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1.  A Comparison of two Case-crossover Methods for Studying the Dose-Response Relationship Between Alcohol and Injury 
Contemporary drug problems  2014;41(1):04-.
Background:
This study compares dose-response injury risk estimates for two control periods defined as the same 6-hour period the week prior and the set of all non-sleeping 6-hour periods over the past year.
Method:
Dose-response injury risk estimates for the multiple match controls are generated via the application of a maximum-likelihood approach.
Results:
Injury risk associated with any (i.e., 1 drink or more) drinking 6 hours prior to injury was similar for the two control choices (last week and usual frequency). For 1-4 drinks, risk estimates were similar across control period definitions; for 5+ drinks, risk using the week prior as the control was nearly double that using the past 12 months as the control.
Conclusions:
Although studies with smaller ns may benefit from the increase in precision from the use of the multiple control periods, results indicate that heavy drinking injury risk estimates should be used with caution.
PMCID: PMC4013001  PMID: 24817774
relative risk; case-crossover; dose-response; control period definition
2.  Episodic Heavy Drinking, Problem Drinking and Injuries – Results of the WHO/NIAAA Collaborative Emergency Room Study in South Korea 
Alcohol (Fayetteville, N.Y.)  2012;46(5):407-413.
Alcohol is the 5th leading risk factor to the global disease burden and disability and about half of the global alcohol burden was attributable to injuries. Despite a large body of evidence documenting the associations between alcohol and injuries, data from Asian countries including South Korea are sparse. The aim of this study was to investigate the associations between episodic heavy past-year drinking, problem drinking symptomatic of alcohol dependence and alcohol-related and intentional injuries. Data from 1,989 injured patients recruited for the WHO/NIAAA Collaborative Study on Alcohol and Injury in South Korea were analyzed with respect to the prevalence rates and associations between injuries and frequency of past-year episodic heavy drinking and problem drinking. In estimating the odds ratios (ORs) and the associated 95% confidence intervals between alcohol intake and injuries multivariable logistic models were employed to adjust for sociodemographic characteristics and selected drinking variables. All analyses were conducted using the SAS 9.2 software. Findings of this study were consistent with prior studies that the risk of alcohol-related or intentional injury was positively associated with the frequency of episodic heavy drinking. The magnitudes of the associations were larger with frequent consumption of 5+ drinks (OR=4.0 approximately) than with frequent consumption of 12+ drinks (OR=3.1). Strong associations were also noted between RAPS4-assessed alcohol dependence and alcohol-related and intentional injuries. Further, the prevalence of intentional injury and its association with alcohol increased sharply once the acute alcohol intake exceeded 90 ml. Our results were consistent with prior studies that episodic heavy consumption, acute intoxication and problem drinking are pervasive among emergency room patients. Results of our study also lent support for administering a single-item screener querying consumption of 5+ drinks at a sitting in the past 12 months as a triage tool in Korea.
doi:10.1016/j.alcohol.2012.03.002
PMCID: PMC3431286  PMID: 22579122
emergency room (ER) study; episodic heavy drinking; problem drinking; alcohol-related and intentional injury
3.  MULTI-LEVEL ANALYSIS OF ALCOHOL-RELATED INJURY AND DRINKING PATTERN: EMERGENCY DEPARTMENT DATA FROM 19 COUNTRIES 
Addiction (Abingdon, England)  2012;107(7):1263-1272.
Aim
While drinking in the event is an important factor in injury occurrence, pattern of usual drinking may also be important in risk of injury. Explored here is the relationship of an alcohol-related injury with individual usual drinking pattern.
Design
Alcohol-related injury is examined using Hierarchical Linear models, taking into account individual usual volume of consumption over the past 12 months, as well as aggregate-level detrimental drinking pattern (DDP) and alcohol policy measures.
Setting
Data analyzed are from emergency departments (EDs) in 19 countries, comprising three collaborative studies on alcohol and injury, all of which used a similar methodology.
Participants
The sample consists of 14,132 injured drinkers across 46 ER studies.
Measurements
Alcohol-related injury was measured, separately, by any self-reported drinking prior to injury, a blood alcohol concentration (BAC) ≥ .08, and self-reported causal attribution of injury to drinking.
Findings
While individual usual volume strongly predicted an alcohol-related injury for all three measures, usual drinking pattern also predicted an alcohol-related injury (controlling for volume), with episodic heavy and frequent heavy drinking both more predictive of alcohol-related injury than other drinking patterns. When individual usual volume and drinking pattern were controlled, DDP was no longer a significant predictor of alcohol-related injury. Alcohol policy measures were predictive of both BAC and causal attribution (the stronger the policy the lower the rates of alcohol-related injury).
