Differential criterion functioning of alcohol use symptomatology in major depressive disorder?

Abstract

Background. Major depressive disorder (MDD) and alcohol use disorders (AUDs) are among the most prevalent psychiatric disorders and are frequently co-morbid. However, some component of this co-morbidity may be artifactual and arise from the influence of current mental state on self-reports of AUD.Method. This study examined whether past-year MDD is associated with differential criterion functioning (DCF) in reports of AUD symptomatology in male and female participants in the National Epidemiological Survey on Alcohol and Related Conditions (NEASRC).Results. Reports of past-year AUD symptomatology were adequately summarized by a single-factor model in which each of the 11 abuse and dependence criteria had high factor loadings (0.71-0.93) and did not vary between men and women after allowing for threshold differences. Co-morbid MDD was associated with higher AUD mean scores. There was some evidence for DCF with past-year MDD being associated with a lower endorsement of use in hazardous situations among men whereas women with MDD were more likely to endorse both social/interpersonal problems and emotional/physical problems.Conclusions. Several items assessing AUD display DCF in the presence of MDD. While these findings highlight the need to consider the possibility that mental state can influence reporting of psychiatric symptoms and potentially inflate estimates of co-morbidity, they suggest that only a negligible component of the co-morbidity between MDD and AUDs can be attributed to over-reporting of alcohol symptomatology conditional on current MDD.

Item Response Theory Analysis of Binge Drinking and Its Relationship to Lifetime Alcohol Use Disorder Symptom Severity in an American Indian Community Sample

“…The findings of this study do not confirm the current DSM‐IV dichotomy between alcohol abuse and dependence and indicate that DSM‐IV alcohol abuse symptoms are not, as a group, milder that dependence symptoms in this sample. These findings are similar to the findings of several IRT analyses of DSM‐III‐R and DSM‐IV AUD symptoms from a variety of predominantly EuroAmerican samples, including adults (Langenbucher et al., 2004) and adolescents (Martin et al., 2006) from inpatient and outpatient addiction treatment programs, community family studies (Krueger et al., 2004), and the NESARC epidemiologic sample (Kahler et al., 2006; Lynskey and Agrawal, 2008; Saha et al., 2006, 2007). Taken together, the results of this study and these other IRT studies are consistent with the notion that alcohol abuse and dependence diagnoses as currently formulated measure the same disorder in both American Indians and EuroAmericans.…”

“…IRT analysis has also been used to examine both past year and lifetime DSM‐IV AUD symptoms in several previous studies of adults and adolescents from epidemiological, community, and treatment samples (Kahler and Strong, 2006; Kirisci et al., 2006; Krueger et al., 2004; Langenbucher et al., 2004; Lynskey and Agrawal, 2008; Martin et al., 2006; Saha et al., 2006). In general, these studies of have found that alcohol abuse and dependence symptoms are intermixed in terms of severity and that AUD symptoms occupied the moderate and severe portions of the severity continuum.…”

Functioning of Alcohol Use Disorders Criteria Among Middle-Aged and Older Adults: Implications for DSM-5

“…That said, it is reasonable to assume that given the extensive process of informed consent and assurances of confidentiality that data were reliable and valid, providing ample information for the current analysis. DCF analyses were exploratory in nature and did not specifically control for alternative factors (either measured or unmeasured) other than the attributes we chose that may have influenced criteria endorsement, such as depression in the case of gender (Lynskey & Agrawal, 2008). Finally, inclusion of individuals 50 to 65 limits our ability to generalize our results to an older adult population 65 and older.…”

Predictors of alcohol-related problems among depressed and non-depressed women

“…About one in five women will develop an episode of major depression in their lives (Hasin et al, 2005) and these women are at increased risk to also be engaging in alcohol misuse (Lynskey & Agrawal, 2008). In this study, women who had experienced an episode of major depression in the last year were significantly more likely to have problems related to alcohol use, such as drunk driving, conflicts with others, or job difficulties.…”

“…Alcohol misuse is frequently comorbid with depression in women. For example, data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) showed that women with major depressive disorder were more likely than non-depressed women to report multiple criteria for alcohol abuse and dependence (Lynskey & Agrawal, 2008). Research has also repeatedly found associations of women’s depression with binge drinking.…”