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Study breakdown

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

Cross SectionalModerate evidence
The takeaway

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?
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 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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