Agrawal Arpana, Lynskey Michael T
Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid, Box 8134, St. Louis, MO 63110, USA.
Drug Alcohol Depend. 2007 May 11;88(2-3):300-7. doi: 10.1016/j.drugalcdep.2006.10.003. Epub 2006 Nov 3.
Previous research has noted that a unidimensional latent construct underlies criteria for cannabis abuse and dependence. However, no study to date has explored whether gender contributes to heterogeneity in the latent abuse and dependence construct and furthermore, whether after accounting for differences in the mean scores of abuse and dependence across genders, there is any evidence for heterogeneity in the individual abuse and dependence criteria. The present study utilizes data on criteria for cannabis abuse and dependence from a large, nationally representative sample (National Epidemiological Survey on Alcohol and Related Conditions) of 8172 lifetime cannabis users to investigate whether gender contributes to heterogeneity in the underlying construct of cannabis abuse and dependence, and in each individual criterion as well. Analyses, all of which were conducted in MPlus, included factor analysis, as well as MIMIC and multiple-group models for an examination of dimensionality and gender heterogeneity, respectively. Results favor a unidimensional construct for cannabis abuse/dependence, as seen in prior research. We also identify two abuse (legal and hazard) and two dependence (quit and problems) criteria, which show significant gender heterogeneity with the abuse criteria exhibiting higher thresholds in women and the dependence criteria in men. We conclude that the criteria that serve as indicators of DSM-IV cannabis abuse and dependence do not function identically in men and women and that certain criteria (e.g. hazardous use) require further refinement.
先前的研究指出,大麻滥用和依赖标准背后存在一个单维潜在结构。然而,迄今为止尚无研究探讨性别是否会导致潜在滥用和依赖结构的异质性,此外,在考虑了不同性别在滥用和依赖平均得分上的差异之后,是否有证据表明个体滥用和依赖标准存在异质性。本研究利用来自一个具有全国代表性的大样本(酒精及相关状况全国流行病学调查)中8172名终生大麻使用者的大麻滥用和依赖标准数据,来调查性别是否会导致大麻滥用和依赖潜在结构的异质性,以及是否会导致每个个体标准的异质性。所有分析均在MPlus中进行,包括因子分析,以及分别用于检验维度和性别异质性的MIMIC模型和多组模型。结果支持大麻滥用/依赖的单维结构,正如先前研究所见。我们还确定了两个滥用标准(法律和危害)和两个依赖标准(戒断和问题),它们显示出显著的性别异质性,其中滥用标准在女性中表现出更高的阈值,而依赖标准在男性中更高。我们得出结论,作为《精神疾病诊断与统计手册》第四版大麻滥用和依赖指标的标准在男性和女性中并非具有相同作用,并且某些标准(例如危险使用)需要进一步完善。