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Conceptualizing and scaling the developmental structure of behavior disorder: The Lifetime Alcohol Problems Score -as an example

Published online by Cambridge University Press:  05 December 2003

ROBERT A. ZUCKER
Affiliation:
University of Michigan
W. HOBART DAVIES
Affiliation:
Children's Hospital of Wisconsin and Medical College of Wisconsin
STEPHEN B. KINCAID
Affiliation:
University of Michigan
HIRAM E. FITZGERALD
Affiliation:
Michigan State University
EVE E. REIDER
Affiliation:
Johns Hopkins University

Extract

We contrast the current, clinically based framework for behavior disorder against a life course framework, as an alternative structure upon which to map the variations in onset and stability of clinical symptomatology known to take place in adult life. This alternative developmental framework is used as a base around which to understand known variations in rates of alcohol abuse/dependence over the life course and to review existing schemes for the evaluation of developmental variation in “caseness.” From this work, it was proposed that symptom structure be regarded as a mass of greater or lesser breadth, with properties of extensiveness in time and life course invasiveness, as a function of where in the life course the symptomatology first emerged, and the degree to which the mass sustained itself in developmental time. This framework guided the construction of a time-based measure of alcohol related symptomatology, called the Lifetime Alcohol Problems Score (LAPS). The LAPS discriminated among a variety of alcohol-specific and nonalcohol-specific measures of alcohol-related difficulty, including diagnosis of alcohol dependence, having been in treatment, level of other psychopathology, and measures of family disorganization. The measure has potential applicability for prospective studies, and in estimating clinical prognosis. The utility of the paradigm as a framework within which to conceptualize the emergence, ebb, and flow of other behavior disorders is also discussed.

Type
Research Article
Copyright
© 1997 Cambridge University Press

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