Diagnostic Orphans
From Drug Rehab Wiki
Many individuals who struggle with alcohol do so without the ability to get help. They have one or two behaviors that indicate a problem, but without enough severity or lacking specific indicators that would warrant professional assistance.
Alcohol use disorders are evaluated using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. As preparations are made to update the DSM, research has been released that encourages a new evaluation method for diagnosing those with alcohol use disorders.
Thomas C. Harford, Hsiao-Ye Yi and Bridget F. Grant recently published a study that evaluated the five-year diagnostic utility of “diagnostic orphans” for alcohol use disorders. The study used a national sample of young adults.
The study was done to examine the association of “diagnostic orphans” at baseline and at the subsequent development of DSM-IV that was issued 5 years later for alcohol use disorders.
To gather data, the researchers used a sample of respondents from the National Longitudinal Survey of Youth. There was a total of 8.534 respondents for the years 1989 and 1994.
The study defined diagnostic orphans as respondents who met one or two alcohol dependence symptom criteria but did not have enough symptoms or meet the criteria for a full diagnosis of alcohol abuse or dependence.
The researchers used multinomial logistic regression analysis to examine the data. 1994 assessments of DSM-IV were regressed on 1989 baseline assessments of individuals given diagnostic orphan status and DSM-IV alcohol use disorder. The researchers also examined background variables such as heavy episodic drinking at baseline and early problem behaviors like antisocial behaviors, illicit drug use, and examined the age of the onset of alcohol use.
The results of the study show that an individual who was shown to be a diagnostic orphan was more likely to be diagnosed with alcohol use disorder using DSM-IV at a five-year follow-up. The results were consistent even when other early behavioral problems were taken into consideration.
The results of the study are important because they may have some impact on the diagnostic measures used for the proposed DSM-V for alcohol use disorder. Less severe forms of alcohol dependence may need treatment, and recognition within the DSM model for diagnosis.
It is important that individuals who struggle with alcohol are not left untreated or to self-treat an alcohol use disorder. Careful examination of the DSM diagnosis tool may help diagnostic orphans get help for their alcohol use disorder before it becomes a more difficult problem.
