Measuring addiction propensity and severity: the need for a new instrument.
Drug addiction research requires but lacks a valid and reliable way to measure both the risk (propensity) to develop addiction and the severity of manifest addiction. This paper argues for a new measurement approach and instrument to quantify propensity to and severity of addiction, based on the testable assumption that these constructs can be mapped onto the same dimension of liability to addiction. The case for this new direction becomes clear from a critical review of empirical data and the current instrumentation. The many assessment instruments in use today have proven utility, reliability, and validity, but they are of limited use for evaluating individual differences in propensity and severity. The conceptual and methodological shortcomings of instruments currently used in research and clinical practice can be overcome through the use of new technologies to develop a reliable, valid, and standardized assessment instrument(s) to measure and distinguish individual variations in expression of the underlying latent trait(s) that comprises propensity to and severity of drug addiction. Such instrumentation would enhance our capacity for drug addiction research on linkages and interactions among familial, genetic, psychosocial, and neurobiological factors associated with variations in propensity and severity. It would lead to new opportunities in substance abuse prevention, treatment, and services research, as well as in interventions and implementation science for drug addiction.
Conway
Kevin P
KP
Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892-9589, USA. kconway@nida.nih.gov
Levy
Janet
J
Vanyukov
Michael
M
Chandler
Redonna
R
Rutter
Joni
J
Swan
Gary E
GE
Neale
Michael
M
D006801:Humans; D011569:Psychiatric Status Rating Scales; D012306:Risk; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires
Br J Addict. 1990 Nov;85(11):1501-4
2285849
Drug Alcohol Depend. 1995 Aug;39(2):139-50
8529533
J Consult Clin Psychol. 2000 Oct;68(5):818-29
11068968
Arch Gen Psychiatry. 2008 Mar;65(3):310-8
18316677
Psychol Bull. 1992 Jul;112(1):64-105
1529040
J Appl Meas. 2007;8(1):48-64
17215565
Arch Gen Psychiatry. 1998 Nov;55(11):967-72
9819064
Ann N Y Acad Sci. 2004 Oct;1025:1-13
15542694
J Clin Invest. 2003 May;111(10):1444-51
12750391
Harv Rev Psychiatry. 2005 Jul-Aug;13(4):218-32
16126608
Arch Gen Psychiatry. 1998 Nov;55(11):973-9
9819065
Nicotine Tob Res. 2007 May;9(5):557-69
17454712
Psychophysiology. 2010 Jan 1;47(1):123-32
19674392
Harv Rev Psychiatry. 2004 Nov-Dec;12(6):305-20
15764467
J Abnorm Psychol. 1982 Jun;91(3):199-209
7096790
Am J Psychiatry. 2006 Dec;163(12):2134-40
17151165
Drug Alcohol Depend. 2009 Mar 1;100(3):221-7
19062204
Biol Psychiatry. 2009 Jul 1;66(1):9-16
19103437
Drug Alcohol Depend. 2000 Apr 1;59(1):63-75
10706976
J Subst Abuse Treat. 2008 Jan;34(1):14-24
17574804
Arch Gen Psychiatry. 1995 Jan;52(1):42-52
7811161
J Subst Abuse Treat. 2005;28 Suppl 1:S51-62
15797639
J Nerv Ment Dis. 1980 Jan;168(1):26-33
7351540
Arch Gen Psychiatry. 2008 Mar;65(3):345-55
18316681
Addict Behav. 1995 Mar-Apr;20(2):149-57
7484309
Drug Alcohol Depend. 2000 May 1;59(2):101-23
10891624
Am J Psychiatry. 2003 Apr;160(4):687-95
12668357
Am J Addict. 2004 Jan-Feb;13(1):74-82
14766440
Neurosci Biobehav Rev. 2003 Oct;27(6):507-15
14599432
Drug Alcohol Depend. 1998 Jan 1;49(2):115-21
9543648
Arch Gen Psychiatry. 2002 Aug;59(8):750-7
12150652
Annu Rev Neurosci. 2009;32:225-47
19400720
Addiction. 1995 May;90(5):607-14
7795497
Drug Alcohol Depend. 2009 Jan 1;99(1-3):296-308
18938047
Drug Alcohol Depend. 2004 Feb 7;73(2):121-32
14725951
Psychiatry Res. 2008 Feb 28;158(1):43-53
18178256
J Abnorm Psychol. 1991 Nov;100(4):449-63
1757658
J Consult Clin Psychol. 1994 Dec;62(6):1096-107
7860808
