Psychometric Properties of the AUDIT, AUDIT-C, CRAFFT and ASSIST-Y among Swedish Adolescents

Abstract

Background/Aims: Not enough is known about the psychometric properties of screening instruments for problematic alcohol consumption among adolescents. The aim of the current study was to evaluate and compare the performance of the screening instruments: Alcohol Use Disorders Identification Test (AUDIT), AUDIT-C, CRAFFT, and the alcohol domain of Alcohol, Smoking and Substance Involvement Screening Test-Youth (ASSIST-Y) among adolescents and to suggest optimal cut-offs indicating problematic use. Methods: Data was collected from a general population sample (n = 1,421) and a treatment-seeking sample (n = 59) using electronic versions of the instruments. Results: The internal consistencies for the instruments were fair (alpha’s AUDIT 0.74, AUDIT-C 0.75, CRAFFT 0.67, ASSIST-Y 0.62), and test-retest reliabilities were good to excellent (intraclass correlation coefficients AUDIT 0.86, AUDIT-C 0.93, CRAFFT 0.77, ASSIST-Y 0.63). The CRAFFT and ASSIST-Y demonstrated reasonable construct validities while factor solutions for AUDIT and AUDIT-C could not be determined. The optimal cut-off score was 2 for both CRAFFT and ASSIST-Y (61 and 73% sensitivities and 79 and 65% specificities, respectively), while sensitivity scores were poor for AUDIT and AUDIT-C. Conclusion: Based on the current sample, ASSIST-Y and the CRAFFT performed better than AUDIT and AUDIT-C. Health-care clinics working with adolescents should carefully consider their choice of screening instruments.

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“…For tobacco products, alcoholic beverages, and inhalants, a score in the range of 2-5 is considered moderate risk, while a score of 6+ is considered high risk; for cannabis, cocaine, amphetamine-type stimulants, sedatives, hallucinogens, opioids, and other substances, a score of 2+ is considered high risk. The ASSIST-Y has fair" internal consistencies" (0.62) and" test-retest reliability" was good (intraclass correlation coefficient is 0.63) with an optimal cutoff score of 2, yielding 73% sensitivity and 65% specificity [14].…”

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“…Self-reported alcohol use within the last 12 months was assessed using the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C). In a recent study, the AUDIT-C was psychometrically evaluated among 15–18-year-olds [51]. Results revealed a good internal consistency (alpha 0.75) and an excellent test-retest reliability (Intraclass Correlation Coefficient 0.93, however, an optimal cut-off score could not be determined.…”