Screening for substance abuse in individuals with traumatic brain injury.
OBJECTIVE
To determine the utility of the CAGE, the Brief Michigan Alcohol Screening Test (BMAST) and the Substance Abuse Subtle Screening Inventory (SASSI-3) with individuals with traumatic brain injury (TBI), two studies were conducted examining the accuracy, sensitivity and specificity of these instruments.


METHODS
Data from self-report instruments were compared to a clinical interview, Structured Clinical Interview for DSM-IV (SCID), to determine the accuracy, sensitivity and specificity.


METHODS
Two studies were conducted. In study I, 100 individuals with TBI were screened for alcohol abuse using the CAGE and the resulting classifications were compared with those derived from the SCID. In study II, 223 individuals were screened for alcohol abuse and drug abuse using the BMAST and SASSI-3 and the results of these screenings were compared with diagnoses obtained by the SCID.


RESULTS
The specificity of the self-report instruments was moderately high, ranging between 81-83%. The specificity of the CAGE for alcohol abuse both pre- and post-TBI was high, 96% and 86%, respectively. The sensitivity of the self-report instruments was most variable, ranging from 32-95%, with the SASSI face valid drug scale and the CAGE alcohol post-TBI indicating the most sensitivity, 95 and 91%, respectively.


CONCLUSIONS
The findings suggest that the CAGE may be useful in screening for alcohol abuse and the face valid drug sub-scale of the SASSI-3 may be useful in screening for drug abuse in individuals with TBI.
Ashman
Teresa A
TA
Department of Rehabilitation Medicine, Mount Sinai School of Medicine, New York, NY 10021, USA. teresa.ashman@mssm.edu
Schwartz
Michael E
ME
Cantor
Joshua B
JB
Hibbard
Mary R
MR
Gordon
Wayne A
WA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000150:complications / Q000175:diagnosis; D001930:Brain Injuries / Q000150:complications* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D019966:Substance-Related Disorders / Q000150:complications / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D013997:Time Factors