Midwest Alcoholism Research Center and Department of Psychological Sciences, University of Missouri-Columbia, Columbia, Missouri.
Psychology Department, Texas Tech University, Lubbock, Texas.
J Stud Alcohol Drugs. 2014 May;75(3):530-5. doi: 10.15288/jsad.2014.75.530.
Some individuals will not meet criteria for a lifetime alcohol use disorder (AUD) at a baseline assessment but will at a follow-up measurement, but not because the disorder began after the initial evaluation. Despite several research implications, this type of unreliability of lifetime AUD estimates has not been studied extensively. The present study investigated the extent of false negatives in the assessment of lifetime AUDs using longitudinal data.
A prospective cohort of college freshmen (baseline N = 489) were assessed seven times between ages 18 and 34 years using the Diagnostic Interview Schedule. Individuals were categorized as false negatives at the index assessment using a retrospective (using Diagnostic and Statistical Manual of Mental Disorders, Third Edition [DSM-III], and DSM-IV data), a prospective (using DSM-III data only), and a combined approach (using DSM-III data only).
For DSM-IV, of the 29 ostensible new onsets at a follow-up 5 years later (age approximately 34 years), 28 (96%) reported meeting AUD criteria before the index assessment (age approximately 29 years). For DSM-III, of the 25 ostensible new onsets, the retrospective, prospective, and combined approaches categorized 18 (72%) individuals as false negatives at the index assessment.
These findings further demonstrate sensitivity issues with lifetime AUD assessments and call into question the validity of "onset" cases that rely on only two waves of data, especially when the follow-up assessment fails to reassess lifetime fully (i.e., across the entire drinking history).
有些个体在基线评估时不符合终身酒精使用障碍（AUD）的标准，但在随访测量时符合，但这并非因为该障碍是在初始评估后开始的。尽管存在一些研究意义，但这种终身 AUD 估计的不可靠性尚未得到广泛研究。本研究使用纵向数据调查了评估终身 AUD 时假阴性的程度。
一项针对大学新生的前瞻性队列研究（基线 N=489）在 18 至 34 岁之间使用诊断访谈表进行了 7 次评估。使用回溯法（使用《精神障碍诊断与统计手册》第三版[DSM-III]和 DSM-IV 数据）、前瞻性法（仅使用 DSM-III 数据）和综合法（仅使用 DSM-III 数据），根据索引评估将个体归类为假阴性。
对于 DSM-IV，在随后的 5 年随访（年龄约为 34 岁）中，29 例假定的新发病例中有 28 例（96%）在索引评估（年龄约为 29 岁）前报告符合 AUD 标准。对于 DSM-III，在 25 例假定的新发病例中，回溯法、前瞻性法和综合法将 18 例（72%）个体归类为索引评估时的假阴性。
这些发现进一步证明了终身 AUD 评估存在敏感性问题，并对仅依赖两波数据的“发病”病例的有效性提出了质疑，特别是当随访评估未能全面重新评估终身情况（即，跨越整个饮酒史）时。
