Caffeine use disorder: An item-response theory analysis of proposed DSM-5 criteria

Caffeine is a common psychoactive substance with a documented addictive potential. Caffeine withdrawal has been included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but caffeine use disorder (CUD) is considered to be a condition for further study. The aim of the current study is (1) to test the psychometric properties of the Caffeine Use Disorder Questionnaire (CUDQ) by using a confirmatory factor analysis and an item response theory (IRT) approach, (2) to compare IRT models with varying numbers of parameters and models with or without caffeine consumption criteria, and (3) to examine if the total daily caffeine consumption and the use of different caffeinated products can predict the magnitude of CUD symptomatology.

A cross-sectional study was conducted on an adult sample (N = 2259). Participants answered several questions regarding their caffeine consumption habits and completed the CUDQ, which incorporates the nine proposed criteria of the DSM-5 as well as one additional item regarding the suffering caused by the symptoms.

Factor analyses demonstrated the unidimensionality of the CUDQ. The suffering criterion had the highest discriminative value at a higher degree of latent trait. The criterion of failure to fulfill obligations and social/interpersonal problems discriminate only at the higher value of CUD latent factor, while endorsement the consumption of more caffeine or longer than intended and craving criteria were discriminative at a lower level of CUD. Total daily caffeine intake was related to a higher level of CUD. Daily coffee, energy drink, and cola intake as dummy variables were associated with the presence of more CUD symptoms, while daily tea consumption as a dummy variable was related to less CUD symptoms. Regular smoking was associated with more CUD symptoms, which was explained by a larger caffeine consumption.

The IRT approach helped to determine which CUD symptoms indicate more severity and have a greater discriminative value. The level of CUD is influenced by the type and quantity of caffeine consumption.