Edward And Gross Criteria For Alcohol Dependence
Walda Caesar
The Alcohol Dependence Data Questionnaire (SADD) is a treatment evaluation instrument is used to measure an individual's current level of alcohol dependence. The evaluation was created by Raistrick D. S., Dunbar G., and Davidson R. J. in 1983. The evaluation is aimed at adults who have a mild to moderate dependence on alcohol and are seeking help.[1]
The SADD was designed to be quick, with it being a 15 item questionnaire that may be self administered or administered through a structured interview.[1] The items on the evaluation ask about the drinking habits of the patient as well as the physical and mental effects of their drinking. Each item is scored on a scale of 0 to 3, giving the evaluation a range of 0 to 45. A score of 1-9 is indicative of a low dependence on alcohol, a score of 10-19 is indicative of a moderate dependence on alcohol, and a score of 20 or greater is indicative of a high dependence on alcohol.[2]
Alcohol dependence syndrome is the physical or psychological need for consuming alcohol. This syndrome was given its name by Edward and Gross, the creators of the Severity of Alcohol Dependence Questionnaire (SADQ). The Short Alcohol Dependence Data Questionnaire is based on alcohol dependence syndrome and how severe the participant's dependence is.[3]
The Severity of Alcohol Dependence Questionnaire (SADQ) was the first assessment tool created to measure alcohol dependence and was created by Edwards and Gross. This instrument was created to assess alcohol dependence in a simplified manner for people seeking help for their alcohol dependence. The Severity of Alcohol Dependence Questionnaire contains twenty questions and is rated on a frequency scale from one to four. There are five sections covered in the SADQ, which are: physical withdrawal signs (PHYS), affective withdrawal signs (AFF), withdrawal relief drinking (NEED), quantity and frequency of alcohol consumption (ALC), and the rate at which withdrawal symptoms start after a period of non-consumption (POSTAB). Within these five sections, there are four items that evaluate the criteria for alcohol dependence. The questionnaire gave a score between 0 and 60. Based on the score, participants received feedback anywhere from mild to severe dependence. A score of 35 or over is considered to be severe dependence issues, and 30 or under is considered mild or moderate dependence. The Severity of Alcohol Dependence Questionnaire mainly focuses on the physical and psychological symptoms of withdrawal and how they are relieved through the consumption of alcohol. There is evidence that this assessment has strong internal validity and reliability in addressing how severe a person's alcohol dependence is.[4]
The Alcohol Dependence Data (ADD) was developed by Raistrick et al. to evaluate the degree of alcohol dependence in a self-given questionnaire that contained 39 questions. From the Alcohol Dependence Data came the shortened version, the Short Alcohol Dependence Data Questionnaire (SADD).[5] The shortened version of the Alcohol Dependence Data Questionnaire has the same validity as the original, it just makes the process simpler.[3]
Because only 3 of the 7 DSM-IV criteria for alcohol dependence are required, not all patients meet the same criteria and therefore not all have the same symptoms and problems related to drinking. Not everyone with alcohol dependence, therefore, experiences physiological dependence. Alcohol dependence is differentiated from alcohol abuse by the presence of symptoms such as tolerance and withdrawal. Both alcohol dependence and alcohol abuse are sometimes referred to by the less specific term alcoholism. However, many definitions of alcoholism exist, and only some are compatible with alcohol abuse. There are two major differences between alcohol dependence and alcoholism as generally accepted by the medical community.
AUDIT has replaced older screening tools such as CAGE but there are many shorter alcohol screening tools,[7] mostly derived from the AUDIT. The Severity of Alcohol Dependence Questionnaire (SAD-Q) is a more specific twenty-item inventory for assessing the presence and severity of alcohol dependence.
The Alcohol Use Disorders Identification Test (AUDIT) is considered the most accurate alcohol screening tool for identifying potential alcohol misuse, including dependence.[8] It was developed by the World Health Organisation, designed initially for use in primary healthcare settings with supporting guidance.[9]
Withdrawals from alcohol dependence is a common side effect that occurs when a person with the dependency stops drinking abruptly or even cuts back on their drinking after a prolonged period of indulgence. Withdrawal from alcohol dependence can vary from mild, moderate to severe, depending on several factors such as: how long the person has been drinking, whether they are a binge drinker, whether they relapse chronically, and how much they drink daily. All these factors can vary from one person to the next depending on psychological, environmental, and biological factors.[11] Some common withdrawal side effects are as listed:
The spectrum of alcohol withdrawal symptoms range from such minor symptoms as insomnia and tremulousness to severe complications such as withdrawal seizures and delirium tremens.[12] Alcohol withdrawal syndrome can be very tricky to diagnose, due to other preliminary conditions that may exist from individual to individual.
