title: Measuring addiction propensity and severity: the need for a new instrument.
abstract: 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.
authors.affiliation: 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
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Conway
authors.forename: Janet
authors.initials: J
authors.lastname: Levy
authors.forename: Michael
authors.initials: M
authors.lastname: Vanyukov
authors.forename: Redonna
authors.initials: R
authors.lastname: Chandler
authors.forename: Joni
authors.initials: J
authors.lastname: Rutter
authors.forename: Gary E
authors.initials: GE
authors.lastname: Swan
authors.forename: Michael
authors.initials: M
authors.lastname: Neale
mesh_terms: 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
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