Validation in Different Populations

Publication Date Language Abstracts Access
Aalto, M., Hyvönen, S., Seppä, K.
Do primary care physicians' own AUDIT scores predict their use of brief alcohol intervention? A cross-sectional survey. Drug and Alcohol Dependence, Volume 83, Issue 2, 28 June 2006, Pages 169-173
2006 English Background: To define whether the Alcohol Use Disorders Identification Test (AUDIT) scores of primary care physicians themselves predict their willingness to use brief alcohol intervention. Methods: Cross-sectional self-administered questionnaire survey to all 3193 physicians providing primary health care in Finland. The response rate was 1909 (59.8%). Odds ratios from multinomial regression analysis were calculated for self-reported frequency (never, occasionally or regularly) of conducting brief interventions by physicians with AUDIT scores of 0-1, 2, 3, 4, 5-7 or ≥8. Results: The prevalence of heavy drinkers based on AUDIT score (≥8) was 14.5% among all physicians, 7.0% among females and 27.0% among males. Of the respondents 9.4% reported doing brief intervention regularly and 50.0% occasionally. AUDIT scores did not significantly predict either regular or occasional use of brief intervention. Instead, some other independent predictors for more frequent use of brief intervention were found. These included having a specialist licence in general practice or occupational health care and the location of the practice, but not gender or age. Conclusions: The present results indicate that in general heavy drinking among primary care physicians do not explain the low frequency with which brief intervention is used in primary health care.  Via Publisher
Almarri, T.S.K., Oei, T.P.S., Amir, T.
Validation of the Alcohol Use Disorders Identification Test in a prison sample living in the Arabian gulf region. Substance Use and Misuse, Volume 44, Issue 14, 23 November 2009, Pages 2001-2013
2009 English The purpose of this study was to assess the utility of the Arabic translation of the Alcohol Use Disorders Identification Test (AUDIT) among a sample of male Muslim prisoners (N=107) in Dubai, United Arab Emirates (UAE). Confirmatory factor analysis indicated a two-factor model to be the best fit of the data. Good internal reliability (α=.91) and predictive validity were also observed. While the limitations of the study are observed, these promising results suggest that the Arabic version of the AUDIT is a reliable and sound measure of alcohol use disorders among prisoners in the UAE. Via Publisher
Alvarado, M.E., Garmendia, M.L., Acuña, G., Santis, R., Arteaga, O.
Assessment of the Alcohol Use Disorders Identification Test (AUDIT) to detect problem drinkers | [Validez y confiabilidad de la versión chilena del alcohol use disorders identification test (AUDIT)]. Revista Medica de Chile Volume 137, Issue 11, November 2009, Pages 1463-1468
2009 Spanish Background: AUDIT is a self reported questionnaire used to detect problem drinkers. It must be translated into Spanish and validated in order to be used in Chile. Aim: To assess the validity of a Chilean version of the AUDIT questionnaire. Results: The internal consistency of AUDIT was 0.93, its test re-tests reliability was 0.97 (95% confidence intervals 0.96-0.98). Using a cutoff point of 6 for hazardous consumption, its sensitivity and specificity were 83% and 88%, respectively. The figures for dependence and harmful consumption, using a cutoff point of 9, were 87% and 85%, respectively. Conclusions: AUDIT is a valid questionnaire to detect problem drinkers. Open Access
Álvarez Montero, S., Gallego Casado, P., Latorre de la Cruz, C., Bermejo Fernández, F.
AUDIT test (Alcohol Use Disorders Identification Test) for the detection of alcohol related problems in Primary Health Care | [Papel del test AUDIT (Alcohol Use Disorders Identification Test) para la detección de consumo excesivo de alcohol en atención primaria]. MEDIFAM - Revista de Medicina Familiar y Comunitaria, Volume 11, Issue 9, 2001, Pages 553-557
2001 Spanish The AUDIT test (cut-off ≥8) shows sensitivity 57-59%; specificty 91-96 %; positive likehood ratio 6.3-14. 7 and negative likehood ratio 0.47-0.42 for screening heavy drinking. The positive predictive value (10% of estimated prevalence) is 41-62% (≥8 points) and the negative predictive value is 4.4-4.9 (<8 points). If this test were applied in a Primary Health Care setting with a 10% prevalence for heavy drinking, it will detect 12 patients, it will lost 8, and it will produce a false positivo in 10 patients. Open Access
Bae, H.-C., Hong, S., Jang, S.-I., Lee, K.-S., Park, E.-C.
Patterns of alcohol consumption and suicidal behavior: Findings from the fourth and fifth Korea National Health and Nutritional Examination Survey (2007-2011). Journal of Preventive Medicine and Public Health, Volume 48, Issue 3, 1 May 2015, Pages 142-150
2015 English Objectives: The purpose of this study was to investigate the association between suicidal behavior and patterns of alcohol consumption in Korean adults. Methods: This study was based on data provided by the Korea National Health and Nutritional Examination Survey from 2007 to 2011. A total of 42 347 subjects were included in the study, of whom 19 292 were male and 23 055 were female. Logistic regression analysis was performed to assess the association between patterns of alcohol consumption and suicidal behavior. Results: Among the study subjects, 1426 males (11.3%) and 3599 females (21.2%) had experienced suicidal ideation, and 106 males (0.8%) and 190 females (1.1%) had attempted suicide during the previous 12 months. Alcohol Use Disorders Identification Test (AU-DIT) scores were found to be associated with suicidal ideation in males and associated with both suicidal ideation and suicide attempts in females. Alcoholic blackouts were associated with suicidal ideation and suicide attempts in males, and were also associated with suicidal ideation in females. Conclusions: In this study, we found that certain patterns of alcohol consumption were associated with suicidal behaviors. In particular, only alcoholic blackouts and categorized AUDIT scores were found to be associated with suicidal behavior in males. We therefore suggest that further research is needed to examine this relationship prospectively and in other settings. Open Access
Bergman, H., Källmén, H.
Alcohol use among Swedes and a psychometric evaluation of the Alcohol Use Disorders Identification Test. Alcohol and Alcoholism, Volume 37, Issue 3, 2002, Pages 245-251
2002 English The Alcohol Use Disorders Identification Test (AUDIT) was completed by 997 persons randomly selected from the general Swedish population (80% response rate). Eighteen per cent of the men and 5% of the women had hazardous or harmful alcohol use according to the ≥8 score criterion. AUDIT scores decreased with increasing age in both genders. Women are more sensitive to alcohol than men and when the cut-off score was set to ≥6, the female prevalence of hazardous or harmful alcohol use increased to nearly 11%. The ‘binge drinking’ question explained half of the total AUDIT variance and is thus the best item indicator of hazardous or harmful alcohol use in the test. Confirmatory and exploratory factor analyses revealed two AUDIT basic factors, the first three items defining a ‘hazardous consumption’ factor and the other seven items an ‘alcohol-related problems’ factor. Both the internal and test– retest reliability of the Swedish version of AUDIT were satisfactory. A table for converting raw scores to non-normalized T-scores for each combination of gender and three age intervals is presented. Open Access
Bergman, H., Källmén, H.
Swedish women have developed riskier and more harmful alcohol habits. Study of changes in Swedes' alcohol habits during 1997-2001 | [Svenska kvinnor har fått mer riskfyllda och skadligare alkoholvanor]. Lakartidningen, Volume 100, Issue 12, 20 March 2003, Pages 1028-1035
2003 Swedish A random sample of 1,250 persons from the general Swedish population responded to the Alcohol Use Disorders Identification Test, AUDIT. The results (72.5% response rate) were compared to the results from an identical survey made 1997 (79.8% response rate). The factor structure and the internal reliability showed good correspondence with those of 1997, indicating a stable and satisfactory psychometric quality of the Swedish AUDIT version. The female prevalence of hazardous or harmful alcohol use had increased from 11 to 15 percent between 1997 and 2001. Thus, women, particularly 28-38 yers old, reported drinking more often and in greater amounts. Furthermore, the prevalence of female teetotallers had de creased from 18 to 13 percent. The corresponding trends among men were not significant but might have been underestimated due to a greater dropout, particularly among young men in the year of 2001. Open Access
Bergman, H., Källmén, H., Rydberg, U., Sandahl, C.
A 10-item questionnaire identifying alcohol problems was tested psychometrically at a psychiatric emergency ward | [Tio frågor om alkohol identifierar beroendeproblem: Psykometrisk prövning på psykiatrisk akutmottagning]. Lakartidningen, Issue 43, 21 October 1998, Pages 4731-4735
1998 Swedish It is important to develop and evaluate methods of identifying alcohol dependent patients and patients at risk of alcohol problems. The World Health Organisation recommends a 10-item questionnaire, AUDIT (Alcohol Use Disorders Identification Test), which assesses hazardous alcohol use, dependence symptoms, and harmful alcohol use. The article describes a Swedish version of AUDIT that has been psychometrically tested on a sample of patients admitted to a psychiatric emergency ward. Both internal consistency, reliability and validity were found to be satisfactory in terms of sensitivity and specificity in predicting DSM alcoholism diagnoses. Open Access
Bernards, S., Graham, K., Demers, A., Kairouz, S., Wells, S.
Gender and the assessment of at-risk drinking: Evidence from the GENACIS Canada (2004-2005) telephone survey version of the AUDIT. Drug and Alcohol Dependence, Volume 88, Issue 2-3, 11 May 2007, Pages 282-290
2007 English The Alcohol Use Disorders Identification test (AUDIT) is widely used in general population surveys as a method of determining prevalence of hazardous drinking. However, its interpretation has been questioned particularly regarding the unequal contribution of the items to the total score, specifically, that the drinking frequency item contributes disproportionately to the score and may lead to inappropriate identification of some drinkers as hazardous drinkers. To explore these issues further as well as possible gender differences in the applicability of the AUDIT, we conducted analyses using a modified version of the AUDIT (AUDITM) as part of a general population survey that used random digit dialing and computer-assisted telephone interviewing. Item and factor analyses were performed separately for men and women, and the impacts of excluding the frequency of drinking item in the measurement of mean scores, percentages and types of problems for men and women were examined. We found that the AUDITMitems loaded onto three distinct dimensions for both men and women: frequency of drinking; usual quantity and frequency of heavy-episodic drinking; problem consequences from drinking. In addition, we found that excluding the frequency question may give a more meaningful estimate of the percent of drinkers actually at risk of experiencing problems from drinking for both men and women. Finally, although our analyses identified only minor gender differences in the structure of the AUDIT and good sensitivity for identifying problem drinkers among both men and women, significant gender differences in the types of problems experienced suggest that use and interpretation of the AUDIT should routinely take gender into consideration. Via Publisher
Berner, M.M., Kriston, L., Bentele, M., Härter, M.
The Alcohol Use Disorders Identification Test for detecting at-risk drinking: A systematic review and meta-analysis. Journal of Studies on Alcohol and Drugs, Volume 68, Issue 3, May 2007, Pages 461-473.
2007 English Objective: The purpose of this study was to perform a systematic review of the diagnostic accuracy of the AlcoholUse Disorders Identification Test (AUDIT) for detecting at-risk drinking. Results: Twenty-three studies were included in the systematic review, 19 of which were included in the meta-analysis. With a cutoff of 8 points, sensitivity ranged from .31 to .89 and specificity ranged from .83 to .96 across the eight studies conducted in primary care. A single trial in general hospital inpatients found a sensitivity of .93 and a specificity of .94; another trial in emergency-department patients found a sensitivity of .72 and a specificity of .88. A study in university students found a sensitivity of .82 and a specificity of .78. Three studies in elderly patients found sensitivities between .55 and .83 at a pooled specificity of .96. There was large heterogeneity between study results, which could only partly be explained by setting diversity. The analysis of results with population-specific cutoff points led to similar findings. Conclusions: Findings on the diagnostic performance of the AUDIT proved to be largely heterogeneous. Its use should be restricted to primary care populations, inpatients, and elderly patients. Via Publisher
Bickram Pradhan, François Chappuis, Dharanidhar Baral, Prahlad Karki, Suman Rijal, Antoine Hadengue and Pascal Gache.
The Alcohol Use Disorders Identification Test (AUDIT): Validation of a Nepali version for the detection of alcohol use disorders and hazardous drinking in medical settings. Pradhan et al. Substance Abuse Treatment, Prevention, and Policy 2012, 7:42
2012 English Alcohol problems are a major health issue in Nepal and remain under diagnosed. Increase in consumption are due to many factors, including advertising, pricing and availability, but accurate information is lacking on the prevalence of current alcohol use disorders. The AUDIT (Alcohol Use Disorder Identification Test) questionnaire developed by WHO identifies individuals along the full spectrum of alcohol misuse and hence provides an opportunity for early intervention in non-specialty settings. This study aims to validate a Nepali version of AUDIT among patients attending a university hospital and assess the prevalence of alcohol use disorders along the full spectrum of alcohol misuse. Results: A total of 1068 individuals successfully completed the study. According to DSM-IV, drinkers were classified as follows: No alcohol problem (n=562; 59.5%), alcohol abusers (n= 78; 8.3%) and alcohol dependent (n=304; 32.2%). The prevalence of hazardous drinker was 67.1%. The Nepali version of AUDIT is a reliable and valid screening tool to identify individuals with alcohol use disorders in the Nepalese population. AUDIT showed a good capacity to discriminate dependent patients (with AUDIT ≥11 for both the gender) and hazardous drinkers (with AUDIT ≥5 for males and ≥4 for females). For alcohol dependence/abuse the cut off values was ≥9 for both males and females. Conclusion: The AUDIT questionnaire is a good screening instrument for detecting alcohol use disorders in patients attending a university hospital. This study also reveals a very high prevalence of alcohol use disorders in Nepal. Open Access
Bischof, G., Grothues, J., Reinhardt, S., (...), Ulbricht, S., Rumpf, H.-J.
Alcohol screening in general practices using the AUDIT: How many response categories are necessary? European Addiction Research, Volume 13, Issue 1, December 2006, Pages 25-30
2006 English Aims: The Alcohol Use Disorders Identification Test (AUDIT) is a common screening instrument. This study analyses if response categories of the AUDIT might be dichotomized without affecting the psychometric properties of the questionnaire. Methods: Participants between 18 and 65 years were recruited from general practices in two northern German cities. In total, 10,803 screenings were conducted (refusal rate: 5.9%). For those who were screened positive, the Munich-Composite International Diagnostic Interview (M-CIDI) was used for identification of 12-month Alcohol Use Disorders and at-risk consumption (exceeding 20/30 g per day). Abstinent subjects and screening positives without diagnostic interview were excluded from the analysis, leaving a sample of 7,112 subjects. ROC-Curves were calculated separately for each item in order to identify an optimal cut-off value. Finally, a version of the AUDIT based on dichotomized items was compared to the original version and its short-form, the AUDIT version based on three questions dealing with consumption AUDIT-C. Results: As an optimal cut-off value for items on consumption, drinking at least once a week, having more than 1-2 drinks per occasion, and drinking 6 or more drinks in one sitting at least once a month were identified. For all questions on alcohol-related problems or dependence symptoms, having 'ever occurred' differed best between subjects with and without Alcohol Use Disorders or at-risk consumption. Sensitivity and specificity of the dichotomized version of the AUDIT did not differ from the original version, and both full versions performed superior compared to the AUDIT-C. Conclusion: Data indicate that the AUDIT response categories may be dichotomized without affecting its validity.  Via Publisher
Blair, A.H., Pearce, M.E., Katamba, A., (...), Schechter, M.T., Spittal, P.M.
The Alcohol Use Disorders Identification Test (AUDIT): Exploring the factor structure and cutoff thresholds in a representative post-conflict population in Northern Uganda. Alcohol and Alcoholism, Volume 52, Issue 3, 1 May 2017, Pages 318-327
2017 English Aims: Despite increased use of the Alcohol Use Disorders Identification Test (AUDIT) in sub-Saharan Africa, few studies have assessed its underlying conceptual framework, and none have done so in post-conflict settings. Further, significant inconsistencies exist between definitions used for problematic consumption. Such is the case in Uganda, facing one of the highest per-capita alcohol consumption levels regionally, which is thought to be hindering rebuilding in the North after two decades of civil war. This study explores the impact of varying designation cutoff thresholds in the AUDIT as well as its conceptual factor structure in a representative sample of the population.Methods: In all, 1720 Cango Lyec Project participants completed socio-economic and mental health questionnaires, provided blood samples and took the AUDIT. Participant characteristics and consumption designations were compared at AUDIT summary score thresholds of ≥3, ≥5 and ≥8. Confirmatory factor analyses (CFA) explored one-, two- and three-factor level models overall and by sex with relative and absolute fit indicators.Results: There were no significant differences in participant demographic characteristics between thresholds. At higher cutoffs, the test increased in specificity to identify those with hazardous drinking, disordered drinking and suffering from alcohol-related harms. All conceptual models indicated good fit, with three-factor models superior overall and within both sexes.Conclusion: In Northern Uganda, a three-factor AUDIT model best explores alcohol use in the population and is appropriate for use in both sexes. Lower cutoff thresholds are recommended to identify those with potentially disordered drinking to best plan effective interventions and treatments.Short summary: A CFA of the AUDIT showed good fit for one-, two, and three-factor models overall and by sex in a representative sample in post-conflict Northern Uganda. A three-plus total AUDIT cutoff score is suggested to screen for hazardous drinking in this or similar populations. Open Access
Blank, M.-L., Connor, J., Gray, A., Tustin, K.
Screening for hazardous alcohol use among university students using individual questions from the Alcohol Use Disorders Identification Test-Consumption. Drug and Alcohol Review, Volume 34, Issue 5, 1 September 2015, Pages 540-548
2015 English Introduction and Aims: Abbreviated versions of the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) instrument have not been investigated among students. We compared a modified second item (AUDIT-2*) (typical quantity per occasion as the number of drinks, rather than categorical responses) and the third item (AUDIT-3) (heavy episodic drinking frequency) with AUDIT-C scores and described their associations with sociodemographic variables. Design and Methods: We analysed cross-sectional data from the 2011 baseline of the Graduate Longitudinal Study New Zealand, including respondents aged up to 25 years (n = 5082, response rate 65%). Hazardous drinking was defined as an AUDIT-C score of seven or greater for men and five or greater for women. We calculated the area under receiver operating characteristic curves, sensitivities, specificities, and positive and negative predictive values for the AUDIT-2* and AUDIT-3. Odds ratios and 95% confidence intervals were calculated to describe the associations between drinking patterns and sociodemographic factors. Results: Based on the sex-specific AUDIT-C cut-points, 36% of participants reported drinking at hazardous levels. For the AUDIT-2*, the best combination of sensitivity and specificity was obtained for a cut-point of five standard drinks. The best cut-point for the AUDIT-3 was for monthly heavy episodic drinking. Positive and negative predictive values were above 0.80 for both cut-points. Consumption was associated with age, degree level, domestic/international status, accommodation type, relationship status and employment. Discussion and Conclusions: The AUDIT-2* and the AUDIT-3 appear to be promising standalone screening items for detecting hazardous drinking in this population of heavy-drinking students. Via Publisher
Boschloo, L., Vogelzangs, N., Smit, J.H., (...), Beekman, A.T.F., Penninx, B.W.J.H.
The performance of the Alcohol Use Disorder Identification Test (AUDIT) in detecting alcohol abuse and dependence in a population of depressed or anxious persons. Journal of Affective Disorders, Volume 126, Issue 3, November 2010, Pages 441-446
2010 English Background: Alcohol use disorders are highly prevalent but often remain unrecognized among depressed and/or anxious persons. This study examines the performance of the Alcohol Use Disorder Identification Test (AUDIT) in detecting alcohol abuse and dependence in this high-risk group and compares it to that in healthy controls. Results: The AUDIT accurately detected alcohol dependence in depressed and/or anxious men (AUC = 0.89) and women (AUC= = 0.88), with detected cut-off points of ≥ 9 and ≥ 6, respectively, comparable to that in healthy controls (men: AUC = 0.89; women: AUC = 0.94). However, the overall accuracy in detecting alcohol abuse was limited in depressed/anxious men (AUC = 0.74) and women (AUC = 0.78) and no adequate cut-off points with both acceptable sensitivity and specificity could be identified. Limitations: Persons with a primary diagnosis of an addiction disorder were excluded and therefore the sample may not be fully representative of the most severely addicted patients. Conclusions: These findings confirm the accuracy of the AUDIT in detecting alcohol dependence, but not alcohol abuse, in depressed and/or anxious persons. Screening for alcohol dependence in this high-risk group could improve identification of persons suffering from this impairing comorbid condition.  Via Publisher
Bradley, K.A., Maynard, C., Kivlahan, D.R., McDonell, M.B., Fihn, S.D.
