The dimensionality of alcohol use disorders: Results from Israel

Dvora Shmulewitz, Katherine Keyes, Cheryl Beseler, Efrat Aharonovich, Christina Aivadyan, Baruch Spivak, Deborah Hasin

Research output: Contribution to journalArticlepeer-review

59 Scopus citations


Aims: To prepare for DSM-V, the structure of DSM-IV alcohol dependence and abuse criteria and a proposed additional criterion, at-risk drinking, require study in countries with low per-capita consumption, and comparison of current and lifetime results within the same sample. We investigated DSM-IV Alcohol Use Disorder (AUD) criteria in Israel, where per-capita alcohol consumption is low. Methods: Household residents selected from the Israeli population register (N=1338) were interviewed with the AUDADIS. Item response theory analyses were conducted using MPlus, and diagnostic thresholds were examined with the kappa statistic. Results: Dependence and abuse criteria fit a unidimensional model interspersed across the severity continuum, for both current and lifetime timeframes. Legal problems were rare and did not improve model fit. Weekly at-risk drinking reflected greater severity than in U.S. samples. When dependence and abuse criteria were combined, a diagnostic threshold of ≥3 criteria produced the best agreement with DSM-IV diagnoses (kappa>0.80). Conclusion: Consistent with other studies, alcohol dependence and abuse criteria reflected a latent variable representing a single AUD. Results suggested little effect in removing legal problems and little gained by adding weekly at-risk drinking. Results contribute to knowledge about AUD criteria by examining them in a low-consumption country.

Original languageEnglish (US)
Pages (from-to)146-154
Number of pages9
JournalDrug and Alcohol Dependence
Issue number1-2
StatePublished - Sep 2010


  • Alcohol dependence
  • Alcohol use disorders
  • DSM-IV
  • DSM-V
  • Israel
  • Item response theory

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)


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