Age-related Psychometric Dimensionality Using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition Opioid Use Disorder Diagnostic Criteria.

IF 4.2 3区 医学 Q1 SUBSTANCE ABUSE
Journal of Addiction Medicine Pub Date : 2024-11-01 Epub Date: 2024-07-23 DOI:10.1097/ADM.0000000000001343
Alyssa M Falise, Ziying Li, Anne Corinne Huggins-Manley, Catalina Lopez-Quintero, Linda B Cottler, Catherine W Striley
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引用次数: 0

Abstract

Objectives: Age-related psychometric differences in Diagnostic and Statistical Manual of Mental Disorders, 5th Edition ( DSM-5 ) opioid use disorder (OUD) diagnostic criteria have been hypothesized, but not been tested. This study investigated DSM-5 OUD diagnostic criteria for age-related measurement noninvariance among younger adults (YAs) and middle/older adults (MOAs) with past 12-month nonmedical use of prescription opioids.

Methods: People who participated in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions III and reported past 12-month nonmedical use of prescription opioids were included. YAs were 18-49 years old, and MOAs were 50+ years old. Item response theory, differential item functioning (DIF), and differential test functioning were used to assess for age-related measurement noninvariance.

Results: One in 5 people met the DSM-5 OUD diagnostic criteria for OUD within the past 12 months, with the most endorsed criteria being tolerance (17.96%). DIF was identified for 3 criteria, including (1) taking opioids for longer or in larger doses than intended, (2) long periods spent obtaining/using/recovering from use, and (3) withdrawal. DIF was associated with the latent OUD severity needed to correctly endorse the criteria, with criteria being correctly endorsed at less severe levels of latent OUD for MOAs when compared with YAs. Differential test functioning analyses showed collectively the criteria had improved detection in MOAs when compared with YAs ( P < 0.01).

Conclusions: These findings suggest that there may be age-related variations in the DSM-5 OUD diagnostic criteria's ability to detect latent OUD. Future research should identify contributing factors and the influence it has on the accuracy of age-specific surveillance estimations.

使用《精神障碍诊断与统计手册》第五版《阿片类药物使用障碍诊断标准》进行与年龄相关的心理测量维度分析。
目的:有人假设《精神疾病诊断与统计手册》第 5 版(DSM-5)阿片类药物使用障碍(OUD)诊断标准存在与年龄相关的心理测量差异,但尚未进行测试。本研究调查了过去 12 个月非医疗使用处方阿片类药物的年轻成人(YAs)和中老年成人(MOAs)中与年龄相关的 OUD 诊断标准的测量非方差性:方法:纳入了参加 2012 年至 2013 年全国酒精及相关疾病流行病学调查 III 并报告过去 12 个月非医疗使用处方类阿片的人群。YAs为18-49岁,MOAs为50岁以上。采用项目反应理论、差异项目功能(DIF)和差异测试功能来评估与年龄有关的测量非方差:每 5 人中就有 1 人在过去 12 个月内符合 DSM-5 OUD 诊断标准,其中最认可的标准是耐受性(17.96%)。在 3 个标准中发现了 DIF,包括:(1)服用阿片类药物的时间或剂量超过预期;(2)长时间获取/使用/从使用中恢复;以及(3)戒断。DIF 与正确认可这些标准所需的潜在 OUD 严重程度有关,与 YAs 相比,MOA 的潜在 OUD 严重程度较低时,其认可的标准也较正确。差异测试功能分析显示,与青年患者相比,MOA 患者对标准的集体检测能力有所提高(P < 0.01):这些研究结果表明,DSM-5 OUD 诊断标准检测潜在 OUD 的能力可能存在与年龄相关的差异。未来的研究应确定诱因及其对特定年龄监测估计准确性的影响。
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来源期刊
Journal of Addiction Medicine
Journal of Addiction Medicine 医学-药物滥用
CiteScore
6.10
自引率
9.10%
发文量
260
审稿时长
>12 weeks
期刊介绍: The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.
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