The relationship between alcohol screening questionnaires and mortality among male veteran outpatients. Journal of Studies on Alcohol, Volume 62, Issue 6, 2001, Pages 826–833
2001 English Objective: This study evaluated whether responses to alcohol screening questionnaires predicted mortality in a Department of Veterans Affairs (VA) primary care population. Method: This study involved 5,703 male outpatients (mean age = 64) who were enrolled in General Internal Medicine clinics at three Veterans Affairs (VA) medical centers and returned mailed questionnaires in 1993-94. The two questionnaires included the CAGE and Alcohol Use Disorders Identification Test (AUDIT) alcohol screening tests. Mortality was ascertained using the VA Beneficiary Identification and Record Locator System. Five-year crude and adjusted mortality rates were calculated for patients who screened positive and patients who screened negative on each alcohol screening test. Results: The risk of mortality was increased among drinkers who scored ≥8 on the full AUDIT (hazard ratio: 1.47; 95% confidence interval [CI]: 1.08-2.00) or the three AUDIT consumption questions (1.58; 1.11-2.27), after adjusting for age, smoking, socio-demographic characteristics and chronic illnesses. The risk of mortality was also increased among drinkers who reported drinking ≥3 drinks daily (1.69; 1.28-2.22) or prior alcohol treatment (1.66; 1.27-2.17), in "fully adjusted" models. A positive CAGE score (≥2) was associated with significantly increased risk of mortality among drinkers in a model adjusted only for age and smoking (1.27; 1.02-1.58). Among nondrinkers, neither a positive CAGE score (≥2) nor report of prior alcohol treatment was associated with increased risk of mortality. Conclusions: VA outpatients who reported drinking during the previous year and who had a positive result on an alcohol screening test experienced higher mortality over the subsequent 5 years than did patients who screened negative. Via Publisher
Bryce, S., Spitz, G., Ponsford, J.
Screening for Substance Use Disorders Following Traumatic Brain Injury: Examining the Validity of the AUDIT and the DAST. Journal of Head Trauma Rehabilitation, Volume 30, Issue 5, 25 September 2015, Pages E40-E48
2015 English Objective: To examine the validity of the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Abuse Screening Test (DAST)-2 widely recommended rating scales-in a traumatic brain injury (TBI) population at 24 months following injury. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders was used as the gold standard criterion. Setting: TBI rehabilitation program at Epworth Hospital, Victoria, Australia. Participants: A total of 113 individuals, 87 males and 26 females, with complicated mild to severe TBI. Design: Prospective study documenting substance use following TBI. Main measures: AUDIT, DAST, and Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders. Results: In individuals with TBI, a cutoff score of 11 on the AUDIT may be the most appropriate indicator of an alcohol use disorder whereas a cutoff score of 6 on the DAST may be the most appropriate indicator of drug use disorder. Both screening measures demonstrated excellent diagnostic accuracy at 24 months following injury. Conclusion: The optimal cutoff score for the AUDIT may need to be elevated for use following TBI. Nevertheless, both the AUDIT and the DAST are suitable measures for assessing substance use following TBI. Given the importance of uniformity in postinjury assessment, the AUDIT and the DAST may serve as future screening standards in TBI research. Via Publisher
Campbell, C.E., Maisto, S.A.
Validity of the AUDIT-C screen for at-risk drinking among students utilizing university primary care. Journal of American College Health 2018, 66:8, 774-782.
2018 English Objective: Research is needed to establish the psychometric properties of brief screens in university primary care settings. This study aimed to assess the construct validity of one such screen, the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), for detecting at-risk drinking among students who have utilized on-campus primary care. Participants: 389 students recently seen in university primary care completed a confidential online survey in December 2014. Methods: Bivariate correlations between the AUDIT-C and measures of alcohol consumption and negative drinking consequences provided concurrent evidence for construct validity. Receiver Operating Characteristic curve analyses determined optimal cut-off scores for at-risk drinking. Results: The AUDIT-C significantly correlated with measures of alcohol consumption and negative drinking consequences (p < .001). Analyses support optimal AUDIT-C cut-off scores of 5 for females and 7 for males. Conclusions: The AUDIT-C is a valid screen for at-risk drinking among students who utilize university primary care. Via Publisher
Cassidy, C.M., Schmitz, N., Malla, A.
Validation of the Alcohol Use Disorders Identification Test and the Drug Abuse Screening Test in first episode psychosis. Canadian Journal of Psychiatry, Volume 53, Issue 1, January 2007, Pages 26-33
2008 English Objective: To determine the validity and reliability of the Alcohol Use Disorders Identification Test (AUDIT) and Drug Abuse Screening Test (DAST) for detecting alcohol and drug use disorders, respectively, in a population with first-episode psychosis (FEP). Method: Subjects with FEP completed the AUDIT and DAST and were divided into groups according to the presence or absence of a Structured Clinical Interview for DSM-IV (SCID) diagnosis of either current alcohol or drug misuse. The data were analyzed to see whether AUDIT and DAST scores were predictive of SCID diagnosis. Results: Patients with alcohol-related SCID diagnoses and those with drug-related SCID diagnoses scored significantly higher on the AUDIT and DAST, respectively, than the group without the respective SCID diagnosis (P < 0.001 in both cases). The AUDIT functioned best with a problem drinking cut-off score of 10 (sensitivity, 85%; specificity, 91%). The DAST functioned best with a problem drug use cut-off score of 3 (sensitivity, 85%; specificity, 73%). The area under the receiver operating characteristic curve was 0.86 for the AUDIT and 0.83 for the DAST. Conclusion: The DAST and AUDIT may reliably identify FEP patients with substance abuse. Open Access
Caviness, C.M., Hatgis, C., Anderson, B.J., (...), Friedmann, P.D., Stein, M.D.
Three brief alcohol screens for detecting hazardous drinking in incarcerated women. Journal of Studies on Alcohol and Drugs, Volume 70, Issue 1, 2009, Pages 50-54
2009 English Objective: Screening methods for hazardous drinking have not been evaluated in a population of incarcerated women. This study examines abbreviated versions of the Alcohol Use Disorders Identification Test (AUDIT) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) heavy episodic drinking criterion in a sample of female detainees. Method: A total of 2,079 women at the Adult Correctional Institute in Rhode Island were approached for screening between February 2004 and June 2007. The AUDIT-consumption (AUDIT-C), AUDIT-3, and the NIAAA heavy episodic drinking criterion (four or more drinks on one occasion for women) were compared with the full AUDIT at different cut points. Results: More than 55% of the sample endorsed an AUDIT score of 4 or greater - the NIAAA recommended threshold for detecting hazardous drinking. The three-item AUDIT-C with a cut score of 3 yielded a classification most consistent with the AUDIT score of 4 or more; sensitivity and specificity exceeded .9, and 91.5% of participants were correctly classifi ed. The AUDIT-3 and NIAAA episodic drinking criteria were less sensitive measures. We found no evidence of interactions between the screening instruments and age or ethnicity. Conclusions: The three-item AUDIT-C has robust test characteristics for detecting hazardous drinking in female inmates. Universal screening for hazardous drinking is recommended for incarcerated women, given their high rates of alcohol misuse. Via Publisher
Celio, M.A., Vetter-O'Hagen, C.S., Lisman, S.A., Johansen, G.E., Spear, L.P.
Integrating field methodology and web-based data collection to assess the reliability of the Alcohol Use Disorders Identification Test (AUDIT). Drug and Alcohol Dependence, Volume 119, Issue 1-2, 1 December 2011, Pages 142-144
2011 English Field methodologies offer a unique opportunity to collect ecologically valid data on alcohol use and its associated problems within natural drinking environments. However, limitations in follow-up data collection methods have left unanswered questions regarding the psychometric properties of field-based measures. The aim of the current study is to evaluate the reliability of self-report data collected in a naturally occurring environment - as indexed by the Alcohol Use Disorders Identification Test (AUDIT) - compared to self-report data obtained through an innovative web-based follow-up procedure. Individuals recruited outside of bars (N= 170; mean age = 21; range 18-32) provided a BAC sample and completed a self-administered survey packet that included the AUDIT. BAC feedback was provided anonymously through a dedicated web page. Upon sign in, follow-up participants (n= 89; 52%) were again asked to complete the AUDIT before receiving their BAC feedback. Reliability analyses demonstrated that AUDIT scores - both continuous and dichotomized at the standard cut-point - were stable across field- and web-based administrations. These results suggest that self-report data obtained from acutely intoxicated individuals in naturally occurring environments are reliable when compared to web-based data obtained after a brief follow-up interval. Furthermore, the results demonstrate the feasibility, utility, and potential of integrating field methods and web-based data collection procedures.  Via Publisher
Chan-Pensley, E.
Alcohol Use Disorders Identification Test: A comparison between paper and pencil and computerized versions. Alcohol and Alcoholism, Volume 34, Issue 6, 1999, Pages 882-885
1999 English The use of screening questionnaires to detect early problem drinking has been stimulated by the development of the AUDIT (Alcohol Use Disorders Identification Test). A comparison of a computerized version of the test and its paper and pencil original was conducted on 110 consecutive attenders at an alcoholism day-treatment facility. The findings suggest that the computer version is as acceptable as the paper and pencil one and that scores on the two formats are comparable. Open Access
Chang, J.W., Kim, J.S., Jung, J.G., (...), Yoon, S.J., Jang, H.S.
Validity of Alcohol Use Disorder Identification Test-Korean revised version for screening alcohol use disorder according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Korean Journal of Family Medicine, Volume 37, Issue 6, 2016, Pages 323-328.
2016 English Background: The Alcohol Use Disorder Identification Test (AUDIT) has been widely used to identify alcohol use disorder (AUD). This study evaluated the validity of the AUDIT-Korean revised version (AUDIT-KR) for screening AUD according to Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) criteria. Methods: This research was conducted with 443 subjects who visited the Chungnam National University Hospital for a comprehensive medical examination. All subjects completed the demographic questionnaire and AUDIT-KR without assistance. Subjects were divided into two groups according to DSM-5 criteria: an AUD group, which included patients that fit the criteria for AUD (120 males and 21 females), and a non-AUD group, which included 146 males and 156 females that did not meet AUD criteria. The appropriate cut-off values, sensitivity, specificity, and positive and negative predictive values of the AUDIT-KR were evaluated. Results: The mean±standard deviation AUDIT-KR scores were 10.32±7.48 points in males and 3.23±4.42 points in females. The area under the receiver operating characteristic curve (95% confidence interval, CI) of the AUDIT-KR for identifying AUD was 0.884 (0.840-0.920) in males and 0.962 (0.923-0.985) in females. The optimal cut-off value of the AUDIT-KR was 10 points for males (sensitivity, 81.90%; specificity, 81.33%; positive predictive value, 77.2%; negative predictive value, 85.3%) and 5 points for females (sensitivity, 100.00%; specificity, 88.54%; positive predictive value, 52.6%; negative predictive value, 100.0%). Conclusion: The AUDIT-KR has high reliability and validity for identifying AUD according to DSM-5 criteria. Open Access
Chen, C.-H., Chen, W.J., Cheng, A.T.A.
New approach to the validity of the Alcohol Use Disorders Identification Test: Stratum-specific likelihood ratios analysis. Alcoholism: Clinical and Experimental Research, Volume 29, Issue 4, April 2005, Pages 602-608
2005 English Background: Previous validation studies of the Alcohol Use Disorders Identification Test (AUDIT) used either the fixed-threshold approach or receiver operating characteristic (ROC) analyses. This study was aimed to conduct a stratum-specific likelihood ratio (SSLR) analysis on the validity of the AUDIT for detecting alcohol use disorders. Methods: A two-phase validation study was conducted among nonpsychiatric inpatients at a general hospital, using the AUDIT for phase 1 screening and the Schedules for Clinical Assessment in Neuropsychiatry for the phase 2 interview. All of the patients with positive screening results and a subsample of the patients with negative screening results were interviewed in the second phase. The validity of the AUDIT for current alcohol use disorders was estimated using the ROC first, and an SSLR analysis was performed subsequently. Results: In 422 inpatients who completed the screening, 193 had a negative result with a zero score, 103 had a negative result with a nonzero score, and 126 had a positive result. Twenty screened patients with a negative result and a nonzero score and 107 patients with a positive result were interviewed in the second phase, in which 59 patients were found to have current alcohol use disorders according to DSM-IV criteria. The area under the ROC curve of the AUDIT for current alcohol use disorders was 0.98. The sensitivity and specificity of the AUDIT at the optimal cutoff of 8 were 0.97 and 0.90, respectively. Three strata of the AUDIT scores (0-7, 8-13, and ≥ 14) were derived for alcohol use disorders, with the SSLRs being 0.04, 3.67, and 49.72, and the corresponding posttest probabilities being 0.01, 0.42, and 0.91, respectively. Conclusions: The AUDIT is a valid screening tool for alcohol use disorders, and the three strata derived from the SSLR analysis are informative and readily applicable in clinical practice. Via Publisher
Chishinga, N., Kinyanda, E., Weiss, H.A., (...), Ayles, H., Seedat, S.
Validation of brief screening tools for depressive and alcohol use disorders among TB and HIV patients in primary care in Zambia. BMC Psychiatry Volume 11, 4 May 2011, Article number 75
2011 English Background: This study was conducted to evaluate the diagnostic accuracy and determine the optimum cut-off scores for clinical use of the Center for Epidemiological Studies Depression scale (CES-D) and Alcohol Use DisordersIdentification Test (AUDIT) against a reference psychiatric diagnostic interview, in TB and anti-retroviral therapy (ART) patients in primary care in Zambia.Conclusions: The CES-D and AUDIT showed high discriminatory ability in measuring MINI-defined current MDD and AUD respectively. They are suitable mental health screening tools for use among TB and ART patients in primary care in Zambia. Open Access
Chung, T., Colby, S.M., Barnett, N.P., Monti, P.M.
Alcohol Use Disorders Identification Test: Factor structure in an adolescent emergency department sample. Alcoholism: Clinical and Experimental Research Volume 26, Issue 2, 2002, Pages 223-231
2002 English This study examined whether the factor structure of a modified version of the Alcohol Use Disorders Identification Test (AUDIT) represented the three intended conceptual domains of consumption, dependence symptoms, and alcohol‐related consequences in an adolescent sample. Additionally, the utility of factor‐specific cut scores in identifying patients with DSM‐IV alcohol diagnoses was investigated. The AUDIT comprised two correlated factors: consumption and dependence/consequences. The better performance of the consumption factor in detecting adolescents with DSM‐IV alcohol diagnoses suggests the utility of including consumption items in brief alcohol screens used with adolescents. Results also indicate the need to identify developmentally appropriate alcohol‐related problems to enhance screening performance among adolescents. Via Publisher
The Alcohol Use Disorders Identification Test (AUDIT) in a routine health examination of long‐term unemployed. Addiction. Volume 88, Issue 3, March 1993, Pages 363-368
1993 English A representative sample of 310 long‐term unemployed in Norway was followed for 2 years with clinical examinations and the AUDIT questionnaire. 30% of the men and 8% of the women scored over the cut‐off point for an alcohol use disorder. This gives a probable prevalence of 16%. The test predicted return to employment in this sample. The AUDIT answers were also used as a basis for dividing into three groups:‘normal',‘hazardous’ and‘harmful'. At 2 year follow‐up, 27% had changed group, 32 respondents to the worse and 24 to the better. This‘unstable’ group was characterized by weaker social network and more frequent drinking. The AUDIT was judged as a useful instrument both in a routine health examination and as an epidemiological tool. Via Publisher
Clay, S.W.
Comparison of AUDIT and CAGE questionnaires in screening for alcohol use disorders in elderly primary care outpatients. Journal of the American Osteopathic Association, Volume 97, Issue 10, October 1997, Pages 588-592
1997 English Alcohol use disorders (AUD) can be destructive in the elderly because of drug interactions, higher blood alcohol levels per amount consumed, and limited functional reserve. However, physicians diagnose only about 30% of elderly with AUD. The objective of this study was to screen for AUD in rural elderly family medicine outpatients using the Alcohol Use Disorders Identification Test (AUDIT). A survey of all presenting patients aged 65 years or older who consented (N=93) was done in four family practices in Southeast Ohio. Measurements included the CAGE and AUDIT questionnaires. On the AUDIT, 13 subjects (14.0%), [10 men, 3 women], screened positive for AUD, scoring 5 or more points, and seven subjects (7.5%) [six men, one woman] screened positive for AUD, scoring 8 or more points. On the CAGE, five men (5.4%) but no women screened positive (≤2 affirmatives). The prevalence of AUD found in this survey (5.4% to 14.0%) is consistent with previous studies. Based on these findings, the AUDIT may be a useful screening instrument in the elderly population. Open Access
Clifford, P.R., Sparadeo, F., Minugh, P.A., (...), Longabaugh, R., Becker, B.
Identification of hazardous/harmful drinking among subcritically injured patients. Academic Emergency Medicine, Volume 3, Issue 3, 1996, Pages 239-245
1996 English Objectives: To examine the relationship between a saliva alcohol test (SAT) and hazardous/harmful drinking, as measured by the Alcohol Use Disorders Identification Test (AUDIT), among a sample of subcritically injured patients. Methods: Patients (n = 78) seeking treatment for a subcritical injury were saliva-tested for alcohol and interviewed regarding their drinking behaviors and related difficulties. Associations of SAT values with AUDIT results were determined. Results: SAT results and hazardous/harmful drinking were not independent events (p < 0.001). Estimates of sensitivity and specificity (using a dichotomous SAT result [≥4 mmol/L] to identify positive AUDIT patients) were 65.2% and 83.6%, respectively. SAT- positive people had significantly higher AUDIT scores than did SAT-negative individuals (p < 0.0001). Patients experiencing assault-type injuries were much more likely to be SAT-positive than were patients incurring other types of injury. Discriminant function analysis suggests that AUDIT scores can successfully identify SAT-positive and SAT-negative patients; the analysis accounted for 42.5% of the variance and correctly classified 84.6% of the sample. Conclusions: The use of an easy-to-administer, noninvasive, routine SAT, among patients presenting for a subcritical injury in a hospital ED, provides a mechanism for the identification of individuals with a history of hazardous/harmful drinking. However, since discrimination of hazardous/harmful drinking is imperfect, some caution is warranted when conducting such screening activities. Open Access
Conde Martel, A., Gómez Arnáiz, A., Aguiar Bautista, J.A., (...), Jorrín Moreno, A., Suárez Ortega, S.
Diagnostic usefulness of the questionnaire "Alcohol Use Disorders Identification Test" (AUDIT) to detect conditions associated with alcohol in hospitalized patients | [Utilidad diagnóstica del cuestionario "Alcohol Use Disorders Identification Test" (AUDIT) para detectar trastornos relacionados con el alcohol en pacientes hospitalizados.]. Anales de Medicina Interna, Volume 17, Issue 11, November 2000, Pages 576-581
2000 Spanish OBJECTIVE: To evaluate the diagnostic usefulness of AUDIT (Alcohol Use Disorders Identification Test) for detection of alcohol-related problems (ARP) among hospitalized patients, to assess the potential differences according to age or sex and to compare its diagnostic value with that of some other conventionally used measures (CAGE questionnaire and biological markers). MATERIAL AND METHODS: This is a cross-sectional study for evaluation of diagnostic tests including 179 hospitalized patients in a Medicine Unit. Data about weekly alcohol intake were collected through a semistructured interview. AUDIT and CAGE questionnaires were administered and blood levels of GGT, MCV, AST, ALT, alkaline phosphatase, platelet count, trylicerides and uric acid were determined. RESULTS: AUDIT sensitivity in detecting ARP was of 98%, specificity was of 94% and area under ROC was 0.99 (95% CI: 0.98-1). Its sensitivity was shown to be lower both in the female group (94% vs. 99%) and in age group under 60 years (97% vs. 100%). CAGE showed a sensitivity of 78% and a specificity of 99%. Among biological markers GGT and MCV should be highlighted with sensitivities of 83% and 74% and specificities of 53% and 74% respectively. CONCLUSIONS: AUDIT is an effective tool for detection of ARP among hospitalized patients. Its diagnostic usefulness being lower for females, similar for both age groups considered and clearly higher than that of other commonly used measures.
Conley, T.B., O'Hare, T.
Factorial validity of the Alcohol Use Disorders Identification Test: Drunk drivers versus college students. Journal of Social Work Practice in the Addictions, Volume 6, Issue 3, 20 September 2006, Pages 25-36
2006 English Secondary analysis was undertaken on the data from two previous studies involving the Alcohol Use Disorders Identification Test (AUDIT). Test results for 257 multiple offender drunk drivers and 505 college drinkers were compared. Exploratory factor analysis were run to examine the factorial validity of the test's hypothesized constructs. Internal consistency reliability was .87 with drunk drivers and .76 with college drinkers. Factor analyses of the AUDIT failed to validate the existence of its three hypothesized constructs regardless of sample population; a review of Eigenvalues indicates that there is a two-factor structure to the test with these populations. These factors are labeled problem drinking and hazardous drinking. The test was generally reliable. It is suggested that when using rapid assessment instruments in social work practice settings like those in the original studies, that their conceptual structure be evaluated for context specific validity. Via Publisher
Contel Guillamon, M., Gual Sole, A., Colom Farran, J.
Alcohol Use Disorders Identification Test (AUDIT): Translation and validation of Catalan and Spanish | [Test para la identificacion de transtornos por uso de alcohol (AUDIT): Traduccion y validacion del audit al Catalan y Castellano]. Adicciones, Volume 11, Issue 4, 1999, Pages 337-347
1999 Spanish AIM: Validation of the AUDIT questionnaire (in Catalan and Spanish) for early diagnosis of risk consumption and alcohol related problems in Primary Health Care. METHODOLOGY: A full examination of 409 subjects was carried out: AUDIT, DSM-3-R criteria and Laboratory parameters. RESULTS: No differences were found between the Catalan and Spanish versions but there were between the male and female population. To detect risk consumption, 9 was the best cut-off point among males but it was not possible to find a clear cut-off point for females. As for ADS diagnosis, 10 was the cut-off point among males, and 10 or 11 indistinctly among females: CONCLUSION: The AUDIT can be considered a good instrument for determining risk consumption and ADS. However, some details, as the lack of a cut-off point among females needs further research. Open Access
Cook, S., de Stavola, B., Saburova, L., (...), Gil, A., Leon, D.A.
