Center for Alcohol and Addiction Studies, Brown University, 60 Staniford Street, Boston, MA 02114, USA.
Drug Alcohol Depend. 2011 Jun 1;115(3):196-204. doi: 10.1016/j.drugalcdep.2010.10.023. Epub 2010 Dec 13.
Current initiatives to update diagnostic criteria for alcohol use disorders (AUDs) have stimulated dialogue about the usefulness of indicators of alcohol consumption in the diagnosis of AUDs.
This study used Rasch model analyses to examine the properties of alcohol consumption descriptors and AUD symptoms among 3382 treatment-seeking adolescents, aged 12-18 years, in the DATOS-A (United States Department of Health and Human Services, 1993-1995) baseline assessment, and evaluated the predictive validity of different scoring methods (with and without alcohol consumption) for 12-month alcohol involvement.
Rasch model analyses supported the unidimensionality of indices of alcohol consumption and AUD symptoms. Test information functions showed that adding consumption items provides further information at all points of the alcohol involvement severity spectrum. Combining AUD symptoms with indices of alcohol consumption provided better prediction of alcohol involvement after treatment than either AUD symptom counts or DSM-IV dependence diagnosis alone. Differential item functioning (DIF), however, was observed for select items. Generally, indices of drinking "too much too fast" were more severe for females, African Americans and Hispanics, while the opposite was true for items measuring "too much too often". For age, "too much too often" items were more severe for the younger (12-14 years) age group, and AUD symptoms were more severe for the older (15-18 years) age group.
Indices of alcohol consumption can be validly scaled along with AUD symptoms in this population, and their inclusion provides statistical measurement advantages. Nevertheless, caution is necessary in using consumption items in measuring alcohol involvement due to DIF observed across sex, race and age.
目前更新酒精使用障碍（AUD）诊断标准的举措激发了关于在 AUD 诊断中使用饮酒指标的有用性的讨论。
本研究使用 Rasch 模型分析，在年龄为 12-18 岁的 3382 名接受治疗的青少年中，检查了酒精消耗描述符和 AUD 症状的特征，这些青少年是 DATOS-A（美国卫生与公众服务部，1993-1995 年）基线评估的一部分，并评估了不同计分方法（有和无饮酒）对 12 个月酒精参与度的预测有效性。
Rasch 模型分析支持酒精消耗和 AUD 症状指标的单一维度。测验信息函数表明，在酒精参与严重程度谱的所有点上，添加消耗项目都会提供更多信息。将 AUD 症状与酒精消耗指数相结合，比单独使用 AUD 症状计数或 DSM-IV 依赖诊断，能更好地预测治疗后的酒精参与度。然而，观察到了选择性项目的差异项目功能（DIF）。一般来说，对于女性、非裔美国人和西班牙裔人，“喝得太多太快”的饮酒指标更为严重，而衡量“太多太频繁”的项目则相反。对于年龄，“太多太频繁”的项目对于年龄较小的（12-14 岁）年龄组更为严重，而 AUD 症状对于年龄较大的（15-18 岁）年龄组更为严重。
在该人群中，酒精消耗指标可以与 AUD 症状一起进行有效的定标，并且它们的包含提供了统计测量优势。然而，由于观察到性别、种族和年龄的 DIF，在使用消耗项目来衡量酒精参与度时需要谨慎。
