Toward DSM-V: An Item Response Theory Analysis of the Diagnostic Process for DSM-IV Alcohol Abuse and Dependence in Adolescents

• NCJ Number: 224981
• Journal: Journal of the American Academy of Child & Adolescent Psychiatry Volume: 47 Issue: 11 Dated: November 2008 Pages: 1329-1339
• Author(s): Heather Gelhorn Ph.D.; Christie Hartman Ph.D.; Joseph Saki M.D.; Michael Stallings Ph.D.; Susan Young Ph.D.; Soo Hyun Rhee Ph.D.; Robin Corley Ph.D.; John Hewitt Ph.D.; Christian Hopfer M.D.; Thomas Crowley M.D.
• Date Published: November 2008
• Length: 11 pages
• Grant Number(s): DA11015; DA12845; DA05131; DA015522; MH01865; DA016314
• Sponsoring Agency: National Institute of Mental Health
• Publication Format: Article
• Publication Type: Report (Study/Research)
• Language: English
• Country: United States of America

Annotation

Item response theory analyses were used to examine alcohol abuse and dependence symptoms and diagnoses in adolescents, with a view toward determining the adequacy of the DSM-IV distinction between alcohol abuse and dependence symptoms.

Abstract

The study concludes that the distinction between DSM-IV alcohol abuse and dependence based on severity can be improved by using an alternative diagnostic algorithm that considers all of the alcohol abuse and dependence symptoms conjointly. Although the DSM-IV diagnostic categories differ in severity of alcohol-use disorders (AUDs), there is substantial overlap and inconsistency in AUD severity across these categories. Item Response Theory-based AUD severity estimates suggest that many persons diagnosed with abuse have AUD severity greater than persons with alcohol dependence. Similarly, many persons who have some symptoms but do not qualify for a diagnosis have more severe AUDs than persons with a diagnosis of abuse. In addition, two alcohol-dependence items, “tolerance” and “larger/longer,” show differences in severity between samples. The study involved 5,587 adolescents between the ages of 12 and 18, who were recruited from adjudicated, clinical, and community samples. They were administered structured clinical interviews. Analyses then examined the severity of alcohol abuse and dependence symptoms as well as the severity of AUDs within the diagnostic categories created by the DSM-IV. 2 tables, 4 figures, and 41 references