Socio-demographic predictors of dimensions of the AUDIT score in a population sample of working-age men in Izhevsk, Russia. Alcohol and Alcoholism, Volume 46, Issue 6, November 2011, Article number agr076, Pages 702-708
2011 English Aims: To investigate the relationship between socio-demographic factors and alcohol drinking patterns identified through a formal analysis of the factor structure of the Alcohol Use Disorders Identification Test (AUDIT) score in a population sample of working-age men in Russia. Methods: In 2008-2009, a sample of 1005 men aged 25-59 years living in Izhevsk, Russia were interviewed and information collected about socio-demographic circumstances. Responses to the AUDIT questions were obtained through a self-completed questionnaire. Latent dimensions of the AUDIT score were determined using confirmatory factor analysis and expressed as standard deviation (SD) units. Structural equation modelling was used to estimate the strength of association of these dimensions with socio-demographic variables. Results: The AUDIT was found to have a two-factor structure: alcohol consumption and alcohol-related problems. Both dimensions were higher in men who were unemployed seeking work compared with those in regular paid employment. For consumption, there was a difference of 0.59 SDs, (95% confidence interval (CI): 0.23, 0.88) and for alcohol-related problems one of 0.66 SD (95% CI: 0.31, 1.00). Alcohol-related problems were greater among less educated compared with more educated men (P-value for trend = 0.05), while consumption was not related to education. Similar results were found for associations with an amenity index based on car ownership and central heating. Neither dimension was associated with marital status. While we found evidence that the consumption component of AUDIT was underestimated, this did not appear to explain the associations of this dimension with socio-demographic factors. Conclusions: Education and amenity index, both measures of socio-economic position, were inversely associated with alcohol-related problems but not with consumption. This discordance suggests that self-reported questions on frequency and volume may be less sensitive markers of socio-economic variation in drinking than are questions about dependence and harm. Further investigation of the validity of the consumption component of AUDIT in Russia is warranted as it appears that the concept of a standard 'drink' as used in the instrument is not understood. Open Access
Daeppen, J.-B., Yersin, B., Landry, U., Pécoud, A., Decrey, H.
Reliability and validity of the Alcohol Use Disorders Identification test (AUDIT), imbedded within a general health risk screening: Results of a survey in 332 primary care patients. Alcoholism: Clinical and Experimental Research, Volume 24, Issue 5, May 2000, Pages 659-665
2000 English Self‐administered, general health risk screening questionnaires that are administered while patients wait in the doctor's office may be a reasonable and time-saving approach to address the requirements of preventive medicine in a typical 10‐min medical visit. The psychometric characteristics of the Alcohol Use Disorders Identification Test (AUDIT) incorporated within a health questionnaire (H‐AUDIT) have not been examined. The reliability and validity of the self‐administered AUDIT were compared between the H‐AUDIT and the AUDIT used as a single scale (S‐AUDIT) in 332 primary care patients. Conclusions: The AUDIT incorporated in a health risk screening questionnaire is a reliable and valid self‐administered instrument to identify at‐risk drinkers and alcohol‐dependent individuals in primary care settings.

Via Publisher
Dawe, S., Seinen, A., Kavanagh, D.
An examination of the utility of the AUDIT in people with schizophrenia. Journal of Studies on Alcohol, Volume 61, Issue 5, 2000, Pages 744-750
2000 English Objective: To examine the reliability and validity of the Alcohol Use Disorders Identification Test (AUDIT) compared to a structured diagnostic interview, the Composite International Diagnostic Interview (CIDI; 12-month version) in psychiatric patients with a diagnosis of schizophrenia. Results: The CIDI identified 32.4% of the sample as having an alcohol use disorder. Of these, 5 (7.0%) met diagnostic criteria for harmful use of alcohol, 1 (1.4%) met diagnostic criteria for alcohol abuse and 17 (23.9%) met diagnostic criteria for alcohol dependence. The AUDIT was found to have good internal reliability (coefficient = 0.85). An AUDIT cutoff of ≥8 had a sensitivity of 87% and specificity of 90% in detecting CIDI-diagnosed alcohol disorders. All items except Item 9 contributed significantly to discriminant validity. Conclusions: The findings replicate and extend previous findings of high rates of alcohol use disorders in people with severe mental illness. The AUDIT was found to be reliable and valid in this sample and can be used with confidence as a screening instrument for alcohol use disorders in people with schizophrenia. Via Publisher
De La Villa Moral Jiménez, M., Molleda, C.B., Bernal, A.O., Quintero, L.A.M., Díaz, F.J.R.
Socio health emergency risk of alcohol consumption and symptoms of reliance on youth | [Emergencia sociosanitaria en consumo de riesgo de alcohol y síntomas de dependencia en jóvenes]. Health and Addictions / Salud y Drogas, Volume 17, Issue 2, 2017, Pages 91-99
2017 Spanish Introduction. The excess consumption of alcohol in the adolescent and young population constitutes a problem of great magnitude and a health care. Objective. Evaluate the psychometric characteristics of the Alcohol Use Disorders Identification Test (AUDIT) in young people and studying alcohol use disorders (excessive alcohol consumption, harmful and dependent) in adolescents and young Spaniards and Mexicans, establishing a differential analysis. Method. Descriptive observational study with cross-sectional analysis of 1313 adolescents and youth of Spain and Mexico, with aged between 13 and 19 years, and both sexes. It has chosen a design correlational no experimental research, conducted on a within-subject design and selecting participants. Results. Have confirmed the psychometric properties of the test sample AUDIT juvenile adequate construct validity and reliability, and its factorial structure. In assessing disorders alcohol consumption, confirms the existence of significant differences between young Spaniards and Mexicans, all indicators tested, resulting in a size large effect. Conclusions. Intensive alcohol consumption in the youth group constitutes a problem with many implications, hence the importance of assessing risk behaviors and symptoms of dependence in young people. Open Access
De Silva, P., Jayawardana, P., Pathmeswaran, A.
Concurrent validity of the Alcohol Use Disorders Identification test (AUDIT). Alcohol and Alcoholism, Volume 43, Issue 1, January 2008, Pages 49-50
2008 English Aims: To determine cut-offs for the Alcohol Use Disorders Identification Test (AUDIT) 10-item questionnaire, differentiating hazardous drinking (HZD) and alcohol use disorders (AUD) from low risk drinking (LRD), and AUD from HZD and LRD among married men in a Sri Lankan sample. Methods: Using 62 low risk drinkers and 88 each from hazardous drinkers and AUD, the AUDIT instrument was compared with adapted and translated versions of a beverage-specific, quantity-frequency questionnaire, and the alcohol use module of the Composite International Diagnostic Interview (CIDI), and two receiver operating characteristic (ROC) curves were plotted. Results: The area under the ROC curves to differentiate HZD + AUD from LRD and AUD from HZD + LRD were 0.96 (95% CI: 0.94-0.99) and 0.97 (95% CI: 0.95-0.99) respectively. The cut-off values of 7 and 16 were observed to have the best trade-offs between sensitivity, specificity, the ratio of positive likelihood to negative likelihood ratios, and positive predictive values. Conclusion: The AUDIT could be used to screen for LRD, HZD, and AUD among Sinhalese married men in Sri Lanka. Open Access
de Torres, L.A.P., Rebollo, E.M., Ruiz-Moral, R., (...), Vega, R.A., Palomino, M.M.
Diagnostic usefulness of the Alcohol Use Disorders Identification Test (AUDIT) questionnaire for the detection of hazardous drinking and dependence on alcohol among Spanish patients. European Journal of General Practice, Volume 15, Issue 1, 2009, Pages 15-21
2009 English Objective: To check the validity of the Alcohol Use Disorders Identification Test (AUDIT) among Spanish adult citizens. Methods: This is a descriptive observational study. The surveyed group comprised patients aged 18-80 years who went to their doctors' surgeries at two primary care centres located in Cordoba (Spain). We examined the psychometric properties of AUDIT and its capacity to correctly diagnose alcohol abuse or dependence, as defined by DSM-IV, ICD-10, and hazardous drinking. Results: Six hundred and fourteen patients were studied (meanage 43±1.43 years). At a cut-off value of 7 points, the sensitivity of AUDIT in detecting hazardous drinking was 91.7%, and its specificity 91.9%; the area below the curve was 0.95 (95% confidence interval [CI] 0.937-0.975). To detect possible dependence, the optimum cut-off value was 6 points. According to ICD-10, sensitivity was 81.6%, specificity 82.3%, and the area under the curve 0.885 (95% CI 0.848-0.923; p<0.001), whereas according to DSM-IV criteria, sensitivity was 88.3%, specificity 83.1%, and the area under the curve 0.918 (95% CI 0.885-0.951). Conclusion: The high criterion-related validity of AUDIT was proven, regardless of the gold standard used. Open Access
Degenhardt, L.J., Conigrave, K.M., Wutzke, S.E., Saunders, J.B.
The validity of an Australian modification of the AUDIT questionnaire. Drug and Alcohol Review, Volume 20, Issue 2, June 2001, Pages 143-154
2001 English The Alcohol Use Disorders Identification Test (AUDIT) has been used widely and is reported to be superior to conventional questionnaires in detection of current hazardous and harmful alcohol use. We assessed the validity of an Australian modification of the AUDIT (the AusAUDIT), which has been employed widely in Australian and New Zealand early intervention programmes. We used a cross-sectional study of 370 subjects from the follow-up phase of a randomized controlled trial of early intervention to reduce hazardous alcohol consumption. Scores on the AusAUDIT were compared against 12-month ICD-10 diagnoses of harmful alcohol use and dependence, as determined by the Composite International Diagnostic Interview, and against self-report of alcohol consumption exceeding Australian National Health and Medical Research Council (NH&MRC) recommended limits. AusAUDIT had good internal consistency and discriminated significantly between persons meeting criteria for ICD-10 alcohol use disorders, and drinkers who did not. At currently recommended cut-off scores, AusAUDIT detected more than 85% of people meeting criteria for ICD-10 alcohol use disorders, or drinking over NH&MRC recommended limits, but its specificity was limited (29% in men, and 58% in women for drinking over NH&MRC limits). No subset of questions performed as well as the full AusAUDIT in detection of drinking problems, but the alcohol consumption items provided a reasonable screen for drinking over NH&MRC limits. We conclude that AusAUDIT is effective in detecting problematic drinking, but positive cases should be confirmed by clinical assessment. The findings illustrate the need for validation of questionnaire modifications, and the difficulty in increasing test sensitivity without reducing specificity. Via Publisher
Dolman, J.M., Hawkes, N.D.
Combining the AUDIT questionnaire and biochemical markers to assess alcohol use and risk of alcohol withdrawal in medical inpatients. Alcohol and Alcoholism, Volume 40, Issue 6, November 2005, Pages 515-519
2005 English Aims: Alcohol consumption is often under-reported in patients admitted to general hospitals with acute illness. For alcohol-dependent individuals hospital admission results in an enforced period of abstinence with potential alcohol withdrawal symptoms, and possible life threatening complications. Early detection of alcohol use is therefore beneficial to patients and health services. The purpose of this study was to investigate the performance of the alcohol use disordersidentification test (AUDIT) questionnaire in the acute medical setting, and the effect of combining routine biological markers - glutamyltransferase, alanine aminotransferase, aspartate aminotransferase, and mean corpuscular volume (MCV) on its performance in the early identification of in-patients with alcohol use disorders and at risk of developing symptoms of alcohol withdrawal. Conclusion: These findings confirm that AUDIT is a useful alcohol screen in general medical settings and that its ability to correctly predict which patients will experience alcohol withdrawal is increased when used in combination with biological markers. Open Access
Donovan, D.M., Dunn, C.W., Rivara, F.P., (...), Ries, R.R., Gentilello, L.M.
Comparison of Trauma Center Patient Self-Reports and Proxy Reports on the Alcohol Use Identification Test (AUDIT). Journal of Trauma - Injury, Infection and Critical Care, Volume 56, Issue 4, April 2004, Pages 873-882
2004 English Background: There has been increased attention on identifying alcohol problems among individuals admitted to trauma centers. Reports about patients' drinking made by significant others represent one potential method to address both concerns about the validity of patients' self-reports and the need to have a proxy measure for trauma patients who are unable to provide information about their drinking behavior. The present study evaluated the level of agreement between trauma patients' self-report and proxy report on the Alcohol Use Disorders Identification Test (AUDIT). Conclusion: The relative comparability of proxy- and patient-completed AUDIT scores and classifications suggests that patient and proxy reports corroborate and, in cases of trauma patients' inability to provide self-reports, may serve as proxies for patients' reports of drinking. Via Publisher
Donovan, D.M., Kivlahan, D.R., Doyle, S.R., Longabaugh, R., Greenfield, S.F.
Concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT zones in defining levels of severity among out-patients with alcohol dependence in the COMBINE study. Addiction, Volume 101, Issue 12, December 2006, Pages 1696-1704
2006 English Aims: To examine among alcohol‐dependent out‐patient clients the concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) total score and ‘zones’ suggested by the World Health Organization for defining levels of severity of alcohol use problems. Conclusions: The AUDIT total score is a brief measure that appears to provide an index of severity of dependence in a sample of alcohol‐dependent individuals seeking out‐patient treatment, extending its potential utility beyond its more traditional role as a screening instrument in general populations. Via Publisher
dos Santos, W.S., Gouveia, V.V., Fernandes, D.P., de Souza, S.S.B., Grangeiro, A.S.M.
Alcohol Use Disorder Identification Test (AUDIT): Explorando seus parâmetros psicométricos | [Alcohol Use Disorder Identification Test (AUDIT): Exploring its psychometric parameters]. Jornal Brasileiro de Psiquiatria, Volume 61, Issue 3, 2012, Pages 117-123
2012 Portuguese Objective: This study aimed to know evidences of validity and reliability of the Alcohol Use Disorder Identification Test (AUDIT). Methods: For this purpose, we considered 547 college students from Fortaleza (CE) with a mean age of 21.6 years (sd = 4.86, varying from 18 to 53), mostly male (51.5%), single (91.4%) and catholic (62.5%). The participants answered the AUDIT and demographic questions. Looking to know AUDIT's factorial structure, we carried out a principal component analysis. Additionally, in order to evaluate its reliability, we calculated Cronbach's alpha (internal consistency), Pearson correlation r and intraclass coefficient correlation - ICC (test-retest). Also, descriptive statistics were evaluated. Results: According to the principal component analysis using oblimin rotation, the bifactorial structure of the AUDIT proved to be consistent, once all items showed satisfactory saturations exceeding |0.40|, with the first factor explaining 47.5% of the total variance with alpha of 0.84 and Factor 2 explaining 11.6% of the total variance with alpha of 0.69. The results of the test-retest showed strong correlation between data obtained in the first (t1) and in the second (t2) applications (rtt= 0.94, p < 0.01), with no significant difference between the means in both applications (mt1= 0.37, sd = 0.49, = 0.34 mt2, dp2= 0.47, p > 0.05) with satisfactory ICC (0.96). Conclusions: The findings support the psychometric adequacy of the AUDIT, with the exploratory factor analysis pointing as more satisfactory the structure with two factors, and also showing its good temporal stability. Open Access
Doyle, S.R., Donovan, D.M., Kivlahan, D.R.
The factor structure of the Alcohol Use Disorders Identification Test (AUDIT). Journal of Studies on Alcohol and Drugs, Volume 68, Issue 3, May 2007, Pages 474-479
2007 English Objective: Past research assessing the factor structure of the Alcohol Use Disorders Identification Test (AUDIT) with various exploratory and confirmatory factor analytic techniques has identified one-, two-, and three-factor solutions. Because different factor analytic procedures may result in dissimilar findings, we examined the factor structure of the AUDIT using the same factor analytic technique on two new large clinical samples and on archival data from six samples studied in previous reports. Results: Across samples, analyses supported a correlated, two-factor solution representing alcohol consumption and alcohol-related consequences. The three-factor solution fit the data equally well, but two factors (alcohol dependence and harmful alcohol use) were highly correlated. The one-factor solution did not provide a good fit to the data. Conclusions: These findings support a two-factor solution for the AUDIT (alcohol consumption and alcohol-related consequences). The results contradict the original three-factor design of the AUDIT and the prevalent use of the AUDIT as a one-factor screening instrument with a single cutoff score. Via Publisher
Durbeej, N., Berman, A.H., Gumpert, C.H., (...), Kristiansson, M., Alm, C.
Validation of the Alcohol Use Disorders Identification Test and the Drug Use Disorders Identification Test in a Swedish sample of suspected offenders with signs of mental health problems: Results from the Mental Disorder, Substance Abuse and Crime study. Journal of Substance Abuse Treatment, Volume 39, Issue 4, December 2010, Pages 364-377
2010 English Substance abuse is common among offenders. One method widely used for the detection of substance abuse is screening. This study explored the concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT) screening tools in relation to (a) substance abuse and dependency diagnoses and (b) three problem severity domains of the sixth version of the Addiction Severity Index in a sample of 181 suspected offenders with signs of mental health problems. The screening tools showed moderate to high accuracy for identification of dependency diagnoses. The AUDIT was associated with alcohol problem severity, whereas the DUDIT was associated with drug and legal problem severity. Administering the screening tools in the current population yields valid results. However, the suggested cutoff scores should be applied with caution due to the discrepancy between present and previous findings. Via Publisher
Dybek, I., Bischof, G., Grothues, J., (...), Hohagen, F., Rumpf, H.-J.
The reliability and validity of the Alcohol Use Disorders Identification Test (AUDIT) in a German general practice population sample. Journal of Studies on Alcohol, Volume 67, Issue 3, May 2006, Pages 473-481
2006 English Objective: Our goal was to analyze the retest reliability and validity of the Alcohol Use Disorders Identification Test (AUDIT) in a primary-care setting and recommend a cut-off value for the different alcohol-related diagnoses. Method: Participants recruited from general practices (GPs) in two northern German cities received the AUDIT, which was embedded in a health-risk questionnaire. In total, 10,803 screenings were conducted.Conclusions: Embedded in a health-risk questionnaire in primary-care settings, the AUDIT is a reliable and valid screening instrument to identify at-risk drinkers and patients with an AUD. Our findings strongly suggest a lowering of the recommended cut-off value of eight points. Via Publisher
El-Bassel, N., Schilling, R., Ivanoff, A., Chen, D.-R., Hanson, M.
Assessing the World Health Organization’s Alcohol Use Disorder Identification Test among incarcerated women. Journal of Offender Rehabilitation, Volume 26, Issue 3-4, 4 February 1998, Pages 71-89
1998 English The Alcohol Use Disorder Identification Test (AUDIT), developed by the World Health Organization, was administered to 400 incarcerated, drug-using women in order to assess its utility, validity, and reliability. Principal component factor analysis and reliability tests were conducted. Sensitivity and specificity for all possible AUDIT cutoff points were computed, and a Receiver Operating Characteristics (ROC) curve was plotted to suggest an AUDIT cutoff point for identifying problem drinkers. This cutoff point was then assessed as to its concurrent and discriminant validity. Principal component factor analysis identified one factor that accounted for a substantial portion (67.3%) of the total variance of the AUDIT, a result that indicated that the AUDIT could be used as a consistent and summated screening tool for identifying problem drinkers. Internal consistency was high (Alpha = 0.94). The ROC curve, sensitivity, and specificity tests suggest that a total AUDIT score of 10 or more is a reliable indicator of problem drinking. Significant differences were found between problem drinkers and non-problem drinkers with respect to psychological symptoms, trauma history, physical illness, and socio-demographic characteristics. This study’s results demonstrate that the AUDIT can be used to identify problem drinkers among incarcerated, drug-using women Via Publisher
Endsley, P., Weobong, B., Nadkarni, A.
Psychometric properties of the AUDIT among men in Goa, India. Asian Journal of Psychiatry, Volume 29, 1 October 2017, Pages 54-58
2017 English Aims: The Alcohol Use Disorders Identification Test (AUDIT) is a 10-item screening questionnaire used to detect alcohol use disorders. The AUDIT has been validated in only two studies in India and although it has been previously used in Goa, India, it has yet to be validated in that setting. In this paper, we aim to report data on the validity of the AUDIT for the screening of AUDs among men in Goa, India. Methods: Concurrent and convergent validity of the AUDIT were assessed against the Mini International Neuropsychiatric Interview (MINI) and World Health Organisation Disability Assessment Scale (WHODAS) for alcohol abuse, alcohol dependence, and functional status respectively through the secondary analysis of data from a community cohort of men from Goa, India. Results: The AUDIT showed high internal reliability and acceptable criterion validity with adequate psychometric properties for the detection of alcohol abuse and dependence. However, all of the optimal cut-off points from ROC analyses were lower than the WHO recommended for identification of risk of all AUDs, with a score of 6–12 detecting alcohol abuse and 13 and higher alcohol dependence. Conclusions: In order to optimize the utility of the AUDIT, a lowered cut-off point for alcohol abuse and dependence is recommended for Goa, India. Further validation studies for the AUDIT should be conducted for continued validation of the tool in other parts of India. Open Access
Feldman, N., Chatton, A., Khan, R., Khazaal, Y., Zullino, D.
