Dimensionality of hallucinogen and inhalant/solvent abuse and dependence criteria: Implications for the diagnostic and statistical manual of mental disorders—Fifth edition

Abstract

Background Prior research has demonstrated the dimensionality of Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) alcohol, nicotine, cannabis, cocaine and amphetamine abuse and dependence criteria. The purpose of this study was to examine the dimensionality of hallucinogen and inhalant/solvent abuse and dependence criteria. In addition, we assessed the impact of elimination of the legal problems abuse criterion on the information value of the aggregate abuse and dependence criteria, another proposed change for DSM- IV currently lacking empirical justification. Methods Factor analyses and item response theory (IRT) analyses were used to explore the unidimisionality and psychometric properties of hallucinogen and inhalant/solvent abuse and dependence criteria using a large representative sample of the United States (U.S.) general population. Results Hallucinogen and inhalant/solvent abuse and dependence criteria formed unidimensional latent traits. For both substances, IRT models without the legal problems abuse criterion demonstrated better fit than the corresponding model with the legal problem abuse criterion. Further, there were no differences in the information value of the IRT models with and without the legal problems abuse criterion, supporting the elimination of that criterion. No bias in the new diagnoses was observed by sex, age and race-ethnicity. Conclusion Consistent with findings for alcohol, nicotine, cannabis, cocaine and amphetamine abuse and dependence criteria, hallucinogen and inhalant/solvent criteria reflect underlying dimensions of severity. The legal problems criterion associated with each of these substance use disorders can be eliminated with no loss in informational value and an advantage of parsimony. Taken together, these findings support the changes to substance use disorder diagnoses recommended by the DSM-V Substance and Related Disorders Workgroup, that is, combining DSM-IV abuse and dependence criteria and eliminating the legal problems abuse criterion.

Latent Class Analysis of DSM-5 Criteria for Opioid Use Disorders: Results from the Iranian National Survey on Mental Health

“…Other studies using LCA agree that classes represent a continuum of severity [5,24,25,42]. Results of other recent studies on opioids [9,10,14], alcohol [7,8,10,29,31,32,33,41], cannabis [9,10,11,12,13], nicotine [16,38], and other addictive substances [9,17,18] are in agreement with this finding. In addition, the association of history of treatment for OUD in the past 12 months with the resulting classification by LCA showed the validity of the classification.…”

“…Results of some older studies demonstrated that abuse and dependence criteria are distinct and show two different aspects [3,4,5,6]. However, recent studies on consumers of alcohol [7,8], cannabis [9,10,11,12,13], opioids [9,10,14], nicotine [15,16], and other addictive substances [9,17,18] suggest one aspect for both.…”

Investigação de critérios diagnósticos utilizados no transtorno do uso de nicotina do DSM-5 em indivíduos da Área Metropolitana de São Paulo

“…The following socio-demographic correlates were considered: gender, age (categorized as [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] and 55 years or more); education (0-4, 5-8, 9-11, 12 years or more, respectively defined as low, low-average, high-average, and high); marital status (married/cohabiting, previously married [separated/divorced/widowed], never married); employment (working/student, homemaker, retired, unemployed/other);…”

“…Isso aproxima o conceito de TUT dos conceitos de transtorno do uso de álcool (Preuss et al, 2013), maconha , estimulantes , opioides (CastaldelliMaia et al, 2016), sedativos/tranqüilizantes , alucinógenos (Kerridge et al, 2011), e inalantes . No entanto, poucos estudos têm explorado a dimensionalidade da dependência do tabaco através de critérios tanto do DSM-IV como da CID-10 , especialmente fora dos países de alta renda.…”

“…The new structure of the DSM-5 [11] fuses abuse and dependence criteria from DSM-IV and ICD-10 for tobacco similar to those used in all substance disorders [12], paralleling the conceptual framework of alcohol [13], cannabis [14], stimulants [15], opioids [16], sedatives/tranquilizers [17], hallucinogens [18], and inhalants [19]. However, in the ICD-11, which should be released in 2018, the concepts and diagnostic categories of dependence and harmful use have been maintained [20].…”