A new brief screen for adolescent substance abuse.
OBJECTIVE
To develop a brief alcohol and other drug (AOD) screening test for adolescents.


METHODS
A 9-item test was constructed by combining and modifying items from several AOD assessments, and administered concurrently with the Personal Involvement With Chemicals Scale (PICS), the criterion standard.


METHODS
A hospital-based adolescent clinic.


METHODS
Fourteen- to 18-year-old patients consecutively arriving for routine medical care who were known to have used AOD.


METHODS
Internal consistency of the 9 items was calculated using the Cronbach alpha. The relationship between the brief screen and PICS raw score was determined by stepwise linear regression analysis. The PICS T score has been shown to correctly classify substance abuse treatment need as no treatment (T<35), brief office intervention (T = 35-40), outpatient or short-term treatment (T = 41-54), and inpatient or long-term treatment (T> or =55). Sensitivity and specificity rates for predicting a PICS T score of 55 or higher were calculated from 2 x 2 tables.


RESULTS
Ninety-nine adolescents were tested (70.7% female, 36.4% black, 32.3% white, 19.2% Hispanic, mean age, 16.3 years). The 9 items had good internal consistency (Cronbach alpha = .79). Stepwise linear regression analysis identified 6 items whose total combined score was highly correlated with PICS (Pearson r = 0.84, P<.01). This model correctly classified 86% of subjects according to the PICS criteria. Two or more yes answers had a sensitivity of 92.3% and specificity of 82.1% for intensive AOD treatment need. The 6 items were arranged into a mnemonic (CRAFFT).


CONCLUSIONS
Further research must confirm the test's psychometric properties in a general clinic population. However, CRAFFT seems promising as a brief AOD screening test.
Knight
J R
JR
Division of General Pediatrics, Children's Hospital, Harvard Medical School, Boston, Mass 02115, USA. knight_j@a1.tch.harvard.edu
Shrier
L A
LA
Bravender
T D
TD
Farrell
M
M
Vander Bilt
J
J
Shaffer
H J
HJ
D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration*; D000437:Alcoholism / Q000175:diagnosis*; D001900:Boston; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D011594:Psychometrics; D012680:Sensitivity and Specificity; D015813:Substance Abuse Detection / Q000379:methods*; D011795:Surveys and Questionnaires