Alcohol-related brief intervention in patients treated for opiate or cocaine dependence: A randomized controlled study. Substance Abuse: Treatment, Prevention, and Policy, Volume 6, Issue 1, 17 August 2011, Article number 22
2011 English Background: Despite the importance of heavy drinking and alcohol dependence among patients with opiate and cocaine dependence, few studies have evaluated specific interventions within this group. The aim of the present study was to evaluate the impact of screening with the Alcohol Use Disorders Identification Test (AUDIT) and of brief intervention (BI) on alcohol use in a sample of patients treated for opioid or cocaine dependence in a specialized outpatient clinic.Methods: Adult outpatients treated for opioid or cocaine dependence in Switzerland were screened for excessive alcohol drinking and dependence with the AUDIT. Patients with AUDIT scores that indicated excessive drinking or dependence were randomized into two groups--treatment as usual or treatment as usual together with BI--and assessed at 3 months and 9 months.Results: Findings revealed a high rate (44%) of problematic alcohol use (excessive drinking and dependence) among patients with opiate and cocaine dependence. The number of drinks per week decreased significantly between T0 (inclusion) and T3 (month 3). A decrease in average AUDIT scores was observed between T0 and T3 and between T0 and T9 (month 9). No statistically significant difference between treatment groups was observed.Conclusions: In a substance abuse specialized setting, screening for alcohol use with the AUDIT, followed by feedback on the score, and use of alcohol BI are both possibly useful strategies to induce changes in problematic alcohol use. Definitive conclusions cannot, however, be drawn from the study because of limitations such as lack of a naturalistic group. An important result of the study is the excellent internal consistency of AUDIT in a population treated for opiate or cocaine dependence.  Open Access
Fillmore, M.T., Jude, R.
Defining "binge" drinking as five drinks per occasion or drinking to a.08% BAC: Which is more sensitive to risk? American Journal on Addictions, Volume 20, Issue 5, September 2011, Pages 468-475
2011 English Heavy episodic or "binge" drinking is commonly defined as drinking 4-5 drinks per occasion (5/4 definition) or drinking that results in a blood alcohol concentration (BAC) of.08%. The present study compared the validity of each binge definition as an indicator of at-risk, problem drinking. Two hundred and fifty-one college students were classified as nonbinge drinkers or as binge drinkers based on the 5/4 definition or the.08% BAC definition. The two definitions of binge drinking were examined in terms of their sensitivity and specificity as indicators of alcohol-related problems as determined by scores on the Alcohol Use Disorders Identification Test (AUDIT). Over half the sample (56%) were at-risk drinkers according to the AUDIT. The.08% definition detected only one-half of these individuals. Gender differences were also evident. Female binge drinkers actually achieved significantly higher estimated BACs per episode than their male binge drinking counterparts. The findings suggest that drinking to a subthreshold BAC (ie, < .08%) is not sufficient to avoid alcohol-related problems, and that total quantity (ie, total standard drinks) per occasion might contribute to risk independent of the BAC achieved during drinking episodes. The findings also highlight the importance of considering frequency of consumption in determining risky drinking versus relying solely on quantity measures.  Via Publisher
Fleming, M.F., Barry, K.L., MacDonald, R.
The Alcohol Use Disorders Identification Test (AUDIT) in a college sample. International Journal of the Addictions. Volume 26, Issue 11, 1991, Pages 1173-1185
1991 English This study was conducted to estimate the psychometric properties of the questionnaire section of the Alcohol Use Disorders Identification Test (AUDIT) in a college sample using DSM-III criteria for alcohol abuse as the criterion standard. This alcohol screening test was developed for the 10 country AMETHYST project. In this young adult sample the instrument exhibited a sensitivity of 84 and specificity of. 71 when utilizing the recommended cut-off score of 11. The 10-item questionnaire section of the AUDIT appears to have important advantages over other alcohol screening instruments such as the CAGE and the MAST. Via Publisher
Foxcroft, D.R., Smith, L.A., Thomas, H., Howcutt, S.
Accuracy of Alcohol Use Disorders Identification Test for detecting problem drinking in 18-35 year-olds in England: Method comparison study. Alcohol and Alcoholism, Volume 50, Issue 2, 2015, Article number agu095, Pages 244-250
2015 English Aims: To assess the accuracy of Alcohol Use Disorders Identification Test (AUDIT) scores for problem drinking in males and females aged 18-35 in England. Methods: A method comparison study with 420 primary care patients aged 18-35. Test measures were AUDIT and AUDIT-C. Reference standard measures were (a) Time-Line Follow-Back interview for hazardous drinking; World Mental Health Composite International Diagnostic Interview for (b) DSM-IV alcohol abuse, (c) DSM-IV alcohol dependence, (d) DSM-5 alcohol use disorders. Results: Area under the curve (AUC) was (a) 0.79 (95% CI 0.73-0.85; males) and 0.84 (0.79-0.88; females); (b) 0.62 (0.54-0.72; males) and 0.65 (0.57-0.72; females); (c) 0.77 (0.65-0.87; males) and 0.76 (0.67-0.74; females); (d) 0.70 (0.60-0.78; males) and 0.73 (CI 0.67-0.78; females). Identification of threshold cut-point scores from the AUC was not straightforward. Youden J statistic optimal cut-point scores varied by 4-6 AUDIT scale points for each outcome according to whether sensitivity or specificity were prioritized. Using Bayes' Theorem, the post-test probability of drinking problems changed as AUDIT score increased, according to the slope of the probability curve. Conclusion: The full AUDITscale showed good or very good accuracy for all outcome measures for males and females, except for alcohol abuse which had sufficient accuracy. In a screening scenario where sensitivity might be prioritized, the optimal cut-point is lower than established AUDIT cut-points of 8+ for men and 6+ for women. Bayes' Theorem to calculate individual probabilities for problem drinking offers an alternative to arbitrary cut-point threshold scores in screening and brief intervention programmes. Open Access
Ganz, T., Braun, M., Laging, M., Heidenreich, T.
Screening for hazardous drinking among German university students: Criterion validity and cut-off scores for the Alcohol Use Disorders Identification Test–Consumption | [Erfassung des riskanten Alkoholkonsums bei Studierenden deutscher Hochschulen: Analysen zur Kriteriumsvalidität und zur Optimierung der Cut-Off-Werte des Alcohol Use Disorders Identification Test(‐Consumption)]. Zeitschrift fur Klinische Psychologie und Psychotherapie, Volume 46, Issue 3, July 2017, Pages 187-197
2017 German? Background: The Alcohol Use Disorders Identification Test (AUDIT) and the short version AUDIT-C are established instruments in screening for hazardous drinking. Objective: The aim of this study was the validation and evaluation of cut-off-values in student samples of German universities. Method: Analyses were based on samples of one university of applied sciences (n = 490, 60% male) and three universities (n = 1,456, 47% male). The external criterion of > 60 or > 120 g ethanol (women/men, respectively) and > 0 risky single-occasion drinking were measured using an adaptation of the Daily Drinking Questionnaire. Additionally, alcohol-related problems were assessed. Results: The prevalence of hazardous drinking during the last month was 53% and 56%, respectively, and was associated with significantly more alcohol-related problems. The quality in the detection of hazardous drinking of both screenings was good to excellent. Overall, the best AUDIT cut-off was ≥ 5 points, the AUDIT-C cut-off ≥ 4 points, and in each case ≥ 4 for women and ≥ 5 for men. Conclusion: According to its characteristics, the AUDIT-C can be recommended as short and valid screening for hazardous drinking in students of German universities. Via Publisher
Göransson, M., Magnusson, Å., Bergman, H., Rydberg, U., Heilig, M.
Fetus at risk: Prevalence of alcohol consumption during pregnancy estimated with a simple screening method in Swedish antenatal clinics. Addiction Volume 98, Issue 11, November 2003, Pages 1513-1520
2003 English Aims: Maternal alcohol consumption is a major health hazard for the fetus. Sweden has an extensive system of public antenatal care clinics, whose mission is to detect and prevent this type of health hazards. However, very few cases of alcohol consumption during pregnancy are detected. The aim of this study was to examine the prevalence of hazardous or harmful alcohol consumption during pregnancy in a consecutive series of Swedish pregnant females. Design, setting, participants and measurements: The Alcohol Use Disorders Identification Test (AUDIT) was used to collect anonymous data from consecutive pregnant subjects admitted during 1 year to an antenatal clinic in Stockholm, and signing up for parental education offered routinely (n = 1327). AUDIT scores for the year prior to pregnancy and subject age, but not education level were significant predictors of continued alcohol use during pregnancy. Conclusions: Alcohol use during pregnancy is more extensive than has been presumed in Sweden. Simple, clinically useful screening methodology detects hazardous consumption during pregnancy in a manner which regular antenatal care does not. If this methodology can be shown to have similar sensitivity when administered under non-anonymous conditions, it should be made part of routine antenatal care. Via Publisher
Guo, W., Lanzi, G., Luobu, O., (...), Ball, D., Li, T.
An epidemiological survey of alcohol use disorders in a Tibetan population. Psychiatry Research, Volume 159, Issue 1-2, 30 May 2008, Pages 56-66
2008 English We performed an epidemiological survey in order to detect the prevalence of alcohol use disorders in a sub-group of the population of Tibet. The Alcohol Use Disorders Identification Test (AUDIT) questionnaire, the Severity of Alcohol Dependence Questionnaire (SADQ), and a 12-item version of the General Health Questionnaire (GHQ12) were used to obtain epidemiological data on alcohol use disorders and to assess the severity of 'problem drinking' and general mental health status. The AUDIT is a reliable and valid screening tool for both alcohol abuse and dependence in the Tibetan population to identify individuals with alcohol use problems. The cut-off points were set to be 10 and 13 of the AUDIT scores as a diagnostic discriminator of alcohol abuse and alcohol dependence, respectively, with both sensitivity and specificity > 0.84. The prevalence of alcohol abuse, was 2.7% (female: 2.0%; male: 6.2%), alcohol dependence 13.5% (female: 7.6%; male: 25.4%) and alcohol use disorders 16.2% (female: 9.6%; male: 31.6%). Age and sex were the main factors affecting an individual's alcohol use and general mental health status. The epidemiological data on alcohol use disorders documented in this project may be helpful in future work seeking more valid causal inferences or interpretations related to this prevalent health problem in Tibet.  Via Publisher
Gureje, O., Obikoya, B., Ikuesan, B.A.
Alcohol abuse and dependence in an urban primary care clinic in Nigeria. Drug and Alcohol Dependence. Volume 30, Issue 2, June 1992, Pages 163-167
1992 English A two-stage epidemiological survey was conducted in an urban walk-in clinic in Nigeria to detect, among other disorders, the prevalence of alcohol abuse and dependence using DSM-IIIR criteria. At the first stage, respondents were administered the 12-item General Health Questionnaire and the Alcohol Use Disorders Identification Test (AUDIT). A proportion of the respondents were selected for detailed interview at the second stage using the Composite International Diagnostic Interview (CIDI). An estimated 1.7% of this sample met the criteria for alcohol abuse or dependence. All the identified cases were males, thus giving an estimated prevalence of 5.2% in males. In this setting, the AUDIT performed poorly as a screening instrument. It had a sensitivity of 32% but a specificity of 93%. Apart from reasons relating to the low base rates of the disorders under investigation, cultural factors influencing the ways alcohol use are perceived may explain this poor performance.  Via Publisher
Hagman, B.T.
Performance of the AUDIT in Detecting DSM-5 Alcohol Use Disorders in College Students. Substance Use and Misuse, Volume 51, Issue 11, 18 September 2016, Pages 1521-1528
2016 English Background: It is critical that our alcohol screening instruments maintain their accuracy at detecting DSM-5 Alcohol Use Disorder (AUD) symptomatology. The Alcohol Use Disorders Identification Test (AUDIT) is one of the most widely used alcohol screening instruments, despite no studies evaluating its performance for detecting DSM-5 AUDs. Objectives: The present study evaluated the performance of the AUDIT in the screening of DSM-5 AUDs in non-treatment seeking college students. Methods: Participants (N = 251) were undergraduate students who had at least one binge drinking occasion in the past 90-days. Results: The AUROC value for DSM-5 AUD status in the overall sample was.779 (SE =.029; 95% CIs =.721 to.837). The AUROC values for the reference groups of any DSM-IV AUD and any binge drinker were.798 (SE =.028; 95% CIs =.742 to.853) and.827 (SE =.03; 95% CIs.768 –.886), respectively. A similar pattern of findings emerged between males and females. Gender differences emerged in the identification of AUDIT cut-off scores. A score of ≥ 8 and ≥ 9 had the best balance of sensitivity and specificity for females and males in college, respectively. Conclusion: Findings indicate that the AUDIT has a reasonable degree of diagnostic proficiency in screening for DSM-5 AUDs in college students. Via Publisher
Hallinan, P., McGilloway, S., Dempster, M., Donnelly, M.
Factor structure and validity of the Alcohol Use Disorders Identification Test (AUDIT) in a sample of mentally disordered offenders. Journal of Forensic Psychiatry and Psychology, Volume 22, Issue 4, August 2011, Pages 586-602
2011 English Investigations of the factor structure of the Alcohol Use Disorders Identification Test (AUDIT) have produced conflicting results. The current study assessed the factor structure of the AUDIT for a group of Mentally Disordered Offenders (MDOs) and examined the pattern of scoring in specific subgroups. The sample comprised 2005 MDOs who completed a battery of tests including the AUDIT. Confirmatory factor analyses revealed that a two-factor solution - alcohol consumption and alcohol-related consequences - provided the best data fit for AUDIT scores. A three-factor solution provided an equally good fit, but the second and third factors were highly correlated and a measure of parsimony also favoured the two-factor solution. This study provides useful information on the factor structure of the AUDIT amongst a large MDO population, while also highlighting the difficulties associated with the presence of people with mental health problems in the criminal justice system.  Via Publisher
Harris, A.H., Lembke, A., Henderson, P., (...), Moos, R., Bradley, K.A.
Risk of future trauma based on alcohol screening scores: a two-year prospective cohort study among US veterans. Addiction Science & Clinical Practice, Volume 7, Issue 1, 2012, Page 6
2012 English Severe alcohol misuse as measured by the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) is associated with increased risk of future fractures and trauma-related hospitalizations. This study examined the association between AUDIT-C scores and two-year risk of any type of trauma among US Veterans Health Administration (VHA) patients and assessed whether risk varied by age or gender. Outpatients (215, 924 male and 9168 female) who returned mailed AUDIT-C questionnaires were followed for 24 months in the medical record for any International Statistical Classification of Diseases and Related Health Problems (ICD-9) code related to trauma. The two-year prevalence of trauma was examined as a function of AUDIT-C scores, with low-level drinking (AUDIT-C 1-4) as the reference group. Men and women were examined separately, and age-stratified analyses were performed. Having an AUDIT-C score of 9-12 (indicating severe alcohol misuse) was associated with increased risk for trauma. Mean (SD) ages for men and women were 68.2 (11.5) and 57.2 (15.8), respectively. Age-stratified analyses showed that, for men≤50 years, those with AUDIT-C scores≥9 had an increased risk for trauma compared with those with AUDIT-C scores in the 1-4 range (adjusted prevalence, 25.7% versus 20.8%, respectively; OR=1.24; 95% confidence interval [CI], 1.03-1.50). For men≥65 years with average comorbidity and education, those with AUDIT-C scores of 5-8 (adjusted prevalence, 7.9% versus 7.4%; OR=1.16; 95% CI, 1.02-1.31) and 9-12 (adjusted prevalence 11.1% versus 7.4%; OR=1.68; 95% CI, 1.30-2.17) were at significantly increased risk for trauma compared with men≥65 years in the reference group. Higher AUDIT-C scores were not associated with increased risk of trauma among women. Men with severe alcohol misuse (AUDIT-C 9-12) demonstrate an increased risk of trauma. Men≥65 showed an increased risk for trauma at all levels of alcohol misuse (AUDIT-C 5-8 and 9-12). These findings may be used as part of an evidence-based brief intervention for alcohol use disorders. More research is needed to understand the relationship between AUDIT-C scores and risk of trauma in women. Open Access
Hildebrand, M., Noteborn, M.G.C.
Exploration of the (Interrater) Reliability and Latent Factor Structure of the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT) in a Sample of Dutch Probationers. Substance Use and Misuse, Volume 50, Issue 10, 24 August 2015, Pages 1294-1306
2015 English Background: The use of brief, reliable, valid, and practical measures of substance use is critical for conducting individual (risk and need) assessments in probation practice. In this exploratory study, the basic psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT) are evaluated. Methods: The instruments were administered as an oral interview instead of a self-report questionnaire. The sample comprised 383 offenders (339 men, 44 women). A subset of 56 offenders (49 men, 7 women) participated in the interrater reliability study. Data collection took place between September 2011 and November 2012. Results: Overall, both instruments have acceptable levels of interrater reliability for total scores and acceptable to good interrater reliabilities for most of the individual items. Confirmatory factor analyses (CFA) indicated that the a priori one-, two- and three-factor solutions for the AUDIT did not fit the observed data very well. Principal axis factoring (PAF) supported a two-factor solution for the AUDIT that included a level of alcohol consumption/consequences factor (Factor 1) and a dependence factor (Factor 2), with both factors explaining substantial variance in AUDIT scores. For the DUDIT, CFA and PAF suggest that a one-factor solution is the preferred model (accounting for 62.61% of total variance). Conclusions: The Dutch language versions of the AUDIT and the DUDIT are reliable screening instruments for use with probationers and both instruments can be reliably administered by probation officers in probation practice. However, future research on concurrent and predictive validity is warranted. Via Publisher
Hiro, H., Shima, S.
Availability of the Alcohol Use Disorders Identification Test (AUDIT) for a complete health examination in Japan. Japanese Journal of Alcohol Studies and Drug Dependence, Volume 31, Issue 5, 1996, Pages 437-450
1996 Japanese Objective: The Alcohol Use Disorders Identification Test (AUDIT) is an instrument designed to identify hazardous drinkers, harmful drinkers and alcoholics. It was translated into Japanese using the WHOQOL method. The concurrent validity and reliability of the Japanese version of AUDIT were evaluated in a complete health examination. The instrument was also compared with the CAGE questionnaire. Method: The subjects were 93 applicants attending for health checks in a human dry dock. They completed self-report questionnaires containing the Core AUDIT and CAGE, and underwent a semi- structured interview conducted by a professional physician. Result: From the semi-structured interview, it was determined that 23 of the subjects were problem drinkers and 10 were alcoholics. Analyses indicated that the Core AUDIT was sufficiently sensitive and specific for discriminating problem drinkers and alcoholics. Core AUDIT was also superior to CAGE for discriminating problem drinkers from non-problem drinkers, as well as identifying alcoholics. Conclusion: The data suggest that the Japanese version of AUDIT is useful for early detection of hazardous or harmful drinkers. Via Publisher
Holloway, A., Watson, H.E.
Screening for hazardous/harmful alcohol consumption amongst general hospital in-patients: Establishing concurrent validity of the Alcohol Use Disorders Identification Test in the UK. Journal of Substance Use, Volume 5, Issue 3, 2000, Pages 263-271
2000 English Aim. The study aimed to establish the concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) as a screening instrument for use in the identification of potential problem drinkers amongst general hospital in-patients in the UK. Design. Survey/correlational. Setting. General medical, surgical, otolaryngology and dermatology wards of a general hospital. Participants. One hundred and eighty-three male and thirty-two female, general hospital in-patients aged between 18 and 75 years. Measurements. Self-reports of weekly alcohol consumption (WAC), AUDIT, and Short Alcohol Dependence Data (SADD) questionnaire. Findings. Correlations were computed using Spearman's rank correlation coefficient. The linear relationship between the scores obtained from the AUDIT and SADD indicated a good concurrent validity (r=0.87, P<0.001). The correlations between the AUDIT and WAC also suggested a significant correlation (r=0.76, P< 0.001). Conclusions. The data presented in this study can be interpreted as important in supporting evidence for the concurrent validity of the AUDIT in the UK, for the given setting and subjects described. The efficacy of the AUDIT as a screening instrument within the UK amongst both similar and diverse samples and settings merits future research. Via Publisher
Hulse, G.K.
Impediments to screening for hazardous alcohol use and dependence in general hospital psychiatric inpatients. Australian and New Zealand Journal of Psychiatry, Volume 35, Issue 5, 2001, Pages 606-612
2001 English Objective: The Alcohol Use Disorders Identification Test (AUDIT) has been developed to screen for hazardous and harmful alcohol consumption. It has been used among a variety of primary care, general population and general hospital populations. However, with the exception of one study undertaken by the author and colleagues, the use of the AUDIT in general hospital psychiatric patients has not been reported. This paper reports on a substudy of this larger study whose aim was to determine the frequency of hazardous alcohol use and dependence among patients admitted to the psychiatric units of general hospitals in Perth, Western Australia, and discusses major reasons for non-AUDIT screening among this group. Conclusions: Failure to screen patients was largely due to short hospital stays. Screening was impeded by the brief window period, commonly 1 or 2 days, between the absence of acute psychiatric sequelae and discharge. This situation contrasts dramatically to the medical or surgical admission where major sequelae are largely resolved in 2-3 days and AUDIT screening can take place over the remaining 3-4 days prior to discharge. To be effective in the general hospital psychiatric setting, alcohol screening needs to be incorporated into the routine ward assessment procedures. The brevity of the AUDIT makes this possible. This would maximize the time available to implement an intervention programme to those found to be consuming alcohol at a hazardous or harmful level. Via Publisher
Hulse, G.K., Saunders, J.B., Roydhouse, R.M., Stockwell, T.R., Basso, M.R.
