Classification of substance use disorders in adolescents

描述（由申请人提供）：此更新R 01申请建立在我们对物质使用障碍（SUD）流行病学的生产性研究基础上。通过利用全国药物使用和健康调查（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的使用或滥用，以及与物质滥用治疗服务的利用相关的因素。鉴于缺乏对新兴DSM-V青少年个体和共病SUD经验分类的研究，本申请利用我们对NSDUH的扎实知识作为基础，并扩展了我们对物质使用和疾病的研究工作，以调查以前未解决的有关测量偏倚和DSM-IV诊断标准潜在结构的问题，用于生成DSM-IV SUD的国家估计值。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，方法是应用流行病学和几种潜变量建模方法来分析已收集的大量诊断数据，并对12-17岁青少年SUD的诊断评估和诊断分类质量提供新的见解。研究目的是：（1）确定10种物质类别中依赖症状与滥用共现的程度;（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）调查项目反应偏倚（4）评价特定SUD分类的维度、分类以及整合维度和分类方法;（5）检查每个SUD的经验定义的诊断亚组的外部验证变量;和（6）使用新的诊断分类方法识别经验定义的共病SUD亚型，并评估经验定义的共病SUD亚型的外部验证变量。 公共卫生相关性：正在进行的全国吸毒和健康调查是记录吸毒病症全国统计数据的主要来源。这项拟议研究的结果将通过阐明用于生成青少年物质使用障碍国家估计数的诊断标准的质量或测量偏倚，并通过提供与新兴DSM-V和ICD-11的物质使用障碍分类的经验基础相关的新发现，对该领域做出非常及时和高影响力的贡献。

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.