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Drug Alcohol Depend. 2010 Sep 1;111(1-2):146-54. doi: 10.1016/j.drugalcdep.2010.04.002. Epub 2010 May 26.

The dimensionality of alcohol use disorders: results from Israel.

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1
New York State Psychiatric Institute, New York, NY 10032, USA.

Abstract

AIMS:

To prepare for DSM-V, the structure of DSM-IV alcohol dependence and abuse criteria and a proposed additional criterion, at-risk drinking, require study in countries with low per-capita consumption, and comparison of current and lifetime results within the same sample. We investigated DSM-IV Alcohol Use Disorder (AUD) criteria in Israel, where per-capita alcohol consumption is low.

METHODS:

Household residents selected from the Israeli population register (N=1338) were interviewed with the AUDADIS. Item response theory analyses were conducted using MPlus, and diagnostic thresholds were examined with the kappa statistic.

RESULTS:

Dependence and abuse criteria fit a unidimensional model interspersed across the severity continuum, for both current and lifetime timeframes. Legal problems were rare and did not improve model fit. Weekly at-risk drinking reflected greater severity than in U.S. samples. When dependence and abuse criteria were combined, a diagnostic threshold of > or =3 criteria produced the best agreement with DSM-IV diagnoses (kappa>0.80).

CONCLUSION:

Consistent with other studies, alcohol dependence and abuse criteria reflected a latent variable representing a single AUD. Results suggested little effect in removing legal problems and little gained by adding weekly at-risk drinking. Results contribute to knowledge about AUD criteria by examining them in a low-consumption country.

PMID:
20537809
PMCID:
PMC3884677
DOI:
10.1016/j.drugalcdep.2010.04.002
[Indexed for MEDLINE]
Free PMC Article
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