Construct validity of the dependence syndrome as measured by DSM-IV for different psychoactive substances

Abstract

The Diagnosis of Drug Dependence in the Official Psychiatric Nomenclatures (DSM-III-R, DSM-IV, and ICD 10) are based on the Drug Dependence Syndrome construct. Although the validity and utility of the dependence syndrome has been widely documented for alcohol, the generalizability of the dependence syndrome to other psychoactive substances is still not clear. Thus, this article examines the construct validity of the drug dependence syndrome, as measured by diagnostic criteria for DSM-IV, using both internal consistency analyses and confirmatory factor analyses. Data were obtained from non-mutually exclusive groups of abusers for five drugs (alcohol, cocaine, marijuana, opioids, sedatives, stimulants) drawn from a pool of 521 subjects obtained from drug treatment, general psychiatric and community samples. As predicted by the theory, drug dependence items were found to be unidimensional and factorially distinct from measures of the consequences of substance abuse (e.g. legal problems) for all drug groups. Moreover, the drug dependence items yielded internally consistent scales that produced a distribution of scores reflecting a continuum from low to high severity of abuse for all drugs.