A Dimensional Option for the Diagnosis of Substance Dependence in DSM-V

Overview

Journal Int J Methods Psychiatr Res

Specialty Psychiatry

Date 2007 Aug 19

PMID 17623392

Citations 30

Authors

John E Helzer

Kathleen K Bucholz

Michael Gossop

Affiliations

Soon will be listed here.

Abstract

In this paper we discuss the creation of dimensional equivalents for categorically defined substance use disorders (SUDs) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), which now is being created. We begin with a review of the considerable literature that has accumulated on the dimensional properties of the SUDs. These studies have primarily examined the alcohol use disorders, but work relevant to other substances is reviewed as well. The weight of evidence indicates that SUDs fit well into a unidimensional concept. We next discuss potential advantages, drawbacks, and challenges in developing a dimensional alternative for the SUDs and highlight some issues for an ongoing research agenda to further explore the challenges. Finally we offer a specific proposal for a SUDs dimensional option for DSM-V. The model we propose is based on, and would relate directly back to, the categorical criteria that will be created for the SUDs by the substance use diagnostic workgroup. It is our contention that offering a dimensional equivalent for the DSM-V categories would be of great value, but that the categorical and dimensional definitions should be based on the same symptoms and closely linked. A dimensional scale that does not relate directly to the categorical definition would be counterproductive.

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References

Teesson M, Lynskey M, Manor B, Baillie A . The structure of cannabis dependence in the community. Drug Alcohol Depend. 2002; 68(3):255-62. DOI: 10.1016/s0376-8716(02)00223-5. View

Lynskey M, Nelson E, Neuman R, Bucholz K, Madden P, Knopik V . Limitations of DSM-IV operationalizations of alcohol abuse and dependence in a sample of Australian twins. Twin Res Hum Genet. 2005; 8(6):574-84. DOI: 10.1375/183242705774860178. View

Morey L, Skinner H, Blashfield R . A typology of alcohol abusers: correlates and implications. J Abnorm Psychol. 1984; 93(4):408-17. DOI: 10.1037//0021-843x.93.4.408. View

Muthen B, Hasin D, Wisnicki K . Factor analysis of ICD-10 symptom items in the 1988 National Health Interview Survey on Alcohol Dependence. Addiction. 1993; 88(8):1071-7. DOI: 10.1111/j.1360-0443.1993.tb02126.x. View

Kosten T, Rounsaville B, Babor T, Spitzer R, Williams J . Substance-use disorders in DSM-III-R. Evidence for the dependence syndrome across different psychoactive substances. Br J Psychiatry. 1987; 151:834-43. DOI: 10.1192/bjp.151.6.834. View

Saha T, Stinson F, Grant B . The role of alcohol consumption in future classifications of alcohol use disorders. Drug Alcohol Depend. 2007; 89(1):82-92. PMC: 2727876. DOI: 10.1016/j.drugalcdep.2006.12.003. View

Kahler C, Strong D . A Rasch model analysis of DSM-IV Alcohol abuse and dependence items in the National Epidemiological Survey on Alcohol and Related Conditions. Alcohol Clin Exp Res. 2006; 30(7):1165-75. DOI: 10.1111/j.1530-0277.2006.00140.x. View

Kirisci L, Vanyukov M, Dunn M, Tarter R . Item response theory modeling of substance use: an index based on 10 drug categories. Psychol Addict Behav. 2002; 16(4):290-8. View

Johnson E, Breslau N, Anthony J . The latent dimensionality of DIS/DSM-III-R nicotine dependence: exploratory analyses. Addiction. 1996; 91(4):583-8. View

10.

FEINGOLD A, Rounsaville B . Construct validity of the dependence syndrome as measured by DSM-IV for different psychoactive substances. Addiction. 1995; 90(12):1661-9. DOI: 10.1046/j.1360-0443.1995.901216618.x. View

11.

Edwards G, Gross M . Alcohol dependence: provisional description of a clinical syndrome. Br Med J. 1976; 1(6017):1058-61. PMC: 1639901. DOI: 10.1136/bmj.1.6017.1058. View

12.

Helzer J, ROBINS L, McEvoy L, Spitznagel E, Stoltzman R, Farmer A . A comparison of clinical and diagnostic interview schedule diagnoses. Physician reexamination of lay-interviewed cases in the general population. Arch Gen Psychiatry. 1985; 42(7):657-66. DOI: 10.1001/archpsyc.1985.01790300019003. View

13.

Kraemer H, Noda A, OHara R . Categorical versus dimensional approaches to diagnosis: methodological challenges. J Psychiatr Res. 2003; 38(1):17-25. DOI: 10.1016/s0022-3956(03)00097-9. View

14.

Muthen B . Psychometric evaluation of diagnostic criteria: application to a two-dimensional model of alcohol abuse and dependence. Drug Alcohol Depend. 1996; 41(2):101-12. DOI: 10.1016/0376-8716(96)01226-4. View

15.

Grant B, Stinson F, Dawson D, Chou S, Dufour M, Compton W . Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry. 2004; 61(8):807-16. DOI: 10.1001/archpsyc.61.8.807. View

16.

Hasin D, Muthuen B, Wisnicki K, Grant B . Validity of the bi-axial dependence concept: a test in the US general population. Addiction. 1994; 89(5):573-9. DOI: 10.1111/j.1360-0443.1994.tb03333.x. View

17.

Morgenstern J, Langenbucher J, Labouvie E . The generalizability of the dependence syndrome across substances: an examination of some properties of the proposed DSM-IV dependence criteria. Addiction. 1994; 89(9):1105-13. DOI: 10.1111/j.1360-0443.1994.tb02787.x. View

18.

Gossop M, Darke S, Griffiths P, Hando J, Powis B, Hall W . The Severity of Dependence Scale (SDS): psychometric properties of the SDS in English and Australian samples of heroin, cocaine and amphetamine users. Addiction. 1995; 90(5):607-14. DOI: 10.1046/j.1360-0443.1995.9056072.x. View

19.

Muthen B . Factor analysis of alcohol abuse and dependence symptom items in the 1988 National Health Interview Survey. Addiction. 1995; 90(5):637-45. DOI: 10.1046/j.1360-0443.1995.9056375.x. View

20.

Rohan W . Quantitative dimensions of alcohol use for hospitalized problem drinkers. Dis Nerv Syst. 1976; 37(3):154-9. View