Item Response Theory analyses of DSM-5 substance use disorder criteria in French outpatient addiction clinic participants. How much is craving special?
Drug and Alcohol Dependence. 2020-07-01; 212: 108036
DOI: 10.1016/j.drugalcdep.2020.108036
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Kervran C(1), Shmulewitz D(2), Serre F(1), Stohl M(3), Denis C(4), Hasin D(5), Auriacombe M(6).
Author information:
(1)University of Bordeaux, Phenomenology and Determinants of Appetitive Behaviors
(Addiction Team), Sleep, Addiction and Neuropsychiatry Laboratory (SANPSY), USR
CNRS 3413, 146 Bis Rue Léo Saignat, 33076, Bordeaux, France; Pôle Addictologie,
CH Ch. Perrens and CHU de Bordeaux, 121 Rue De La Béchade, 33076, Bordeaux,
France.
(2)New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY
10032, USA; Department of Psychiatry, Columbia University Irving Medical Center,
1051 Riverside Drive, New York, NY 10032, USA.
(3)New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY
10032, USA.
(4)Center for Studies of Addiction, Department of Psychiatry, Perelman School of
Medicine, University of Pennsylvania, 3535 Market St, Suite 4000, Philadelphia,
PA 19104, USA; University of Bordeaux, Phenomenology and Determinants of
Appetitive Behaviors (Addiction Team), Sleep, Addiction and Neuropsychiatry
Laboratory (SANPSY), USR CNRS 3413, 146 Bis Rue Léo Saignat, 33076, Bordeaux,
France.
(5)New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY
10032, USA; Department of Psychiatry, Columbia University Irving Medical Center,
1051 Riverside Drive, New York, NY 10032, USA; Department of Epidemiology,
Columbia University Mailman School of Public Health, 722 West 168th Street, New
York, NY 10032, USA.
(6)University of Bordeaux, Phenomenology and Determinants of Appetitive Behaviors
(Addiction Team), Sleep, Addiction and Neuropsychiatry Laboratory (SANPSY), USR
CNRS 3413, 146 Bis Rue Léo Saignat, 33076, Bordeaux, France; Pôle Addictologie,
CH Ch. Perrens and CHU de Bordeaux, 121 Rue De La Béchade, 33076, Bordeaux,
France; Center for Studies of Addiction, Department of Psychiatry, Perelman
School of Medicine, University of Pennsylvania, 3535 Market St, Suite 4000,
Philadelphia, PA 19104, USA. Electronic address: .
BACKGROUND: To evaluate the dimensionality and psychometric validity of the 11
DSM-5 criteria for 5 substance use disorders, with a focus on craving, and taking
into account age, gender and psychiatric comorbidities in a French sample of
subjects seeking addiction treatment.
METHODS: This cross-sectional study, included participants with DSM-5 substance
use disorders that sought treatment for at least one addiction from outpatient
clinics. Diagnostic criteria were evaluated with the Mini international
Neuropsychiatric Interview. In Current regular user (2 times per week), factor
and 2-parameter IRT analysis was used to investigate the dimensionality and
psychometric properties of the 11 DSM-5 SUD criteria. Differential Item and Test
functioning (DIF and DTF) analysis were performed across sociodemographic
characteristics and psychiatric disorders.
RESULTS: 1359 participants (alcohol n = 787, opiates n = 131, cocaine n = 141,
tobacco n = 1014, cannabis n = 504), were included (68% male; mean age 38.7).
One-factor dimensionality was confirmed, except for tobacco. Craving criterion
had the strongest factor loadings, lower difficulty (range, -1.29 to -0.67) and
higher discrimination (range, 2.11-3.05), and no DIF compared to other criteria.
The tobacco criteria set functioned differently by mood and anxiety disorders.
CONCLUSIONS: We confirmed the unidimensionality of the 11 SUD DSM-5 criteria and
furthermore that craving was the most selective criterion because of its
psychometric properties and no DIF compared to other criteria, regardless of the
substance in this adult clinical sample. Unidimensionality of tobacco criteria
was not confirmed, suggesting DSM-IV abuse criteria limitations as indicators of
the construct.
Copyright © 2020 Elsevier B.V. All rights reserved.
DOI: 10.1016/j.drugalcdep.2020.108036
PMID: 32464467
Conflict of interest statement: Declarations of competing interest No author
reports conflicts of interest related to this work. Dr. Auriacombe reports grants
from French Health Ministry Research Grant (PHRC), French Addiction Agency
Research Grant (MILDT/MILDECA), Aquitaine Regional Council Research Support
(CRA), during the conduct of the study; grants from Indivior, personal fees from
Bouchara Recordati, Camurus, Indivior outside the submitted work; Dr. Serre
reports grants and personal fees from French Government Addiction Agency MILDECA,
during the conduct of the study; Dr. Hasin reports grants from NIH – NIAAA,
during the conduct of the study; Dr. Kervran reports grant from French Rotary
club of Saint Medard-En-Jalles and Libourne-Saint Emilion during the conduct of
the study.