Screening for hazardous alcohol use and dependence in psychiatric in-patients using the AUDIT questionnaire. Drug and Alcohol Review, Volume 19, Issue 3, September 2000, Pages 291-298
2000 English The Alcohol Use Disorders Identification Test (AUDIT) has been used to screen for hazardous and harmful alcohol consumption among general hospital populations but not in psychiatric patients. Using the AUDIT, we assessed alcohol use in patients with four major types of psychiatric disorder, namely mood, adjustment, anxiety and psychotic disorders. Nine hundred and ninety consecutive admissions to the psychiatric units of two hospitals during a 12-month period underwent assessment. In each diagnostic group a high proportion of patients was alcohol-dependent. Among those with mood disorders 25.4% of men were alcohol-dependent, compared with 16.3% of women, while 34.5% of men with anxiety disorder were alcohol-dependent compared with 25.0% of women. Both gender differences were statistically significant. The differences were even greater for adjustment disorder (44.4% vs. 14.5%) and psychosis (29.2% and 4.2%, respectively). More men than women with anxiety disorder were classified as hazardous (24.1% vs. 11.7%) or harmful drinkers (13.8% vs. 3.3%), but for the other diagnostic groupings the percentages in these drinking categories were more nearly similar. Thus, there is a high rate of excessive alcohol consumption in people with psychiatric disorders, especially males. Such individuals may be particularly vulnerable to complications of alcohol misuse such as suicide and exacerbation of their disorder. The potential for decreased severity of psychiatric symptoms and a reduction in the number of hospital admissions following cessation or reduction in alcohol consumption is considerable. The AUDIT is a simple screening device for investigating alcohol use and dependence, and offers a means of initiating intervention in this population. Via Publisher
Imani, G., Barrios, C., Anderson, C.L., (...), Pham, J.K., Lotfipour, S.
Computerized alcohol screening identified more at-risk drinkers in a level 2 than a level 1 trauma center. BMC Public Health, Volume 17, Issue 1, 6 January 2017, Pages 1-7
2017 English Background: Alcohol abuse is recognized as a significant contributor to injury. It is therefore essential that trauma centers implement screening and brief intervention (SBI) to identify patients who are problem drinkers. Although, the utility of SBI in identifying at-risk drinkers have been widely studied in level 1 trauma centers, few studies have been done in level 2 centers. This study evaluates the usefulness of SBI in identifying at-risk drinkers and to investigate the pattern of alcohol drinking among level 2 trauma patients. Methods: This is a retrospective study of a convenience sample of trauma patients participating in computerized alcohol screening, brief intervention, and referral to treatment (CASI) in an academic level 1 trauma center and a nearby suburban community hospital level 2 trauma center. CASI utilized Alcohol Use Disorders Identification Test (AUDIT) to screen patients. We compared the pattern of alcohol drinking, demographic factors, and readiness-to-change scores between those screened in a level 2 and 1 trauma center. Results: A total of 3,850 and 1,933 admitted trauma patients were screened in level 1 and 2 trauma centers respectively. There was no difference in mean age, gender, and language between the two centers. Of those screened, 10.2% of the level 1 and 14.4% of the level 2 trauma patients scored at-risk (AUDIT 8-19) (p < 0.005). Overall, 3.7% of the level 1 and 7.2% of the level 2 trauma patients had an AUDIT score consistent with dependency (AUDIT > =20) (p < 0.005). After adjusting for age, sex, education, and language, the odds of being a drinker at the level 2 center was two times of those at the level 1 center (p < 0.005). The odds of being an at-risk or dependent drinker at level 2 trauma center were 1.72 times of those at the level 1 center (p < 0.005). Conclusions: Findings suggest that SBI is effective in identifying at-risk drinkers in level 2 trauma center. SBI was able to identify all drinkers, including at-risk and dependent drinkers at higher rates in level 2 versus level 1 trauma centers. Further studies to evaluate the effectiveness of SBI in altering drinking patterns among level 2 trauma patients are warranted. Open Access
Isaacson, J.H., Butler, R., Zacharke, M., Tzelepis, A.
Screening with the Alcohol Use Disorders Identification Test (AUDIT) in an inner-city population. Journal of General Internal Medicine. Volume 9, Issue 10, October 1994, Pages 550-553
1994 English Objectives: 1) To determine the operating characteristics of the Alcohol Use Disorders Identification Test (AUDIT) in an inner-city population and 2) to compare AUDIT performance with physician recognition of alcohol-related problems.Conclusions: 1) Alcohol-related problems were common in this setting. 2) The AUDIT had a high sensitivity and a high specificity for detection of current alcohol problems in this setting, but it failed to detect patients with only past histories of alcohol problems. 3) The AUDIT performed significantly better than did the physicians in detecting alcohol problems. 4) The addition of an assessment of past alcohol use to supplement information from the AUDIT would appear to represent a promising screening strategy worthy of further investigation. Via Publisher
Ivis, F.J., Adlaf, E.M., Rehm, J.
Incorporating the AUDIT into a general population telephone survey: A methodological experiment. Drug and Alcohol Dependence, Volume 60, Issue 1, 1 July 2000, Pages 97-104
2000 English This study assessed potential ordering and wording effects of the Alcohol Use Disorders Identification Test (AUDIT). In total, 688 respondents were randomly assigned to one of four experimental conditions: Intact order/original wording (n=148), intact order/revised wording (n=183), split order/original wording (n=192), split order/revised wording (n=166). Changes to question order and wording had no discernable impact on the scores of the AUDIT. Our results suggest that alterations to the AUDIT can be made in order to integrate it within a larger survey without adversely affecting its measurement properties. Via Publisher
Jeong, H.S., Park, S., Lim, S.M., (...), Yoon, S., Kim, J.E.
Psychometric Properties of the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) in Public First Responders. Substance Use and Misuse, Volume 52, Issue 8, 3 July 2017, Pages 1069-1075
2017 English Problematic alcohol consumption is prevalent among first responders because alcohol is commonly used to cope with occupational stress and frequent exposure to traumatic incidents, making them an at-risk population for alcohol use disorders (AUD). This study investigated the psychometric properties of the Korean version of the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) among public first responders. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision (SCID), AUDIT-C, AUDIT, and CAGE were administered to 222 public first responders, who were recruited by convenience sampling. One-week test–retest reliability was evaluated in a subsample (n = 24). Receiver operating characteristic (ROC) curve analyses were conducted to evaluate the diagnostic accuracy and estimate the optimal cut-off scores for any AUD and alcohol dependence. Three different analytic criteria were utilized to calculate the cut-off scores. The AUDIT-C demonstrated good test–retest reliability (intraclass correlation coefficient for test–retest reliability = 0.91) and satisfactory convergent validity. The areas under the ROC curves for any AUD and alcohol dependence of the AUDIT-C were 0.87 and 0.93, respectively. For any AUD, all three criteria suggested a cut-off score of 7.5 (sensitivity = 81.8%, specificity = 79.8%), whereas for alcohol dependence, a cut-off score of 8.5 (sensitivity = 85.7%, specificity = 86.1%) was derived from two criteria. In conclusion, the AUDIT-C demonstrated good reliability and validity and proved to be a brief and effective screening test for AUD among first responders. Via Publisher
Källmén, H., Sinadinovic, K., Berman, A.H., Wennberg, P.
Risky drinking of alcohol in Sweden: A randomized population survey comparing web- and paper-based self-reports. NAD Nordic Studies on Alcohol and Drugs, Volume 28, Issue 2, 2011, Pages 123-130
2011 English AIMS - This study compared data quality and response rates for the Alcohol Use Disorders Identification Test (AUDIT) in a web-based versus in a paper-and-pencil format survey. SETTING - Subjects were randomised to one of two parallel samples, one web-based and the other paper-based. Data were collected during 2009. RESULTS - The web-based format yielded a lower response rate compared to the paper version (26.2% vs. 53.6%), internal consistency was quite similar (0.82 vs. 0.77), while the mean AUDIT scores were higher in the web-based format for both men and women. Conclusions - Future studies should focus on methods for combining different administration methods in order to maximize response rates. Open Access
Källmén, H., Wennberg, P., Ramstedt, M., Hallgren, M.
The psychometric properties of the AUDIT: A survey from a random sample of elderly Swedish adults. BMC Public Health Volume 14, Issue 1, 1 July 2014, Article number 672
2014 English Background: Increasing alcohol consumption and related harms have been reported among the elderly population of Europe. Consequently, it is important to monitor patterns of alcohol use, and to use a valid and reliable tool when screening for risky consumption in this age group. The aim was to evaluate the internal consistency reliability and construct validity of the Alcohol Use Disorders Identification Test (AUDIT) in elderly Swedish adults, and to compare the results with the general Swedish population. Another aim was to calculate the level of alcohol consumption (AUDIT-C) to be used for comparison in future studies. Methods. The questionnaire was sent to 1459 Swedish adults aged 79-80 years with a response rate of 73.3%. Internal consistency reliability, were assessed using Cronbach alpha, and confirmatory factor analysis assessed construct validity of the Alcohol Use Disorders Identification Test (AUDIT) in elderly population as compared to a Swedish general population sample. Results: The results showed that AUDIT was more reliable and valid among the Swedish general population sample than among the elderly and that Item 1 and 4 in AUDIT was less reliable and valid among the elderly. Conclusions: While the AUDIT showed acceptable psychometric properties in the general population sample, it's performance was of less quality among the elderly respondents. Further psychometric assessments of the AUDIT in elderly populations are required before it is implemented more widely. Open Access
Karno, M., Granholm, E., Lin, A.
Factor structure of the Alcohol Use Disorders Identification Test (AUDIT) in a mental health clinic sample. Journal of Studies on Alcohol Volume 61, Issue 5, 2000, Pages 751-758
2000 English Objective: To examine the factor structure of the Alcohol Use Disorders Identification Test (AUDIT) and to identify the implications of this structure for its clinical use. Method: The AUDIT was administered to mental health clinic outpatients (N = 197; 86% men) at high risk for alcohol-use disorders. Confirmatory and exploratory factor analyses were used to determine the underlying factor structure of the AUDIT for this high-risk population. Results: Confirmatory analyses indicated that the a priori three- and one-factor solutions did not fit the observed data. The exploratory analyses supported a two-factor solution that included level of alcohol consumption and drinking problems, with both factors explaining substantial variance in AUDIT scores. These findings contrast the original three-factor design of the AUDIT and the conventional use of the AUDIT as a one-factor screening device with a single cutoff score. Conclusions: Other screening methods that incorporate this two-factor model may be important for mental health patient populations. Replication of these findings among other mental health samples is needed. Via Publisher
Kawada, T., Inagaki, H., Kuratomi, Y.
The Alcohol Use Disorders Identification Test: Reliability study of the Japanese version. Alcohol, Volume 45, Issue 3, May 2011, Pages 205-207
2011 English Alcohol abuse is recognized as a major health issue, and early detection of alcohol abuse is very important. The Alcohol Use Disorders Identification Test (AUDIT) has been widely used as a specific tool for its detection. We conducted a cross-sectional survey of Japanese male workers to validate the Japanese version of this test. The Japanese version of AUDIT also contains 10 questions. A score greater than or equal to 11 was considered as indicative of serious alcohol abuse or dependence. A total of 168 subjects took part in the survey, and 145 of these subjects sent in their responses to the questionnaire. Among these 145 subjects, there were 136 men. The average age of these male subjects was 38.2 years (±9.9). Among the 136 male subjects, 113 returned completely filled-in questionnaires. There were no significant differences in the mean values of the AUDIT score, short version of AUDIT (AUDIT-C) score, or age between the subjects who did or did not indicate their names in the questionnaire. The internal reliability (Cronbach alpha) of AUDIT was 0.67 for the total subject population and 0.45 for the subjects who indicated their names in the questionnaire (n= 69). Cronbach's alpha of AUDIT-C was 0.51 for the total subject population and 0.43 for the subjects who indicated their names in the questionnaire. The Spearman's rho between AUDIT and AUDIT-C was 0.92 (P< .01), and the percentage of subjects with an AUDIT score greater than or equal to 11 was 8.0% (9/113). Thus, the Japanese version of AUDIT showed satisfactory internal reliability. AUDIT is easy to use and is useful for the detection of alcohol-related problems in occupational workers. Via Publisher
Kelly, T.M., Donovan, J.E.
Confirmatory factor analyses of the Alcohol use Disorders Identification Test (AUDIT) among adolescents treated in emergency departments. Journal of Studies on Alcohol, Volume 62, Issue 6, 2001, Pages 838-842
2001 English Objective: The Alcohol Use Disorders Identification Test (AUDIT) is a 10-item instrument designed by the World Health Organization to assess problematic drinking. The objective of this study was to conduct confirmatory factor analysis of the AUDIT in a sample of adolescents and young adults who were treated in emergency departments. Conclusions: Our findings support those of others who have reported that the AUDIT assesses a consumption factor and an alcohol-related problems factor among primary care patients at risk for problematic drinking behavior. Via Publisher
Khadjesari, Z., White, I.R., McCambridge, J., (...), Godfrey, C., Murray, E.
Validation of the AUDIT-C in adults seeking help with their drinking online. Addiction Science & Clinical Practice, Volume 12, Issue 1, 4 January 2017, Page 2
2017 English BACKGROUND: The abbreviated Alcohol Use Disorder Identification Test for Consumption (AUDIT-C) is rapidly becoming the alcohol screening tool of choice for busy practitioners in clinical settings and by researchers keen to limit assessment burden and reactivity. Cut-off scores for detecting drinking above recommended limits vary by population, setting, country and potentially format. This validation study aimed to determine AUDIT-C thresholds that indicated risky drinking among a population of people seeking help over the Internet.METHOD: The data in this study were collected in the pilot phase of the Down Your Drink trial, which recruited people seeking help over the Internet and randomised them to a web-based intervention or an information-only website. Sensitivity, specificity, and positive and negative likelihood ratios were calculated for AUDIT-C scores, relative to weekly consumption that indicated drinking above limits and higher risk drinking. Receiver-operating characteristic (ROC) curves were created to assess the performance of different cut-off scores on the AUDIT-C for men and women. Past week alcohol consumption was used as the reference-standard and was collected via the TOT-AL, a validated online measure of past week drinking.RESULTS: AUDIT-C scores were obtained from 3720 adults (2053 female and 1667 male) searching the internet for help with drinking, mostly from the UK. The area under the ROC curve for risky drinking was 0.84 (95% CI 0.80, 0.87) (female) and 0.80 (95% CI 0.76, 0.84) (male). AUDIT-C cut-off scores for detecting risky drinking that maximise the sum of sensitivity and specificity were ≥8 for women and ≥8 for men; whereas those identifying the highest proportion of correctly classified individuals were ≥4 for women and ≥5 for men. AUDIT-C cut-off scores for detecting higher risk drinking were also calculated.CONCLUSIONS: AUDIT-C cut-off scores for identifying alcohol consumption above weekly limits in this largely UK based study population were substantially higher than those reported in other validation studies. Researchers and practitioners should select AUDIT-C cut-off scores according to the purpose of identifying risky drinkers and hence the relative importance of sensitivity and/or specificity. Open Access
Kim, C.-G., Kim, J.S., Jung, J.-G., (...), Yoon, S.-J., Suh, H.-S.
Reliability and validity of the Alcohol Use Disorder Identification Test-Korean revised version for screening at-risk drinking and alcohol use disorders. Korean Journal of Family Medicine, Volume 35, Issue 1, January 2014, Pages 2-10
2014 English Background: There needs to be an amendment to the Korean version of the Alcohol Use Disorder Identification Test (AUDIT) with regards to the recent change in percent alcohol by volume (ABV) Korean liquor. This study was performed to suggest a cutoffvalue, reliability and validity of AUDIT-Korean revised version (AUDIT-KR), which reflect the change of the ABV of Korean alcohol. Methods: The subjects were 435 peoples (210 males and 225 females), who visited the Chungnam National University Hospital for a comprehensive medical examination. The respondents completed the AUDIT-KR. At-risk drinking and alcohol use disorders had been evaluated by diagnostic interview. The Cronbach's alpha value, the receiver operating characteristic curve, the appropriate cutoffvalue, sensitivity and specificity of the AUDIT-KR were evaluated. Results: There were 190 at-risk drinkers (111 males and 79 females), and 66 people with alcohol use disorders (48 males and 18 females). The cutoffvalue of the AUDIT-KR for at-risk drinking was 3 points (sensitivity 93.69% and specificity 78.79%) for males and 3 points (sensitivity 92.40% and specificity 78.08%) for females. The cutoffvalue for alcohol use disorders was 10 points (sensitivity 100.00% and specificity 89.51%) for males and 8 points (sensitivity 100.00% and specificity 93.71%) for females. Cronbach's alpha of the AUDIT-KR was 0.885. Conclusion: The above results suggest that the AUDIT-KR shows a high reliability and validity in identifying at-risk drinking and alcohol use disorders.  Open Access
Kim, K., Kim, J.-S.
The association between alcohol consumption patterns and health-related quality of life in a nationally representative sample of South Korean adults. PLoS ONE, Volume 10, Issue 3, 18 March 2015, Article number e0119245
2015 English This study examined the relationship between alcohol consumption and health-related quality of life (HRQOL) in a nationally representative sample of middle-aged to older South Koreans. Data collected from 3,408 men and 3,361 women aged ≥ 40 years were obtained from the 2010 and 2011 Korea National Health and Nutrition Examination Survey. Based on the World Health Organization guidelines, the participants were categorized into zones I (0-7), II (8-15), III (16 -19), or IV (20-40) according to their Alcohol Use Disorders Identification Test (AUDIT) scores, with a higher zone indicating a higher level of alcohol consumption. Data collected from the AUDIT and EuroQol 5-Dimension (EQ-5D) test were subjected to multiple regression analysis in order to examine the relationship between alcohol consumption patterns and health-related quality of life, and to identify intersex and interzone differences. Significant intersex differences were found for the mean total AUDIT and EQ-5D scores and the proportion of participants rating their pain/discomfort and impairment in mobility and usual activities as "moderate" or "severe" (p < 0.001). The analysis of the EQ-5D scores by alcohol consumption pattern and sex suggested the existence of an inverted U-shaped relationship between the total AUDIT and EQ-5D scores. The HRQOL of moderate alcohol drinkers was higher than that of non-drinkers and heavy drinkers. The results of this study will be valuable in designing appropriate interventions to increase the HRQOL impaired by the harmful use of alcohol, in comparing HRQOL among different countries, and in implementing alcohol-related health projects. Open Access
Kim, S.S., Gulick, E.E., Nam, K.A., Kim, S.-H.
Psychometric Properties of the Alcohol Use Disorders Identification Test: A Korean Version. Archives of Psychiatric Nursing, Volume 22, Issue 4, August 2008, Pages 190-199
2008 English Objective: The Alcohol Use Disorders Identification Test (AUDIT) is an important screening tool but has never been administered to Korean Americans. This study was conducted to examine the psychometric properties of a Korean version of the AUDIT referred to as AUDIT-K and to determine which cutoff score of the scale would perform better in Korean Americans. Conclusions: The AUDIT-K was found to be internally consistent and stable over time and should be used in primary health care settings to screen Korean American men for alcohol use disorders to facilitate early interventions. Via Publisher
Kinder, L.S., Bryson, C.L., Sun, H., Williams, E.C., Bradley, K.A.
Alcohol screening scores and all-cause mortality in male veterans affairs patients. Journal of Studies on Alcohol and Drugs, Volume 70, Issue 2, 2009, Pages 253-260
2009 English Objective: Extensive research demonstrates a J- or U-shaped association between in-depth interview measures of alcohol consumption and mortality. Little is known about the relationship between alcohol screening questionnaires and mortality. This study examined the association between scores (ranging from 0 to 12) on the three-item Alcohol Use Disorder Identifi cation Test-Consumption Questionnaire (AUDIT-C) and mortality. Conclusions: A U-shaped association between the AUDIT-C and mortality was observed, with important differences by age group. This is the first study to demonstrate that a clinical scaled screening measure of alcohol use has a similar association with mortality to that observed in epidemiological research with lengthier measures. Via Publisher
Kissell, A., Taylor, P.J., Walker, J., (...), Hammond, A., Amos, T.
Disentangling alcohol-related needs among pre-trial prisoners: A longitudinal study. Alcohol and Alcoholism, Volume 49, Issue 6, 2014, Pages 639-644
2014 English Aims: To disentangle the alcohol-related needs of short stay, revolving door, male prisoners, and offer a theoretically driven but practical approach for allocation of scarce service resources. Methods: A prospective longitudinal interview, questionnaire and records study of pre-trial men newly imprisoned inWales and SW England. Results: Two hundred and forty-one pre-trial men completed an interview and questionnaires within a week of a new reception into prison; 170 completed follow-up 3 weeks later. Questions about problems with alcohol or illicit drugs revealed that problem drinkers were less likely than problem drug users to recognize their difficulty or seek or get help for this during their first month of imprisonment. Co-morbidity was common, but a third of the men had alcohol problems alone. Use of the Alcohol Use Disorders Identification Test (AUDIT) questionnaire identified 80% (195/241) men likely to require some intervention, twice the number identified by direct questions relying on prisoners' judgment about problem use. Furthermore it allowed categorization according to likely risk (dependency), need (problem recognition) and responsivity (wish for help). Conclusion: Alcohol misuse is recognized, worldwide, as fuelling crime and more common among prisoners than the general population. In England and Wales, it is a particular factor in brief but recurrent periods of imprisonment. There have been calls to pay more attention to its use in this context, albeit without any increase in resources. Adding two questions to standard screening enables application of the risk-need-responsivity model to problem drinkers and may identify those most likely to benefit from treatment. Open Access
Knibbe, R.A., Derickx, M., Kuntsche, S., Grittner, U., Bloomfield, K.
