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The role of craving in AUDs: dimensionality and Differential Functioning in the DSM-5.

Creator:

Martina Casey, Gary Adamson, Mark Shevlin, Adele McKinney

Type: Report
Region: Republic of Ireland
Northern Ireland
Description:

The dimensionality and the contribution of the proposed diagnostic criteria for the DSM-5 model of alcohol-use disorders (AUDs) which will provide guidelines for future diagnoses have not been examined in depth. METHOD: Data from past year drinkers in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), Wave 2 (n=22 177) were analysed. Severity and discrimination of DSM-5 diagnostic criteria was determined using a two-parameter logistic Item Response Theory model. Comparative analyses were conducted on the DSM-IV criteria. Differential functioning of the criteria across a number of socio-demographic variables was assessed. RESULTS: The proposed criteria supported a unidimensional AUD model, with a factor loading range of 0.625-0.914 (craving=0.818). The model measured intermediate severity of AUDs with 'reduced time on important/pleasurable activities' and 'failure to meet major role obligations' criteria having the highest severity and discrimination. Craving, endorsed by 4.2% of the general population, was in the mid-range for both severity (sixth) and discrimination (seventh). Significant measurement bias was found on four criteria across socio-demographic subgroups. CONCLUSIONS: Application of the proposed DSM-5 changes yields an improved one-factor model of AUD over the existing DSM-IV model. Inclusion of a craving criterion improves the application of the diagnostic criteria in a general population sample, covering a previously unrepresented problem area. Additionally, criteria measuring the milder end of the AUD continuum remain absent and some criteria exhibit measurement non-invariance. The AUD classification may require further refinement to enhance validity and reliability.

Date:

01/01/2012

Rights: Public
Suggested citation:

Martina Casey, Gary Adamson, Mark Shevlin, Adele McKinney. (2012) The role of craving in AUDs: dimensionality and Differential Functioning in the DSM-5. [Online]. Available from: http://publichealthwell.ie/node/413076 [Accessed: 16th September 2019].

  

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Contributor:

National Drugs Library
 
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