Rasch analysis of alcohol abuse and dependence diagnostic criteria in persons with spinal cord injury

Study design: Cross-sectional. Objective: The objective of the study is to examine whether alcohol use disorders should be conceptualized categorically as abuse and dependence as in the 'Diagnostic and Statistical Manual of Mental Disorders' 4th edition or on a single continuum with mild t...

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Bibliographic Details
Published in:Spinal cord 2017-05, Vol.55 (5), p.497-501
Main Authors: Reslan, S, Kalpakjian, C Z, Hanks, R A, Millis, S R, Bombardier, C H
Format: Article
Language:English
Subjects:
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692/700
Adolescent
Adult
Alcohol-Related Disorders - complications
Alcohol-Related Disorders - diagnosis
Anatomy
Biomedical and Life Sciences
Biomedicine
Cross-Sectional Studies
Diagnostic and Statistical Manual of Mental Disorders
Female
Human Physiology
Humans
Male
Middle Aged
Models, Statistical
Neurochemistry
Neuropsychology
Neurosciences
original-article
Severity of Illness Index
Spinal Cord Injuries - complications
United States
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Summary:Study design: Cross-sectional. Objective: The objective of the study is to examine whether alcohol use disorders should be conceptualized categorically as abuse and dependence as in the 'Diagnostic and Statistical Manual of Mental Disorders' 4th edition or on a single continuum with mild to severe category ratings as in the 'Diagnostic and Statistical Manual of Mental Disorders' 5th edition in people with spinal cord injury (SCI). Setting: United States of America. Methods: Data from 379 individuals who sustained SCI either traumatically or non-traumatically after the age of 18 and were at least 1 year post injury. Rasch analyses used the alcohol abuse and dependence modules of the Structured Clinical Interview for DSM-IV-TR Axis I Disorders Non-patient Edition (SCID-I/NP). Results: Fifty-seven percent ( n =166) of the entire sample endorsed criteria for alcohol abuse, and 25% ( n =65) endorsed criteria for alcohol dependence. Fit values were generally acceptable except for one item (for example, alcohol abuse criterion 2), suggesting that the items fit the expectation of unidimensionality. Examination of the principal components analysis did not provide support for unidimensionality. The item–person map illustrates poor targeting of items. Conclusions: Alcohol abuse and dependence criterion appear to reflect a unidimensional construct, a finding that supports a single latent construct or factor consistent with the DSM-5 diagnostic model.
ISSN:1362-4393
1476-5624
DOI:10.1038/sc.2016.146