Alcohol Dependence and Abuse Diagnoses: Validity in Community Sample Heavy Drinkers

Abstract

Despite the widespread influence of the alcohol dependence syndrome concept on the major nosological classification systems, little work has been done to test the validity of the alcohol dependence syndrome in community samples. In addition, numerous questions have been asked about the validity of current definitions of alcohol abuse. We examined the cross-sectional validity of DSM-IV alcohol dependence and abuse in 936 household residents randomly selected and screened for elevated drinking. We investigated validity by testing the association of a set of seven "criterion" variables, external to the alcohol diagnostic criteria, with dependence and abuse diagnoses. Results indicated that dependence diagnoses were significantly associated with all criterion variables when compared to those with no diagnosis, even though all subjects had elevated drinking and the cases of alcohol dependence were mild. In contrast, abuse diagnoses did not show a pattern of association with the criterion variables when compared to no diagnosis. When associations were tested comparing dependence cases to those with abuse only, results were mixed. This study is one in a series of investigations in this sample of household residents screened for elevated drinking levels.

Differentiating DSM-IV alcohol dependence and abuse by course: Community heavy drinkers

“…This report lends further weight to evidence from cross-sectional research (Hasin et al, 1996b;Hasin et al, 1997) that the dependence diagnosis is indeed valid in this group, given the differences in course between those with dependence and those with either alcohol abuse or no alcohol diagnosis.…”

Evidence for a closing gender gap in alcohol use, abuse, and dependence in the United States population

“…The alcohol abuse diagnosis has been shown to have adequate reliability when measured independently of the alcohol dependence diagnosis (Canino et al, 1999;Chatterji et al, 1997). The validity of these diagnoses has been documented in numerous studies including the World Health Organization/National Institutes of Health and Reliability and Validity Study Canino et al, 1999;Cottler et al, 1997;Pull et al, 1997;Ustun et al, 1997;Vrasti et al, 1998;Hasin et al, 1997b) and others (Hasin et al, 1997c;Hasin et al, 1997a;Grant et al, 2003;Grant et al, 1995). Further, the symptom items have been validated using clinical reappraisals conducted by psychiatrists (Canino et al, 1999); good validity of the alcohol diagnoses was documented (K = 0.60, 0.76).…”

Evidence for a two-stage model of dependence using the NESARC and its implications for genetic association studies

“…These had excellent reliability in U.S. and international clinical and general population samples, with alcohol diagnoses having a minimum kappa of 0.74 and drug diagnoses having a minimum reliability of 0.79 (Canino et al, 1999;Chatterji et al, 1997;Grant et al, 1995;Grant et al, 2003;Hasin et al, 1997b). Validity was demonstrated in numerous studies including the World Health Organization/National Institutes of Health and Reliability and Validity Study (Chatterji et al, 1997;Cottler et al, 1997;Hasin et al, 2003;Pull et al, 1997;Vrasti et al, 1998), psychiatrist re-examination (Canino et al, 1999) and others (Grant et al, 1992;Grant, 1996;Grant and Harford, 1990;Hasin and Grant, 1994;Hasin et al, 1997a;Hasin et al, 1997c;Hasin and Paykin, 1999).…”

“…The ordinal variable was divided into four ordinal categories: 0% positive, >0% -<25% positive, >25% -<50% positive, and >50% positive. The test-retest reliability of AUDADIS family history variables is very good to excellent (Grant et al, 1995;Grant et al, 2003;Hasin et al, 1997c).…”