title: The choice of screening instrument matters: the case of problematic cannabis use screening in spanish population of adolescents.
abstract: The aim of this study was to examine the feasibility of problem cannabis use screening instruments administration within wide school surveys, their psychometric properties, overlaps, and relationships with other variables. Students from 7 Spanish regions, aged 14-18, who attended secondary schools were sampled by two-stage cluster sampling (net sample 14,589). Standardized, anonymous questionnaire including DSM-IV cannabis abuse criteria, Cannabis Abuse Screening Test (CAST), and Severity of Dependence Scale (SDS) was self-completed with paper and pencil in the selected classrooms. Data was analysed using classical psychometric theory, bivariate tests, and multinomial logistic regression analysis. Not responding to instruments' items (10.5-12.3%) was associated with reporting less frequent cannabis use. The instruments overlapped partially, with 16.1% of positives being positive on all three. SDS was more likely to identify younger users with lower frequency of use who thought habitual cannabis use posed a considerable problem. CAST positivity was associated with frequent cannabis use and related problems. It is feasible to use short psychometric scales in wide school surveys, but one must carefully choose the screening instrument, as different instruments identify different groups of users. These may correspond to different types of problematic cannabis use; however, measurement bias seems to play a role too.
authors.affiliation: Prevalence and Consequences and Data Management Unit, European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Cais do Sodré, 1249-289 Lisbon, Portugal.
authors.forename: Danica
authors.identifier: 0000-0002-5215-0225
authors.initials: D
authors.lastname: Thanki
authors.affiliation: IMIM-Hospital del Mar, CIBERESP, Dr. Aiguader 88, 08003 Barcelona, Spain.
authors.forename: Antónia
authors.initials: A
authors.lastname: Domingo-Salvany
authors.affiliation: Escuela Nacional de Sanidad, Instituto de Salud Carlos III, CIBERESP, Avenida Monforte de Lemos 5, 28029 Madrid, Spain.
authors.forename: Gregorio
authors.initials: G
authors.lastname: Barrio Anta
authors.affiliation: Unidad de Conductas Adictivas, Departamento de Salud Valencia, Hospital Arnau de Villanova, Plaza Clot de Joan s/n, Paterna, 46980 Valencia, Spain.
authors.forename: Amparo
authors.initials: A
authors.lastname: Sánchez Mañez
authors.affiliation: Delegación del Gobierno para el Plan Nacional sobre Drogas (DGPNSD), Ministerio de Sanidad, Servicios Sociales e Igualdad, Plaza de España 17, 28071 Madrid, Spain.
authors.forename: Noelia
authors.initials: N
authors.lastname: Llorens Aleixandre
authors.affiliation: Agència de Salut Pública de Catalunya, Departament de Salut de la Generalitat de Catalunya, Roc Boronat 81-95, 08005 Barcelona, Spain.
authors.forename: Josep Maria
authors.identifier: 0000-0002-7716-6944
authors.initials: JM
authors.lastname: Suelves
authors.affiliation: Delegación del Gobierno para el Plan Nacional sobre Drogas (DGPNSD), Ministerio de Sanidad, Servicios Sociales e Igualdad, Plaza de España 17, 28071 Madrid, Spain.
authors.forename: Begoña
authors.initials: B
authors.lastname: Brime Beteta
authors.affiliation: Prevalence and Consequences and Data Management Unit, European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Cais do Sodré, 1249-289 Lisbon, Portugal.
authors.forename: Julián
authors.initials: J
authors.lastname: Vicente