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Ronald C. Kessler, PhD; Kathleen R. Merikangas, PhD

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Cottler and Grant et al raise 2 concerns regarding the estimates of alcohol and illicit drug dependence in the NCS-R: (1) that the algorithm required respondents to endorse at least 1 lifetime abuse symptom for a diagnosis of dependence, yielding an underestimate of DSM-IV¹ dependence; and (2) that our approach of aggregate assessment of drug dependence rather than separate assessment of individual classes of illicit drugs is inconsistent with the fact that DSM-IV does not have a category of generic drug dependence.

The first of these 2 concerns is legitimate. The decision to skip respondents out of the dependence questions if they denied all lifetime abuse symptoms has the potential to cause downward bias in estimates of dependence. The decision to use this skip was based on evidence in the baseline NCS that only a small proportion of people with . . . [Full Text of this Article]

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