Construct validity of the abuse-dependence distinction as measured by DSM-IV criteria for different psychoactive substances.
This article used the diagnostic criteria of the Diagnostic and Statistical Manual-Fourth Edition (DSM-IV) to compare the validity of a qualitative and a quantitative model of the abuse-dependence distinction for different psychoactive substances in samples of drug users drawn from drug treatment inpatients, general psychiatric patients, and the community. The hypothesis that DSM-IV abuse criteria differ from dependence criteria in kind rather than degree (a qualitative model) was only occasionally supported by confirmatory factor analyses of DSM-IV diagnostic criteria, by patterns of correlations of the two kinds of criteria with Addiction Severity Score (ASI) composites and measures of frequency of substance abuse, and by concurrent/prognostic validity analyses. However, the findings were consistent with a quantitative model of the abuse-dependence distinction that posits that abuse is a mild form of dependence. Whether abuse and dependence categories of users were established from separate DSM-IV criteria for abuse and dependence or from scores from a severity-of-dependence scale based on the pooled DSM-IV dependence and abuse criteria, abusers generally used drugs less than users in the dependence category and reported less problems associated with substance abuse on the ASI.
Feingold
A
A
Department of Psychiatry, Yale University, New Haven, CT 06519, USA.
Rounsaville
B
B
D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000145:classification / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D003042:Cocaine; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D002189:Marijuana Abuse / Q000145:classification / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000145:classification / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D011379:Prognosis; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011594:Psychometrics; D011619:Psychotropic Drugs; D015203:Reproducibility of Results; D019966:Substance-Related Disorders / Q000145:classification / Q000175:diagnosis* / Q000523:psychology / Q000534:rehabilitation
D013287:Illicit Drugs; D011619:Psychotropic Drugs; D003042:Cocaine