Conclusions
Volume of alcohol typically consumed and occurrence of heavy drinking episodes are independently associated with incidence of alcohol-related injury. The stronger the anti-alcohol policies in a country, the lower the rates of alcohol-related injury.
doi:10.1111/j.1360-0443.2012.03793.x
PMCID: PMC3330192  PMID: 22236278
4.  Analyses Related to the Development of DSM-5 Criteria for Substance Use Related Disorders: 1. Toward Amphetamine, Cocaine and Prescription Drug Use Disorder Continua Using Item Response Theory 
Drug and Alcohol Dependence  2011;122(1-2):38-46.
Background
Prior research has demonstrated the dimensionality of alcohol, nicotine and cannabis use disorders criteria. The purpose of this study was to examine the unidimensionality of DSM-IV cocaine, amphetamine and prescription drug abuse and dependence criteria and to determine the impact of elimination of the legal problems criterion on the information value of the aggregate criteria.
Methods
Factor analyses and Item Response Theory (IRT) analyses were used to explore the unidimensionality and psychometric properties of the illicit drug use criteria using a large representative sample of the U.S. population.
Results
All illicit drug abuse and dependence criteria formed unidimensional latent traits. For amphetamines, cocaine, sedatives, tranquilizers and opioids, IRT models fit better for models without legal problems criterion than models with legal problems criterion and there were no differences in the information value of the IRT models with and without the legal problems criterion, supporting the elimination of that criterion.
Conclusion
Consistent with findings for alcohol, nicotine and cannabis, amphetamine, cocaine, sedative, tranquilizer and opioid abuse and dependence criteria reflect underlying unitary dimensions of severity. The legal problems criterion associated with each of these substance use disorders can be eliminated with no loss in informational value and an advantage of parsimony. Taken together, these findings support the changes to substance use disorder diagnoses recommended by the American Psychiatric Association’s DSM-5 Substance and Related Disorders Workgroup.
doi:10.1016/j.drugalcdep.2011.09.004
PMCID: PMC3272309  PMID: 21963414
amphetamine use disorder; cocaine use disorder; prescription drug use disorder; DSM-5; item response theory
5.  Dimensionality of Hallucinogen and Inhalant/Solvent Abuse and Dependence Criteria: Implications for the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition 
Addictive Behaviors  2011;36(9):912-918.
Background
Prior research has demonstrated the dimensionality of Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) alcohol, nicotine, cannabis, cocaine and amphetamine abuse and dependence criteria. The purpose of this study was to examine the dimensionality of hallucinogen and inhalant/solvent abuse and dependence criteria. In addition, we assessed the impact of elimination of the legal problems abuse criterion on the information value of the aggregate abuse and dependence criteria, another proposed change for DSM- IV currently lacking empirical justification.
Methods
Factor analyses and item response theory (IRT) analyses were used to explore the unidimisionality and psychometric properties of hallucinogen and inhalant/solvent abuse and dependence criteria using a large representative sample of the United States (U.S.) general population.
Results
Hallucinogen and inhalant/solvent abuse and dependence criteria formed unidimensional latent traits. For both substances, IRT models without the legal problems abuse criterion demonstrated better fit than the corresponding model with the legal problem abuse criterion. Further, there were no differences in the information value of the IRT models with and without the legal problems abuse criterion, supporting the elimination of that criterion. No bias in the new diagnoses was observed by sex, age and race-ethnicity.
Conclusion
Consistent with findings for alcohol, nicotine, cannabis, cocaine and amphetamine abuse and dependence criteria, hallucinogen and inhalant/solvent criteria reflect underlying dimensions of severity. The legal problems criterion associated with each of these substance use disorders can be eliminated with no loss in informational value and an advantage of parsimony. Taken together, these findings support the changes to substance use disorder diagnoses recommended by the DSM-V Substance and Related Disorders Workgroup, that is, combining DSM-IV abuse and dependence criteria and eliminating the legal problems abuse criterion.
doi:10.1016/j.addbeh.2011.04.006
PMCID: PMC3370431  PMID: 21621334
Hallucinogen use disorder; inhalant/solvent use disorder; DSM-V; item response theory; dimensionality
6.  The Prevalence and Correlates of Alcohol Use Disorders in the United States and Korea – A Cross-National Comparative Study 
Alcohol (Fayetteville, N.Y.)  2010;44(4):297-306.
