CONTENTS

About This Course

Table of Contents

1. Introduction to the Issues
2. Understanding Alcohol Abuse
3. Understanding Violence Against Women
4. Alcohol and Domestic Violence
5. Alcohol, Sexual Assault, and Rape
6. Prevention and Early Intervention
7. Screening and Assessment
8. Diagnosis and Treatment
9. Legal and Ethical Issues

Supplements
Fact Sheets
Videos
Resources

Silence Hurts
Alcohol Abuse and Violence Against Women

DSM-IV Criteria for Dependence

The official DSM-IV criteria for dependence (including alcohol) state that:⁹

Substance dependence is a maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following:

• Tolerance, as defined by either of the following:
  1. A need for markedly increased amounts of the substance to achieve intoxication or desired effect, or
  2. Markedly diminished effect with continued use of the same amount of the substance.
  
  
• Withdrawal, as manifested by either of the following:
  1. The characteristic withdrawal syndrome for the substance (For more information, refer to criteria A and B of the criteria sets for withdrawal from the specific substances within the DSM-IV), or
  2. The same (or closely related) substance is taken to relieve or avoid withdrawal symptoms.
  
  
• The substance is taken in larger amounts or over a longer period than was intended.
• There is a persistent desire or unsuccessful efforts to cut down or control substance use.
• A great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use of the substance (e.g., chain smoking), or recover from its effects.
• Important social, occupational, or recreational activities are given up or reduced because of substance use.
• The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (e.g., current cocaine use despite recognition of cocaine-induced depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption).

Specify if:

With Physiological Dependence: Evidence of tolerance or withdrawal (e.g., Item 1 or 2 is present); or

Without Physiological Dependence: No evidence of tolerance or withdrawal (i.e., Neither item 1 nor item 2 is present).