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A DSM-IV diagnosis of substance abuse disorder does not include?

  1. a period of at least two years of involvement

  2. legal difficulties related to substance abuse

  3. repeated episodes of substance intoxication

  4. substance related relationship difficulties at work or within the family

The correct answer is: a period of at least two years of involvement

A DSM-IV diagnosis of substance abuse disorder does not require a specific period of at least two years of involvement. The criteria focus more on the behavior and impact of the substance use rather than the duration of use itself. For a diagnosis of substance abuse, the individual must exhibit a pattern of use that leads to significant impairment or distress, which can occur within a shorter timeframe than two years. The criteria for substance abuse include elements such as legal problems, recurrent substance use resulting in failure to fulfill major roles at work, school or home, and presence of interpersonal problems related to substance use. These factors highlight the negative consequences and dysfunction associated with the use, rather than a particular duration of use. Thus, the emphasis is on the behavioral consequences and patterns of use, not on how long an individual has been using substances.