Skip to main content
Journal cover image

Abuse and dependence on prescription opioids in adults: a mixture categorical and dimensional approach to diagnostic classification.

Publication ,  Journal Article
Wu, L-T; Woody, GE; Yang, C; Pan, J-J; Blazer, DG
Published in: Psychol Med
March 2011

BACKGROUND: For the emerging DSM-V, it has been recommended that dimensional and categorical methods be used simultaneously in diagnostic classification; however, little is known about this combined approach for abuse and dependence. METHOD: Using data (n=37 708) from the 2007 National Survey on Drug Use and Health (NSDUH), DSM-IV criteria for prescription opioid abuse and dependence among non-prescribed opioid users (n=3037) were examined using factor analysis (FA), latent class analysis (LCA, categorical), item response theory (IRT, dimensional), and factor mixture (hybrid) approaches. RESULTS: A two-class factor mixture model (FMM) combining features of categorical latent classes and dimensional IRT estimates empirically fitted more parsimoniously to abuse and dependence criteria data than models from FA, LCA and IRT procedures respectively. This mixture model included a severely affected group (7%) with a comparatively moderate to high probability (0.32-0.88) of endorsing all abuse and dependence criteria items, and a less severely affected group (93%) with a low probability (0.003-0.16) of endorsing all criteria. The two empirically defined groups differed significantly in the pattern of non-prescribed opioid use, co-morbid major depression, and substance abuse treatment use. CONCLUSIONS: A factor mixture model integrating categorical and dimensional features of classification fits better to DSM-IV criteria for prescription opioid abuse and dependence in adults than a categorical or dimensional approach. Research is needed to examine the utility of this mixture classification for substance use disorders and treatment response.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Psychol Med

DOI

EISSN

1469-8978

Publication Date

March 2011

Volume

41

Issue

3

Start / End Page

653 / 664

Location

England

Related Subject Headings

  • Young Adult
  • United States
  • Severity of Illness Index
  • Psychiatry
  • Prevalence
  • Prescription Drugs
  • Opioid-Related Disorders
  • Male
  • Logistic Models
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Wu, L.-T., Woody, G. E., Yang, C., Pan, J.-J., & Blazer, D. G. (2011). Abuse and dependence on prescription opioids in adults: a mixture categorical and dimensional approach to diagnostic classification. Psychol Med, 41(3), 653–664. https://doi.org/10.1017/S0033291710000954
Wu, L. -. T., G. E. Woody, C. Yang, J. -. J. Pan, and D. G. Blazer. “Abuse and dependence on prescription opioids in adults: a mixture categorical and dimensional approach to diagnostic classification.Psychol Med 41, no. 3 (March 2011): 653–64. https://doi.org/10.1017/S0033291710000954.
Wu, L. .. T., et al. “Abuse and dependence on prescription opioids in adults: a mixture categorical and dimensional approach to diagnostic classification.Psychol Med, vol. 41, no. 3, Mar. 2011, pp. 653–64. Pubmed, doi:10.1017/S0033291710000954.
Journal cover image

Published In

Psychol Med

DOI

EISSN

1469-8978

Publication Date

March 2011

Volume

41

Issue

3

Start / End Page

653 / 664

Location

England

Related Subject Headings

  • Young Adult
  • United States
  • Severity of Illness Index
  • Psychiatry
  • Prevalence
  • Prescription Drugs
  • Opioid-Related Disorders
  • Male
  • Logistic Models
  • Humans