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《精神疾病诊断与统计手册》第四版(DSM-IV)所测量的不同精神活性物质依赖综合征的结构效度。

Construct validity of the dependence syndrome as measured by DSM-IV for different psychoactive substances.

作者信息

Feingold A, Rounsaville B

机构信息

Yale University, Substance Abuse Center, Connecticut Mental Health Center, New Haven 06519, USA.

出版信息

Addiction. 1995 Dec;90(12):1661-9. doi: 10.1046/j.1360-0443.1995.901216618.x.

Abstract

The Diagnosis of Drug Dependence in the Official Psychiatric Nomenclatures (DSM-III-R, DSM-IV, and ICD 10) are based on the Drug Dependence Syndrome construct. Although the validity and utility of the dependence syndrome has been widely documented for alcohol, the generalizability of the dependence syndrome to other psychoactive substances is still not clear. Thus, this article examines the construct validity of the drug dependence syndrome, as measured by diagnostic criteria for DSM-IV, using both internal consistency analyses and confirmatory factor analyses. Data were obtained from non-mutually exclusive groups of abusers for five drugs (alcohol, cocaine, marijuana, opioids, sedatives, stimulants) drawn from a pool of 521 subjects obtained from drug treatment, general psychiatric and community samples. As predicted by the theory, drug dependence items were found to be unidimensional and factorially distinct from measures of the consequences of substance abuse (e.g. legal problems) for all drug groups. Moreover, the drug dependence items yielded internally consistent scales that produced a distribution of scores reflecting a continuum from low to high severity of abuse for all drugs.

摘要

官方精神疾病命名法(《精神疾病诊断与统计手册》第三版修订本、《精神疾病诊断与统计手册》第四版和国际疾病分类第十版)中药物依赖的诊断基于药物依赖综合征结构。尽管依赖综合征在酒精方面的有效性和实用性已得到广泛记录,但该依赖综合征对其他精神活性物质的可推广性仍不明确。因此,本文使用内部一致性分析和验证性因素分析,检验了以《精神疾病诊断与统计手册》第四版诊断标准衡量的药物依赖综合征的结构效度。数据来自从521名受试者中抽取的非相互排斥的五组药物(酒精、可卡因、大麻、阿片类药物、镇静剂、兴奋剂)滥用者,这些受试者来自药物治疗、普通精神科和社区样本。正如该理论所预测的,对于所有药物组,发现药物依赖项目是单维的,并且在因子上与物质滥用后果(如法律问题)的测量不同。此外,药物依赖项目产生了内部一致的量表,这些量表产生的分数分布反映了所有药物从低到高滥用严重程度的连续体。

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