Kosten T A, Kosten T R
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06519.
Recent Dev Alcohol. 1990;8:47-68.
The dependence syndrome concept has been defined by both behavioral and biological changes that occur with excessive substance use. Originally developed for alcohol, this concept was adopted for diagnosing dependence on other substances of abuse, although little research had been done to test its validity for other drugs. This chapter addresses the validity of the dependence concept across drug classes in the following ways. First, we compare the dependence items for three different drugs, alcohol, opiates, and cocaine, in measures of internal consistency. Second, biological items are correlated with behavioral items to assess the usefulness of defining dependence by both biological and behavioral criteria. Finally, we draw upon ideas developed in motivational theory and apply these to the dependence syndrome concept. These analyses, while supporting the validity of the concept, lead to suggestions for refining the concept of dependence.
依赖综合征的概念是由过度使用物质时发生的行为和生物学变化所定义的。该概念最初是针对酒精提出的，后来被用于诊断对其他滥用物质的依赖，尽管几乎没有研究来检验其对其他药物的有效性。本章通过以下方式探讨依赖概念在不同药物类别中的有效性。首先，我们比较酒精、阿片类药物和可卡因这三种不同药物在内部一致性测量中的依赖项目。其次，将生物学项目与行为项目进行关联，以评估通过生物学和行为标准来定义依赖的有用性。最后，我们借鉴动机理论中提出的观点，并将其应用于依赖综合征的概念。这些分析虽然支持了该概念的有效性，但也为完善依赖概念提出了建议。
