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.
Clinicians diagnosing CUD, psychometricians, and researchers interested in diagnostic validity.
What the researchers 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.
Why it 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 numbers in context
249 inpatients with active cannabis use. Unidimensionality confirmed by two statistical tests. Symptom #8 showed misfit.
How the study worked
Rasch analysis applied to DSM-5 CUD criteria in 249 adults receiving inpatient substance use treatment who reported active cannabis use at admission.
What this study cannot tell us
Inpatient-only sample represents the severe end of CUD. Relatively small sample for psychometric analysis. Single-site study.
How to read the evidence
Appropriate psychometric methodology applied to a clinical sample, but small sample and inpatient-only recruitment limit generalizability.
When this study was published
2025 publication.
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.
Questions still open
- Should the hazardous use criterion be revised or removed in future DSM editions?
- Would results differ in an outpatient or community sample?
Common questions
What is Rasch analysis?
What does it mean that hazardous use showed misfit?
Read the original research
Rasch Analysis of Cannabis Use Disorder in an Adult Inpatient Sample.
Cannabis (Albuquerque, N.M.), 8(2), 141-152
Citation
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
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