The purpose of this study was to compare the prevalence rates of DSM-IV 12-month diagnoses of alcohol use disorders between the United States and South Korea using two large nationally representative surveys. Cross-tabulations were used to derive weighted prevalences of alcohol abuse and dependence, and odds ratio derived from linear logistic regression analyses were used to determine the relationships between alcohol abuse and dependence across sociodemographic characteristics of the general population samples. The prevalence of 12-month alcohol abuse was greater in the U.S. (5.3%) than Korea (2.0%) whereas the rate of alcohol dependence was greater in Korea (5.1%) compared with the U.S. (4.4%). The odds of abuse were significantly greater among men, and in the youngest age groups in both countries. There were increased odds of 12-month dependence among men, and those who were employed or never married in each country. Further, the rates of abuse and dependence in the U.S. and of abuse in Korea decreased as a function of age, a result that did not generalize to dependence among Koreans. The implications of the results of this study are discussed in terms of national differences between the U.S. and Korea as the result of gender roles and drinking patterns, and the need to understand the potential influence of the cultural applicability and specificity of psychiatric assessment interviews across countries.
doi:10.1016/j.alcohol.2010.02.005
PMCID: PMC2918727  PMID: 20570084
Alcohol use disorder; cross-national comparisons; prevalence; sociodemographic correlates; United States; South Korea
7.  Sociodemographic and Psychopathologic Predictors of First Incidence of DSM-IV Substance Use, Mood, and Anxiety Disorders: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions 
Molecular psychiatry  2008;14(11):1051-1066.
The objective of this study was to present nationally representative findings on sociodemographic and psychopathologic predictors of first incidence of DSM-IV substance, mood and anxiety disorders using the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. One-year incidence rates of DSM-IV substance, mood and anxiety disorders were highest for alcohol abuse (1.02) alcohol dependence (1.70), major depressive disorder (MDD: 1.51) and generalized anxiety disorder (GAD: 1.12). Incidence rates were significantly greater (p < 0.01) among men for substance use disorders and greater among women for mood and anxiety disorders except bipolar disorder and social phobia. Age was inversely related to all disorders. Black individuals were at decreased risk of incident alcohol abuse and Hispanic individuals were at decreased risk of GAD. Anxiety disorders at baseline more often predicted incidence of other anxiety disorders than mood disorders. Reciprocal temporal relationships were found between alcohol abuse and dependence, MDD and GAD, and GAD and panic disorder. Borderline and schizotypal personality disorders predicted most incident disorders. Incidence rates of substance, mood and anxiety disorders were comparable to or greater than rates of lung cancer, stroke, and cardiovascular disease. The greater incidence of all disorders in the youngest cohort underscores the need for increased vigilance in identifying and treating these disorders among young adults. Strong common factors and unique factors appear to underlie associations between alcohol abuse and dependence, MDD and GAD, and GAD and panic disorder. The major results of this study are discussed with regard to prevention and treatment implications.
doi:10.1038/mp.2008.41
PMCID: PMC2766434  PMID: 18427559
Incidence; epidemiology; prospective study; substance use disorders; mood disorders; anxiety disorders
8.  Antisocial Behavioral Syndromes and Past-Year Physical Health Among Adults in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions 
Objective
To describe associations of DSM-IV antisocial personality disorder (ASPD), conduct disorder without progression to ASPD (“CD only”), and syndromal antisocial behavior in adulthood without CD before age 15 (AABS, not a DSM-IV diagnosis) with past-year physical health status and hospital care utilization in the general U.S. adult population.
Methods
This report is based on the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (n=43,093, response rate=81%). Respondents were classified according to whether they met criteria for ASPD, AABS, “CD only,” or no antisocial syndrome. Associations of antisocial syndromes with physical health status and care utilization were examined using normal-theory and logistic regression.
Results
ASPD and AABS were significantly but modestly associated with total past-year medical conditions, coronary heart and gastrointestinal diseases, and numbers of inpatient hospitalizations, inpatient days, emergency department visits, and clinically significant injuries. ASPD was also associated with liver disease, arthritis, and lower scores on the Short Form-12 version 2 (SF-12v2) Physical Component, Role Physical, and Bodily Pain Scales. AABS was associated with noncoronary heart disease, lower scores on the SF-12v2 General Health and Vitality Scales, and, among men, arthritis. “CD only” was associated with single but not multiple inpatient hospitalizations, emergency department visits, and clinically significant injuries.
