Psychometric analysis supports the DSM-5 cannabis use disorder diagnosis but one symptom may not fit

Rasch analysis of DSM-5 cannabis use disorder criteria in 249 inpatients broadly supports the diagnosis as a valid unidimensional measure, though the hazardous use criterion showed poor fit.

Gendy, Marie N S et al.·Cannabis (Albuquerque·2025·Moderate EvidenceCross-Sectional
RTHC-06520Cross SectionalModerate Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=249

What This Study Found

The DSM-5 CUD criteria fit the Rasch model well overall, supporting unidimensionality. Symptom #3 was least endorsed and highest severity, symptom #9 was most endorsed and lowest severity. Symptom #8 (hazardous use) showed misfit.

Key Numbers

249 inpatients with active cannabis use. Unidimensionality confirmed by two statistical tests. Symptom #8 showed misfit.

How They Did This

Rasch analysis applied to DSM-5 CUD criteria in 249 adults receiving inpatient substance use treatment who reported active cannabis use at admission.

Why This Research Matters

Validating the psychometric properties of CUD diagnostic criteria ensures clinicians are measuring a coherent construct. The hazardous use misfit suggests this criterion may capture something different from core addiction.

The Bigger Picture

This study complements taxometric work showing CUD is dimensional. Together, they suggest the DSM-5 approach is sound overall but could be refined regarding the hazardous use criterion.

What This Study Doesn't Tell Us

Inpatient-only sample represents the severe end of CUD. Relatively small sample for psychometric analysis. Single-site study.

Questions This Raises

  • ?Should the hazardous use criterion be revised or removed in future DSM editions?
  • ?Would results differ in an outpatient or community sample?

Trust & Context

Key Stat:
hazardous use criterion showed poor fit with the overall CUD model
Evidence Grade:
Appropriate psychometric methodology applied to a clinical sample, but small sample and inpatient-only recruitment limit generalizability.
Study Age:
2025 publication.
Original Title:
Rasch Analysis of Cannabis Use Disorder in an Adult Inpatient Sample.
Published In:
Cannabis (Albuquerque, N.M.), 8(2), 141-152 (2025)
Database ID:
RTHC-06520

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

What is Rasch analysis?

A psychometric technique that tests whether a set of items measure a single underlying construct in a consistent, orderly way. It can identify symptoms that do not fit.

What does it mean that hazardous use showed misfit?

Using cannabis in physically dangerous situations may be driven by different factors than core addiction symptoms like craving, tolerance, and withdrawal.

Read More on RethinkTHC

Cite This Study

RTHC-06520·https://rethinkthc.com/research/RTHC-06520

APA

Gendy, Marie N S; Taisir, Radia; Britton, Emily; Costello, Jean; MacKillop, James. (2025). Rasch Analysis of Cannabis Use Disorder in an Adult Inpatient Sample.. Cannabis (Albuquerque, N.M.), 8(2), 141-152. https://doi.org/10.26828/cannabis/2025/000229

MLA

Gendy, Marie N S, et al. "Rasch Analysis of Cannabis Use Disorder in an Adult Inpatient Sample.." Cannabis (Albuquerque, 2025. https://doi.org/10.26828/cannabis/2025/000229

RethinkTHC

RethinkTHC Research Database. "Rasch Analysis of Cannabis Use Disorder in an Adult Inpatien..." RTHC-06520. Retrieved from https://rethinkthc.com/research/gendy-2025-rasch-analysis-of-cannabis

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.