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Further validation of the alcohol dependence scale as an index of severity . OBJECTIVE The Alcohol Dependence Scale ( ADS ) yields continuous scores purported to reflect the severity of the dependence syndrome . We evaluated the concurrent validity of the ADS as a general measure of severity and the screening accuracy of the total score and subscales to detect Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition ( DSM-IV ) , physiological dependence . METHOD Treatment-seeking , alcohol-dependent individuals entering the Combining Pharmacotherapies and Behavioral Interventions for Alcohol Dependence ( COMBINE ) Study ( N = 1,372 ; 69 % men ) completed the ADS , diagnostic interviews , and other measures before randomization . Analyses of variance tested differences between ADS quartiles on alcohol- related measures . Areas under the receiver operating characteristic ( AUROC ) curve assessed screening accuracy for DSM-IV physiological dependence ( tolerance or withdrawal ) or withdrawal alone . RESULTS ADS quartiles differed on age , other demographics , and prior treatment episodes . Linear correlation showed moderate to large magnitude associations with alcohol-related self-report measures and most indices of consumption . ADS quartiles differed significantly on proportion with DSM-IV physiological dependence , but AUROC curves indicated that the ADS had limited accuracy as a continuous measure to detect DSMIV physiological dependence ( AUROC = .75 [ 95 % confidence interval { CI } : .70-.79 ] and .67 [ 95 % CI : .60-.74 ] for men and women , respectively ; p = .08 ) or withdrawal alone ( AUROC = .77 [ 95 % CI : .74-.80 ] and .74 [ 95 % CI : .69-.79 ] for men and women , respectively ; p = .30 ) . Screening accuracy was comparably limited based on ADS subscales reflecting psychoperceptual or psychophysical withdrawal . CONCLUSIONS The ADS reflected variation in symptom severity but did not adequately identify physiological dependence or withdrawal in treatment-seeking individuals with DSM-IV alcohol dependence .
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Intervention_Other
Alcohol Dependence Scale
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Intervention_Educational
ADS
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Outcome_Other
concurrent validity of the ADS as a general measure of severity and the screening accuracy
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Outcome_Mental
Analyses of variance tested differences between ADS quartiles on alcohol- related measures .
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Outcome_Mental
proportion with DSM-IV physiological dependence
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Outcome_Other
accuracy
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Outcome_Mental
DSMIV physiological dependence
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Outcome_Other
Screening accuracy
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Participant_Condition
alcohol-dependent
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Participant_Condition
Alcohol Dependence
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Participant_Sample-size
1,372
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Participant_Sample-size
69 %
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Participant_Condition
DSM-IV alcohol dependence