Psychiatr Serv. 1998 Jun;49(6):782-7
9634157
Arch Gen Psychiatry. 1998 Nov;55(11):982-8
9819066
J Stud Alcohol Drugs. 2009 May;70(3):414-25
19371493
Annu Rev Clin Psychol. 2008;4:325-48
18370620
Annu Rev Neurosci. 2006;29:565-98
16776597
J Stud Alcohol. 2003 Jan;64(1):127-36
12608493
J Abnorm Psychol. 2007 Nov;116(4):645-66
18020714
Nicotine Tob Res. 2003 Oct;5(5):735-46
14577990
Alcohol Clin Exp Res. 1988 Aug;12(4):458-64
3056065
Drug Alcohol Depend. 2007 Jun 15;89(1):82-92
17240085
Neuropsychopharmacology. 2010 Jan;35(1):217-38
19710631
Arch Gen Psychiatry. 2007 Nov;64(11):1313-20
17984400
Am J Psychiatry. 1972 Mar;128(9):1132-6
5060834
Dev Psychopathol. 1999 Fall;11(4):869-900
10624730
J Abnorm Psychol. 2002 Aug;111(3):411-24
12150417
J Subst Abuse Treat. 1992;9(1):27-38
1317464
Am J Psychiatry. 2003 Jun;160(6):1078-85
12777265
J Subst Abuse Treat. 2009 Jan;36(1):S5-14
19062348
Drug Alcohol Depend. 2008 Jun 1;95 Suppl 1:S29-44
18249508
Drug Alcohol Depend. 2003 Mar 1;69(2):151-67
12609696
Addict Behav. 2006 Jun;31(6):1035-49
16647219
J Nerv Ment Dis. 2001 Jun;189(6):384-92
11434639
Drug Alcohol Depend. 2008 Jun 1;95 Suppl 1:S5-S28
18343607
Arch Gen Psychiatry. 2004 Sep;61(9):922-8
15351771
J Stud Alcohol. 2006 Mar;67(2):195-203
16568565
Twin Res Hum Genet. 2006 Feb;9(1):38-45
16611466
Drug Alcohol Depend. 2009 Jan 1;99(1-3):193-203
18775607
Drug Alcohol Depend. 2003 Nov 24;72(2):183-92
14636973
Psychol Addict Behav. 2002 Dec;16(4):290-8
12503901
Neuropsychopharmacology. 2008 Jan;33(1):166-80
17805308
Am J Addict. 2006;15 Suppl 1:80-91
17182423
Nat Neurosci. 2005 Nov;8(11):1450-7
16251987
J Abnorm Psychol. 2009 Feb;118(1):117-30
19222319
Mol Psychiatry. 2008 Jul;13(7):649-53
18504426
Addict Sci Clin Pract. 2007 Dec;4(1):45-55
18292710
Am J Psychiatry. 2004 Apr;161(4):670-6
15056513
Am J Med Genet. 1996 Sep 20;67(5):473-7
8886164
Drug Alcohol Depend. 2003 Nov 24;72(2):151-62
14636970
Addict Behav. 2002 Mar-Apr;27(2):207-25
11817763
Addiction. 1997 Feb;92(2):151-62
9158226
Am J Addict. 2003;12(s2):S36-S47
12857662
Br J Psychiatry. 1996 Sep;169(3):276-81
8879712
J Nerv Ment Dis. 1992 Mar;180(3):197-201
1588339
Br J Addict. 1986 Aug;81(4):485-94
3463348
Addict Behav. 2006 Jun;31(6):1010-34
16723188
J Abnorm Psychol. 2002 Feb;111(1):124-33
11871377
Psychol Assess. 2004 Jun;16(2):107-19
15222807
Drug Alcohol Depend. 2003 Jul 20;71(1):65-75
12821207
Addict Behav. 2000 Nov-Dec;25(6):807-20
11125772
Am J Med Genet. 2000 Oct 9;96(5):684-95
11054778
Behav Pharmacol. 2009 Feb;20(1):1-17
19179847
J Abnorm Psychol. 2003 May;112(2):282-9
12784838
Am J Psychiatry. 2002 Oct;159(10):1642-52
12359667
Arch Gen Psychiatry. 1970 Aug;23(2):104-11
5428294
Adv Genet. 2005;55:41-104
16291212
Arch Gen Psychiatry. 2003 Sep;60(9):929-37
12963675
Addiction. 1993 Oct;88(10):1335-40
8251870
Mol Psychiatry. 2004 Jun;9(6):557-69
15098002
J Neurosci. 2006 Jun 14;26(24):6583-8
16775146
J Nerv Ment Dis. 1985 Jul;173(7):412-23
4009158
Alcohol Clin Exp Res. 2001 Oct;25(10):1457-66
11696665
Science. 1997 Oct 3;278(5335):52-8
9311926
Br Med J. 1976 May 1;1(6017):1058-61
773501
Am J Psychiatry. 2002 Oct;159(10):1760-6
12359684
Arch Gen Psychiatry. 1997 Jan;54(1):71-80
9006403
Addiction. 2007 Jun;102(6):920-30
17523987
Drug Alcohol Depend. 2002 Feb 1;65(3):225-34
11841894
Psychophysiology. 2007 Jan;44(1):98-105
17241145
Arch Pediatr Adolesc Med. 2008 Dec;162(12):1133-41
19047540
Behav Genet. 2009 May;39(3):233-44
19377872
Psychiatr Genet. 2007 Dec;17(6):323-32
18075472
Br J Addict Alcohol Other Drugs. 1979 Mar;74(1):79-87
283831
J Psychiatr Res. 2008 Oct;42(14):1213-9
18321529
Am J Addict. 2009 Jan-Feb;18(1):36-47
19219664
Am J Psychiatry. 2005 Aug;162(8):1403-13
16055761
Neurosci Biobehav Rev. 2003 Oct;27(6):517-26
14599433
Drug Alcohol Depend. 2012 Jun;123 Suppl 1:S18-23
22245078
Nat Rev Genet. 2009 Apr;10(4):225-31
19238175