Classification and Assessment of Substance use Disorders in Adolescents

This chapter focuses primarily on the dependence and abuse/harmful use diagnoses because they are the most widely used diagnoses for identification of persons with addiction. Corresponding diagnoses from the DSM-IV and ICD-10 systems will be presented side by side to highlight their differences. Because DSM-IV provides a greater description of the disorders, characterizations of the diagnoses are quoted from the DSM-IV. Classification of adolescent substance use disorders (SUDs) and related disorders has greatly improved. However, large gaps remain in the understanding of these disorders, including basic questions regarding the generalization of existing SUD classification nomenclature to adolescents. Existing data suggest that classification schemes developed for adults do not generalize to adolescents. For this reason, "skip out" formats ought to be avoided in the assessment of adolescent SUDs. In spite of significant advances in theory and assessment, basic demographic variables such as gender, age, and socioeconomic status continue to be characteristics associated with trends in substance use. Other domains that ought to be evaluated to obtain a comprehensive assessment of an individual's SUDs include medical history and current health status, comorbid psychiatric disorders and family history of psychiatric disorders, family functioning, and social functioning and support. A great deal of research remains to be conducted before a classification, nomenclature, and assessment of adolescent SUDs will be completed. Better understanding of SUDs should also enhance treatment for the disorders as well as the understanding of the course, etiology and prevention of SUDs.