Cocaine use disorder criteria in a clinical sample: an analysis using Item Response Theory, factor analysis, and network analysis

Abstract

Background: The conceptualization of substance use disorders (SUDs) was modified in successive editions of the DSM. Dimensionality and inclusion/exclusion of several criteria was studied using various analytic approaches. Objective: The study aimed to deepen our knowledge of the interrelationships between the diagnostic criteria for cocaine use disorder (CUD), applying three different analytical techniques: factor analysis, Item Response Theory (IRT) models, and network analysis. Methods: 425 (85.4% male) outpatients were evaluated for CUD using the Substance Dependence Severity Scale. Confirmatory Factor Analysis, 2-parameter logistic model (IRT) and network analysis were applied to analyze the relationships between the diagnostic criteria. Results: The results show that “legal problems” criterion is not congruent with the CUD measure on three analyses. Also, network analysis suggests the usefulness of the “craving” criterion. The criterion “quit/control” is the one that presents the best centrality indices and expected influence, showing strong relationships with the criteria of “craving,” “tolerance,” “neglect roles” and “activities given up.” Conclusions: Network analysis appears to be a useful and complementary technique to factor analysis and IRT for understanding CUD. The “quit/control” criterion emerges as a central criterion to understand CUD.