IV SUDs. This application seeks to address Crosscutting Issues recommended by PA-08-124 Epidemiology of Drug Abuse by applying both epidemiological and several latent variable modeling approaches to analyze the already collected wealth of diagnostic data and to shed new light on the quality of diagnostic assessments and diagnostic classification of SUDs in adolescents aged 12-17 years. Study aims are to: (1) determine the extent of co-occurrences of dependence symptoms with abuse across 10 substance classes; (2) evaluate the dimensionality and item-level psychometric properties of the criteria for each SUD; (3) investigate item-response bias (measurement error) in the assessment of SUDs; (4) evaluate dimensional, categorical, and integrated dimensional and categorical approaches to the classification of specific SUDs; (5) examine external validator variables of empirically defined diagnostic subgroups for each SUD; and (6) identify empirically defined comorbid SUD subtypes using new diagnostic classifying approaches and evaluate external validator variables of empirically defined comorbid SUD subtypes. PUBLIC HEALTH RELEVANCE: The ongoing National Survey on Drug Use and Health serves as the primary source for documenting national statistics for substance use disorders. Findings from this proposed study will make a very timely and high-influence contribution to the field by elucidating the quality or measurement bias of diagnostic criteria used to generate national estimates of substance use disorders in adolescents and by providing new findings relevant to an empirical base of substance use disorder classification for the emerging DSM-V and ICD-11.