VALIDITY OF THE BI-AXIAL DEPENDENCE CONCEPT - A TEST IN THE UNITED-STATES GENERAL-POPULATION

According to the ''bi-axial'' concept of alcohol dependence, the Alcoh ol Dependence Syndrome (ADS) constitutes an axis or dimension of alcoh ol difficulties, while other alcohol-related problems (social, legal, etc.) constitute one or more separate dimensions. The validity of the bi-axial distinction was investigated in a stratified probability samp le of 3212 US current drinkers who were interviewed in their household s. Indicators of the Alcohol Dependence Syndrome and potentially disti nct alcohol-related problems were covered in a structured interview ad ministered by carefully trained interviewers. This interview provided extensive coverage of drinking patterns and problems. Aspects of the A DS covered included narrowing, salience, tolerance, withdrawal, withdr awal relief/avoidance and compulsion/control. Other alcohol problems i ncluded difficulties with work, health, the law, general social diffic ulties and problems in marriage/home life. Confirmatory and explorator y factor analyses were used to determine whether a single factor (dime nsion) or two or more factors fit the data best. Using all methods, we found that one general factor explained the structure of the data bet ter than a two-factor model or other models for males, females, blacks and whites. Thus, the utility of this approach to distinguishing betw een types of alcohol problems was challenged, raising some questions a bout abuse/dependence distinctions in various nomenclatures.