DSM-IV 酒精使用障碍标准与大学生 binge 饮酒的潜类别分析。
A latent class analysis of DSM-IV alcohol use disorder criteria and binge drinking in undergraduates.
机构信息
Department of Psychology, Colorado State University, Fort Collins, USA.
出版信息
Alcohol Clin Exp Res. 2012 Jan;36(1):153-61. doi: 10.1111/j.1530-0277.2011.01595.x. Epub 2011 Oct 17.
BACKGROUND
Adolescent and adult samples have shown that the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) abuse and dependence criteria lie on a continuum of alcohol problem severity, but information on criteria functioning in college students is lacking. Prior factor analyses in a college sample (Beseler et al., 2010) indicated that a 2-factor solution fit the data better than a single-factor solution after a binge drinking criterion was included. The second dimension may indicate a clustering of criteria related to excessive alcohol use in this college sample.
METHODS
The present study was an analysis of data from an anonymous, online survey of undergraduates (N = 361) that included items pertaining to the DSM-IV alcohol use disorder (AUD) diagnostic criteria and binge drinking. Latent class analysis (LCA) was used to determine whether the criteria best fit a categorical model, with and without a binge drinking criterion.
RESULTS
In an LCA including the AUD criteria only, a 3-class solution was the best fit. Binge drinking worsened the fit of the models. The largest class (class 1, n = 217) primarily endorsed tolerance (18.4%); none were alcohol dependent. The middle class (class 2, n = 114) endorsed primarily tolerance (81.6%) and drinking more than intended (74.6%); 34.2% met criteria for dependence. The smallest class (class 3, n = 30) endorsed all criteria with high probabilities (30 to 100%); all met criteria for dependence. Alcohol consumption patterns did not differ significantly between classes 2 and 3. Class 3 was characterized by higher levels on several variables thought to predict risk of alcohol-related problems (e.g., enhancement motives for drinking, impulsivity, and aggression).
CONCLUSIONS
Two classes of heavy-drinking college students were identified, one of which appeared to be at higher risk than the other. The highest risk group may be less likely to "mature out" of high-risk drinking after college.
背景
青少年和成年人群体的研究表明，《精神疾病诊断与统计手册》第四版（DSM-IV）的滥用和依赖标准存在于酒精问题严重程度的连续体上，但缺乏关于大学生群体中标准功能的信息。在一个大学生样本中进行的先前因素分析（Beseler 等人，2010 年）表明，在纳入 binge drinking 标准后，双因素解决方案比单因素解决方案更能拟合数据。第二个维度可能表明在这个大学生样本中，与过度饮酒相关的标准聚类。
方法
本研究分析了一项针对本科生的匿名在线调查（N=361）的数据，其中包括与 DSM-IV 酒精使用障碍（AUD）诊断标准和 binge drinking 相关的项目。潜在类别分析（LCA）用于确定标准是否最适合类别模型，包括和不包括 binge drinking 标准。
结果
在仅包括 AUD 标准的 LCA 中，三分类解决方案是最佳拟合。 binge drinking 降低了模型的拟合度。最大的类别（类别 1，n=217）主要支持耐受性（18.4%）；没有人依赖酒精。中间类别（类别 2，n=114）主要支持耐受性（81.6%）和饮酒量超过预期（74.6%）；34.2%符合依赖标准。最小的类别（类别 3，n=30）以高概率（30%至 100%）支持所有标准；所有人都符合依赖标准。2 类和 3 类之间的饮酒模式没有显著差异。类别 3 的特点是几个被认为预测与酒精相关问题风险的变量水平较高（例如，饮酒的增强动机、冲动和攻击性）。
结论
确定了两类大量饮酒的大学生，其中一类似乎比另一类风险更高。风险最高的群体在大学毕业后可能不太可能“成熟”，不再有高风险的饮酒行为。
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