A Latent Class Analysis of DSM-IV and Fagerstrom (FTND) Criteria for Nicotine Dependence

作者：Agrawal Arpana^*; Scherrer Jeffrey F; Pergadia Michele L; Lynskey Michael T; Madden Pamela A F; Sartor Carolyn E; Grant Julia D; Duncan Alexis E; Haber Jon R; Jacob Theodore; Bucholz Kathleen K; Xian Hong

来源：Nicotine & Tobacco Research, 2011, 13(10): 972-981.

DOI：10.1093/ntr/ntr105

Background: Nicotine dependence is associated with considerable morbidity and mortality. Two predominant classification systems, the Diagnostic and Statistical Manual (DSM-IV) and Fagerstrom Test for Nicotine Dependence (FTND), have been used to measure liability to nicotine dependence, yet few studies have attempted to simultaneously examine both sets of criteria.
Methods: Using a sample of 624 regular smoking individuals who are offspring of Vietnam Era Twin fathers ascertained for an offspring of twin study, we applied latent class analysis to the 7 DSM-IV and the 6 FTND criteria to classify individuals by their nicotine dependence symptom profiles. Post-hoc across-class comparisons were conducted using a variety of smoking-related variables and aspects of psychopathology. Whether a single class identified offspring at high genetic and environmental vulnerability was also investigated.
Results: The cross-diagnosis kappa was .30. A 4-class solution fit these data best. The classes included a low DSM-low FTND class and a high DSM-high FTND class; a moderate DSM-moderate FTND class, which was distinguished by moderate levels of smoking and intermediate levels of comorbid psychopathology; and a light smoking-moderate FTND class consisting primarily of lighter smokers with a more recent onset of regular smoking. High genetic and environmental vulnerability to nicotine dependence was noted in all classes with no statistically significant across-class differences.
Conclusions: In general, the DSM-IV and FTND criteria performed similarly to define a continuum of risk for nicotine dependence. The emerging class of light smokers should be further investigated to assess whether they transition to another class or remain as such.

• 出版日期2011-10