ArticleFrontiers in psychiatry2014
How Many People have Alcohol Use Disorders? Using the Harmful Dysfunction Analysis to Reconcile Prevalence Estimates in Two Community Surveys.
Article in Frontiers in psychiatry, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Guideline
- Screening for high-risk drinking and alcohol use disorder: update of the 2023 national clinical practice guideline.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026Guideline
- Simultaneous alcohol and cannabis use is associated with daily consequences reflective of alcohol use disorder symptoms.Drug and alcohol dependence · 2025Article
- Examination of the mild, moderate, and severe alcohol use disorder severity indicators using a nationally representative sample.Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors · 2024Article
- Prevalence and characteristics of participants inFrontiers in public health · 2024Article
- An exploration of multivariate symptom clusters of cannabis use disorder in young adults.Addictive behaviors · 2022Article
- Age-based differences in quantity and frequency of consumption when screening for harmful alcohol use.Addiction (Abingdon, England) · 2022Article
- Is lower severity alcohol use disorder qualitatively different than more severe manifestations? An evaluation of multivariate symptom clusters.Addiction (Abingdon, England) · 2022Article
- Correlates of mild, moderate, and severe Alcohol Use Disorder among adults with problem substance use: Validity implications for DSM-5.Alcoholism, clinical and experimental research · 2021Article
- Patterns of polysubstance use and simultaneous co-use in high risk young adults.Drug and alcohol dependence · 2019Article
- Deriving alternative criteria sets for alcohol use disorders using statistical optimization: Results from the National Survey on Drug Use and Health.Experimental and clinical psychopharmacology · 2019Article
- Intensity of Daily Drinking and Its Relation to Alcohol Use Disorders.Alcoholism, clinical and experimental research · 2018Article
- Article
- Limits of Current Approaches to Diagnosis Severity Based on Criterion Counts: An Example with DSM-5 Alcohol Use Disorder.Clinical psychological science : a journal of the Association for Psychological Science · 2015Article
- Drosophila and Caenorhabditis elegans as Discovery Platforms for Genes Involved in Human Alcohol Use Disorder.Alcoholism, clinical and experimental research · 2015Review
- DSM-5, psychiatric epidemiology and the false positives problem.Epidemiology and psychiatric sciences · 2015Article
- Anxiety and substance use disorders: co-occurrence and clinical issues.Current psychiatry reports · 2015Review
- Alternative models of addiction.Frontiers in psychiatry · 2015Article
- Truth or consequences in the diagnosis of substance use disorders.Addiction (Abingdon, England) · 2014Article
- Combinatorial Optimization of Clustering Decisions: An Approach to Refine Psychiatric Diagnoses.Multivariate behavioral researchArticle
Corrections and comments
- Erratum issued
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Community prevalence rates of alcohol use disorders (AUDs) provided by epidemiological studies using DSM-based diagnostic criteria pose several challenges: the rates appear implausibly high to many epidemiologists; they do not converge across similar studies; and, due to low service utilization by those diagnosed as disordered, they yield estimates of unmet need for services so high that credibility for planning purposes is jeopardized. For example, two early community studies using DSM diagnostic criteria, the Epidemiologic Catchment Area Study (ECA) and the National Comorbidity Survey (NCS), yielded lifetime AUD prevalence rates of 14 and 24%, respectively, with NCS unmet need for services 19% of the entire population. Attempts to address these challenges by adding clinical significance requirements to diagnostic criteria have proven unsuccessful. Hypothesizing that these challenges are due to high rates of false-positive diagnoses of problem drinking as AUDs, we test an alternative approach. We use the harmful dysfunction (HD) analysis of the concept of mental disorder as a guide to construct more valid criteria within the framework of the standard out-of-control model of AUD. The proposed HD criteria require harm and dysfunction, where harm can be any negative social, personal, or physical outcome, and dysfunction requires either withdrawal symptoms or inability to stop drinking. Using HD criteria, ECA and NCS lifetime prevalences converge to much-reduced rates of 6 and 6.8%, respectively. Due to higher service utilization rates, NCS lifetime unmet need is reduced to 3.4%. Service use and duration comparisons suggest that HD criteria possess increased diagnostic validity. Moreover, HD criteria eliminate 90% of transient teenage drinking from disorder status. The HD version of the out-of-control model thus potentially resolves the three classic prevalence challenges while offering a more rigorous approach to distinguishing AUDs from problematic drinking.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.