title: Refining measures of alcohol problems for general population surveys.
abstract: BACKGROUND
  There is a need to improve classification of alcohol use disorders (AUDs) in general population surveys. We developed and tested follow-up questions for 2 commonly reported symptom domains (withdrawal and larger/longer) to assess effects on Diagnostic and Statistical Manual-5 AUD classification.
  
  
  METHODS
  Telephone interviews recontacted a selective follow-up sample of respondents under age 46 from the 2010 National Alcohol Survey with at least 1 lifetime AUD symptom (n = 244). Items included detailed questions about past-year AUD symptoms. Three items (vomiting, sweating, irritability) were recoded as acute intoxication rather than withdrawal if they most recently occurred within 8 hours of stopping drinking. The larger/longer criterion was recoded as socially motivated if respondents endorsed "got caught up in drinking with a group of friends" and not "feel compelled to drink and just can't stop" as a reason for drinking more than intended.
  
  
  RESULTS
  Of 225 current drinkers, 11% reported past-year withdrawal, with 28% of those reporting acute intoxication instead of physical withdrawal. Adjusting past-year withdrawal classification reduced AUD prevalence by 6%. A minority (12%) reported the past-year larger/longer criterion. Of those, 50% indicated social reasons for drinking more than intended, rather than compulsion to drink. Adjusting the past-year larger/longer criterion reduced AUD prevalence by 8%. Accounting for both adjustments reduced AUD prevalence by 13%. Cases that met AUD criteria after both adjustments were substantially heavier drinkers than those that were reclassified.
  
  
  CONCLUSIONS
  Follow-up items could be implemented in epidemiologic studies with minimal response burden and may help reduce misclassification of AUD.
authors: Alcohol Research Group, Public Health Institute, Emeryville, California.
authors: Katherine J
authors: KJ
authors: Karriker-Jaffe
authors: Jane
authors: J
authors: Witbrodt
authors: Thomas K
authors: TK
authors: Greenfield
mesh_terms: D000293:Adolescent; D000328:Adult; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000453:epidemiology; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology*; D002492:Central Nervous System Depressants / Q000009:adverse effects*; D004361:Drug Tolerance; D000431:Ethanol / Q000009:adverse effects*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D002492:Central Nervous System Depressants; D000431:Ethanol
keywords: Alcohol Use Disorder; Measurement; Population Surveys