A data-driven method for identifying shorter symptom criteria sets: the case for DSM-5 alcohol use disorder

AbstractBackgroundAlthough the DSM is a widely used diagnostic guide, lengthy criteria sets can be problematic and provide the primary motivation to identify short-forms. Using the 11 diagnostic criteria provided by the DSM-5 for alcohol use disorder (AUD), the present study develops a data-driven method to systematically identify subsets and associated cut-offs that yield diagnoses as similar as possible to use all 11 criteria.MethodRelying on data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III), our methodology identifies diagnostic short-forms for AUD by: (1) maximizing the association between the sum scores of all 11 criteria with newly constructed subscales from subsets of criteria; (2) optimizing the similarity of AUD prevalence between the current DSM-5 rule and newly constructed diagnostic short-forms; (3) maximizing sensitivity and specificity of the short-forms against the current DSM-5 rule; and (4) minimizing differences in the accuracy of the short-form across chosen covariates. Replication is shown using NESARC-Wave 2.ResultsMore than 11 000 diagnostic short-forms for DSM-5 AUD can be created and our method narrows down the optimal choices to eight. Results found that ‘Neglecting major roles’ and ‘Activities given up’ could be dropped with practically no change in who is diagnosed (specificity = 100%, sensitivity ⩾ 99.6%) or the severity of those diagnosed (κ = 0.97).ConclusionsWith a continuous improvement model adopted by the APA for DSM revisions, we offer a data-driven tool (a SAS Macro) that identifies diagnostic short-forms in a systematic and reproducible way to help advance potential improvements in future DSM revisions.

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Prevalence and Correlates of Past‐Year Recovery From DSM‐5 Alcohol Use Disorder: Results From National Epidemiologic Survey on Alcohol and Related Conditions‐III

Alcoholism Clinical and Experimental Research ◽

10.1111/acer.14192 ◽

2019 ◽

Vol 43 (11) ◽

pp. 2406-2420 ◽

Cited By ~ 7

Author(s):

Amy Z. Fan ◽

Sanchen Patricia Chou ◽

Haitao Zhang ◽

Jeesun Jung ◽

Bridget F. Grant

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Dsm 5 ◽

Epidemiologic Survey

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Childhood Trauma Predicts Less Remission from PTSD among Patients with Co-Occurring Alcohol Use Disorder and PTSD

Journal of Clinical Medicine ◽

10.3390/jcm9072054 ◽

2020 ◽

Vol 9 (7) ◽

pp. 2054

Author(s):

Paul Brunault ◽

Kevin Lebigre ◽

Fatima Idbrik ◽

Damien Maugé ◽

Philippe Adam ◽

...

Keyword(s):

Alcohol Use ◽

Childhood Trauma ◽

Alcohol Use Disorder ◽

Short Form ◽

Baseline Risk ◽

Longitudinal Assessment ◽

Post Traumatic Stress ◽

Childhood Trauma Questionnaire ◽

Dsm 5 ◽

History Of

Post-traumatic stress disorder (PTSD) is highly prevalent among patients hospitalized for an alcohol use disorder (AUD). Hospitalization can improve PTSD and AUD outcomes in some but not all patients, but we lack data on the baseline predictors of PTSD non-remission. This study aimed to determine the baseline risk factors for non-remitted PTSD in patients hospitalized for an AUD. Of 298 AUD inpatients recruited in a rehabilitation center (Le Courbat, France), we included 91 AUD inpatients with a co-occurring PTSD and a longitudinal assessment at baseline (T1) and before discharge (T2: 8 weeks later). Patients were assessed for PTSD diagnosis/severity (PCL-5=PTSD Checklist for DSM-5), different types of trauma including childhood trauma (LEC-5=Life Events Checklist for DSM-5/CTQ-SF=Childhood Trauma Questionnaire, Short-Form), and AUD diagnosis/severity (clinical interview/AUDIT=Alcohol Use Disorders Identification Test). Rate of PTSD remission between T1 and T2 was 74.1%. Non-remitted PTSD at T2 was associated with a history of childhood trauma (physical, emotional or sexual abuse, physical negligence), but not with other types of trauma experienced, nor baseline PTSD or AUD severity. Among patients hospitalized for an AUD with co-occurring PTSD, PTSD remission was more strongly related to the existence of childhood trauma than to AUD or PTSD severity at admission. These patients should be systematically screened for childhood trauma in order to tailor evidence-based interventions.

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DSM-5 alcohol use disorder features among treatment-seeking older adults

SUCHT - Zeitschrift für Wissenschaft und Praxis / Journal of Addiction Research and Practice ◽

10.1024/0939-5911/a000550 ◽

2018 ◽

Vol 64 (4) ◽

pp. 185-196 ◽

Cited By ~ 2

Author(s):

Silke Behrendt ◽

Barbara Braun ◽

Randi Bilberg ◽

Gerhard Bühringer ◽

Michael Bogenschutz ◽

...

Keyword(s):

Older Adults ◽

Alcohol Use ◽

Alcohol Use Disorder ◽

The Elderly ◽

Treatment Seeking ◽

Controlled Clinical Trial ◽

Dsm 5 ◽

Wide Range ◽

And Gender ◽

International Multicenter

Abstract. Background: The number of older adults with alcohol use disorder (AUD) is expected to rise. Adapted treatments for this group are lacking and information on AUD features in treatment seeking older adults is scarce. The international multicenter randomized-controlled clinical trial “ELDERLY-Study” with few exclusion criteria was conducted to investigate two outpatient AUD-treatments for adults aged 60+ with DSM-5 AUD. Aims: To add to 1) basic methodological information on the ELDERLY-Study by providing information on AUD features in ELDERLY-participants taking into account country and gender, and 2) knowledge on AUD features in older adults seeking outpatient treatment. Methods: baseline data from the German and Danish ELDERLY-sites (n=544) were used. AUD diagnoses were obtained with the Mini International Neuropsychiatric Interview, alcohol use information with Form 90. Results: Lost control, desired control, mental/physical problem, and craving were the most prevalent (> 70 %) AUD-symptoms. 54.9 % reported severe DSM-5 AUD (moderate: 28.2 %, mild: 16.9 %). Mean daily alcohol use was 6.3 drinks at 12 grams ethanol each. 93.9 % reported binging. More intense alcohol use was associated with greater AUD-severity and male gender. Country effects showed for alcohol use and AUD-severity. Conclusion: European ELDERLY-participants presented typical dependence symptoms, a wide range of severity, and intense alcohol use. This may underline the clinical significance of AUD in treatment-seeking seniors.

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Towards the characterization and validation of alcohol use disorder subtypes: integrating consumption and symptom data

Psychological Medicine ◽

10.1017/s0033291713000573 ◽

2013 ◽

Vol 44 (1) ◽

pp. 143-159 ◽

Cited By ~ 6

Author(s):

K. M. Jackson ◽

K. K. Bucholz ◽

P. K. Wood ◽

D. Steinley ◽

J. D. Grant ◽

...

Keyword(s):

Alcohol Consumption ◽

Alcohol Use ◽

Alcohol Use Disorder ◽

Model Comparison ◽

Latent Class ◽

Common Factor ◽

Hybrid Approaches ◽

Epidemiologic Survey ◽

Alcohol Involvement ◽

Best Fitting

BackgroundThere is evidence that measures of alcohol consumption, dependence and abuse are valid indicators of qualitatively different subtypes of alcohol involvement yet also fall along a continuum. The present study attempts to resolve the extent to which variations in alcohol involvement reflect a difference in kindversusa difference in degree.MethodData were taken from the 2001–2002 National Epidemiologic Survey of Alcohol and Related Conditions. The sample (51% male; 72% white/non-Hispanic) included respondents reporting past 12-month drinking at both waves (wave 1:n = 33644; wave 2:n = 25186). We compared factor mixture models (FMMs), a hybrid of common factor analysis (FA) and latent class analysis (LCA), against FA and LCA models using past 12-month alcohol use disorder (AUD) criteria and five indicators of alcohol consumption reflecting frequency and heaviness of drinking.ResultsModel comparison revealed that the best-fitting model at wave 1 was a one-factor four-class FMM, with classes primarily varying across dependence and consumption indices. The model was replicated using wave 2 data, and validated against AUD and dependence diagnoses. Class stability from waves 1 to 2 was moderate, with greatest agreement for the infrequent drinking class. Within-class associations in the underlying latent factor also revealed modest agreement over time.ConclusionsThere is evidence that alcohol involvement can be considered both categorical and continuous, with responses reduced to four patterns that quantitatively vary along a single dimension. Nosologists may consider hybrid approaches involving groups that vary in pattern of consumption and dependence symptomatology as well as variation of severity within group.

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Cognitive deficits in problematic drinkers with and without mild to borderline intellectual disability

Journal of Intellectual Disabilities ◽

10.1177/1744629516664840 ◽

2016 ◽

Vol 22 (1) ◽

pp. 5-17 ◽

Cited By ~ 6

Author(s):

Neomi van Duijvenbode ◽

Robert Didden ◽

Joanne EL VanDerNagel ◽

Hubert PLM Korzilius ◽

Rutger CME Engels

Keyword(s):

Intellectual Disability ◽

Alcohol Use ◽

Cognitive Deficits ◽

Alcohol Use Disorder ◽

Short Form ◽

Adult Intelligence Scale ◽

Intelligence Scale ◽

Wechsler Adult Intelligence Scale ◽

Disorder Identification ◽

Wechsler Adult Intelligence

We examined cognitive deficits in problematic drinkers with and without mild to borderline intellectual disability (MBID). Problematic drinkers were expected to show a significantly lower estimated performance IQ (PIQ), but not a lower estimated verbal IQ (VIQ), compared to light drinkers. Participants ( N = 474) were divided into four groups based on IQ and severity of alcohol use-related problems. IQ was estimated using (a short form of) the Wechsler Adult Intelligence Scale third edition. Severity of alcohol use-related problems was assessed using the Alcohol Use Disorder Identification Test. Overall, there were no significant differences between light and problematic drinkers on estimated VIQ. Within the group without MBID, estimated PIQ was significantly lower. Estimated PIQ was not lower in problematic drinkers with MBID compared to light drinkers with MBID. The results are indicative of cognitive deficits in problematic drinkers without MBID. Screening for cognitive deficits with additional instruments is advised.

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