Conclusions
Estimates of burden related to antisocial behavioral syndromes need to consider associated physical health problems. Prevention and treatment guidelines for injuries and common chronic diseases may need to address comorbid antisociality, and interventions targeting antisociality may need to consider general health status, including prevention and management of injuries and chronic diseases.
PMCID: PMC2958062  PMID: 18348594
Antisocial personality disorder; conduct disorder; coronary heart disease; liver disease; arthritis; gastrointestinal disease; injury; health care utilization
9.  The Relationship of Impairment to Personality Disorder Severity Among Individuals with Specific Axis I Disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions 
Journal of personality disorders  2008;22(4):405-417.
The present study examined one dimensional approach to personality disorders (PDs) in a large (n=43,093), nationally representative sample of the U.S. population. Respondents were classified in four personality severity categories (no PD, subthreshold PD, simple PD, complex PD). Linear regression analyses were conducted to examine mental disability by PD severity for major DSM-IV substance use, mood and anxiety disorders. Significant increases in disability were observed between no PD and simple PD and between simple PD and complex PD for each Axis I disorder except drug dependence, but few differences in disability were found between no PD and subthreshold PD. This study found support for the clinical utility of the dimensional classification of PD severity with regard to the distinction between simple and complex PD and for a combined no PD-subthreshold PD level of severity. Future planned analyses will address the clinical utility of the classification prospectively, with a full battery of all Axis II PDs.
doi:10.1521/pedi.2008.22.4.405
PMCID: PMC2925256  PMID: 18684052
10.  Violent Behavior and DSM-IV Psychiatric Disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions 
Objective
To present nationally representative data on the lifetime prevalence and population estimates of violent behavior among individuals with DSM-IV psychiatric disorders.
Method
The data were derived from the National Epidemiologic Survey on Alcohol and Related Conditions. Prevalences, population estimates, and associations of violent behavior occurring among individuals with pure, comorbid and specific DSM-IV psychiatric disorders were examined.
Results
Controlling for sociodemographic characteristics and other comorbidity, the odds of violent behavior were significantly increased (p < 0.05) among individuals with substance use disorders, pathological gambling, major depressive disorder, bipolar disorders, panic disorder with agoraphobia, specific phobia, and paranoid, schizoid, histrionic, and obsessive-compulsive personality disorders. Percentages of violent behavior among individuals with each comorbid disorders was significantly greater (p < 0.05 – p < 0.0001) than the corresponding percentages among those presenting with the pure form of each disorder. Alcohol and drug use disorders were the most significant contributors to the public health burden of violent behavior.
Conclusion
The majority of individuals with psychiatric disorders do not engage in violent behavior, and public perception associated with stereotypic violence among individuals with psychiatric disorders appears unwarranted. Elevated risks and burden of violent behavior were not equally shared across the spectrum of psychiatric disorders, with particular disorders, especially substance use disorders, contributing disproportionately to the burden. Future research should examine the circumstances under which violence among individuals with psychiatric disorders occurs with a view towards improving clinical prediction and developing more effective prevention strategies.
PMCID: PMC2922980  PMID: 18312033
Violent behavior; Psychiatric disorders; Mood and anxiety disorders; Substance use disorders; Personality disorders
11.  Transitions In and Out of Alcohol Use Disorders: Their Associations with Conditional Changes in Quality of Life Over a 3-Year Follow-Up Interval† 
Aims: The aim of this study was to investigate longitudinal changes in quality of life (QOL) as a function of transitions in alcohol use disorders (AUD) over a 3-year follow-up of a general US population sample. Methods: The analysis is based on individuals who drank alcohol in the year preceding the Wave 1 National Epidemiologic Survey on Alcohol and Related Conditions and were reinterviewed at Wave 2 (n = 22,245). Using multiple linear regression models, changes in SF-12 QOL were estimated as a function of DSM-IV AUD transitions, controlling for baseline QOL and multiple potential confounders. Results: Onset and offset of AUD were strongly associated with changes in mental/psychological functioning, with significant decreases in mental component summary (NBMCS) scores among individuals who developed dependence and significant increases among those who achieved full and partial remission from dependence. The increases in overall NBMCS and its social functioning, role emotional and mental health components were equally great for abstinent and nonabstinent remission from dependence, but improvements in bodily pain and general health were associated with nonabstinent remission only. Onset of abuse was unrelated to changes in QOL, and the increase in NBMCS associated with nonabstinent remission from abuse only was slight. Individuals with abuse only or no AUD who stopped drinking had significant declines in QOL. Conclusions: These results suggest the possible importance of preventing and treating AUD for maintaining and/or improving QOL. They are also consistent with the sick quitter hypothesis and suggest that abuse is less a mental disorder than a maladaptive pattern of behavior.
