Construct and differential item functioning in the assessment of prescription opioid use disorders among American adolescents.
Abstract
OBJECTIVE:To examine the psychometric properties of diagnostic criteria for prescription
analgesic opioid use disorders (OUDs) and to identify background predictors of a latent
continuum for OUD liability. METHOD:Data were drawn from the adolescent sample of
the 2006 National Survey of Drug Use and Health. Item response theory (IRT) and multiple
indicators-multiple causes methods were used to examine DSM-IV criteria for OUDs in
a subsample of adolescents who reported nonmedical prescription opioid use in the
past year (N = 1,290). RESULTS:Among nonmedical users of prescription opioids, the
criteria of OUDs were arrayed along a single continuum of severity. All abuse criteria
were endorsed at a severity level higher than D1 (tolerance) and D5 (time spent) but
lower than D3 (taking larger amounts) and D4 (inability to cut down). Differential
item functioning in reports of dependence symptoms across adolescents' sex and race/ethnicity
were identified: withdrawal, time spent, and continued use despite medical or psychological
problems. Adjusting for the effects of differential item functioning and the demographic
variables examined, female subjects were more likely than male subjects to exhibit
a higher level of OUD liability. CONCLUSIONS:Study findings do not support the DSM-IV's
current hierarchical distinction between abuse of and dependence on prescription opioids.
Abuse symptoms in adolescents are not necessarily less severe than those of dependence.
There is evidence of some differential item functioning in the assessment of OUDs.
Type
Journal articleSubject
HumansOpioid-Related Disorders
Analgesics, Opioid
Health Surveys
Factor Analysis, Statistical
Cross-Sectional Studies
Adolescent Behavior
Psychometrics
Socioeconomic Factors
Diagnostic and Statistical Manual of Mental Disorders
Adolescent
Child
United States
Female
Male
Prescription Drugs
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https://hdl.handle.net/10161/20010Published Version (Please cite this version)
10.1097/CHI.0b013e31819e3f45Publication Info
Wu, Li-Tzy; Ringwalt, Christopher L; Yang, Chongming; Reeve, Bryce B; Pan, Jeng-Jong;
& Blazer, Dan G (2009). Construct and differential item functioning in the assessment of prescription opioid
use disorders among American adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 48(5). pp. 563-572. 10.1097/CHI.0b013e31819e3f45. Retrieved from https://hdl.handle.net/10161/20010.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.
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Show full item recordScholars@Duke
Daniel German Blazer
J. P. Gibbons Distinguished Professor Emeritus of Psychiatry
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
Bryce B. Reeve
Professor in Population Health Sciences
Dr. Bryce Reeve is a Professor of Population Health Sciences and Professor of Pediatrics
at Duke University School of Medicine. He also serves as Director of the Center for
Health Measurement since 2017. Trained in psychometric methods, Dr. Reeve’s work
focuses on assessing the impact of disease and treatments on the lives of patients
and their caregivers. This includes the development of clinical outcome assessments
using both qualitative and quantitative methods, and
Li-Tzy Wu
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.

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