Do DSM-5 substance use disorder criteria differ by user care settings? An item response theory analysis approach
Addictive Behaviors. 2021-05-01; 116: 106797
DOI: 10.1016/j.addbeh.2020.106797
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Kervran C(1), Shmulewitz D(2), Serre F(1), Denis C(3), Roux P(4), Jauffret-Roustide M(5), Lalanne L(6), Hasin D(7), Auriacombe M(8).
Author information:
(1)University of Bordeaux, Addiction Team, Sleep Addiction and Neuropsychiatry Laboratory (SANPSY), Bordeaux, France; USR CNRS 3413, Bordeaux, France; Pôle Addictologie, CH Ch. Perrens and CHU de Bordeaux, Bordeaux, France.
(2)New York State Psychiatric Institute, New York, NY, United States; Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States.
(3)University of Bordeaux, Addiction Team, Sleep Addiction and Neuropsychiatry Laboratory (SANPSY), Bordeaux, France; USR CNRS 3413, Bordeaux, France; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
(4)Aix Marseille University, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l’Information Médicale, Marseille, France. (5)Cermes3, Inserm U988, CNRS UMR 8236, Université de Paris, EHESS, Paris, France; British Columbia Centre on Substance Use (BCCSU), Vancouver, Canada; Baldy Center for Law and Social Policy, Buffalo University of Social Sciences, Buffalo, NY, United States.
(6)INSERM 1114, Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France.
(7)Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States.
(8)University of Bordeaux, Addiction Team, Sleep Addiction and Neuropsychiatry Laboratory (SANPSY), Bordeaux, France; USR CNRS 3413, Bordeaux, France; Pôle Addictologie, CH Ch. Perrens and CHU de Bordeaux, Bordeaux, France; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States. Electronic address:
.
AIM: To examine differences in the psychometric characteristics of diagnostic criteria for Substance Use Disorders (SUD) between substance users in harm reduction settings (HR) and substance users seeking treatment (Tx).
METHODS: Differential Item and Test Functioning (DIF & DTF) analysis were performed to examine differences in the difficulty of endorsement and in discrimination of the 11 diagnostic criteria and to test if the criteria set as a whole (the « test ») functioned differently by care settings (Tx vs. HR) for alcohol, cocaine, cannabis, opiates and tobacco. To test uniform and nonuniform DIF, multiple indicator multiple cause (MIMIC) structural equation models were
used.
RESULTS: Regardless of the substance, the DSM-5 criteria « craving », « large amount », « time spent », « tolerance » and « activities given up » had similar functioning by care settings. Little evidence for DIF was found for other criteria. The criteria set as a whole did not function differently by care
settings for alcohol, cocaine and tobacco. At the same trait severity, compared to HR, the Tx subgroup had a greater number of endorsed criteria for cannabis and a smaller number of endorsed criteria for opioids.
CONCLUSION: The unidimensionality of the 11 DSM-5 criteria and applicability of all criteria and diagnosis was confirmed in this large sample of problematic substance users. While the majority of the criteria related to loss of control of substance use, functioned well in both care settings, the criteria related to consequences of substance use had several differential functioning.