Garber Molly L, Belisario Kyla, Levitt Emily E, McCabe Randi E, Kelly John, MacKillop James
Department of Psychology, Neuroscience and Behaviour, McMaster University, 1280 Main St. West, Hamilton, Ontario L8S 4L8, Canada.
Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton and McMaster University, 100 West 5th Street, Hamilton, Ontario L8N 3K7, Canada.
Alcohol Alcohol. 2024 Nov 18;60(1). doi: 10.1093/alcalc/agae088.
Structured clinical interviewing is considered the gold standard in psychiatric diagnosis. The Diagnostic Assessment Research Tool (DART) is a novel modularized, non-copywritten, semi-structured interview; however, no studies have examined the psychometric properties of its alcohol use disorder (AUD) module. The primary aims of this study were to: (i) validate the factor structure of the DART AUD module and (ii) examine measurement invariance across several key demographic and subgroup factors.
Participants were community members in Hamilton, Canada and Boston, USA who self-identified as making a significant AUD recovery attempt (N = 499). Internal reliability was examined via the Kuder-Richardson 20 statistic, and correlations between symptom count and drinking quantity/frequency were examined. Then, symptom-level data were included in a confirmatory factor analysis to examine model fit of a single hypothesized factor structure. Finally, measurement invariance analyses were conducted for sex, age, ethnicity (White vs. racialized), and study site.
This study found evidence for adequate internal reliability (rKR20 = 0.75), and symptom scores correlated with drinking quantity and frequency (r = 0.16-0.43). Confirmatory factor analysis results suggested excellent fit for the unidimensional one-factor AUD model (χ2 = 0.09, confirmatory factor index = 0.99, Tucker Lewis index = 0.99, standardized root mean square residual = 0.06, root mean square error of approximation = 0.02). Measurement invariance analyses revealed that the factor structure was equivalent between sex, age, ethnicity, and study site.
Findings provide strong evidence for the psychometric validity of the DART AUD module and support its use in research and clinical practice. The DART represents a credible alternative to other diagnostic interviewing tools for AUD.
结构化临床访谈被认为是精神科诊断的金标准。诊断评估研究工具（DART）是一种新颖的模块化、无版权的半结构化访谈；然而，尚无研究考察其酒精使用障碍（AUD）模块的心理测量特性。本研究的主要目的是：（i）验证DART AUD模块的因子结构，以及（ii）考察几个关键人口统计学和亚组因素的测量不变性。
参与者为加拿大汉密尔顿和美国波士顿的社区成员，他们自我认定为正在进行重大的AUD康复尝试（N = 499）。通过库德-理查森20统计量检验内部信度，并考察症状计数与饮酒量/频率之间的相关性。然后，将症状水平数据纳入验证性因子分析，以检验单一假设因子结构的模型拟合度。最后，对性别、年龄、种族（白人 vs. 非白人）和研究地点进行测量不变性分析。
本研究发现有证据表明内部信度充足（rKR20 = 0.75），且症状评分与饮酒量和频率相关（r = 0.16 - 0.43）。验证性因子分析结果表明，单维单因子AUD模型拟合良好（χ2 = 0.09，验证性因子指数 = 0.99，塔克-刘易斯指数 = 0.99，标准化根均方残差 = 0.06，近似根均方误差 = 0.02）。测量不变性分析表明，因子结构在性别、年龄、种族和研究地点之间是等效的。
研究结果为DART AUD模块的心理测量效度提供了有力证据，并支持其在研究和临床实践中的应用。DART是AUD其他诊断访谈工具的可靠替代方案。
