THE DIMENSIONALITY OF ALCOHOL-ABUSE AND DEPENDENCE - FACTOR-ANALYSIS OF DSM-III-R AND PROPOSED DSM-IV CRITERIA IN THE 1988 NATIONAL-HEALTH INTERVIEW SURVEY

Decisions on the final version of the DSM-IV alcohol abuse and depende nce criteria will be determined largely by the APA's substance abuse f ield trials, conducted primarily in treated, clinical samples. Among t he major objectives of the field trials are to study the boundaries be tween abuse and dependence, and to identify specific criteria that def ine the abuse category. The decisions on revisions of the abuse and de pendence criteria in DSM-IV should, however, be informed by data from non-treated or general population samples as well. The present study a ddresses the field trial objectives using recent data from a large gen eral population survey, the 1988 National Health Interview Survey (NHI S88). The paper reports on factor analyses to assess the dimensions un derlying the DSM-III-R and DSM-IV dependence and abuse criteria as ope rationalized in the NHIS88. The focus of the analyses is on whether mo dels with more than one dimension are needed and if so, the correspond ence of the dimensions to criteria sets defined in the DSM-III-R and D SM-IV. The analyses show that a two-dimensional model is required. The dimension are interpreted as abuse and dependence, but the sets of cr iteria that define each of the dimensions show important deviations fr om the criteria sets used in the DSM definitions.