Treatments for alcohol dependence can be separated into two groups, those directed towards severely alcohol-dependent people, and those focused for those at risk of becoming dependent on alcohol. Treatment for alcohol dependence often involves utilizing relapse prevention, support groups, psychotherapy,[13] and setting short-term goals.[14] The Twelve-Step Program is also a popular faith-based process used by those wishing to recover from alcohol dependence.[15]
The ultimate goal when it comes to treating alcohol dependence or as the DSM-5 now calls it alcohol use disorder, is to help with establishing abstinence from drinking. There are several other benefits that come along with treatment. For some, it is reconnecting with themselves and obtaining self-esteem and confidence, a healthier lifestyle (physically and mentally), creating new relationships with other like-minded people as well as rekindling or mending old relationships if possible. The treatment process consists typically of two parts short-term and long-term. First, there is the path to abstinence and/or recovery. There are several reasons why someone with alcohol use disorder or alcohol dependency would seek treatment. This can either be a personal reason or because of law enforcement. There is a series of different levels of treatment processes depending on the severity subtype. Some would or could benefit from medication treatment with psychosocial treatment, while others could just benefit from psychosocial treatment. Listed below are some different types of treatments that are used with treating alcohol dependency/alcohol use disorder depending on several factors that vary from person to person.[16]
Acceptance and mindfulness-based interventions show evidence of efficacy in being used to target Alcohol Use Disorder. These types of interventions are often most effectively delivered in group settings, however, they are also proven effective in individual therapy contexts. Overall, this is crucial in helping individuals who are dependent on alcohol because it raises awareness, provides a non-judgemental environment for people to express their thoughts, and allows individuals to be heard and accepted in the present moment. [17]
About 12% of American adults have had an alcohol dependence problem at some time in their life.[18] In the UK the NHS estimates that around 9% of men and 4% of UK women show signs of alcohol dependence.[19]
A 2015 study found that alcohol dependency may have genetic risk factors. Linkage disequilibrium between an AD-associated GABA receptor gene cluster, GABRB3/GABRG3, and eye color genes, OCA2/HERC2, as well as between AD-associated GRM5 and pigmentation-associated TYR, were all associated with alcohol dependency.[20] GABA downregulation may decrease sensitivity to the toxic effects of alcohol, leading to increased alcohol consumption in blue-eyed individuals.[21]
The term 'alcohol dependence' has replaced 'alcoholism' as a term in order that individuals do not internalize the idea of cure and disease, but can approach alcohol as a chemical they may depend upon to cope with outside pressures.
The alcohol dependence syndrome was seen as a cluster of seven elements that concur. It was argued that not all elements may be present in every case, but the picture is sufficiently regular and coherent to permit clinical recognition. The syndrome was also considered to exist in degrees of severity rather than as a categorical absolute. Thus, the proper question is not 'whether a person is dependent on alcohol', but 'how far along the path of dependence has a person progressed'.
SESA is a reliable and valid questionnaire for the assessment of alcohol addiction. It is based on the alcohol addiction syndrome as defined by Edwards and Gross (1976), which is the foundation of the diagnosis for alcohol addiction according to the ICD-10 and the DSM-IV.
The definition of alcohol addiction according to Edwards and Gross (1976) provides a potential measurement of alcohol dependence without accompanying symptoms which are not typical for addiction problems (e.g. somatic diseases) or for assessing the severity of the addiction. According to the publication of Edwards and Gross (1976), three questionnaires were publicized aiming to evaluate the alcohol dependence syndrome: SADQ, SADD, and ADS. All three instruments show limitations: (1) They are not clearly limited to the criteria of the alcohol addiction syndrome according to Edwards and Gross (1976). Some questions address problems with alcohol consumption but are not part of the alcohol addiction syndrome. (2) The criteria of the alcohol addiction syndrome are not fully represented. (3) The topics to be answered do not provide a complete match to determine the prevalence of different symptoms. The aim was to develop a questionnaire without these limitations.
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