The AUDIT was developed by the World Health Organization as a simple method of screening for excessive drinking and to assist in brief assessment.
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The AUDIT was developed by the World Health Organization as a simple method of screening for excessive drinking and to assist in brief assessment.
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Since 2013, the AUDIT has not been validated on the college student population to determine cut-off scores for men and women or assess the accuracy in classifying DSM-5 alcohol use disorder to other drinker classification groups including the previous DSM-IV alcohol abuse or alcohol dependence, or binge drinking.
This study fills a critical gap in the literature by establishing cut-off thresholds based on the new DSM-5 alcohol use disorder diagnostic guidelines. A rigorous empirical validation of the AUDIT will ensure that current alcohol screening procedures are able to accurately identify and properly refer high risk non-treatment seeking college students.
This study sample consisted of 251 undergraduate students at a southeastern university in the United States who engaged in at least one binge drinking episode in the past 90 days during the year 2013. The participants were diverse with regard to class rank (senior, junior, etc.), gender, and race/ethnicity. The Composite International Diagnostic Interview-Substance Abuse Module (CIDI-SAM) was used to collect DSM-IV and DSM-5 alcohol use diagnostic information.
The participants were classified as having no alcohol use disorder, DSM-5 alcohol use disorder, DSM-IV alcohol use disorder (either abuse or the more severe form of dependence), and the presence or absence of binge drinking in the previous two weeks (5+ drinks for men and 4 for women in a sitting). Advanced statistical analysis was used to determine optimal cut-off scores for college men and women and the accuracy in classifying DSM-5 alcohol use disorder to other drinker classification groups including the DSM-IV alcohol abuse or alcohol dependence, or binge drinking.
From the 251 students, the percent who did not meet criteria for a DSM-5 alcohol use disorder was 38.2%. The remaining 61.8% who had a DSM-5 alcohol use disorder diagnoses were categorized as follows:
When classified according to DSM-IV guidelines, the percent of students who met criteria for an alcohol use disorder was 60.2% from which 15.1% met criteria for alcohol abuse and 45% alcohol dependence. DSM-IV alcohol dependence is equivalent to the current DSM-5 guidelines for moderate and severe alcohol use disorder.
Overall, the analysis showed that the AUDIT had reasonably good discrimination across all of the DSM-IV and DSM-5 classifications with the highest level of discrimination occurring for the assessment of binge drinking within the previous two weeks.
To determine the best cut-off scores on the AUDIT that distinguish between students with and without a DSM-5 alcohol use disorder, the researchers identified the score that simultaneously optimized both the sensitivity (ability of the AUDIT to correctly identify students with alcohol use disorder) and specificity (ability of the AUDIT to correctly identify students without alcohol use disorder) which was a score greater than or equal to 8.
Another important finding was that the AUDIT performed almost equally well in the detection of DSM-IV and DSM-5 diagnostic status. Therefore, any reduction in the diagnostic precision in detecting DSM-IV or DSM-5 classification should be marginal. The result that indicated the AUDIT had more discrimination for the detection of binge drinking was probably due to the items that measure drinking quantity and frequency which can result in increased precision.
According to the DSM-5 criteria for alcohol use disorder, there are three classifications of severity: mild (2-3 criteria), moderate (4-5 criteria), and severe (6-7 criteria). More work needs to done to identify AUDIT cut scores that correspond with each of these classifications for college student populations. The identification of severity cut scores would facilitate treatment recommendations and recovery plans.
Hagman, B. T. (2016). Performance of the AUDIT in detecting DSM-5 alcohol use disorders in college students, Substance Use & Misuse, 51:11, 1521-1528. DOI: 10.1080/10826084.2016.1188949
l
Since 2013, the AUDIT has not been validated on the college student population to determine cut-off scores for men and women or assess the accuracy in classifying DSM-5 alcohol use disorder to other drinker classification groups including the previous DSM-IV alcohol abuse or alcohol dependence, or binge drinking.
This study fills a critical gap in the literature by establishing cut-off thresholds based on the new DSM-5 alcohol use disorder diagnostic guidelines. A rigorous empirical validation of the AUDIT will ensure that current alcohol screening procedures are able to accurately identify and properly refer high risk non-treatment seeking college students.
This study sample consisted of 251 undergraduate students at a southeastern university in the United States who engaged in at least one binge drinking episode in the past 90 days during the year 2013. The participants were diverse with regard to class rank (senior, junior, etc.), gender, and race/ethnicity. The Composite International Diagnostic Interview-Substance Abuse Module (CIDI-SAM) was used to collect DSM-IV and DSM-5 alcohol use diagnostic information.
The participants were classified as having no alcohol use disorder, DSM-5 alcohol use disorder, DSM-IV alcohol use disorder (either abuse or the more severe form of dependence), and the presence or absence of binge drinking in the previous two weeks (5+ drinks for men and 4 for women in a sitting). Advanced statistical analysis was used to determine optimal cut-off scores for college men and women and the accuracy in classifying DSM-5 alcohol use disorder to other drinker classification groups including the DSM-IV alcohol abuse or alcohol dependence, or binge drinking.
