Item response theory analysis of DSM-IV criteria for inhalant-use disorders in adolescents.
OBJECTIVE
Inhalants are a serious public health concern and a dangerous form of substance use. An important unresolved issue in the inhalant literature concerns the validity of inhalant-use diagnoses and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, distinction between inhalant abuse and inhalant dependence. To address these limitations and provide the foundation for helping build stronger diagnostic and assessment tools related to inhalant problems, this study examined the dimensionality of the criteria set and the abuse-dependence distinction using item response theory (IRT) analysis.


METHODS
This study used data from a survey of the population of Missouri Division of Youth Services' residents of the residential treatment system. The current study focused on adolescents and young adults who reported a lifetime history of inhalant use (N = 279).


RESULTS
The results from the IRT analysis showed no consistent hierarchical ordering of abuse and dependence criteria, providing strong evidence against the abuse-dependence distinction. The abuse criterion of legal problems associated with use represented the item with the highest level of inhalant severity. The dependence criterion that was related to giving up important social, occupational, or recreational activities provided the most accurate discrimination between individuals at different levels of severity.


CONCLUSIONS
Inhalant-use disorders are best represented using a dimensional versus a categorical approach. IRT analysis provides guidance for selecting criteria that can be useful for brief assessments of inhalant-use problems.
Perron
Brian E
BE
School of Social Work, University of Michigan, 1080 South University Avenue, #3849, Ann Arbor, Michigan 48109-1106, USA. beperron@umich.edu
Vaughn
Michael G
MG
Howard
Matthew O
MO
Bohnert
Amy
A
Guerrero
Erick
E
D000280:Administration, Inhalation; D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D003625:Data Collection / Q000379:methods*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008923:Missouri / Q000453:epidemiology; D008960:Models, Psychological; D012114:Residential Treatment / Q000379:methods; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*