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. 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

Dvora Shmulewitz  1 , Katherine Keyes, Cheryl Beseler, Efrat Aharonovich, Christina Aivadyan, Baruch Spivak, Deborah Hasin
Affiliations

The dimensionality of alcohol use disorders: results from Israel

Dvora Shmulewitz et al. Drug Alcohol Depend. .

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.

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Figures

Figure 1
Figure 1
Item Characteristic Curves, Current Drinkers
Figure 2
Figure 2
Item Information Curves, Current Drinkers
Figure 3
Figure 3
Item Characteristic Curves, Lifetime Drinkers
Figure 4
Figure 4
Item Information Curves, Lifetime Drinkers
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