Screening and Assessment of Co-Occurring Disorders in the Justice ...

differences were found in using the AUDIT among adolescent inpatients(Kelly et al., 2002)Concerns•y The AUDIT does not examine substance abuse problems occurring prior tothe last year, and is more effective in detecting current rather than previousalcohol problems (McCann, Simpson, Ries, & Roy-Byrne, 2000)•y The instrument has only moderate specificity (74 percent for the “Core”,and 40 percent for the “Clinical” component; Bohn et al., 1995)•y There has been little research examining the temporal stability of theAUDIT•y The AUDIT has been found to be more effective in identifying needs forassessment and treatment for justice-involved individuals when conductedseveral weeks after entry to prison (Maggia et al., 2004)•y The AUDIT-CSI is invasive and must be conducted by a trained healthstaff•y The AUDIT is less sensitive and more specific with females (Reinert &Allen, 2002), and is generally a better screen for alcohol use disordersamong women (Dawson, Grant, Stinson, & Zhou, 2005). Some haverecommended that cutoff score thresholds should be lowered when theAUDIT is used with women (Chung, Colby, Barnett, & Monti, 2002),although there is little research to validate the use of specific cutoff scoresfor this purpose•y The AUDIT has not been found to be highly accurate with the elderly(Reinert & Allen, 2002). The AUDIT has been found to have low sensitivitybut good specificity with the elderly (O'Connell et al., 2004)•y Within a DUI sample, the AUDIT was found to be less effective indetecting substance dependence than the MAST (Conley, 2001)Availability and CostThe AUDIT: Guidelines for Use in Primary Care Settings – Second Edition isavailable free of charge from the World Health Organization at http://whqlibdoc.who.int/hq/2001/WHO_MSD_MSB_01.6a.pdf. This manual includes both theinterview and self-report forms of the AUDIT. An online self-test version of theAUDIT is also available at http://www.counseling.caltech.edu/drug/selftest/test1.html, and an easy to use form and scoring rules are available at http://www.narmc.amedd.army.mil/DeWitt/Physical%20Exams/forms/alcohol_survey.pdf.CAGEThe CAGE is a brief four-item screen to identify alcohol use problems (Mayfield,McCleod, & Hall, 1974). The CAGE is among the most widely used brief alcoholscreening measures used with adults (Bastiaens, Riccardi, & Sakhrani, 2002).The four questions make up the acronym CAGE and consist of the following: 1)73