title: Assessing the dimensionality of lifetime DSM-IV alcohol use disorders and a quantity-frequency alcohol use criterion in the Australian population: a factor mixture modelling approach.
abstract: OBJECTIVE
  With the revision of the DSM-IV underway, two important research issues currently dominate the addiction literature: (a) how can the dimensionality of DSM-IV alcohol use disorders (AUD) diagnostic criteria best be described? and (ii) should a quantity-frequency alcohol use (QF) criterion be added to the existing diagnostic criteria set in the DSM-V? The current study addressed these aims by analysing lifetime data from a recent Australian population survey.
  
  
  METHODS
  Data from adults screened for lifetime DSM-IV AUD in the 2007 National Survey on Mental Health and Wellbeing (NSMHWB) were analysed (n = 5409). A series of alternative factor analytic, latent class and factor mixture or 'hybrid' models were used to assess the dimensionality of lifetime DSM-IV AUD diagnostic criteria and a lifetime QF criterion.
  
  
  RESULTS
  Examination of the goodness-of-fit indices revealed that a one-factor or a two-factor model, a three-class latent class model or a two-factor zero-class hybrid model, were all acceptable models for the data. A simple structure one-factor model was considered to be the most parsimonious and theoretically meaningful model, given the high correlation between the abuse and dependence factors (0.874) in the two-factor model. The inclusion of the QF criterion did not enhance the fit of the one-factor model.
  
  
  CONCLUSIONS
  Incorporating both dimensional and categorical conceptions of lifetime AUD did not provide substantial gains over a simple structure unidimensional model of AUD severity. The utility of a QF use criterion in helping to diagnose AUD is questionable. These findings should be of relevance to the DSM-5 substance use disorder workgroup.
authors.affiliation: Department of Psychology, Division of Population Health Sciences, Royal College of Surgeons Ireland, 123 St. Stephen's Green, Dublin 2, Ireland. orlamcbride@rcsi.ie
authors.forename: Orla
authors.initials: O
authors.lastname: McBride
authors.forename: Maree
authors.initials: M
authors.lastname: Teesson
authors.forename: Andrew
authors.initials: A
authors.lastname: Baillie
authors.forename: Tim
authors.initials: T
authors.lastname: Slade
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D001315:Australia / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011569:Psychiatric Status Rating Scales; D012931:Social Environment; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult