RELIABILITY/VALIDITY OF DSM/ICD SUBSTANCE USE DISORDERS

DSM/ICD 物质使用障碍的可靠性/有效性

• 批准号: 2377363
• 负责人: Linda B. Cottler
• 金额: $ 27.02万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1988
• 资助国家: 美国
• 起止时间: 1988-09-30 至 2001-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2377363
• 关键词: African American; adolescence (12-20); behavioral /social science research tag; clinical research; diagnosis quality /standard; disease /disorder classification; human subject; interview; longitudinal human study; mental disorder diagnosis; substance abuse related disorder

This amended competing continuation grant seeks to continue, without interruption, Dr. Cottler's first NIDA-funded study--the "Reliability and Validity of DSM and ICD Substance Use Disorders" (DA05585). Begun in 1988, this reliability and validity study (the "RV" study) has achieved a high level of productivity. Of note is the heterogeneous study sample. In addition, funds from this grant have allowed the investigators to continue development of a widely-used non-clinician administered diagnostic instrument. The RV study is one of only several grants funded by NIDA which have focused on the nosology of substance use disorders. Although numerous findings and accomplishments have been attributable to the RV study, unresolved issues concerning the diagnosis of addiction and impairment remain. The investigators propose to continue reliability studies with new respondent cohorts and to continue validation studies through longitudinal evaluation of subjects previously interviewed. Specifically, they propose: 1) To study the lingering issues related to the classification of substance use disorders, highlighted by the DSM-IV Substance Use Disorders Workgroup by interviewing new cohorts of users of less-investigated substances, by continuing to analyze previously collected data, and by following up previously interviewed subjects to determine course, outcome and impairment to understand if a) one set of criteria is appropriate for all substances and populations; b) tolerance and physical withdrawal symptoms should be required for dependence. Should the two withdrawal criteria (withdrawal symptoms and withdrawal relief) be combined? c) social consequences and occupational impairment should be excluded from the dependence concept; d) caffeine dependence can be reliably and validly assessed; e) attention should be given to abuse to make it more distinct and less a "residual" category; f) dependence and abuse are best represented by a two factor concept or if one factor underlies both. Are these factors different for each substance and for different populations? g) the threshold number of criteria chosen for abuse and dependence predicts course and outcome; h) compared to DSMIII, III-R and ICD-10, the DSM-IV rates of abuse and dependence for all substances differ cross-sectionally and longitudinally; i) the DSM-IV clustering criterion is reliable and valid. 2) To continue the development of a diagnostic instrument which assesses level of addiction, as well as severity and remission, taking advantage of state of the art techniques aimed at improving recall; 3) To continue methodological work on the acceptability, feasibility, coverage and one-week test-retest reliability of multiple dependence concepts focusing on prescribed, as well as non- prescribed drugs of abuse, and adding drug using populations not included in the original and first continuation of the RV study, such as adolescents, chronic pain patients, and sedative-hypnotic abusers.

这项修订的竞争延续赠款试图继续，而无需 中断，科特勒博士的第一项NIDA资助的研究 - “可靠性和 DSM和ICD物质使用障碍的有效性”（DA05585）。始于1988年， 这项可靠性和有效性研究（“ RV”研究）已达到很高 生产力水平。值得注意的是异质研究样本。 在 此外，这笔赠款的资金使调查人员得以继续 开发广泛使用的非临床医生管理诊断 乐器。 RV研究是NIDA资助的仅有的几项赠款之一 专注于物质使用障碍的诺斯学。 虽然 RV归因于许多发现和成就 研究，有关成瘾诊断和的未解决问题 损害仍然存在。调查人员建议继续可靠性 与新受访者队列的研究并继续验证研究 通过对先前采访的受试者的纵向评估。 具体来说，他们建议：1）研究与 DSM-IV强调的物质使用障碍的分类 药物使用障碍工作组通过采访新的众多用户 通过继续分析以前进行分析 收集的数据，并跟进先前对主题的采访 确定课程，结果和损害，以了解a）一组 标准适用于所有物质和种群； b）公差 依赖性应需要身体戒断症状。应该 两个提款标准（戒断症状和戒断的缓解）是 合并？ c）社会后果和职业障碍应该是 排除在依赖概念之外； d）咖啡因依赖性可能是 可靠和有效评估； e）应注意虐待 使其更独特，更少一个“残留”类别； f）依赖和 滥用最好由两个因素概念代表，或者一个因素 两者是两个基础。这些因素是否有不同的因素和 不同的人群？ g）选择的标准阈值数量 虐待和依赖预测课程和结果； h）与DSMIII相比 III-R和ICD-10，所有人的DSM-IV滥用和依赖率 物质在横截面和纵向上有所不同； i）DSM-IV 聚类标准是可靠且有效的。 2）继续发展 评估成瘾水平的诊断工具以及 严重性和缓解，利用最先进的技术 旨在改善召回； 3）继续关于 可接受性，可行性，覆盖范围和一周的重测可靠性 多个依赖概念的重点是规定的以及非依赖概念 规定的滥用药物，并使用不包括种群的人添加药物 在RV研究的原始和首次延续中，例如 青少年，慢性疼痛患者和镇静性催眠虐待者。