This amended competing continuation grant seeks to continue, without interruption, Dr. Cottler's first NIDA-funded study--the """"""""Reliability and Validity of DSM and ICD Substance Use Disorders"""""""" (DA05585). Begun in 1988, this reliability and validity study (the """"""""RV"""""""" study) has achieved a high level of productivity. Of note is the heterogeneous study sample. In addition, funds from this grant have allowed the investigators to continue development of a widely-used non-clinician administered diagnostic instrument. The RV study is one of only several grants funded by NIDA which have focused on the nosology of substance use disorders. Although numerous findings and accomplishments have been attributable to the RV study, unresolved issues concerning the diagnosis of addiction and impairment remain. The investigators propose to continue reliability studies with new respondent cohorts and to continue validation studies through longitudinal evaluation of subjects previously interviewed. Specifically, they propose: 1) To study the lingering issues related to the classification of substance use disorders, highlighted by the DSM-IV Substance Use Disorders Workgroup by interviewing new cohorts of users of less-investigated substances, by continuing to analyze previously collected data, and by following up previously interviewed subjects to determine course, outcome and impairment to understand if a) one set of criteria is appropriate for all substances and populations; b) tolerance and physical withdrawal symptoms should be required for dependence. Should the two withdrawal criteria (withdrawal symptoms and withdrawal relief) be combined? c) social consequences and occupational impairment should be excluded from the dependence concept; d) caffeine dependence can be reliably and validly assessed; e) attention should be given to abuse to make it more distinct and less a """"""""residual"""""""" category; f) dependence and abuse are best represented by a two factor concept or if one factor underlies both. Are these factors different for each substance and for different populations? g) the threshold number of criteria chosen for abuse and dependence predicts course and outcome; h) compared to DSMIII, III-R and ICD-10, the DSM-IV rates of abuse and dependence for all substances differ cross-sectionally and longitudinally; i) the DSM-IV clustering criterion is reliable and valid. 2) To continue the development of a diagnostic instrument which assesses level of addiction, as well as severity and remission, taking advantage of state of the art techniques aimed at improving recall; 3) To continue methodological work on the acceptability, feasibility, coverage and one-week test-retest reliability of multiple dependence concepts focusing on prescribed, as well as non- prescribed drugs of abuse, and adding drug using populations not included in the original and first continuation of the RV study, such as adolescents, chronic pain patients, and sedative-hypnotic abusers.
| Scheier, Lawrence M; Ben Abdallah, Arbi; Inciardi, James A et al. (2008) Tri-city study of Ecstasy use problems: a latent class analysis. Drug Alcohol Depend 98:249-63 |
