Typologies of drug dependence: comparative validity of a multivariate and four univariate models.
Data from a longitudinal cohort study were used to directly compare the concurrent and predictive validity of four univariate typologic approaches with a multivariate approach in subtyping drug dependence. The four univariate typologies were based upon: (a) age-of-onset of drug abuse/dependence, (b) presence of drug abuse in first-degree relatives, (c) presence of antisocial personality disorder, and (d) sex. The multivariate typologic approach was based on indices of vulnerability, chronicity, consequences, and psychopathology, yielding the Type A/B dichotomy first demonstrated in alcohol dependence. Subtypes generated from the univariate typologies were then each compared with the multivariate typology on measures of concurrent and predictive validity, and the strength of association was compared statistically. There was evidence of significantly greater concurrent validity of the Type A/B typology compared with the univariate typologies across all the domains of validation (risk, substance use, psychopathology, personality, and overall functioning). The multivariate typology also fared better than the univariate ones in all three domains on which predictive validity was evaluated: substance use, psychopathology, and overall functioning, as well as the degree of change in several composite scores (drug, medical, legal, and psychiatric) and the global psychiatric symptom index. This direct method of comparison seemed to demonstrate the superior validity of the multivariate cluster-analytic approach over the univariate approaches to classifying subjects with drug dependence.
Basu
Debasish
D
Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA.
Ball
Samuel A
SA
Feinn
Richard
R
Gelernter
Joel
J
Kranzler
Henry R
HR
D000367:Age Factors; D000987:Antisocial Personality Disorder / Q000175:diagnosis; D001526:Behavioral Symptoms / Q000145:classification* / Q000175:diagnosis / Q000523:psychology; D016000:Cluster Analysis; D015331:Cohort Studies; D005163:Factor Analysis, Statistical; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000145:classification* / Q000175:diagnosis / Q000523:psychology