Use of item response theory and latent class analysis to link poly-substance use disorders with addiction severity, HIV risk, and quality of life among opioid-dependent patients in the Clinical Trials Network.

Wu, Li-Tzy

Ling, Walter

Burchett, Bruce

Blazer, Dan G

Yang, Chongming

Pan, Jeng-Jong

Reeve, Bryce B

Woody, George E

2020-02-03T05:37:21Z

2020-02-03T05:37:21Z

2011-11

2020-02-03T05:37:20Z

BACKGROUND:This study applied item response theory (IRT) and latent class analysis (LCA) procedures to examine the dimensionality and heterogeneity of comorbid substance use disorders (SUDs) and explored their utility for standard clinical assessments, including the Addiction Severity Index (ASI), HIV Risk Behavior Scale (HRBS), and SF-36 quality-of-life measures. METHODS:The sample included 343 opioid-dependent patients enrolled in two national multisite studies of the U.S. National Drug Abuse Treatment Clinical Trials Network (CTN001-002). Patients were recruited from inpatient and outpatient addiction treatment settings at 12 programs. Data were analyzed by factor analysis, IRT, LCA, and latent regression procedures. RESULTS:A two-class LCA model fit dichotomous SUD data empirically better than one-parameter and two-parameter IRT models. LCA distinguished 10% of severe comorbid opioid-dependent individuals who had high rates of all SUDs examined-especially amphetamine and sedative abuse/dependence-from the remaining 90% who had SUDs other than amphetamine and sedative abuse/dependence (entropy=0.99). Item-level results from both one-parameter and two-parameter IRT models also found that amphetamine and sedative abuse/dependence tapped the more severe end of the latent poly-SUD trait. Regardless of whether SUDs were defined as a continuous trait or categorically, individuals characterized by a high level of poly-SUD demonstrated more psychiatric problems and HIV risk behaviors. CONCLUSIONS:A combined application of categorical and dimensional latent approaches may improve the understanding of comorbid SUDs and their associations with other clinical indicators. Abuse of sedatives and methamphetamine may serve as a useful marker for identifying subsets of opioid-dependent individuals with needs for more intensive interventions.

S0376-8716(11)00144-X

0376-8716

1879-0046

https://hdl.handle.net/10161/19984

eng

Elsevier BV

Drug and alcohol dependence

10.1016/j.drugalcdep.2011.03.018

Humans

HIV Infections

Substance-Related Disorders

Opioid-Related Disorders

Severity of Illness Index

Risk

Risk-Taking

Quality of Life

Adult

Middle Aged

Female

Male

Use of item response theory and latent class analysis to link poly-substance use disorders with addiction severity, HIV risk, and quality of life among opioid-dependent patients in the Clinical Trials Network.

Journal article

Wu, Li-Tzy|0000-0002-5909-2259

Reeve, Bryce B|0000-0002-6709-8714

186

193

2-3

School of Medicine

Duke

Center for Child and Family Policy

Sanford School of Public Policy

Duke Clinical Research Institute

Institutes and Centers

Duke Institute for Brain Sciences

University Institutes and Centers

Institutes and Provost's Academic Units

Psychiatry & Behavioral Sciences, Social and Community Psychiatry

Psychiatry & Behavioral Sciences

Clinical Science Departments

Medicine, General Internal Medicine

Medicine

Center for the Study of Aging and Human Development

Family Medicine and Community Health

Psychiatry & Behavioral Sciences, Geriatric Behavioral Health

Staff

Duke Cancer Institute

Population Health Sciences

Basic Science Departments

Published

118