<b><i>Background:</i></b> Hazardous drinking among students in higher education is a growing concern. The alcohol use disorders identification test (AUDIT) is the gold standard screening instrument for hazardous drinking in the adult population, for which an abbreviated version has been developed: the AUDIT-Consumption (AUDIT-C). Currently, there’s no gold standard for identifying hazardous drinking among students in higher education and little evidence regarding the concurrent validity of the AUDIT-C as a screening instrument for this group. This study investigated the concurrent validity of the AUDIT-C in a sample of university students and suggests the most appropriate cutoff points. <b><i>Methods:</i></b> Cross-sectional data of health surveys from 5,401 university and university of applied sciences in the Netherlands were used. Receiver operating characteristic (ROC) curves, sensitivity, specificity, and positive and negative predictive values for different cutoff scores of AUDIT-C were calculated for the total sample and for subgroups stratified by age, gender, and educational level. AUDIT-score ≥11 was used as the criterion of hazardous and harmful drinking. <b><i>Results:</i></b> Twenty percent of students were hazardous and harmful drinkers. The area under the ROC curve was 0.922 (95% CI 0.914–0.930). At an AUDIT-C cutoff score of ≥7, sensitivity and specificity were both >80%, while other cutoffs showed less balanced results. A cutoff of ≥8 performed better among males, but for other subgroups ≥7 was most suitable. <b><i>Conclusion:</i></b> AUDIT-C seems valid in identifying hazardous and harmful drinking students, with suggested optimal cutoffs 7 (females) or 8 (males). However, considerations regarding avoiding false-positives versus false-negatives, in relation to the type of intervention following screening, could lead to selecting different cutoffs.
The Motivational Interviewing Skill Code (MISC) is a coding system developed to measure adherence to motivational interviewing (MI). MI is an effective clinical style used in different treatment situations. Counsellors practising MI have to follow general principles and avoid certain traps. In the present study, the content of the MISC is compared with the general principles of MI and the traps to avoid in MI. Investigation of the content validity raises some questions. All general principles are represented but the traps to avoid in MI are not fully covered. The consequences of this under-representation are shown in transcripts of a selection of well-conducted MI training sessions. The reliability of the MISC was investigated by having five independent coders code 39 MI training sessions of different counsellors. The reliability of the MISC is reasonable. The five coders agreed to a large extent on the absolute ratings but the intraclass correlations were low. Although the MISC can be a useful research tool for process research of MI, it remains a labour-intensive instrument and for teaching and practice audit development of a more simple coding system is recommended.
Despite high prevalence of mental health problems among university students, there's a gap between the need for help and the actual treatment received. This study investigated disclosure on distress and hazardous alcohol use and help-seeking behavior in a sample of 1,791 students of a Dutch university of applied sciences. Students' perceived public and personal stigma, and attitudes towards disclosure and help-seeking were assessed as possible predictors of disclosure and help-seeking behavior. Results of the analysis of variance and logistic regression analysis indicated that perceived public and personal stigma did not predict disclosure and helpseeking behavior, but that attitudes towards disclosure and help-seeking did. Students with both distress and hazardous alcohol use have the least tendency to disclose their problems to family, friends or classmates, but at the same time they do tend to seek help. Disclosure and seeking help for mental health challenges are health promoting competencies that seem to need more attention in university students. Although further research needs to validate these findings, it is recommended to promote disclosure and help-seeking among students by investing in mental health literacy programs, to educate students about mental health issues, raise awareness on available mental health services and their potential benefits.
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