From the 251 students, the percent who did not meet criteria for a DSM-5 alcohol use disorder was 38.2%. The remaining 61.8% who had a DSM-5 alcohol use disorder diagnoses were categorized as follows:
When classified according to DSM-IV guidelines, the percent of students who met criteria for an alcohol use disorder was 60.2% from which 15.1% met criteria for alcohol abuse and 45% alcohol dependence. DSM-IV alcohol dependence is equivalent to the current DSM-5 guidelines for moderate and severe alcohol use disorder.
Overall, the analysis showed that the AUDIT had reasonably good discrimination across all of the DSM-IV and DSM-5 classifications with the highest level of discrimination occurring for the assessment of binge drinking within the previous two weeks.
To determine the best cut-off scores on the AUDIT that distinguish between students with and without a DSM-5 alcohol use disorder, the researchers identified the score that simultaneously optimized both the sensitivity (ability of the AUDIT to correctly identify students with alcohol use disorder) and specificity (ability of the AUDIT to correctly identify students without alcohol use disorder) which was a score greater than or equal to 8.
Another important finding was that the AUDIT performed almost equally well in the detection of DSM-IV and DSM-5 diagnostic status. Therefore, any reduction in the diagnostic precision in detecting DSM-IV or DSM-5 classification should be marginal. The result that indicated the AUDIT had more discrimination for the detection of binge drinking was probably due to the items that measure drinking quantity and frequency which can result in increased precision.
According to the DSM-5 criteria for alcohol use disorder, there are three classifications of severity: mild (2-3 criteria), moderate (4-5 criteria), and severe (6-7 criteria). More work needs to done to identify AUDIT cut scores that correspond with each of these classifications for college student populations. The identification of severity cut scores would facilitate treatment recommendations and recovery plans.
Hagman, B. T. (2016). Performance of the AUDIT in detecting DSM-5 alcohol use disorders in college students, Substance Use & Misuse, 51:11, 1521-1528. DOI: 10.1080/10826084.2016.1188949
l
Since 2013, the AUDIT has not been validated on the college student population to determine cut-off scores for men and women or assess the accuracy in classifying DSM-5 alcohol use disorder to other drinker classification groups including the previous DSM-IV alcohol abuse or alcohol dependence, or binge drinking.
This study fills a critical gap in the literature by establishing cut-off thresholds based on the new DSM-5 alcohol use disorder diagnostic guidelines. A rigorous empirical validation of the AUDIT will ensure that current alcohol screening procedures are able to accurately identify and properly refer high risk non-treatment seeking college students.
This study sample consisted of 251 undergraduate students at a southeastern university in the United States who engaged in at least one binge drinking episode in the past 90 days during the year 2013. The participants were diverse with regard to class rank (senior, junior, etc.), gender, and race/ethnicity. The Composite International Diagnostic Interview-Substance Abuse Module (CIDI-SAM) was used to collect DSM-IV and DSM-5 alcohol use diagnostic information.
The participants were classified as having no alcohol use disorder, DSM-5 alcohol use disorder, DSM-IV alcohol use disorder (either abuse or the more severe form of dependence), and the presence or absence of binge drinking in the previous two weeks (5+ drinks for men and 4 for women in a sitting). Advanced statistical analysis was used to determine optimal cut-off scores for college men and women and the accuracy in classifying DSM-5 alcohol use disorder to other drinker classification groups including the DSM-IV alcohol abuse or alcohol dependence, or binge drinking.
From the 251 students, the percent who did not meet criteria for a DSM-5 alcohol use disorder was 38.2%. The remaining 61.8% who had a DSM-5 alcohol use disorder diagnoses were categorized as follows:
When classified according to DSM-IV guidelines, the percent of students who met criteria for an alcohol use disorder was 60.2% from which 15.1% met criteria for alcohol abuse and 45% alcohol dependence. DSM-IV alcohol dependence is equivalent to the current DSM-5 guidelines for moderate and severe alcohol use disorder.
Overall, the analysis showed that the AUDIT had reasonably good discrimination across all of the DSM-IV and DSM-5 classifications with the highest level of discrimination occurring for the assessment of binge drinking within the previous two weeks.
To determine the best cut-off scores on the AUDIT that distinguish between students with and without a DSM-5 alcohol use disorder, the researchers identified the score that simultaneously optimized both the sensitivity (ability of the AUDIT to correctly identify students with alcohol use disorder) and specificity (ability of the AUDIT to correctly identify students without alcohol use disorder) which was a score greater than or equal to 8.
Another important finding was that the AUDIT performed almost equally well in the detection of DSM-IV and DSM-5 diagnostic status. Therefore, any reduction in the diagnostic precision in detecting DSM-IV or DSM-5 classification should be marginal. The result that indicated the AUDIT had more discrimination for the detection of binge drinking was probably due to the items that measure drinking quantity and frequency which can result in increased precision.
According to the DSM-5 criteria for alcohol use disorder, there are three classifications of severity: mild (2-3 criteria), moderate (4-5 criteria), and severe (6-7 criteria). More work needs to done to identify AUDIT cut scores that correspond with each of these classifications for college student populations. The identification of severity cut scores would facilitate treatment recommendations and recovery plans.
Hagman, B. T. (2016). Performance of the AUDIT in detecting DSM-5 alcohol use disorders in college students, Substance Use & Misuse, 51:11, 1521-1528. DOI: 10.1080/10826084.2016.1188949
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