A comparison of the Alcohol Use Disorders Identification Test (AUDIT) in general population surveys in nine European countries. Alcohol and Alcoholism, Volume 41, Issue SUPPL. 1, October 2006, Pages i19-i25
2006 English Aims: This study explored the suitability of the Alcohol Use Disorders Identification Test (AUDIT) for cross-national comparable estimates of problem drinking in general populations. On the item level the focus is on responsiveness to cross-national and gender differences. For the set of items the focus is on intercorrelations between items, indicating to what extent the AUDIT constitutes a scale. Methods: General population surveys from nine European countries were included. Cross-tabulations were used to analyse cross-national and gender differences in scores on the items. Reliability analysis was used to analyse intercorrelations between the items. Results: The items 'blackouts' (men and women) and 'guilt and remorse' (women) are the most frequently reported consequences. Gender differences tended to be smaller for 'guilt and remorse' and 'concern of others', and largest for 'morning drinking'. The reliability analysis shows that in eight of the nine countries frequency of drinking lowers the alpha. Injury and concern of others lead to a lower internal consistency in three countries. Conclusions: There was sufficient variation between countries in the pattern of responses and variation in gender differences to conclude that the set of consequence items was responsive to national and gender differences in problem drinking. Frequency of drinking was not a good indicator of problem drinking. The country differences in item total correlations of consequences might be due to differences in how these items are interpreted. Decisions on which items to include in an instrument to allow comparison of estimates of problem drinking cross-nationally require studies on how these items are interpreted in general populations of different countries. Open Access
Krenek, M., Maisto, S.A., Funderburk, J.S., Drayer, R.
Severity of alcohol problems and readiness to change alcohol use in primary care. Addictive Behaviors, Volume 36, Issue 5, May 2011, Pages 512-515
2011 English Screening measures for hazardous alcohol use that are efficient and can provide clinically relevant information are essential for primary care providers (PCPs). This study examined the clinical utility of the Alcohol Use Disorders Identification Test (AUDIT) and the AUDIT-Consumption (AUDIT-C) as predictors of readiness to change alcohol use in a primary care setting. In total, 114 veterans completed the AUDIT, readiness to change ruler, and an alcohol use disorders diagnostic interview. Two AUDIT-C scores were obtained; one administered during a primary care visit and one derived from the AUDIT. The AUDIT, both AUDIT-C scores, and number of dependence symptoms significantly predicted readiness to change independent of demographic variables. The AUDIT accounted for the greatest percentage of variance in readiness to change (19%). The AUDITprovides information about alcohol severity and readiness to change, which could be clinically useful for providers identifying patients for brief alcohol interventions. Via Publisher
Kuitunen-Paul, S., Pfab, S., Garbusow, M., (...), Smolka, M.N., Wittchen, H.-U.
Identification of heavy drinking in the 10-item AUDIT: Results from a prospective study among 18–21 years old non-dependent German males. Journal of Substance Abuse Treatment, Volume 86, March 2018, Pages 94-101
2018 English Background: Alcohol consumption is pivotal for the subsequent development of alcohol use disorders (AUD). The Alcohol Use Disorders Identification Test (AUDIT) is a recommended AUD screening tool for prevention and primary care settings. The objectives of this study were to test how many participants with heavy drinking are unidentified by the AUDIT, if proportions of unidentified participants vary over time, and whether this unidentified risk group (URG) was clinically relevant in terms of drinking behavior reports and AUD risk factors, as well as future adverse outcomes, such as craving, dependence symptoms, or depression. Methods: Our prospective cohort study followed 164 German males aged 18–19 years without an alcohol dependence diagnosis over 24 months. Only men were included due to higher AUD prevalence and gender-specific differences in metabolism, drinking patterns, and progression to AUD. All participants were screened via telephone interview and answered questionnaires both in person and via internet. Heavy drinking was classified using the AUDIT consumption score (AUDIT-C ≥ 4.50). Standardized AUD diagnoses and symptoms, as well as alcohol use-related outcome criteria were assessed via standardized Composite International Diagnostic Interview (CIDI), and self-report questionnaires. Results: One in four participants (22–28% across all four follow-ups) reported heavy drinking but was unidentified by AUDIT total score (i.e. score < 8), thus qualifying for URG status. The URG status did not fluctuate considerably across follow-ups (repeated-measures ANOVA, p = 0.293). URG participants identified at the six-month follow-up did not generally differ from participants without URG status in terms of AUD family history or temperament (multivariate ANOVA, p = 0.114), except for anxiety sensitivity (pBonferroni< 0.001). After two years, URG participants reported a similar level of adverse outcomes compared to low-risk participants (multivariate ANOVA, p = 0.438), but less alcohol-related problems and less loss of control due to craving compared to high-risk participants (pBonferroni≤ 0.007). Conclusions: Despite the considerable number of heavy-drinking individuals unidentified by AUDIT total scores, an additional classification according to AUDIT-C values did not prove useful. Combining AUDIT and AUDIT-C scores might not be sufficient for identifying AUD risk groups among young adult German males. There is an urgent need for a replication of our findings among female participants. Via Publisher
Kuitunen-Paul, S., Roerecke, M.
Alcohol Use Disorders Identification Test (AUDIT) and mortality risk: A systematic review and meta-analysis. Journal of Epidemiology and Community Health, Volume 72, Issue 9, 1 September 2018, Pages 856-863
2018 English Background: We summarise the evidence for an association between screening scores from the Alcohol Use Disorders Identification Test (AUDIT) and all-cause mortality. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, prospective cohort studies reporting all-cause mortality risk by AUDIT scores (complete AUDIT-10 or AUDIT-C) were identified through MEDLINE, Embase, PubMed and Web of Science up to September 2016. Risk estimates were pooled using random effects meta-analyses. Results: Seven observational studies with 18 920 observed deaths among 309 991 participants were identified. At-risk drinking (ie, hazardous/harmful consumption, AUDIT-10 ≥8 and AUDIT-C ≥4) was associated with elevated mortality risk after 2-10 years of follow-up (pooled relative risk (RR)=1.24, 95% CI 1.12 to 1.37) compared with moderate drinking (AUDIT-10=1-7, AUDIT-C=1-3). Compared to past year abstainers (AUDIT=0), moderate drinkers had a lower mortality risk (RR=0.75, 95% CI 0.71 to 0.79) in US Veterans and a similar mortality risk (RR=0.99, 95% CI 0.72 to 1.38) in population-based studies. Most data came from studies among Veterans using the short AUDIT-C in men and showed a dose-response relationship (RR=1.04, 95% CI 1.04 to 1.05 for each AUDIT-C score among drinkers). Data for women and young adults were scarce. Conclusion: AUDIT screening scores were associated with mortality risk. The association was differential depending on the population examined, which may be related to prevalence of former drinkers among current abstainers. Due to heterogeneity between studies and the small number of populations examined, generalisability may be limited. Open Access
Kypri, K., McGee, R., Saunders, J.B., Langley, J.D., Dean, J.I.
Interpretation of items in the AUDIT questionnaire. Alcohol and Alcoholism, Volume 37, Issue 5, September 2002, Pages 465-467
2002 English Aims: To test for the possibility that tertiary students misinterpret certain items on the Alcohol Use Disorders Identification Test (AUDIT). Methods: Responses to alternative question wordings were compared with responses to standard items. Results: Alterations to items 5 and 9, so that consequences of drinking epitomized in these items were more specifically defined, resulted in markedly different response distributions to the item, but the total AUDIT score was not changed. Conclusions: Caution is necessary before using individual AUDIT items as measures of consequences in population surveys, and the possibility of false positives in total scores should be borne in mind. Open Access
Lapham, G.T., Rubinsky, A.D., Williams, E.C., (...), Kivlahan, D.R., Bradley, K.A.
Decreasing sensitivity of clinical alcohol screening with the AUDIT-C after repeated negative screens in VA clinics. Drug and Alcohol Dependence, Volume 142, 1 September 2014, Pages 209-215
2014 English Background: Routine screening for unhealthy alcohol use is widely recommended in primary care settings. However, the validity of repeat screening among patients who have previously screened negative remains unknown. This study aims to evaluate the performance of a clinical alcohol screen compared to a confidential comparison alcohol screen among patients with previous negative alcohol screens. Methods: This study included four nested samples of Veteran Health Administration (VA) outpatients with at least one (N= 18,493) and up to four (N= 714) prior negative annual clinical AUDIT-C screens who completed the AUDIT-C the following year, both in a VA clinic (clinical screen) and on a confidential mailed survey (comparison screen). AUDIT-C screens were categorized as either negative (0-3 points men; 0-2 women) or positive (≥4 men; ≥3 women). For each sample, the performance of the clinical screen was compared to the comparison screen, the reference measure for unhealthy alcohol use. Results: The sensitivity of clinical screens decreased as the number of prior negative screens in a sample increased (40.0-17.4%) for patients with 1-4 negative screens. The positive predictive value also decreased as the number of prior negative screens in a sample increased (67.7-33.3%) while specificity was consistently high for all samples (≥97.8%). Conclusions: Repeat clinical alcohol screens became progressively less sensitive for identifying unhealthy alcohol use among patients who repeatedly screened negative over several years. Alternative approaches for assessing unhealthy alcohol use may be needed for these patients.  Via Publisher
Lapham, S.C., Brown, P., Suriyawongpaisal, P., (...), Chadbunchachai, W., Paisarnsilp, S.
Use of AUDIT for alcohol screening among emergency room patients in Thailand. Substance Use and Misuse, Volume 34, Issue 13, 1999, Pages 1881-1895
1999 English This study evaluated the Alcohol Use Disorders Identification Test (AUDIT) against blood alcohol levels and medical diagnoses. The population under study included 695 current drinkers admitted to emergency rooms of four regional Thailand hospitals. The AUDIT positivity rate was 61% among 343 patients who drank prior to admission and 32% among 352 patients who did not drink alcohol before admission. Breath alcohol levels were positively associated with AUDIT scores. The sensitivity against a previous or current alcohol-related medical diagnosis was 89%. We concluded that the AUDIT is a satisfactory instrument for alcohol screening in this population. Via Publisher
Lee, J.G., Kim, J.S., Jung, J.G., Choi, T.K., Ryou, Y.I.
Usefulness of the Alcohol Use Disorders Identification Test in screening for problem drinkers among college students. Korean Journal of Family Medicine, Volume 32, Issue 1, January 2011, Pages 29-36
2011 Korean Background: Alcohol Use Disorders Identification Test (AUDIT) is effective in identifying problem drinking. This study purposed to evaluate the usefulness of AUDIT in identifying problem drinking among Korean university students whose drinking characteristic is different from adults. Methods: The subjects were 235 students who had visited the Health Service Center of Chungnam National University. All subjects had a diagnostic interview for the presence of at-risk drinking and alcohol use disorder. At-risk drinking was defined according to the criteria of the National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorder was diagnosed by the criteria of Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSMIV TR). At-risk drinking or alcohol use disorder was classified into problem drinking. At the same time, a survey was conducted using three screening tools: AUDIT, cut down, annoyed, guilty feelings, eye opener (CAGE), and cut down, under influence, guilty feelings, eye opener (CUGE). Area under receiver operating characteristic curve (AUROC) of the questionnaires to the results of interviews were compared. Results: Seventy one students were at-risk drinkers and 46 had alcohol use disorder, and 75 were classified into problem drinkers. For identification of problem drinking, AUROC of AUDIT was 0.970 in men and 0.989 in women. For CAGE, it was 0.650 in men and 0.747 in women. For CUGE, it was 0.689 in men and 0.745 in women. Conclusion: Above results suggest that AUDIT is most effective in identifying university students' problem drinking. Open Access
Lee, K.-W., Park, B.-J., Kang, H.-T., Lee, Y.-J.
Alcohol-drinking patterns and metabolic syndrome risk: The 2007 Korean National Health and Nutrition Examination Survey. Alcohol, Volume 45, Issue 5, August 2011, Pages 499-505
2011 English Alcohol consumption has been known to be related to the prevalence of metabolic syndrome (MS). Although some studies have revealed that mild to moderate alcohol consumption reduces the risk of MS, most of these studies have focused the effect of alcohol consumption amount on MS. We examined the association between alcohol-drinking patterns and MS by using the alcohol use disorders identification test (AUDIT) questionnaire to study 1,768 alcohol drinkers (847 men, 921 women) aged 20-75 years from Korean National Health and Nutrition Examination Survey in 2007. When compared with the subjects in the reference group (AUDIT score ≤7), the odds ratios (ORs, 95% confidence intervals [CIs]) for MS of subjects in the highest group (AUDIT score ≥16) were 3.92 (2.40-6.22) in men and 2.27 (0.87-5.89) in women after adjusting for confounding variables. Among the items of the AUDIT score, several alcohol-drinking patterns, including "drinking frequency," "usual drinking quantity," "frequency of high-risk drinking," "frequency of inability to stop drinking," "frequency of feeling guilty after drinking," and "frequency of inability to remember after drinking" were strongly associated with the prevalence of MS in men. In women, there were significant relationships between MS and "usual drinking quantity," "frequency of feeling guilty after drinking," and "frequency of inability to stop drinking." In summary, AUDIT score was strongly associated with MS in Korean adults, particularly in men. Accordingly, in addition to the amount of daily alcohol consumption, alcohol-drinking patterns should be addressed in the prevention and treatment of MS.  Via Publisher
Leung, S.F., Arthur, D.
The Alcohol Use Disorders Identification Test (AUDIT): Validation of an instrument for enhancing nursing practice in Hong Kong. International Journal of Nursing Studies, Volume 37, Issue 1, February 2000, Pages 57-64
2000 English This paper describes the psychometric analysis of the Alcohol Use Disorders Identification Test (AUDIT) after it was modified for use in Hong Kong and administered to examine the patterns of hazardous and harmful drinking. The modified version of AUDIT was an 18-item instrument in which 10 items were completely adopted from the original version and 8 items were added to improve its cultural sensitivity. It was translated into Chinese and back translation was undertaken to confirm the equivalence of the Chinese and English versions. Following a pilot study the instrument was administered to 450 subjects who were recruited from two acute general hospitals, a University Health Clinic and three community health centres. The content validity was judged as adequate by a panel of five international and local experts and the instrument achieved a high reliability coefficient of 0.99 during a test retest procedure conducted with 20 subjects. Factor analysis was performed on the responses obtained from 450 subjects which supported the construct validity of the 18-item instrument. The modified instrument had a consistently high internal consistency reliability (Cronbach's alpha = 0.96-0.97) when tested in the different settings. It was found that a higher percentage of respondents from the hospitals (14.5%) drank at a hazardous or harmful levels compared to those from the community (6.2%) or the University (5.3%). The AUDIT proved a reliable and valid measure with potential applications in Chinese cultures. Early intervention and identification of 'at risk' drinking by the AUDIT is supported as a strategy to be implemented by nurses in primary and secondary health care settings in Hong Kong, where there are indications of increasing alcohol overuse. Via Publisher
Li, Q., Babor, T.F., Hao, W., Chen, X.
The Chinese translations of the Alcohol Use Disorders Identification Test (AUDIT) in China: A systematic review. Alcohol and Alcoholism, Volume 46, Issue 4, July 2011, Article number agr012, Pages 416-423
2011 English Aims: To systematically review the literature on the Chinese translations of the Alcohol Use Disorders Identification Test (AUDIT) and their cross-cultural applicability in Chinese language populations. Methods: We identified peer-reviewed articles published in English (n = 10) and in Chinese (n = 11) from 1980 to September 2009, with key words China, Chinese and AUDIT among PubMed, EBSCO, PsycInfo, FirstSearch electronic databases and two Chinese databases. Results: Five teams from Beijing, Tibet, Taiwan and Hong Kong reported their region-specific translation procedures, cultural adaptations, validity (0.93-0.95 in two versions) and reliability (0.63-0.99). These Chinese translations and short versions demonstrated relatively high sensitivity (0.880-0.997) and moderate specificity (0.709-0.934) for hazardous/harmful drinking and alcohol dependence, but low specificity for alcohol dependence among Min-Nan Taiwanese (0.58). The AUDIT and its adaptations were most utilized in workplace- and hospital-settings for screening and brief intervention. However, they were under-utilized in population-based surveys, primary care settings, and among women, adolescents, rural-to-urban migrants, the elderly and minorities. Among 12 studies from mainland China, four included both women and men, and only one in Tibet was published in English. Conclusion: There is a growing amount of psychometric, epidemiologic and treatment research using Chinese translations of the AUDIT, much of it still unavailable in the English-language literature. Given the increase in burden of disease and injury attributable to alcohol use in the Western Pacific region, the use of an internationally comparable instrument (such as the AUDIT) in research with Chinese populations presents a unique opportunity to expand clinical and epidemiologic knowledge about alcohol problem epidemics. Open Access
Lima, C.T., Freire, A.C.C., Silva, A.P.B., (...), Farrell, M., Prince, M.
Concurrent and construct validity of the AUDIT in an urban Brazillian sample. Alcohol and Alcoholism, Volume 40, Issue 6, November 2005, Pages 584-589
2005 English Aims: To assess the concurrent and the construct validity of the Alcohol Use Disorders Identification Test (AUDIT) in an urban Brazilian sample. Conclusions: The results supported the use of the self-reported version of the AUDIT in epidemiologic studies, and showed a similar cut-off point for detection of ARDs and hazardous drinking Open Access
Liskola, J., Haravuori, H., Lindberg, N., (...), Kiviruusu, O., Marttunen, M.
AUDIT and AUDIT-C as screening instruments for alcohol problem use in adolescents. Drug and Alcohol Dependence, Volume 188, 1 July 2018, Pages 266-273
2018 English Background: The Alcohol Use Disorders Identification Test (AUDIT) is commonly used in adults to screen for harmful alcohol consumption but few studies exist on its use among adolescents. Our aim was to validate the AUDIT and its derivative consumption questionnaire (AUDIT-C) as screening instruments for the detection of problem use of alcohol in adolescents. Methods: 621 adolescents (age-range, 12–19 years) were drawn from clinical and population samples who completed the AUDIT questionnaire. Psychiatric diagnoses were assessed using K-SADS-PL. A rating based on the K-SADS-PL was used to assess alcohol use habits, alcohol use disorders, screening and symptom criteria questions. Screening performance of the AUDIT and AUDIT-C sum scores and Receiver Operating Characteristic (ROC) curves were calculated. The diagnostic odds ratios (dOR) were calculated to express the overall discrimination between cut-offs. Results: Comparisons of ROC between the AUDIT and AUDIT-C pairs indicated a slightly better test performance by AUDIT for the whole sample and in a proportion of the subsamples. Optimal cut-off value for the AUDIT was ≥5 (sensitivity 0.931, specificity 0.772, dOR 45.22; 95% CI: 24.72–83.57) for detecting alcohol problem use. The corresponding optimal cut-off value for the AUDIT-C was ≥3 in detecting alcohol problem use (sensitivity 0.952, specificity 0.663, dOR 39.31; 95% CI: 19.46–78.97). Agreement between the AUDIT and AUDIT-C using these cut-off scores was high at 91.9%. Conclusions: Our results for the cut-off scores for the early detection of alcohol problem use in adolescents are ≥5 for AUDIT, and ≥3 for AUDIT-C. Via Publisher
Lu, H., Han, Y., He, X., (...), Ruan, Y., Raymond, H.F.
Alcohol use and HIV risk taking among Chinese MSM in Beijing. Drug and Alcohol Dependence, Volume 133, Issue 2, 1 December 2013, Pages 317-323
2013 English Background: Few studies have used standardized alcohol use measures among men who have sex with men in China. Methods: A cross-sectional study was conducted among MSM in Beijing. A computer-assisted self-administered questionnaire was used to collect demographics, risk behaviors the Alcohol Use Disorders Identification Test (AUDIT). AUDIT uses a cutoff score of ≥8 while AUDIT C uses a score of ≥4 to classify respondents as problem drinkers. Both include a binge drinking measure. Results: A total of 500 participants were recruited using respondent-driven sampling. HIV and prevalence is estimated to be 6.1% (95% CI 3.7, 9.2). Almost half of MSM (42.1%, 95% CI 35.8, 49.0) never had a drink containing alcohol in the past year. 5.0% (95% CI 3.1, 7.0) and 8.8% (95% CI 6.1, 11.6) had AUDIT score ≥8 and AUDIT-C score ≥4, respectively. Binge drinking was at 11.8% (95% CI 7.9, 16.0). In multivariate models all measures were associated with alcohol during sex, while AUDIT was associated with high level of attitudes and perceptions on safe sex (AOR 0.9, 95% CI 0.9,1.0), AUDIT-C with being older (AOR 3.5, 95%CI 1.4, 8.8), and HIV status (AOR 2.2, 95% CI 1.4, 10.9), and binge drinking with number of male partners (AOR 2.0, 95% CI 1.0, 3.9) and ever having had an HIV test (AOR 1.0, 95%CI 0.9, 1.0). Compared to AUDIT ≥8, AUDIT-C ≥4 and binge drinking were more suitable in identifying HIV risks related to problem drinking. Conclusions: Findings suggest AUDIT is appropriate for use among MSM in China and reinforces the need for incorporating problem drinking as part of approaches to prevent HIV infection among Chinese MSM. Via Publisher
Lundin, A., Hallgren, M., Balliu, N., Forsell, Y.
