National Drug and Alcohol Research Centre, University of New South Wales, NSW, 2052, Australia.
J Stud Alcohol Drugs. 2011 Sep;72(5):811-22. doi: 10.15288/jsad.2011.72.811.
The current study investigates the performance of alcohol use disorders in young adults using item response theory and differential item functioning (DIF).
The 1997 National Survey of Mental Health and Wellbeing (Australia) sample was based on a stratified, multistage area probability sample of people ages 18 years and older in the Australian population. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), alcohol use disorders were assessed in all current alcohol users (N = 7,746; 44.2% female). The psychometric properties of the DSM-IV alcohol use disorder criteria in young adults were assessed using item response theory. Age-based DIF was also assessed in each of the DSM-IV criteria for alcohol use disorders. The presence of age-based DIF in subgroups defined by sex and consumption was also examined.
Overall, problems were identified in the use in hazardous situations, persistent desire/inability to quit/cut down, and tolerance criteria in young adults. However, the DIF identified at the criterion level had little impact on total information provided by the criteria across the two age groups. Subgroup analyses indicated that for the female-only and non-heavy using subgroups, DIF was no longer detected in the use in hazardous situations criterion. The alcohol use disorder criteria were found to provide maximum information about moderate to severe pathology among young adults. There was little evidence for the DSM-IV abuse/dependence distinction in young adulthood.
Some of the DSM-IV alcohol use disorder criteria appear problematic when applied to young adults, and future research needs to focus on clarifying young adults' understanding of these problematic criteria. Although DIF was identified in three of the alcohol use disorder criteria, the total information provided by these criteria was largely the same among younger and older age groups.
本研究采用项目反应理论和差异项目功能（DIF）考察年轻人的酒精使用障碍表现。
1997 年澳大利亚全国精神健康与福利调查（澳大利亚）样本基于澳大利亚人口中分层、多阶段区域概率抽样的 18 岁及以上人群。所有当前的酒精使用者（N=7746；44.2%为女性）都使用《精神障碍诊断与统计手册》第四版（DSM-IV）评估了酒精使用障碍。采用项目反应理论评估 DSM-IV 酒精使用障碍标准在年轻人中的心理测量特性。还评估了每个 DSM-IV 酒精使用障碍标准中的年龄差异。还检查了按性别和饮酒量定义的亚组中年龄差异的存在。
总体而言，在年轻人中发现了在危险情况下使用、持续渴望/无法停止/减少使用和耐受标准存在问题。然而，在标准水平上识别出的 DIF 对两个年龄组的标准提供的总信息影响不大。亚组分析表明，对于仅女性和非重度使用亚组，在危险情况下使用标准中不再检测到 DIF。发现酒精使用障碍标准在年轻人中提供了关于中度至重度病理的最大信息。在年轻人中，DSM-IV 滥用/依赖的区别几乎没有证据。
当应用于年轻人时，DSM-IV 酒精使用障碍标准中的一些似乎存在问题，未来的研究需要集中在澄清年轻人对这些有问题标准的理解上。尽管在三个酒精使用障碍标准中识别出了 DIF，但这些标准提供的总信息量在年轻和年长人群中基本相同。
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