Rasch Analysis of Cannabis Use Disorder in an Adult Inpatient Sample

Authors

  • Marie N. S. Gendy Peter Boris Center for Addiction Research, McMaster University; Department of Psychiatry and Behavioral Neurosciences, McMaster University; Homewood Research Institute
  • Radia Taisir Homewood Research Institute
  • Emily Britton Homewood Research Institute
  • Jean Costello Homewood Research Institute
  • James MacKillop eter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton; Department of Psychiatry and Behavioral Neurosciences, McMaster University; Homewood Research Institute; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University & St. Joseph's Healthcare Hamilton; Department of Psychology, Neuroscience, and Behavior, McMaster University

Abstract

Objective: The Diagnostic and Statistical Manual of Mental Disorders version 5 (DSM-5) defines cannabis use disorder as a polythetic unidimensional diagnosis (>2 symptoms from up to 11), but few studies have empirically evaluated the latent structure of CUD. Rasch analysis is a psychometric technique that has previously been used to validate unidimensional scales, like DSM-5 CUD. Method: In this study, the Rasch model was used to evaluate the DSM-5 CUD criteria in a clinical sample of adults receiving inpatient treatment for substance use disorder (n = 249) reporting active cannabis use at admission. The unidimensionality of the criteria was evaluated using the Martin-Löf test and the nonparametric –T2 test of Ponocny. Model fit was assessed using the χ2goodness of fit test for individual items. Results: Results supported the unidimensional structure of the criteria. Symptom # 3 was the least endorsed, highest severity item. Conversely, symptom #9 was the most endorsed and had the lowest severity estimate. Overall, the data fit the Rasch model well, although misfit was observed for symptom # 8. Conclusions: Rasch's analysis of CUD symptoms in an inpatient sample broadly supports the DSM-5 CUD syndrome. Further examination is needed to determine if removing or revising the hazardous use symptom criterion in future DSM revisions would improve diagnostic measurement.

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Published

2025-03-10

Issue

Section

Original Report