The dimensionality of alcohol use disorders: results from Israel.


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.

DOI: 10.1016/j.drugalcdep.2010.04.002

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@article{Shmulewitz2010TheDO, title={The dimensionality of alcohol use disorders: results from Israel.}, author={Dvora Shmulewitz and Katherine Keyes and Cheryl Beseler and Efrat Aharonovich and Christina Aivadyan and Baruch Spivak and Deborah Hasin}, journal={Drug and alcohol dependence}, year={2010}, volume={111 1-2}, pages={146-54} }