A dimensional approach to understanding severity estimates and risk correlates of marijuana abuse and dependence in adults.

dc.contributor.author

Wu, Li-Tzy

dc.contributor.author

Woody, George E

dc.contributor.author

Yang, Chongming

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Pan, Jeng-Jong

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Reeve, Bryce B

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Blazer, Dan G

dc.date.accessioned

2020-02-03T04:37:12Z

dc.date.available

2020-02-03T04:37:12Z

dc.date.issued

2012-06

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2020-02-03T04:37:11Z

dc.description.abstract

While item response theory (IRT) research shows a latent severity trait underlying response patterns of substance abuse and dependence symptoms, little is known about IRT-based severity estimates in relation to clinically relevant measures. In response to increased prevalences of marijuana-related treatment admissions, an elevated level of marijuana potency, and the debate on medical marijuana use, we applied dimensional approaches to understand IRT-based severity estimates for marijuana use disorders (MUDs) and their correlates while simultaneously considering gender- and race/ethnicity-related differential item functioning (DIF). Using adult data from the 2008 National Survey on Drug Use and Health (N = 37,897), Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for MUDs among past-year marijuana users were examined by IRT, logistic regression, and multiple indicators-multiple causes (MIMIC) approaches. Among 6917 marijuana users, 15% met criteria for a MUD; another 24% exhibited subthreshold dependence. Abuse criteria were highly correlated with dependence criteria (correlation = 0.90), indicating unidimensionality; item information curves revealed redundancy in multiple criteria. MIMIC analyses showed that MUD criteria were positively associated with weekly marijuana use, early marijuana use, other substance use disorders, substance abuse treatment, and serious psychological distress. African Americans and Hispanics showed higher levels of MUDs than Whites, even after adjusting for race/ethnicity-related DIF. The redundancy in multiple criteria suggests an opportunity to improve efficiency in measuring symptom-level manifestations by removing low-informative criteria. Elevated rates of MUDs among African Americans and Hispanics require research to elucidate risk factors and improve assessments of MUDs for different racial/ethnic groups.

dc.identifier.issn

1049-8931

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1557-0657

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https://hdl.handle.net/10161/19958

dc.language

eng

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Wiley

dc.relation.ispartof

International journal of methods in psychiatric research

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10.1002/mpr.1354

dc.subject

Humans

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Marijuana Abuse

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Health Surveys

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Severity of Illness Index

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Prevalence

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Logistic Models

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Risk Factors

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Retrospective Studies

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Marijuana Smoking

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Age Factors

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Diagnostic and Statistical Manual of Mental Disorders

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Adolescent

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Adult

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Population Groups

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Ethnic Groups

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United States

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Female

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Male

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Young Adult

dc.title

A dimensional approach to understanding severity estimates and risk correlates of marijuana abuse and dependence in adults.

dc.type

Journal article

duke.contributor.orcid

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

duke.contributor.orcid

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

pubs.begin-page

117

pubs.end-page

133

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2

pubs.organisational-group

School of Medicine

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Duke

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Center for Child and Family Policy

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Sanford School of Public Policy

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Duke Clinical Research Institute

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Institutes and Centers

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Duke Institute for Brain Sciences

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University Institutes and Centers

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Institutes and Provost's Academic Units

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Psychiatry & Behavioral Sciences, Social and Community Psychiatry

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Psychiatry & Behavioral Sciences

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Clinical Science Departments

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Medicine, General Internal Medicine

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Medicine

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Center for the Study of Aging and Human Development

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Family Medicine and Community Health

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Psychiatry & Behavioral Sciences, Geriatric Behavioral Health

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Duke Cancer Institute

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Population Health Sciences

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Basic Science Departments

pubs.publication-status

Published

pubs.volume

21

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