University of Houston, Graduate College of Social Work, Texas 77204-4013, United States.
Addict Behav. 2011 Nov;36(11):1095-100. doi: 10.1016/j.addbeh.2011.06.008. Epub 2011 Jun 22.
Clinicians need cannabis-specific diagnostic screens compatible with DSM-IV-TR and proposed DSM-5. A clinical sample (n=174) completed the DSM-Guided-Cannabis Screen (DSM-G-CS) 21 and 11 criteria versions and three drug comparison measures. DSM-G-CS descriptive statistics, reliabilities, three factor analyses, and eight ROC and discriminant analyses evaluated construct validity and empirical scoring. DSM-G-CS reliabilities are .88 (21-items) and .85 (11-criteria). Factor analyses (FA) with varimax rotation derived six and three factors explaining 62% to 60% of variances for the DSM-G-CS 21 and 11 respectively, with ≥.400 loadings supporting retention of all items. Cannabis withdrawal subscale reliability .952 (10-items) and FA supported one factor composite item. ROC and discriminant analyses supports DSM-G-CS 1.5 to 2.5 scoring cutoffs as empirically sound, based upon sensitivity-specificity maximums, accuracy probabilities, confidence levels and correctly classified percentages, optimal with Marijuana Screening Inventory (MSI) comparisons. Results support DSM-G-CS construct validity, empirical scoring and compatibility with DSM-IV-TR cannabis abuse or dependence and proposed DSM-5 cannabis use disorder diagnostic models. Clinically, DSM-G-CS scores of two to three (or more) suggest probable cannabis-use disorder, deserving assessment to determine diagnostic accuracy.
临床医生需要与 DSM-IV-TR 和拟议的 DSM-5 兼容的特定于大麻的诊断屏幕。一个临床样本（n=174）完成了 DSM 指导大麻筛查（DSM-G-CS）的 21 项和 11 项标准版本以及三项药物比较措施。DSM-G-CS 的描述性统计数据、可靠性、三项因素分析以及八项 ROC 和判别分析评估了结构有效性和经验评分。DSM-G-CS 的可靠性为.88（21 项）和.85（11 项标准）。使用方差最大旋转进行因子分析（FA）得出了六个和三个因素，分别解释了 DSM-G-CS 21 和 11 的 62%和 60%的方差，所有项目的负荷值均≥.400，支持保留所有项目。大麻戒断量表的可靠性为.952（10 项），FA 支持一个因子复合项目。ROC 和判别分析支持 DSM-G-CS 的 1.5 到 2.5 评分切点具有经验合理性，这基于灵敏度-特异性最大值、准确性概率、置信水平和正确分类百分比，与大麻筛查量表（MSI）的比较具有最佳效果。结果支持 DSM-G-CS 的结构有效性、经验评分以及与 DSM-IV-TR 大麻滥用或依赖以及拟议的 DSM-5 大麻使用障碍诊断模型的兼容性。从临床角度来看，DSM-G-CS 的得分为 2 到 3（或更高），提示可能患有大麻使用障碍，值得进行评估以确定诊断准确性。