doi:10.1093/alcalc/agn094
PMCID: PMC2605522  PMID: 19042925
12.  Transitions In and Out of Alcohol Use Disorders: Their Associations with Conditional Changes in Quality of Life Over a 3-Year Follow-Up Interval 
Aims
To investigate longitudinal changes in quality of life (QOL) as a function of transitions in alcohol use disorders (AUD) over a 3-year follow-up of a general U.S. population sample.
Methods
The analysis is based on individuals who drank alcohol in the year preceding the Wave 1 National Epidemiologic Survey on Alcohol and Related Conditions and were reinterviewed at Wave 2 (n=22,245). Using multiple linear regression models, changes in SF-12 QOL were estimated as a function of DSM-IV AUD transitions, controlling for baseline QOL and multiple potential confounders.
Results
Onset and offset of AUD were strongly associated with changes in mental/psychological functioning, with significant decreases in mental component summary (NBMCS) scores among individuals who developed dependence and significant increases among those who achieved full and partial remission from dependence. The increases in overall NBMCS and its social functioning, role emotional and mental health components were equally great for abstinent and nonabstinent remission from dependence, but improvements in bodily pain and general health were associated with nonabstinent remission only. Onset of abuse was unrelated to changes in QOL, and the increase in NBMCS associated with nonabstinent remission from abuse only was slight. Individuals with abuse only or no AUD who stopped drinking had significant declines in QOL.
Conclusions
These results suggest the possible importance of preventing and treating AUD for maintaining and/or improving QOL. They are also consistent with the sick quitter hypothesis and suggest that abuse is less a mental disorder than a maladaptive pattern of behavior.
doi:10.1093/alcalc/agn094
PMCID: PMC2605522  PMID: 19042925
quality of life; QOL; HRQOL; alcohol use disorders; remission; transitions
13.  Age at First Drink and the First Incidence of Adult-Onset DSM-IV Alcohol Use Disorders 
Background
Existing studies of the association between age at first drink (AFD) and the risk of alcohol use disorders (AUD) suffer from inconsistent levels of control and designs that may inflate associations by failure to control for duration of exposure to risk.
Methods
This study examined associations between AFD (ages <15 and 15-17 versus 18+ years) and first incidence of DSM-IV alcohol dependence, abuse, and specific AUD criteria over a 3-year follow-up in a longitudinal study of U.S. drinkers 18 years of age and older at baseline (n=22,316), controlling for duration of exposure, family history and a wide range of baseline and childhood risk factors.
Results
After adjusting for all risk factors, the incidence of dependence was increased for AFD <15 years (OR=1.38) and for women only with AFD at ages 15-17 (OR=1.54). The incidence of abuse was increased at AFD <15 and 15-17 years (OR=1.52 and 1.30, respectively). Most dependence criteria showed significant associations with AFD, but hazardous drinking and continued drinking despite interpersonal problems were the only abuse criteria to do so. All associations were nonsignificant after controlling for volume of consumption, except that AFD at all ages <18 combined was associated with a reduced likelihood of impaired control and AFD at ages 15-17 was associated with lower odds of drinking more/longer than intended among heavy-volume drinkers. In a population of low-risk drinkers that excluded those with positive family histories, personality disorders and childhood risk factors, there were strong associations between early AFD (<18) and the incidence of dependence (OR=3.79) and continued drinking despite physical/psychological problems (OR=2.71), but no association with incidence of abuse.
Conclusions
There is a robust association between AFD and the risk of AUD that appears to reflect willful rather than uncontrolled heavy drinking, consistent with misuse governed by poor decision-making and/or reward-processing skills associated with impaired executive cognitive function (ECF). Additional research is needed to determine causality in the role of impaired ECF, including longitudinal studies with samples of low-risk adolescents.
doi:10.1111/j.1530-0277.2008.00806.x
PMCID: PMC2760820  PMID: 18828796
age at first drink; incidence of AUD
14.  Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Narcissistic Personality Disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions 
The Journal of clinical psychiatry  2008;69(7):1033-1045.
