Abuse and dependence on prescription opioids in adults: a mixture categorical and dimensional approach to diagnostic classification.
Repository Usage Stats
For the emerging DSM-V, it has been recommended that dimensional and categorical methods be used simultaneously in diagnostic classification; however, little is known about this combined approach for abuse and dependence.Using data (n=37 708) from the 2007 National Survey on Drug Use and Health (NSDUH), DSM-IV criteria for prescription opioid abuse and dependence among non-prescribed opioid users (n=3037) were examined using factor analysis (FA), latent class analysis (LCA, categorical), item response theory (IRT, dimensional), and factor mixture (hybrid) approaches.A two-class factor mixture model (FMM) combining features of categorical latent classes and dimensional IRT estimates empirically fitted more parsimoniously to abuse and dependence criteria data than models from FA, LCA and IRT procedures respectively. This mixture model included a severely affected group (7%) with a comparatively moderate to high probability (0.32-0.88) of endorsing all abuse and dependence criteria items, and a less severely affected group (93%) with a low probability (0.003-0.16) of endorsing all criteria. The two empirically defined groups differed significantly in the pattern of non-prescribed opioid use, co-morbid major depression, and substance abuse treatment use.A factor mixture model integrating categorical and dimensional features of classification fits better to DSM-IV criteria for prescription opioid abuse and dependence in adults than a categorical or dimensional approach. Research is needed to examine the utility of this mixture classification for substance use disorders and treatment response.
Severity of Illness Index
Factor Analysis, Statistical
Diagnostic and Statistical Manual of Mental Disorders
Published Version (Please cite this version)10.1017/S0033291710000954
Publication InfoWu, L-T; Woody, GE; Yang, C; Pan, J-J; & Blazer, DG (2011). Abuse and dependence on prescription opioids in adults: a mixture categorical and dimensional approach to diagnostic classification. Psychological medicine, 41(3). pp. 653-664. 10.1017/S0033291710000954. Retrieved from https://hdl.handle.net/10161/19993.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
More InfoShow full item record
Professor of Psychiatry and Behavioral Sciences
I am currently semi-retired. Most of my recent work has been focused on roles with the National Academy of Medicine (former Institute of Medicine). I have chaired three committees during the past four years, one on the mental health and substance use workforce, one on cognitive aging, and one on hearing loss in adults. I currently also chair the Board on the Health of Select Populations for the National Academies. In the past I have been PI on a number of research
Professor in Psychiatry and Behavioral Sciences
Education/Training: Pre- and post-doctoral training in mental health service research, psychiatric epidemiology (NIMH T32), and addiction epidemiology (NIDA T32) from Johns Hopkins University School of Public Health (Maryland); Fellow of the NIH Summer Institute on the Design and Conduct of Randomized Clinical Trials.Director: Duke Community Based Substance Use Disorder Research Program.Research interests: COVID-19, Opioid misuse, Opioid overdose, Opioid use disorder
Alphabetical list of authors with Scholars@Duke profiles.