Item Response Theory Analysis of Lifetime Cannabis-Use Disorder Symptom Severity in an American Indian Community Sample

Abstract

ABSTRACT. Objective: the aim of this study was to use item Response theory to assess Diagnostic and statistical Manual of Mental Disorders, third edition, Revised (DsM-iii-R), lifetime cannabis-use disorder (cuD) symptom severity and its relationship to first cannabis use before age 15 years, male gender, and childhood conduct disorder in an american indian community sample. Method: the semi-structured assessment for the genetics of alcoholism was used to determine demographic information, age at first use, and DsM-iii-R childhood conduct disorder and lifetime cuD symptoms in a community sample of 349 american indian participants who had used cannabis at least 21 times in a single year. two-parameter item Response theory models generated marginal maximum likelihood estimates for discrimination (a) and threshold (b) parameters for nine DsM-iii-R cuD symptoms along an underlying latent cuD severity continuum. Differential item Functioning (DiF) analysis was used to assess for differences in symptom severity in groups defined by presence versus absence of age at first use before 15 years, male gender, and childhood conduct disorder. Results: cuD symptoms of "use in larger amounts or over longer periods of time," "activities given up," and "role failure" were the most severe symptoms. all cuD symptoms fell on the moderate portion of the severity continuum. "time spent" was more severe in individuals who first used cannabis after age 15 years, "hazardous use" was more severe in females, and "use in larger amounts or over longer periods of time" was more severe in individuals with co-morbid childhood conduct disorder. Conclusions: specific risk factors for the development of lifetime cuD are associated with increased severity of several cuD symptoms in this high-risk group. (J. Stud. Alcohol

Contributions of Ethnicity to Differential Item Functioning of Cannabis Abuse and Dependence Symptoms

“…This is consistent with a previous study that tested for DIF of DSM-III-R (American Psychiatric Association, 1987) cannabis abuse and dependence symptoms as a function of sex in the present Native American sample. This study reported signifi cant evidence of DIF as a function of sex for only a single symptom (hazardous use) (Gilder et al, 2009), though other studies have reported more prominent sex differences (Harford et al, 2009;Srisurapanont et al, 2012).…”

“…As part of a larger study examining the etiology of substance use disorders in a community sample of American Indians living on reservations (see Ehlers et al, 2001Ehlers et al, , 2004Ehlers et al, , 2007Gilder et al, 2004Gilder et al, , 2009), the present study applied IRT methods to accomplish two specifi c aims: (a) to evaluate whether cannabis misuse symptoms assess a continuous latent trait that indexes the severity of cannabis use in both Native Americans living on reservations and European Americans and (b) to evaluate whether individual cannabis misuse symptoms differentially index severity in these two populations. Because the Native American community under study has been shown to exhibit very high rates of substance use disorders (e.g., 70% alcohol dependent, 60% cannabis dependent), we chose to use an equally affected population of European Americans for the present report, the University of California, San Francisco (UCSF) Family Alcoholism Study population (70% alcohol dependent, 44% cannabis dependent), which is a nationwide population-based sample selected for the presence of alcohol dependence (Ehlers et al, 2010).…”

Measuring historical trauma in an American Indian community sample: Contributions of substance dependence, affective disorder, conduct disorder and PTSD

“…The present report is part of a larger family study exploring risk factors for substance dependence in a community sample of American Indians (Ehlers et al, 2001a, 2001b, 2001c, 2001d, 2004a, 2008c; Gilder et al, 2004, 2006, 2007, 2009). The lifetime prevalence of trauma and substance dependence in this Indian population is high and genetic and environmental risk factors for substance dependence have been identified (Ehlers and Wilhelmsen, 2005, 2007; Ehlers et al, 2004b, 2006, 2007a, 2007b, 2007c, 2008a, 2008b, 2009, 2010a, 2010b, 2011, 2012; Gizer et al, 2011; Wall et al, 2003; Wilhelmsen and Ehlers, 2005).…”

Genome-wide scan for self-rating of the effects of alcohol in American Indians

“…The present report is part of a larger study exploring risk factors for substance dependence among Native American Indians (see Ehlers et al , 2001a,b,c,d; 2004a, 2008c; Gilder et al, 2004, 2006, 2007, 2009). The lifetime prevalence of substance dependence in this Indian population is high and evidence for heritability and linkage to specific chromosome locations and associations with candidate genes has been demonstrated (see Wall et al, 2003; Ehlers et al, 2004b, 2006b, 2007a,b,c, 2008a,b, 2009a,b, 2010a; Ehlers and Wilhelmsen, 2005, 2007; Wilhelmsen and Ehlers, 2005).…”