Mennes Catharine E, Ben Abdallah Arbi, Cottler Linda B
Washington University School of Medicine, Department of Psychiatry, Epidemiology and Prevention Research Group, 40 N. Kingshighway Suite 4, Saint Louis, Missouri 63108, USA.
Addict Behav. 2009 Feb;34(2):223-6. doi: 10.1016/j.addbeh.2008.10.003. Epub 2008 Oct 10.
In NIDA-funded studies, 739 cannabis users were interviewed twice, one week apart, in St. Louis, Miami, and Sydney. To examine differences in reliability of DSM-IV cannabis abuse and dependence criteria, including 19 withdrawal symptoms, the sample was dichotomized by treatment status, GEN POP (n=416) and TX (n=278). GEN POP had good to excellent reliability for abuse criteria (kappa=.56 to .86); TX was similarly reliable (kappa=.58 to .82). The most reliable abuse criterion among both groups was "legal problems"; the least reliable was "failure to fulfill major role obligations". The reliability of dependence criteria revealed similar patterns, with GEN POP (kappa=.49 to .74) and TX (kappa=.44 to .73) being equally reliable. The most reliable dependence criterion for both groups was "tolerance"; the least reliable was "continued use despite knowledge of physical or psychological harm". Although not mentioned in the DSM-IV for cannabis, withdrawal symptoms (especially plausible ones) were commonly and reliably reported. These analyses are important to verify the harms of cannabis, including withdrawal, as well as confirming the reliability of the criteria.
在由美国国家药物滥用研究所(NIDA)资助的研究中,739名大麻使用者在圣路易斯、迈阿密和悉尼接受了两次访谈,每次访谈间隔一周。为了研究《精神疾病诊断与统计手册》第四版(DSM-IV)中大麻滥用和依赖标准的可靠性差异,包括19种戒断症状,样本按治疗状态分为两组,即普通人群组(n = 416)和治疗组(n = 278)。普通人群组在滥用标准方面具有良好到极佳的可靠性(kappa值为0.56至0.86);治疗组的可靠性类似(kappa值为0.58至0.82)。两组中最可靠的滥用标准是“法律问题”;最不可靠的是“未能履行主要角色义务”。依赖标准的可靠性呈现出类似模式,普通人群组(kappa值为0.49至0.74)和治疗组(kappa值为0.44至0.73)的可靠性相当。两组中最可靠的依赖标准是“耐受性”;最不可靠的是“尽管知道身体或心理伤害仍继续使用”。虽然DSM-IV中未提及大麻的戒断症状,但戒断症状(尤其是看似合理的症状)被普遍且可靠地报告。这些分析对于验证大麻的危害(包括戒断反应)以及确认标准的可靠性很重要。