Traffic Tech #199: Problem Drinking Screening Instruments for DWI Offenders Validated |
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PROBLEM DRINKING SCREENING INSTRUMENTS FOR DWI OFFENDERS VALIDATED
Courts throughout the United States seek guidance about which psychometric instruments (tests) best screen for DWI offenders with alcohol problems. The courts seek valid and relatively short questionnaires to help them decide whether the DWI offender is in need of a full assessment as part of DWI sentencing. An earlier NHTSA study found that there was wide variation in how these tests were administered, and that in some cases, the results from these screening instruments were used to make the final decision about whether or not an offender received treatment. Furthermore, most instruments in widespread use had not been independently validated against an objective criterion measure.
In response to these needs, the National Highway Traffic Safety Administration (NHTSA) sponsored a study by Mid-America Research Institute to independently validate some of the more widely used screening instruments against an objectively developed criterion measure.
The Criterion Measure
In the past, the most commonly used criterion against which screening tests have been validated is clinical evaluations by mental health professionals. One goal of the current study was to develop a new criterion measure that could be administered in a standardized manner, and would identify problem drinkers whose level of drinking and associated problems indicated they were in need of further assessment.
| The expert panel defined a problem drinker as one who exhibits at least one of the following characteristics. . . .
Persons who exhibit two or more of the following are also problem drinkers. . .
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Expert Panel
An expert panel of acknowledged leaders in the field of problem drinking assessment assembled to develop this criterion measure. They helped develop two criterion measures (one for adults and one for adolescents). The adult criterion measure was used to validate instruments in this study. The adolescent criterion measure is available for future research on instruments that are specific to adolescents.
Consumption.. ..Dependence... ...Consequences... ....Vulnerability....
The adult criterion measure for problem drinking was derived from responses to questionnaire items in a comprehensive 30-minute personal interview with study participants. These items covered four problem drinking areas, namely: consumption of alcohol, alcohol dependence, consequences of drinking, and vulnerability. The questionnaire is in the appendix to this report.
Four Screening Instruments Validated
The expert panel chose to validate four adult screening instruments from those known to be in widespread use. They are: the Michigan Alcohol Screening Test (MAST); the Mortimer-Filkins Questionnaire (without the interview); the Driver Risk Inventory (DRI); and the Substance Abuse/Life Circumstance Evaluation (SALCE). Questions from a short screener with four items called the CAGE, were also validated. The CAGE was coupled with a few additional items about alcohol consumption from an instrument called the Alcohol Clinical Index (ACI). This final screener was included to validate a shorthand way to identify problem drinkers in an unrelated NHTSA telephone survey.
Data Collected from DWI Offenders
in Two Sites
Adult participants in DWI programs in Allegheny County, Pennsylvania and the Greater Boston, Massachusetts areas provided data to validate the screening instruments. There were 609 first and multiple DWI offenders.
Findings
All of the assessment instruments were effective in identifying problem drinkers. The most sensitive, and least specific, was the SALCE, which correctly identified 92 percent of problem drinkers, but only 57 percent of non-problem drinkers correctly. This means that a DWI program relying upon this instrument to identify persons in need of additional treatment would also be identifying a greater number of false positives, that is, persons presumably not in need of additional treatment.
The other three adult tests, were somewhat less sensitive than the SALCE, correctly identifying about 80 percent of problem drinkers with fewer false positives. The Mortimer-Filkins and DRI correctly identified approximately two-thirds of non-problem drinkers and the MAST was accurate 85 percent of the time. This finding is surprising in that the MAST is a much shorter instrument that might be fairly easy to deceive. The even shorter CAGE plus consumption calculation correctly identified problem drinkers 72 percent of the time, and non-problem drinkers 76 percent of the time.
HOW TO ORDER
For a copy ofValidation of Problem Drinking Screening Instruments for DWI Offenders, (41 pages plus ample appendices) write to the Media and Marketing Division, NHTSA, NTS-21, 400 Seventh Street, S.W., Washington, DC 20590, or send a fax to (202) 493-2062. James F. Frank, Ph.D., was the contract manager for this project, e-mail: jfrank@nhtsa.dot.gov
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