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Validity of proposed DSM-5 diagnostic criteria for nicotine use disorder: results from 734 Israeli lifetime smokers

Published online by Cambridge University Press:  14 January 2013

D. Shmulewitz ,
M. M. Wall ,
E. Aharonovich ,
B. Spivak ,
A. Weizman ,
A. Frisch ,
B. F. Grant  and
D. Hasin
D. Shmulewitz
Affiliation:
New York State Psychiatric Institute, New York, NY, USA Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
M. M. Wall
Affiliation:
New York State Psychiatric Institute, New York, NY, USA Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
E. Aharonovich
Affiliation:
New York State Psychiatric Institute, New York, NY, USA Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
B. Spivak
Affiliation:
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
A. Weizman
Affiliation:
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Felsenstein Medical Research Center, Petach Tikva, Israel Research Unit, Geha Mental Health Center, Petach Tikva, Israel
A. Frisch
Affiliation:
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Felsenstein Medical Research Center, Petach Tikva, Israel
B. F. Grant
Affiliation:
Laboratory of Epidemiology and Biometry, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
D. Hasin*
Affiliation:
New York State Psychiatric Institute, New York, NY, USA Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
*
*Address for correspondence: D. S. Hasin, Ph.D., Columbia University College of Physicians and Surgeons, Department of Psychiatry, 1051 Riverside Drive #123, New York, NY 10032, USA. (Email: dsh2@columbia.edu)
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Abstract

Background

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) proposes aligning nicotine use disorder (NUD) criteria with those for other substances, by including the current DSM fourth edition (DSM-IV) nicotine dependence (ND) criteria, three abuse criteria (neglect roles, hazardous use, interpersonal problems) and craving. Although NUD criteria indicate one latent trait, evidence is lacking on: (1) validity of each criterion; (2) validity of the criteria as a set; (3) comparative validity between DSM-5 NUD and DSM-IV ND criterion sets; and (4) NUD prevalence.

Method

Nicotine criteria (DSM-IV ND, abuse and craving) and external validators (e.g. smoking soon after awakening, number of cigarettes per day) were assessed with a structured interview in 734 lifetime smokers from an Israeli household sample. Regression analysis evaluated the association between validators and each criterion. Receiver operating characteristic analysis assessed the association of the validators with the DSM-5 NUD set (number of criteria endorsed) and tested whether DSM-5 or DSM-IV provided the most discriminating criterion set. Changes in prevalence were examined.

Results

Each DSM-5 NUD criterion was significantly associated with the validators, with strength of associations similar across the criteria. As a set, DSM-5 criteria were significantly associated with the validators, were significantly more discriminating than DSM-IV ND criteria, and led to increased prevalence of binary NUD (two or more criteria) over ND.

Conclusions

All findings address previous concerns about the DSM-IV nicotine diagnosis and its criteria and support the proposed changes for DSM-5 NUD, which should result in improved diagnosis of nicotine disorders.

Keywords

CigarettesDSM-5Israelnicotine dependencenicotine use disordersreceiver operating characteristic curve analysissmokingvalidity
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 10 , October 2013 , pp. 2179 - 2190
Copyright
Copyright © Cambridge University Press 2013 

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