103 - Use of the DSM-IV: Methods and Approaches

Abstract

This chapter summarizes the general organization of Diagnostic and Statistical Manual (DSM-IV) and the historical background of the alcohol abuse and dependence criteria, including the basis of the division between abuse and dependence in DSM-III-R, DSM-IV and ICD-10. Current criteria for diagnoses of dependence and abuse, intoxication and withdrawal are presented. To assess the DSM-IV criteria for alcohol abuse and dependence in a consistent, systematic way, and numerous fully- and semi-structured diagnostic interviews are developed. It compares the fully and semi-structured approach to research interviews, and then presents the development and main features of important semi-structured (SCID, SSAGA, SCAN, PRISM) and fully-structured (CIDI, AUDADIS) research diagnostic interviews. Test-retest reliability studies of alcohol abuse and dependence, as measured by these interviews, have consistently indicated high reliability for the dependence category but much lower reliability for abuse. Studies of validity have included longitudinal studies, factor analysis, multi-method comparisons, and construct validation. Studies generally support the validity of dependence, but raise some questions about the validity of abuse as currently defined.