The Alcohol Dependence Scale and DSM‐5 alcohol use disorder: Severity ratings correspond insufficiently in older patients. Issue 1 (5th December 2019)

• Record Type: Journal Article
• Authors: Mejldal, Anna; Andersen, Kjeld; Bilberg, Randi; Braun, Barbara; Bogenschutz, Michael; Bühringer, Gerhard; Nielsen, Anette Søgaard; Silke, Behrendt
• Is Part Of: International journal of methods in psychiatric research. Volume 29:Issue 1(2020)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-12-05
• Subjects: alcohol dependence -- assessment -- diagnosis -- older adults -- severity; Psychiatry -- Research -- Methodology -- Periodicals; Psychiatry -- Periodicals; 616.890072
• DOI: 10.1002/mpr.1811
• Languages: English
• ISSNs: 1049-8931

Abstract

Abstract: Objectives: To investigate the psychometric properties of the frequently used Alcohol Dependence Scale (ADS) in older adults and the associations between ADS scores and alcohol use and DSM‐5 AUD symptom counts. Methods: Using baseline data from an international multicenter RCT on outpatient AUD treatment for adults aged 60+ with DSM‐5 alcohol use disorder (AUD; n = 529), we computed Cronbach's alpha (α) and applied confirmatory (CFA) and exploratory factor analysis (EFA) to determine the underlying factor structure. A structural equation model (SEM) explored the interrelationship of latent ADS factors with alcohol use and number of DSM‐5 criteria endorsed. Results: Internal consistency of the ADS (α = 0.81) was good. EFA revealed a three‐factor structure. Factor 1 ("Severe withdrawal symptoms") consisted of severe psychoperceptual and psychophysical consequences of excessive drinking, Factor 2 ("Loss of control") consisted of acute physical reactions of intoxication, and Factor 3 ("Obsessive–compulsive drinking") described habitual drinking. The SEM suggested that only Factor 3 had large effects on DSM‐5 symptom score and drinking behavior. Conclusion: Lowering the ADS threshold or focusing on ADS items from Factor 3 may be more suitable measures of severity of alcohol dependence in treatment‐seeking older adults as ADS scores are low and not closely related to DSM‐5 AUD.