The Use of Alcohol Use Disorders Identification Test (AUDIT) in Detecting Alcohol Use Disorder and Risk Drinking in the General Population: Validation of AUDIT Using Schedules for Clinical Assessment in Neuropsychiatry. Alcoholism: Clinical and Experimental Research, Volume 39, Issue 1, 1 January 2015, Pages 158-165
2015 English Background: The Alcohol Use Disorders Identification Test (AUDIT) and AUDIT-Consumption (AUDIT-C) are commonly used in population surveys but there are few validations studies in the general population. Validity should be estimated in samples close to the targeted population and setting. This study aims to validate AUDIT and AUDIT-C in a general population sample (PART) in Stockholm, Sweden. Methods: We used a general population subsample age 20 to 64 that answered a postal questionnaire including AUDIT who later participated in a psychiatric interview (n = 1,093). Interviews using Schedules for Clinical Assessment in Neuropsychiatry was used as criterion standard. Diagnoses were set according to the fourth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Agreement between the diagnostic test and criterion standard was measured with area under the receiver operator characteristics curve (AUC). Results: A total of 1,086 (450 men and 636 women) of the interview participants completed AUDIT. There were 96 individuals with DSM-IV-alcohol dependence, 36 DSM-IV-Alcohol Abuse, and 153 Risk drinkers. AUCs were for DSM-IV-alcohol use disorder 0.90 (AUDIT-C 0.85); DSM-IV-dependence 0.94 (AUDIT-C 0.89); risk drinking 0.80 (AUDIT-C 0.80); and any criterion 0.87 (AUDIT-C 0.84). Conclusions: In this general population sample, AUDIT and AUDIT-C performed outstanding or excellent in identifying dependency, risk drinking, alcohol use disorder, any disorder, or risk drinking. Via Publisher
MacAskill, S., Parkes, T., Brooks, O., (...), McAuley, A., Brown, A.
Assessment of alcohol problems using AUDIT in a prison setting: More than an 'aye or no' question. BMC Public Health, 2011, 11:865
2011 English Background: Alcohol problems are a major UK and international public health issue. The prevalence of alcohol problems is markedly higher among prisoners than the general population. However, studies suggest alcohol problems among prisoners are under-detected, under-recorded and under-treated. Identifying offenders with alcohol problems is fundamental to providing high quality healthcare. This paper reports use of the AUDITscreening tool to assess alcohol problems among prisoners. Methods. Universal screening was undertaken over ten weeks with all entrants to one male Scottish prison using the AUDIT standardised screening tool and supplementary contextual questions. The questionnaire was administered by trained prison officers during routine admission procedures. Overall 259 anonymised completed questionnaires were analysed. Conclusions: To our knowledge, this is the first study to identify differing behaviours and needs among prisoners with high AUDIT score ranges, through additional analysis of individual questions. The study has identified high prevalence of alcohol use, varied problem behaviours, and links across drinking, crime and recidivism, supporting the argument for more extensive provision of alcohol-focused interventions in prisons. These should be carefully targeted based on initial screening and assessment, responsive, and include care pathways linking prisoners to community services. Finally, findings confirm the value and feasibility of routine use of the AUDIT screening tool in prison settings, to considerably enhance practice in the detection and understanding of alcohol problems, improving on current more limited questioning (e.g. 'yes or no' questions). Open Access
Madson, M.B., Schutts, J.W., Jordan, H.R., (...), Whitley, R.B., Mohn, R.S.
Identifying At-Risk College Student Drinkers With the AUDIT-US: A Receiver Operating Characteristic Curve Analysis. Assessment, August 2018 (online).
2018 English The Alcohol Use Disorders Identification Test (AUDIT) is the gold standard screening measure. Recently, there has been increasing call to update the measure to reflect harmful drinking standards in the United States. The purpose of this study was to use receiver operating characteristic curve analysis to evaluate the AUDIT and the United States version (AUDIT-US). Participants were 382 traditional age (M = 20.2, SD = 1.5) college students (68.7% female, 64.9% White) who had consumed alcohol at least once in the 30 days prior to participating. Although results provide evidence for the AUDIT and the AUDIT-US as valid screening tools, the Consumption subscale of the AUDIT-US performed the best in predicting at-risk college drinkers. The Consumption subscale of the AUDIT-US with a single cutoff score of four appears to be the optimal and most parsimonious method of identifying at-risk college drinkers. Via Publisher
Maggia, B., Martin, S., Crouzet, C., (...), Balmès, J.-L., Nalpas, B.
Variation in AUDIT (Alcohol Use Disorder Identification Test) scores within the first weeks of imprisonment. Alcohol and Alcoholism, Volume 39, Issue 3, May 2004, Pages 247-250
2004 English Aims: Although the prevalence of alcohol problems amongst detainees is suspected to be high, often only more flagrant problems are detected, restricting the possibilities for intervention in alcohol misuse and reducing opportunities for preventive efforts. This study examined the re-test reliability of AUDIT (the Alcohol Use Disorder Identification Test) in screening prisoners. Methods: AUDIT was administered for the first time on the day of entry to prison and again about 15 days later. The results were analysed according to two AUDIT thresholds: a score of 8 or higher and 12 or higher. Results: Of 75 consecutive entrants tested, 47 male prisoners completed the study. At the first administration, 19.1% of these 47 men met criteria for a probable alcohol problem but this percentage rose to 59.6% on the second occasion (P = 0.0001). The proportion of subjects with a score 12 or higher (probably dependent) was 10.6% the first time versus 42.6% the second time (P = 0.0001). In the 19 who scored positive at the second administration only, changes in answers to the 10 items were coherent with a total score growing from 3.0 to 18.1 (P = 0.0001). No prisoner had a lower AUDIT score on the second administration. As alcohol problems are not routinely considered during the medical and biological examination at entry, no confirmation of the AUDIT results could be obtained, although those obtained at the second administration fitted well with the prevalence rates in previous reports. Conclusions: AUDIT, for the purpose of giving a prevalence estimate or to enter appropriate prisoners into more detailed assessment or interventions, should not be conducted immediately at entry, but some weeks later. Open Access
Magnusson, Å., Göransson, M., Heilig, M.
Unexpectedly high prevalence of alcohol use among pregnant Swedish women: Failed detection by antenatal care and simple tools that improve detection. Journal of Studies on Alcohol, Volume 66, Issue 2, March 2005, Pages 157-164
2005 English Objective: We examined the use of alcohol during early pregnancy in urban Swedish women, the ability of Swedish antenatal care to identify alcohol-related risk pregnancies and the utility of some potential tools for improving its performance. Method: Women attending regular antenatal care were randomized to regular assessment only (control, n = 156) or intensified screening (intervention, n = 147). In the intervention group, alcohol use was determined using the Timeline Followback (TLFB) interview, alcohol use habits with the Alcohol Use Disorders Identification Test (AUDIT), and biomarkers for alcohol use were analyzed. Data were typically obtained in pregnancy week 12. Results: In the intervention group as a whole, average absolute alcohol consumption during the first 6 weeks of pregnancy was low but highly variable (mean [SD] = 24.9 [50.5] g/week; 4.8 [6.0] episodes for the entire 6 week period); 22 women (15%) drank at levels exceeding 70 g/week during any 2 or more weeks and/or in a heavy episodic drinking pattern, 60 g/episode, on 2 or more episodes. The AUDIT had a moderate sensitivity (54%) to identify these subjects. Biomarkers identified subjects with somatic illness rather than high alcohol consumption. In the control group, only 4 (3%) were identified as using alcohol, indicating a probable underestimation of alcohol use by regular antenatal screening procedures (p = .0001). Conclusions: An unexpected proportion of pregnant women in urban Sweden consume alcohol at levels likely to produce adverse effects. Regular antenatal care did not identify most of these risk pregnancies. The TLFB identified pregnant women with risk use of alcohol during pregnancy who were only partly identified by analyzing prepregnancy alcohol use patterns with the AUDIT. Elevated laboratory markers likely indicated somatic illness rather than harmful drinking. Via Publisher
Maisto, S.A., Conigliaro, J., McNeil, M., Kraemer, K., Kelley, M.E.
An empirical investigation of the factor structure of the AUDIT. Psychological Assessment, Volume 12, Issue 3, 2000, Pages 346-353
2000 English This study investigated the Alcohol Use Disorders Identification Test's (AUDIT) factor structure and psychometric properties. The factor structure was derived from a sample of 7,035 men and women primary care patients. A principal components analysis identified 2 factors in the AUDIT data and was supported in a confirmatory factor analysis (CFA). The 2 factors were Dependence/Consequences and Alcohol Consumption. The CFA also provided support for a 3-factor model whose factors (Alcohol Consumption, Alcohol Dependence, and Related Consequences) matched those proposed by the AUDIT'S developers. Psychometric indexes were determined by use of the baseline and 12-month follow-up data of 301 men and women who entered a clinical trial. The results showed that the 2 factors had good reliability. Validity tests supported the interpretation of what the 2 factors measure, its implications for relationships to other variables, and the comparability of the 2- and 3-factor models.  Via Publisher
Mann, R.E., Smart, R.G., Stoduto, G., Adlaf, E.M., Ialomiteanu, A.
Alcohol Consumption and Problems among Road Rage Victims and Perpetrators. Journal of Studies on Alcohol, Volume 65, Issue 2, March 2004, Pages 161-168
2004 English Objective: Road rage has generated public concern; however, data on the causes of this behavior have not been available. We examine the alcohol consumption correlates of road rage victimization and perpetration based on a population survey of adults. Method: Data are based on the 2001-2002 Centre for Addiction and Mental Health Monitor, a repeated cross-sectional telephone survey of Ontario adults aged 18 and older (N = 2,610). Logistic regression analyses were performed with drinking measures (Alcohol Use Disorders Identification Test [AUDIT] consumption, dependence and problems) and demographic factors as independent variables. Results: In the past year, 44.4% of respondents reported that someone shouted, cursed or made rude gestures at them, 6.0% were threatened with damage to their vehicle or personal injury, and 5.2% had someone attempt to or actually damage their vehicle or hurt them. Over the same period, 32% admitted shouting, etc., at someone, 1.7% threatened someone, and 1.0% attempted to or actually did damage someone's vehicle or hurt someone. Univariate analyses revealed several significant relationships between road rage and alcohol measures. Multivariate analyses revealed that the AUDIT alcohol problems measure was most consistently associated with measures of road rage victimization and perpetration, including reporting attempting or actually hurting someone or attempting or actually damaging his or her vehicle. Conclusions: These data indicate there is a significant relationship between alcohol problems, as measured by the AUDIT, and road victimization and perpetration. Further work must be undertaken to identify the mechanisms involved. Via Publisher
Martins, R.A., Manzatto, A.J., Da Cruz, L.N., Poiate, S.M.G., Scarin, A.C.C.F.
The use of Alcohol Use Disorders Identification Test (AUDIT) to identify alcohol use among high school students | [Utilização do alcohol use disorders identification test (Audit) para identificação do consumo de álcool entre estudantes do ensino médio]. Interamerican Journal of Psychology, Volume 42, Issue 2, 2008, Pages 307-316
2008 Portuguese Alcohol is one of the drugs most widely used among teenagers. Just recently, studies have been developed regarding the screening of use of alcohol by this population. This work aimed to investigate the use of AUDIT as a method for screening and evaluation of alcohol consumption among High School students. The sample was composed by 1227 students from two public schools, who answered to the Alcohol Use Disorders Identification Test (AUDIT) and informed their socioeconomic level, religion, and occurrence of relationship problems caused by drunkenness of family members. Using an 8 cut-off point, AUDIT has identified 17.8% of students with risk drinking. These results have revealed that AUDIT is easy to be applied and well accepted by the students. It was also evident the importance of this instrument in the follow-up programs of prevention and intervention of alcoholic beverages use. Open Access
Mathew, T., Shields, A., Yanov, S., (...), Shin, S., Greenfield, S.F.
Performance of the Alcohol Use Disorders Identification Test among tuberculosis patients in Russia. Substance Use and Misuse, Volume 45, Issue 4, 2010, Pages 598-612
2010 English The Alcohol Use Disorders Identification Test (AUDIT), a screening instrument to identify individuals at risk of alcohol use-related problems, has not been validated in a Russian primary care population. We assessed the reliability, factor structure, sensitivity, and specificity of AUDIT scores among 254 subjects initiating tuberculosis treatment from 2005 to 2007 in Tomsk City. Our findings support the use of the AUDIT as a screening instrument among Russian individuals seeking primary care. We discuss implications, limitations, and future research.  Via Publisher
McAleer, M.A., Mason, D.L., Cunningham, S., (...), Rogers, S., Kirby, B.
Alcohol misuse in patients with psoriasis: Identification and relationship to disease severity and psychological distress. British Journal of Dermatology, Volume 164, Issue 6, June 2011, Pages 1256-1261
2011 English Background: Moderate to severe psoriasis is associated with increased alcohol intake and excessive mortality from alcohol-related causes. Alcohol biomarkers provide an objective measure of alcohol consumption. Carbohydrate-deficient transferrin (CDT) is the single most sensitive and specific alcohol biomarker. Objectives: To assess alcohol consumption in a cohort of patients with moderate to severe psoriasis using standard alcohol screening questionnaires and biomarkers. We investigated whether there was an association between alcohol intake, anxiety, depression and disease severity. Methods: Consecutive patients with chronic plaque psoriasis were recruited and completed a range of anonymized assessments. Psoriasis severity, anxiety and depression, and the impact of psoriasis on quality of life were assessed. Alcohol screening questionnaires were administered. Blood specimens were taken and γ-glutamyltransferase (γGT) and CDT were measured. Results: A total of 135 patients completed the study. Using validated questionnaires, between 22% and 32% had difficulties with alcohol. Seven per cent had CDT > 1·6% indicating a heavy alcohol intake. The Alcohol Use Disorders Identification Test (AUDIT) questionnaire was superior to other validated questionnaires in detecting alcohol misuse. There were no significant associations between measures of excessive alcohol consumption and disease severity. Excessive alcohol intake as measured by the CAGE questionnaire was associated with increased depression (P = 0·001) but other measures of alcohol excess did not correlate with psychological distress. Men had significantly more difficulties with alcohol than women (P < 0·001). Conclusion: Alcohol misuse is common in patients with moderate to severe psoriasis. Screening with the AUDIT questionnaire and CDT may allow the identification of patients who are misusing alcohol and allow appropriate intervention.  Via Publisher
McCambridge, J., Thomas, B.A.
Short forms of the AUDIT in a Web-based study of young drinkers. Drug and Alcohol Review, Volume 28, Issue 1, January 2009, Pages 18-24
2009 English Introduction: The Alcohol Use Disorders Identification Test (AUDIT) is under-studied among young drinkers, as are the contributions of individual items to total AUDIT scores, and online performance of the existing briefer versions of this instrument. Design and Methods: This study examined individual items of theAUDIT,and various combinations, including the existing briefer versions, in relation to total AUDIT scores in aWeb-based study of young drinkers. A total of 167 young people aged 16-24 years old who had consumed any alcohol within the previous 7 days were recruited by both offline and online methods. Results: Considered individually, items 3, 4, 5 and 8 were predictive of the majority of the variance in total AUDIT scores in this Web-based study. Existing briefer versions of the AUDIT do not better predict total scores than possible alternative combinations of items, for which acceptable levels of sensitivity and specificity for screening have been demonstrated. Conclusions: Short forms of the AUDIT, particularly those based only on consumption questions, require further validation study in online applications with young people.  Via Publisher
McCann, B.S., Simpson, T.L., Ries, R., Roy-Byrne, P.
Reliability and validity of screening instruments for drug and alcohol abuse in adults seeking evaluation for Attention-Deficit/Hyperactivity Disorder. American Journal on Addictions, Volume 9, Issue 1, December 2000, Pages 1-9
2000 English A growing number of adults are seeking evaluation for Attention- Deficit/Hyperactivity Disorder (ADHD). Screening for substance use disorders should be included as part of any comprehensive ADHD evaluation. We describe the validity and reliability of the Drug Abuse Screening Test (DAST) and the Alcohol Use Disorders Identification Test (AUDIT) in adults seeking evaluation for ADHD. Internal reliability estimates were excellent for both instruments. Scores on the DAST and AUDIT were higher among patients with a DSM-IV diagnosis of current drug abuse or dependence or current alcohol abuse or dependence, respectively. A cutoff score of 6 or above appears to be optimal for identifying individuals who are current drug abusers. A cutoff score of 6 or above on the AUDIT is suggested for detection of current alcohol abuse in this population. Comparable rates of substance use disorders were observed in ADHD and non-ADHD patients. Both measures are valid and reliable instruments for screening for alcohol and drug abuse among adults seeking evaluation for ADHD. Via Publisher
McCloud, A., Barnaby, B., Omu, N., Drummond, C., Aboud, A.
Relationship between alcohol use disorders and suicidality in a psychiatric population: In-patient prevalence study. British Journal of Psychiatry, Volume 184, Issue MAY, May 2004, Pages 439-445
2004 English Background: Alcohol misuse is a risk factor in suicide and parasuicide. Aims: To measure the prevalence of alcohol use disorders in a cohort of psychiatric admissions using the Alcohol Use Disorders IdentificationTest (AUDIT), and the relationship between the AUDIT score and suicidality. Method: Consecutive psychiatric admissions were interviewed with a lifestyle survey that included the AUDIT, and admission case notes were reviewed. Results: Out of 200 subjects, 48.5% scored 8 or more (indicating hazardous or harmful alcohol use) and 22.5% scored 16 or more (indicating significant alcohol dependence) on the AUDIT. There were no significant gender differences. Alcohol misuse was strongly associated with suicidality. Conclusions: The AUDIT questionnaire should be incorporated into psychiatric assessments when risk of self-harm is being evaluated. Further research is warranted to examine the impact of interventions for alcohol use disorders in psychiatric settings on self-harm and suicidal ideation. Open Access
Medina-Mora, E., Carreño, S., De la Fuente, J.R.
Experience with the Alcohol Use Disorders Identification Test (AUDIT) in Mexico. Recent Developments in Alcoholism: an official publication of the American Medical Society on Alcoholism, the Research Society on Alcoholism, and the National Council on Alcoholism, Volume 14, 1998, Pages 383-396
1998 English This chapter describes the development of the Alcohol Use Disorders Identification Test (AUDIT) among various Mexican populations, the evaluations that followed the World Health Organization international research project from where this screening instrument was derived, its use in nonclinical settings, modifications introduced in its wording, the development of a short version, and validity and reliability tests. It also describes rates of hazardous, harmful, and dependent drinkers and biobehavioral consequences of abuse among various Mexican populations. Data drawn from different samples showed adequate levels of specificity and sensitivity. Findings from general population samples confirmed previous observations in general practice: That the AUDIT could capture not only regular consumption at hazardous levels, but also episodic heavy drinking. Data from an International Labor Office/World Health Organization project on model programs for alcohol prevention in the workplace showed that it was possible to derive a short version, easily used for intervention programs, that differentiated categories of drinkers at various risk levels. Rates of problem drinkers in clinical samples varied between 28 and 43% for males and 3.6 and 4.8% among females. Hazardous drinking varied between 0.7 and 15.5% among males and females in general populations and reached 44% in a sample of male workers; in clinical settings, harmful drinking ranged from 7 to 16% among males and dependence from 3 to 10%. Via Publisher
Miles, H., Winstock, A., Strang, J.
Identifying young people who drink too much: The clinical utility of the five-item Alcohol Use Disorders Identification Test (AUDIT). Drug and Alcohol Review, Volume 20, Issue 1, March 2001, Pages 9-18
2001 English The current study investigated the patterns and consequences of alcohol use among young people and their perceptions of associate health risk, and explored the clinical utility of the five‐item version of the Alcohol Use Disorders Identification Test (AUDIT) in screening young people for hazardous drinking. A cross‐sectional sample of 393 young people aged 16–19 years were accessed through two tertiary colleges in South London and self‐completed an anonymous, confidential questionnaire recording the five‐item AUDIT, patterns of alcohol consumption, hazardous consequences and perception of associate health risk. Over 90% of the sample reported drinking alcohol regularly, commonly excessive weekend use and related physical, psychological and social consequences. A significant minority (20.4% of males, 18.0% of females) reported consumption of alcohol in excess of UK recommended limits, while almost a third (34.2% of males, 30.2% of females) reported scores in the ‘hazardous’ range of the five‐item AUDIT. However, the majority had little perception of associate health risk, perceiving their use to be ‘light’ and unproblematic. Only one in 10 of those drinking at ‘hazardous’ levels recognized their alcohol use as problematic, most believing the hazardous consequences of this use were acceptable. Self‐reported patterns of alcohol consumption (except age first used) and total number of psychological and social hazardous consequences were found to significantly predict AUDIT scores using linear regression analysis. Therefore the five‐item AUDIT appears to have predictive validity, reflecting self‐reported alcohol consumption, perception of associate health risk and hazardous consequences among young people. It is concluded that it may consequently have clinical utility as a simple screening tool (suitable for use by a variety of professionals in contact with young people) for the identification of hazardous alcohol consumption among this population. Via Publisher
Moehring, A., Krause, K., Guertler, D., (...), John, U., Meyer, C.
Measurement invariance of the Alcohol Use Disorders Identification Test: Establishing its factor structure in different settings and across gender. Drug and Alcohol Dependence, Volume 189, 1 August 2018, Pages 55-61
2018 English Introduction: The Alcohol Use Disorders Identification Test (AUDIT) is an internationally well-established screening tool for the assessment of hazardous and harmful alcohol consumption. To be valid for group comparisons, the AUDIT should measure the same latent construct with the same structure across groups. This is determined by measurement invariance. So far, measurement invariance of the AUDIT has rarely been investigated. We analyzed measurement invariance across gender and samples from different settings (i.e., inpatients from general hospital, patients from general medical practices, general population). Methods: A sample of n = 28,345 participants from general hospitals, general medical practices and the general population was provided from six studies. First, we used Confirmatory Factor Analysis (CFA) to establish the factorial structure of the AUDIT by comparing a single-factor model to a two-factor model for each group. Next, Multiple Group CFA was used to investigate measurement invariance. Results: The two-factor structure was shown to be preferable for all groups. Furthermore, strict measurement invariance was established across all groups for the AUDIT. Conclusion: A two-factor structure for the AUDIT is preferred. Nevertheless, the one-factor structure also showed a good fit to the data. The findings support the AUDIT as a psychometrically valid and reliable screening instrument. Via Publisher
Moretti-Pires, R.O., Corradi-Webster, C.M.
