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.
Department of Psychiatry, Yale University, New Haven, CT 06519, USA.
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A
Feingold
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B
Rounsaville
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