The DSM-IV criteria for adolescent alcohol and cannabis use disorders.
OBJECTIVE
The aims of this study are to compare DSM-IV criteria for alcohol and cannabis use disorders with its predecessor, DSM-III-R, and to examine the validity of the new criteria in an adolescent drug clinic sample.


METHODS
During evaluation, a sample of 772 adolescents (63% boys, 77% white) were administered a structured interview of diagnostic symptoms and additional problem severity measures. Independent staff ratings of problem severity and treatment referral were collected as well.


RESULTS
Compared to its predecessor, DSM-III-R, application of the DSM-IV criteria for alcohol and cannabis users resulted in more abuse assignments and fewer dependence assignments. The shift in assignments appeared to be largely due to a lowering of the abuse threshold, rather than to a tightening of the dependence criteria. The external validity data generally supported the DSM-IV abuse and dependence distinction in adolescents, and the newer criteria were as valid as the older criteria.


CONCLUSIONS
In contrast to DSM-III-R, the DSM-IV system yields more abuse cases and fewer dependence cases among adolescent alcohol and cannabis abusers. Validity evidence for the new criteria are defensible, yet the findings are seen as a starting point for discussing the need for tailoring substance use disorder criteria for adolescents.
Winters
K C
KC
Department of Psychiatry, University of Minnesota, Minneapolis 55455, USA.
Latimer
W
W
Stinchfield
R D
RD
D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D000437:Alcoholism / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis*; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results