Showing papers by "Janet B. W. Williams published in 1987"
TL;DR: Findings support the utility of a common dependence syndrome concept for drugs of abuse as well as alcohol, and provide empirical support for the current revision of the DSM-III diagnostic criteria.
Abstract: Using the newly revised DSM-III-R criteria for substance-abuse diagnoses, we examined dependence syndrome elements among 83 psychiatric patients. The sample included 14 with no history of substance abuse. The remainder abused alcohol (52), sedatives (31), hallucinogens (12), stimulants (33), cannabis (44), cocaine (52), or opiates (47). Many patients (52) had abused more than one type of drug. Ten items assessing the proposed dependence symptoms for each type of drug were factor-analysed. The dependence syndrome items formed a single factor for opiates, cocaine, and alcohol, but not for other drugs. When the items were combined into cumulative scales, they had excellent internal consistency. Furthermore, they formed good approximations of unidimensional Guttman scales on which higher scores indicated greater syndrome severity. The items associated with higher scores differed across drugs, with opiates having the most striking differences from the other substances. Medical-psychosocial consequences were relatively independent of the dependence syndrome, although alcohol and cocaine dependence had some association with other problem areas. These findings support the utility of a common dependence syndrome concept for drugs of abuse as well as alcohol, and provide empirical support for the current revision of the DSM-III diagnostic criteria.
122 citations
TL;DR: A high level of agreement was found between the diagnostic systems in rates of diagnosis and in the individuals receiving the diagnosis, and the greatest cross-system agreement occurred when the minimum number of symptoms was set at three.
Abstract: The authors field-tested proposed criteria for diagnoses of psychoactive substance use disorders in the revision of DSM-III (DSM-III-R) and compared them with DSM-III criteria in a treated group of 83 patients They found a high level of agreement between the diagnostic systems in rates of diagnosis and in the individuals receiving the diagnosis The greatest cross-system agreement occurred when the minimum number of symptoms required to make the DSM-III-R diagnosis was set at three Discrepant diagnoses between systems related to removal of social consequences as a requirement for the DSM-III-R diagnoses, less emphasis on physiological tolerance in DSM-III-R, and disagreement in subjects with mild symptoms
48 citations
12 citations
Journal Article•
5 citations
TL;DR: Rey et al. as mentioned in this paper explored whether the relatively high diagnostic reliability achieved could be due to the fact that interviewing partners shared similar training, experience, and theoretical orientation toward diagnosis, and conducted a substudy reported in theArchives.
Abstract: Reply.— Drs Rey et al believe that the high reliability obtained in the DSM-III field trial may only have been due to the fact that the pairs of interviewers each worked together at the same facility and therefore probably had "the same biases." During the field trial itself, we were well aware that this was a potential source of bias. Therefore, in an effort to explore whether the relatively high diagnostic reliability achieved could be due to the fact that interviewing partners shared similar training, experience, and theoretical orientation toward diagnosis, we conducted a substudy reported in theArchives. 1 Essentially, case summaries were sent to 35 clinicians at different facilities who had participated in the live reliability study, to undergo diagnosis using the DSM-III multiaxial system. Several months later, the same case summaries were sent to the clinicians who had been the partners of these raters in the live