Objectives
To present nationally representative findings on prevalence, sociodemographic correlates, disability, and comorbidity of narcissistic personality disorder (NPD) among men and women.
Methods
Face-to-face interviews with 34,653 adults participating in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions.
Results
Prevalence of lifetime NPD was 6.2%, with rates greater for men (7.7%) than women (4.8%). NPD was significantly more prevalent among Black men and women and Hispanic women, younger adults, and separated/divorced/widowed and never married adults. NPD was associated with mental disability among men but not women. High co-occurrence rates of substance use, mood, anxiety, and other personality disorders (PDs) were observed. With additional comorbidity controlled for, associations with bipolar I disorder, PTSD, and schizotypal and borderline PDs remained significant, but weakened, among men and women. Similar associations were observed between NPD and specific phobia, generalized anxiety disorder, and bipolar II disorder among women; and alcohol abuse, alcohol dependence, drug dependence, and histrionic and obsessive-compulsive PDs among men. Dysthymia was significantly and negatively associated with NPD.
Conclusions
NPD is a prevalent PD in the general U.S. population and is associated with considerable disability among men, whose rates exceed those of women. NPD may not be as stable as previously recognized or described in the DSM-IV. The results highlight the need for further research from numerous perspectives to identify the unique and common genetic and environmental factors underlying the disorder-specific associations with NPD observed in this study.
PMCID: PMC2669224  PMID: 18557663
15.  Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Borderline Personality Disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions 
Objectives
To present nationally representative findings on prevalence, sociodemographic correlates, disability, and comorbidity of BPD among men and women.
Methods
Face-to-face interviews with 34,653 adults participating in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions.
Results
Prevalence of lifetime BPD was 5.9% (99% CI: 5.4–6.4). There were no differences in the rates of BPD among men (5.6%, 99% CI: 5.0–6.2) and women (6.2%, 99% CI: 5.6–6.9). BPD was more prevalent among Native American men, younger and separated/divorced/widowed adults, and those with lower incomes and education, and less prevalent among Hispanic men and women and Asian women. BPD was associated with substantial mental and physical disability, especially among women. High co-occurrence rates of mood and anxiety disorders with BPD were similar. With additional comorbidity controlled, associations with bipolar disorder and schizotypal and narcissistic PDs remained strong and significant. Associations of BPD with other specific disorders were no longer significant or were considerably weakened.
Conclusions
Prevalence of BPD in the general population is much greater than previously recognized, equal prevalent among men and women, and associated with considerable mental and physical disability, especially among women. Unique and common factors may differentially contribute to disorder-specific comorbidity with BPD and some of these associations appear to be sex-specific. There is a need for future epidemiologic, clinical and genetically-informed studies to identify unique and common factors that underlie disorder-specific comorbidity with BPD. Important sex differences observed in rates of and associations with BPD can inform more focused, hypothesis-driven investigations of these factors.
PMCID: PMC2676679  PMID: 18426259
16.  The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV): Reliability of New Psychiatric Diagnostic Modules and Risk Factors in a General Population Sample 
Drug and alcohol dependence  2007;92(1-3):27-36.
This study presents test-retest reliability statistics and information on internal consistency for new diagnostic modules and risk factor of alcohol, drug, and psychiatric disorders the Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV). Test-retest statistics were derived from a random sample of 1,899 adults selected from 34,653 respondents who participated in the 2004–2005 Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Internal consistency of continuous scales was assessed using the entire Wave 2 NESARC. Both test and retest interviews were conducted face-to-face. Test-retest and internal consistency results for diagnoses and symptom scales associated with posttraumatic stress disorder, attention-deficit/hyperactivity disorder, and borderline, narcissistic, and schizotypal personality disorders were predominantly good (kappa > 0.63; ICC > 0.69; alpha > 0.75) and reliability for risk factor measures fell within the good to excellent range (intraclass correlations = 0.50–0.94; alpha = 0.64–0.90). The high degree of reliability found in this study suggests that new AUDADIS-IV diagnostic measures can be useful tools in research settings. The availability of highly reliable measures of risk factors of alcohol, drug, and psychiatric disorders will contribute to the validity of conclusions drawn from future research in the domains of substance use disorder and psychiatric epidemiology.
doi:10.1016/j.drugalcdep.2007.06.001
PMCID: PMC2246381  PMID: 17706375
Reliability; alcohol and drug use disorders; risk factors; test-retest reliability; general population; internal consistency

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