Item Response Theory Analysis to Assess Dimensionality of Substance Use Disorder Abuse and Dependence Symptoms

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Published: Feb 2, 2017
DOI: https://doi.org/10.5750/ijpcm.v6i4.613
Keywords:
item response theory bi-factor model substance use disorder factor analysis dimensionality

Main Article Content

Levent Kirisci
Professor of Pharmaceutical Sciences and Psychiatry, University of Pittsburgh; and Co-Investigator and Director of the Statistics Core of the U.S. NIDA-funded Center for Education and Drug Abuse Research.
Ralph Tarter
Department of Pharmaceutical Sciences, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA
Maureen Reynolds
Department of Pharmaceutical Sciences, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA
Michael Vanyukov
Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA

Abstract

Background. Item response theory (IRT) based studies conducted on diverse samples showed a single dominant factor for DSM-III-R and DSM-IV substance use disorder (SUD) abuse and dependence symptoms of alcohol, cannabis, sedative, cocaine, stimulants, and opiates use disorders. IRT provides the opportunity, within a person-centered framework, to accurately gauge each person’s severity of disorder that, in turn, informs required intensiveness of treatment. Objectives. The aim of this study was to determine whether the SUD symptoms indicate a unidimensional trait or instead need to be conceptualized and quantified as a multidimensional scale. Methods. The sample was composed of families of adult SUD+ men (n=349), and SUD+ women (n=173), who qualified for DSM-III-R diagnosis of substance use disorder (abuse or dependence) and families of adult men and women who did not qualify for a SUD diagnosis (SUD- men: n=190, SUD- women: n=133). An expanded version of the Structured Clinical Interview for DSM-III-R (SCID) was administered to characterize lifetime and current substance use disorders. Item response theory methodology was used to assess the dimensionality of DSM-III-R SUD abuse and dependence symptoms.Results. A bi-factor model provided the optimal representation of the factor structure of SUD symptoms in males and females. SUD symptoms are scalable as indicators of a single common factor, corresponding to general (non-drug-specific, common) liability to addiction, combined with drug-specific liabilities. Conclusions. IRT methodology used to quantify the continuous general liability to addiction (GLA) latent trait in individuals having SUD symptoms was found effective for accurately measuring SUD severity in men and women. This may be helpful for person-centered medicine approaches to effectively address intensity of treatment.

Article Details

Issue
Vol. 6 No. 4 (2016)
Section
Regular Articles
Author Biography

Levent Kirisci, Professor of Pharmaceutical Sciences and Psychiatry, University of Pittsburgh; and Co-Investigator and Director of the Statistics Core of the U.S. NIDA-funded Center for Education and Drug Abuse Research.

I received an M.S. degree in applied statistics (1982) and M.A. and Ph.D. degrees (1985 and 1990) in mathematical and applied statistics, respectively.  Following a staff position at the University of Pittsburgh Medical School (1991-1994), I was appointed to the faculty in 1995 as Assistant Professor of Psychiatry in the University of Pittsburgh.  I was promoted to Associate Professor of Pharmaceutical Sciences and Psychiatry in 2003 and Professor in 2009.   I have been a recipient of Independent Scientist Award from U.S. National Institute on Drug Abuse (NIDA). I am also Co-Investigator and Director of the Statistics Core of the U.S. NIDA-funded Center for Education and Drug Abuse Research.  My primary expertise and research focus are devising and evaluating psychometric tools. I have been actively engaged in researching the applications of item response theory methodology and the properties of this methodology. I have spearheaded development of an interval scale to measure the psychological components of SUD liability common across the DSM-IV categories.  Employing item response theory, in conjunction with longitudinal multivariate modeling, a scale termed the liability index has been provisionally validated to quantify SUD risk at ages 10-12, 12-14, 16 and 19 in boys and girls.

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