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- Elgán, T. H., et al.
(author)
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Psychometric properties of the short version of the children of alcoholics screening test (CAST-6) among Swedish adolescents
- 2021
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In: Nordic Journal of Psychiatry. - : Taylor & Francis. - 0803-9488 .- 1502-4725. ; 75:2, s. 155-158
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Journal article (peer-reviewed)abstract
- Aims The Children of Alcoholics Screening Test (CAST-6) is a brief screening instrument developed to identify children with parents having problematic alcohol use. The aim of this study was to evaluate the psychometric properties of the CAST-6 among adolescents aged 15-18 years, and also to identify an optimal cut-off score for this age group. Methods A total of 3000 15 to18 year-olds were randomly selected from a register of postal addresses in Sweden. An invitation letter, including access information to the electronic questionnaire, was sent out by regular mail and 1450 adolescents responded with baseline data. Test-retest reliability within a 2-3-week period was calculated based on the 111 respondents who answered the same questionnaire twice. To determine an optimal cut-off score, a small treatment-seeking sample (n = 22) was recruited from a support group agency to be used as a reference group. Results The six items of the CAST-6 screening test loaded onto one latent factor with good internal consistency (alpha = 0.88), and excellent test-retest reliability (ICC = 0.93, 95% CI 0.90-0.95). The optimal cut-off score among adolescents was 2 points with a sensitivity of 55% and specificity of 79% (AUROC = 0.71, 95% CI 0.58-0.83). Conclusions The CAST-6 has good to excellent psychometric properties among adolescents. The identified optimal cut-off score of 2 points should be treated with caution due to study limitations. The CAST-6 can be used in various settings to identify a vulnerable at-risk group of children and adolescents that may be in need of support.
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- Källmén, Håkan, et al.
(author)
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Alcohol habits in Sweden during 1997-2018 : a repeated cross-sectional study
- 2019
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In: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 73:8, s. 522-526
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Journal article (peer-reviewed)abstract
- Aims: This study describes changes in alcohol habits in age and gender strata among the Swedish general population during the 21-year period following the Swedish EU membership in 1995.Methods: The Alcohol Use Disorders Identification Test (AUDIT) was distributed as a postal questionnaire to randomly selected cross-sectional samples every fourth year, starting in 1997.Results: Six samples were included in this study. A comparison between 2014 and 2018 showed a tendency to decreasing average total AUDIT scores, particularly among men and in the youngest age group (Cohen’s d = 0.28).Conclusion: The results should be understood in the context of declining response rates in this type of survey.
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- Källmén, Håkan, et al.
(author)
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Concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) in relation to Alcohol Use Disorder (AUD) severity levels according to the brief DSM-5 AUD diagnostic assessment screener
- 2019
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In: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 73:7, s. 397-400
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Journal article (peer-reviewed)abstract
- Aims: The Alcohol Use Disorders Identification Test (AUDIT) is a well-established and widely used screening instrument. It has been shown that AUDIT has good criterion validity in relation to alcohol abuse and dependence according to DSM-IV, but it has not yet been validated following the introduction of the DSM-5 diagnostic system. The aim of this study was to evaluate concurrent validity for the AUDIT in relation to self-reported DSM-5 severity levels for Alcohol Use Disorder (AUD) in a Swedish general population sample.Methods: A postal questionnaire, containing the AUDIT and the 13-item brief DSM-5 AUD diagnostic assessment screener, was sent to a random sample of 1,500 persons drawn from the Swedish population, aged between 17 and 80 years and having a public residence address in Sweden. To evaluate the concurrent validity of AUDIT in relation to DSM-5 severity criteria for AUD, a Receiver Operating Characteristics (ROC) curve analysis was conducted.Results: Area under the curve (AUROC) showed excellent differentiation between AUD or not, mild (.93), moderate (.92) and severe (.99). Higher individual AUDIT scores were associated with more severe levels of AUD according to the DSM-5 screener. The optimal cutoff scores approximate earlier research on the DSM-IV and were identified as 5, 7 and 13 points, respectively, for mild, moderate and severe AUD.Conclusions: Our findings indicate that AUDIT is a valid screener for detecting concurrent AUD at three severity levels in the Swedish general population.
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- Berman, Anne H., et al.
(author)
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Hopeless patients? : A study of illicit opiate users who drop out from in-patient detoxification
- 2008
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In: Journal of Substance Use. - : Informa UK Limited. - 1465-9891 .- 1475-9942. ; 13:2, s. 121-130
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Journal article (peer-reviewed)abstract
- Individual and treatment-related factors associated with early self-discharge were studied among illicit opiate users consecutively admitted for hospital detoxification (ITT=68, n=45). Only 20% of the drop-outs had a detailed treatment plan, 20% participated in their own treatment planning, and none were enrolled in a methadone/buprenorphine programme at admission (compared with 60, 80, and 66%, respectively, of those retained in treatment). Having a treatment plan at intake improved the odds for planned discharge by 13 and perceiving fewer positive aspects of drug use increased the odds for drop-out by 12.6. A configural frequency analysis (CFA) showed one significant type: patients with sketchy or no treatment planning at intake, no maintenance treatment, and a low score on positive aspects of drug use were 7.5 times more likely to drop out than expected. Lacking a close maternal relationship characterized patients in this type (83% compared with 31% of non-types). Drop-outs seem to have insecure attachment patterns, which make contact difficult with social services and substance abuse treatment providers. Future research should devise ways of establishing a working alliance with patients likely to drop out, as well as investigating management policies for this patient group.
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