Adaptation and validation of the Alcohol Use Disorders Identification Test (AUDIT) for a river population in the Brazilian Amazon | [Adaptação e validação do Alcohol Use Disorder Identification Test (AUDIT) para população ribeirinha do interior da Amazônia, Brasil]. Cadernos de Saude Publica, Volume 27, Issue 3, March 2011, Pages 497-509
2011 Portuguese The objective of this study was to validate the Alcohol Use Disorders Identification Test (AUDIT) for a river population in the Brazilian Amazon. The original English version of AUDIT was translated into Portuguese, using the procedure recommended by the World Health Organization. The text was then back-translated and submitted to a native English translator, who approved the translation. AUDIT was administered to 361 inhabitants for a total of three times in two weeks. Data were analyzed for test/retest reliability and internal consistency. Cronbach's alpha was 0.87 at the first interview, 0.87 at the second, and 0.86 at the third. Test/retest reliability assessed via the intra-class correlation coefficient for the total AUDIT scale was 0.93. Area under ROC was 0.805 for a cutoff of seven (sensitivity 76.4%; specificity 75%). The validated AUDIT proved to be internally consistent and stable over time, but requires further investigation of its psychometric properties. Open Access
Morojele, N.K., Kekwaletswe, C.T., Nkosi, S., Kitleli, N.B., Manda, S.O.
Reliability and factor structure of the AUDIT among male and female bar patrons in a rural area of South Africa. African Journal of Drug and Alcohol Studies, Volume 14, Issue 1, 2015, Pages 23-35
2015 English We assessed the reliability and dimensional structure of the Alcohol Use Disorders Identification Test (AUDIT) among bar patrons in a rural area of South Africa. In total, 406 bar patrons completed a questionnaire containing the AUDIT, and demographic and psychosocial measures. The participants consisted of 314 (77.3%) males and 92 (22.6%) females. Their combined mean age was 30.0 years (SD = 8.45). The data were analysed using Confirmatory Factor Analysis (CFA) and Cronbach’s alpha reliability analysis which were conducted separately for males and females. We found that Cronbach’s alpha for the AUDIT was 0.81 and 0.72 for the males and females, respectively. CFA supported a two-factor and three-factor model for the males but failed to support a one-factor, two-factor, or three-factor model for the females. The results suggest that the AUDIT is highly reliable, but that potential gender differences in its factor structure should be considered, particularly when applied in new contexts. Open Access
Nesvåg, R., Lange, E.H., Færden, A., (...), Melle, I., Agartz, I.
The use of screening instruments for detecting alcohol and other drug use disorders in first-episode psychosis. Psychiatry Research, Volume 177, Issue 1-2, May 2010, Pages 228-234
2010 English The high rate of drug abuse among patients with psychosis represents a challenge to clinicians in their treatment of the patients. Powerful screening tools to detect problematic drug use in an early phase of psychotic illness are needed. The aim of the present study was to investigate prevalence of drug use disorders and psychometric properties of the Alcohol Use Disorder Identification Test (AUDIT) and the Drug Use Disorder Identification Test (DUDIT) in 205 first-episode psychosis patients in Oslo, Norway. Internal consistency of the instruments and criterion-based validity as compared to a current DSM-IV diagnosis of abuse or dependence of alcohol or other drugs were analyzed. Fifteen percent of the men and 11% of the women had a DSM-IV diagnosis of alcohol use disorders while 33% of the men and 16% of the women had non-alcohol drug use disorders. The instruments were reliable (Cronbach's alpha above 0.90) and valid (Area under the curve above 0.83). Suitable cut-off scores (sensitivity > 0.80 and specificity > 0.70) were ten for men and eight for women on AUDIT and three for men and one for women on DUDIT. The results of this study suggest that AUDIT and DUDIT are powerful screening instruments for detecting alcohol and other drug use disorders in patients with first-episode psychosis. Via Publisher
Neumann, T., Neuner, B., Gentilello, L.M., (...), Kox, W.J., Spies, C.D.
Gender differences in the performance of a computerized version of the Alcohol Use Disorders Identification Test in subcritically injured patients who are admitted to the emergency department. Alcoholism: Clinical and Experimental Research, Volume 28, Issue 11, November 2004, Pages 1693-1701
2004 English The Alcohol Use Disorder Identification Test (AUDIT) has been recommended as a screening tool to detect patients who are appropriate candidates for brief, preventive alcohol interventions. Lower AUDIT cutoff scores have been proposed for women; however, the appropriate value remains unknown. The primary purpose of this study was to determine the optimal AUDIT cutpoint for detecting alcohol problems in subcritically injured male and female patients who are treated in the emergency department (ED). An additional purpose of the study was to determine whether computerized screening for alcohol problems is feasible in this setting. Conclusions: Different AUDIT scoring thresholds for men and women are required to achieve comparable sensitivity and specificity when using the AUDIT to screen injured patients in the ED. Computerized AUDIT administration is feasible and may help to overcome time limitations that may compromise screening in this busy clinical environment.

Via Publisher
Nevitt, J.R., Lundak, J., Galardi, G.
A profile of adolescent alcohol offenders in two rural midwestern counties. Psychological Reports, Volume 98, Issue 2, April 2006, Pages 379-384
2006 English Screening tools specifically developed for use with adolescents may be more sensitive predictors of relapse or recidivism than self-report inventories typically used to screen adults. 70 adolescents in a program for drunk drivers in two counties in southeastern Nebraska were given both the CRAFFT and the Alcohol Use Disorder Identification Test questionnaires during routine alcohol-dependency evaluations. The Michigan Alcoholism Screening Test was also given to 28 subjects selected at random. 11 boys and 6 girls did not successfully complete the program. Significant correlations obtained for AUDIT scores for both the CRAFFT (r69 = .65, p <.01) and failure to complete diversion (r69 = .23, p<.05). Subjects were grouped by age (18 and younger and over 18 years) and by sex. A 2 × 2 analysis of variance for scores on the AUDIT indicated significant main effects for both age (F1.66 = 4.86, p<.05) and sex (F1.66 = 5.96, p<.01). MAST and CRAFFT scores showed no age or sex differences. The AUDIT might be included in drug and alcohol assessments with similar samples of adolescents. Via Publisher
Noorbakhsh, S., Shams, J., Faghihimohamadi, M., (...), Hallgren, M., Kallmen, H.
Psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT) and prevalence of alcohol use among Iranian psychiatric outpatients. Substance Abuse: Treatment, Prevention, and Policy, Volume 13, Issue 1, 30 January 2018, Article number 5
2018 English Background: Iran is a developing and Islamic country where the consumption of alcoholic beverages is banned. However, psychiatric disorders and alcohol use disorders are often co-occurring. We used the Alcohol Use Disorders Identification Test (AUDIT) to estimate the prevalence of alcohol use and examined the psychometric properties of the test among psychiatric outpatients in Teheran, Iran. Methods: AUDITwas completed by 846 consecutive (sequential) patients. Descriptive statistics, internal consistency (Cronbach alpha), confirmatory and exploratory factor analyses were used to analyze the prevalence of alcohol use, reliability and construct validity. Results: 12% of men and 1% of women were hazardous alcohol consumers. Internal reliability of the Iranian version of AUDIT was excellent. Confirmatory factor analyses showed that the construct validity and the fit of previous factor structures (1, 2 and 3 factors) to data were not good and seemingly contradicted results from the explorative principal axis factoring, which showed that a 1-factor solution explained 77% of the co-variances. Conclusions: We could not reproduce the suggested factor structure of AUDIT, probably due to the skewed distribution of alcohol consumption. Only 19% of men and 3% of women scored above 0 on AUDIT. This could be explained by the fact that alcohol is illegal in Iran. In conclusion the AUDIT exhibited good internal reliability when used as a single scale. The prevalence estimates according to AUDIT were somewhat higher among psychiatric patients compared to what was reported by WHO regarding the general population. Open Access
Northrup, T.F., Malone, P.S., Follingstad, D., Stotts, A.L.
Using item response theory to improve alcohol dependence screening for African American and White male and female college students. Addictive Disorders and their Treatment, Volume 12, Issue 2, June 2013, Pages 99-109
2013 English Background: Alcohol-dependent college students rarely seek treatment, despite the availability of efficacious interventions. Overly simplistic screening procedures, failing to account for differential patterns across demographic groupings, exacerbate this when students in need of intervention are not identified. Objective: The criterion validity of the Alcohol Use Disorders Identification Test was evaluated, emphasizing sexrelated and race-related invariance. Methods: Item Response Theory was used to evaluate data (collected: 2008 to 2009) from 1500 lifetime-drinking, southeastern US college students, across sex and self-identified race (ie, White, non-Hispanic and Black/African American). Alcohol dependence criteria were used in the sensitivity/specificity analyses. Results: Item Response Theory results led to item 9's removal (for race-related noninvariance) and a cut score of 4 (problems/dependence subscale) offered more balanced intergroup scoring. Discussion: Optimal college student screening may differ by sex and race. Via Publisher
O'Hare, T., Sherrer, M.V.
Validating the Alcohol Use Disorder Identification Test with college first-offenders. Journal of Substance Abuse Treatment, Volume 17, Issue 1-2, July 1999, Pages 113-119
1999 English Although the Alcohol Use Disorders Identification Test (AUDIT) has been shown to have good validity and reliability with clinical samples, little data has been examined with respect to youthful problem drinkers, particularly college students. Data collected with 312 students cited their first time for breaking university drinking rules was examined to evaluate the factorial validity and internal consistency of the 10-item scale, and also to test the validity of the AUDIT against two scales designed with a previous cohort specifically to measure hazardous (The Drinking Context Scale) and harmful drinking (the College Alcohol Problem Scale) in college students. Overall, results suggest that the AUDIT is a valid and reliable screening device for college students, and could play an important role in assessing youthful problem drinkers for early intervention programming.  Via Publisher
O'Hare, T., Sherrer, M.V., LaButti, A., Emrick, K.
Validating the Alcohol Use Disorders Identification Test with Persons Who Have a Serious Mental Illness. Research on Social Work Practice, Volume 14, Issue 1, January 2004, Pages 36-42
2004 English Objective/Method: The use of brief, reliable, valid, and practical measures of substance use is critical for conducting individual assessments and program evaluation for integrated mental health-substance abuse services for persons with serious mental illness. This investigation examines the internal consistency reliability, concurrent validity, and receiver operating characteristics of the Alcohol Use Disorders Identification Test (AUDIT) with 149 mentally ill adults in community programs. Results/Conclusions: Results suggest that the AUDIT is a reliable screening tool and shows good concurrent validity with other measures of alcohol abuse and psychosocial difficulties. In addition, receiver operating characteristics suggest that, for this population, a lower cutoff score (≥3) leads to more accurate detection of an alcohol use disorder (based on the Alcohol Use Scale) than the traditional cutoff (≥8). This article discusses implications for using screens routinely as part of assessment and evaluation with this population. Via Publisher
Olthuis, J.V., Zamboanga, B.L., Ham, L.S., Van Tyne, K.
The utility of a gender-specific definition of binge drinking on the AUDIT. Journal of American College Health, Volume 59, Issue 4, January 2011, Pages 239-245
2011 English Objective: Although binge drinking is commonly defined as the consumption of at least 5 drinks in 1 sitting for men and 4 for women, the Alcohol Use Disorders Identification Test (AUDIT) defines binge drinking as the consumption of 6 or more drinks in 1 sitting for both men and women. This study examined the effect of using gender-specific binge drinking definitions on overall AUDIT scores. Participants: Participants were 331 college men and 1224 college women. Methods: Participants completed a self-report questionnaire, which included the AUDIT. Results: Findings showed that defining binge drinking as 4 or more drinks for women, rather than 6 or more, does impact their AUDIT scores and could affect the percentage of women classified as hazardous users. Among men, AUDIT scores were unaffected by the use of a gender-specific definition of binge drinking. Conclusions: Results suggest that the AUDIT might be underidentifying hazardous users among college women.  Via Publisher
Osaki, Y., Ino, A., Matsushita, S., (...), Kondo, Y., Kinjo, A.
Reliability and validity of the Alcohol Use Disorders Identification Test - Consumption in screening for adults with alcohol use disorders and risky drinking in Japan. Asian Pacific Journal of Cancer Prevention, Volume 15, Issue 16, 2014, Pages 6571-6574
2014 English Background: Alcohol is well established as a risk factor for cancer development in many organ sites. To assess the reliability and validity of the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) for detecting alcohol use disorders or risky drinking in Japanese adults the present study was conducted. Materials and Methods: A test-retest method was applied with a 2-week interval with 113 health care employees. The k coefficient, Cronbach's coefficient alpha, Spearman's correlation coefficient, and intraclass correlation coefficient (ICC) were determined and the validity of the AUDIT-C was analyzed using the data from a nationwide survey on adult alcohol use conducted in 2008 (n=4,123). Results: The reliability of the AUDIT-C score was high (k coefficient=0.63, Cronbach's alpha=0.98, correlation coefficient=0.95, and ICC=0.95). According to the likelihood ratio and Youden index, appropriate cutoffs for the AUDIT-C were ≥5points in men and ≥4 points in women. The sensitivity and specificity of these cutoffs for identifying ≥8 points on the AUDIT were 0.88 and 0.80, respectively, for men (positive likelihood ratio [LR+]=4.5) and 0.96 and 0.87, respectively, for women (LR+=7.7). The sensitivity and specificity of the cutoffs for identifying ≥12 points on the AUDIT were 0.90 and 0.84, respectively, for men (LR+=5.8) and 0.93 and 0.94, respectively, for women (LR+=15.8). The sensitivity and specificity of the cutoffs for identifying ≥16 points on the AUDIT were 0.93 and 0.80, respectively, for men (LR+=4.7) and 0.92 and 0.98, respectively, for women (LR+=55.6). With higher scores on the AUDIT, the specificity decreased and false-positives increased. The appropriate cutoffs for identifying risky drinking were the same for both genders. Conclusions: The reliability and validity of the AUDIT-C are high, indicating that it is useful for identifying alcohol use disorders or risky drinking among the general population in Japan, a group at high risk of cancer development. Open Access
Ospina-Díaz, J.M., Abril, F.G.M., Riaño, N.E.A.
Reliability and dimensionality of the Alcohol Use Disorders Identification Test (AUDIT) in university students from Tunja (Colombia) | [Confiabilidad y dimensionalidad del cuestionario para identificación de trastornos debidos al consumo de alcohol (AUDIT) en estudiantes universitarios de tunja (Colombia)]. Salud Uninorte, Volume 28, Issue 2, May-August 2012, Pages 276-282
2012 Spanish Objective: To assess the construct validity and internal consistency of a Spanish version of the AUDIT questionnaire. Materials and methods: A Spanish version of the AUDIT test was applied to a randomized stratified sample of 459 University students, it was evaluated the factorability by Kaiser-Meyer-Olkin and of sphericity of Bartlett tests. Later, we determined the internal consistency and factorial structure, by estimating the Cronbach's alpha and factorial analysis extracting by the principal components method. Results: Cronbach's alpha was 0,769. The exploratory extracting technique revealed and unique dimensional structure of the questionnaire. Conclusions: AUDIT test is a reliable tool for detecting problems associated with alcohol use in the clinical environment; it's necessary to deepen in the structural analysis of the questionnaire. Open Access
Palma, F.S., Manríquez, G.S., Barriga, O.A.
Validity and reliability of the Alcohol Use Disorders Identification Test (AUDIT) in Chilean University students | [Validez y confiabilidad del test de Identificación de los Trastornos Debidos al Consumo de Alcohol (AUDIT) en estudiantes de una Universidad Chilena]. Ciencia y Enfermeria, Volume 19, Issue 1, 2013, Pages 23-35
2013 Spanish Objective: to analyze the reliability and validity of the Alcohol Use Disorders Identification Test in a population of students who are entering the university for their first time. Material and method: application of the instrument to 845 students, previous informed consent, selected through faculty stratified random sampling. 789 students completed it successfully, parametric tests for alcohol consumption were applied to obtain results based on cut scores and areas suggested by the World Health Organization. Cronbach's alpha was applied to determine the reliability and factor analysis for validity. Results: The reliability of the instrument was appropriate (α = 0.83), and detected two components relating to alcohol consumption and consequences. Conclusion: This test is a reliable and valid diagnosis tool in both hazardous alcohol consumption and dependency in college students. Open Access
Pascal Gache, Philippe Michaud, Ulrika Landry, Cataldo Accietto, Sonia Arfaoui, Olivier Wenger, and Jean-Bernard Daeppen.
The Alcohol Use Disorders Identification Test (AUDIT) as a Screening Tool for Excessive Drinking in Primary Care: Reliabiility and Validity of a French Version. ALCOHOLISM: CLINICAL AND EXPERIMENTAL RESEARCH Vol. 29, No. 11, November 2005; pp 2001–2007
2005 English Objectives: The aim of the study is to validate a French version of the Alcohol Use Disorders Identifi- cation Test (AUDIT). Conclusions: The AUDIT questionnaire remains a good screening instrument for French-speaking primary care. Via Publisher
Paton-Simpson, G., McCormick, I.R., Powell, A., Adams, P., Bunbury, D.
Problem drinking profiles of patients presenting to general practitioners: Analysis of Alcohol Use Disorders Identification Test (AUDIT) scores for the Auckland area. New Zealand Medical Journal, Volume 113, Issue 1105, 10 March 2000, Pages 74-77
2000 English Aim. To quantify the prevalence and demography of at-risk and problematic drinkers in the population attending a random selection of general practices and to compare this with similar studies. Method. A study examining the uptake and utilisation of the "DRINKLESS" package to 369 New Zealand general practitioners was conducted during 1995/6. The "DRINKLESS" package was developed with the World Health Organisation, collaborative study for brief intervention for at-risk alcohol consumption. The package uses the Alcohol Use Disorders identification Test (AUDIT). There were 15 670 completed AUDIT questionnaires collected during the study. These were analysed to ascertain the prevalence and demography of at-risk and problematic drinkers attending general practitioners. Results. There were 16% of patients identified as having either "risky drinking" or "problematic or dependent drinking". This pattern varied according to the occupation, age and gender of patients. Conclusions. The data confirm that large numbers of patients presenting to general practitioners experience alcohol problems of varying degrees. This study also suggests that the AUDIT will have satisfactory detection rates in a primary care setting. Open Access
Patricia K. Kokotailo Judith Egan Ronald Gangnon David Brown Marlon Mundt Michael Fleming.
Validity of the Alcohol Use Disorders Identification Test in college students. Alcoholism: Clinical and Experimental Research Volume 28, Issue 6, June 2004, Pages 914-920
2004 English High‐risk alcohol use among college students is associated with accidents, partner violence, unwanted sexual encounters, tobacco use, and performance issues. The identification and treatment of high‐risk drinking students is a priority for many college campuses and college health centers. The goal of this study was to test the psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT) in college students. Conclusions: The AUDIT has reasonable psychometric properties in sample of college students using student health services. This study supports the use of the AUDIT in this population. Via Publisher
Patton, R., Boniface, S.
Prevalence of hazardous drinking among UK 18-35 Year Olds; The Impact Of A Revision To The AUDIT cut score. Alcohol and Alcoholism, Volume 51, Issue 3, 1 May 2016, Pages 281-282
2016 English Aim: Most published research utilizes an AUDIT score of >8 as the threshold for hazardous drinking. Recent research suggests that this limit should be amended for younger drinkers (aged 18-35 years). This study aimed to explore the effect of a revision to AUDIT cut scores. Method: Applying Foxcroft et al.'s [(2015) Accuracy of Alcohol Use Disorders Identification Test for detecting problem drinking in 18-35 year-olds in England: method comparison study. Alcohol Alcohol 50, 244-50] suggested cut off scores of nine for males and four for females to the most recent Adult Psychiatric Morbidity Survey (2007) data. Results: This more than doubles the prevalence of female hazardous drinkers, and significantly increases the overall rate for that age group when compared with the standard threshold of >8. Conclusion: The prevalence of hazardous drinking among females ages 18-30 may be significantly higher than current estimates. Open Access
Pecoraro, A., Ewen, E., Horton, T., (...), McGraw, P., Woody, G.
Using the AUDIT-PC to predict alcohol withdrawal in hospitalized patients. Journal of General Internal Medicine, Volume 29, Issue 1, Jan 2014, Pages 34-40
2014 English Alcohol withdrawal syndrome (AWS) occurs when alcohol-dependent individuals abruptly reduce or stop drinking. Hospitalized alcohol-dependent patients are at risk. Hospitals need a validated screening tool to assess withdrawal risk, but no validated tools are currently available. To examine the admission Alcohol Use Disorders Identification Test-(Piccinelli) Consumption (AUDIT-PC) ability to predict the subsequent development of AWS among hospitalized medical-surgical patients admitted to a non-intensive care setting. Retrospective case-control study of patients discharged from the hospital with a diagnosis of AWS. All patients with AWS were classified as presenting with AWS or developing AWS later during admission. Patients admitted to an intensive care setting and those missing AUDIT-PC scores were excluded from analysis. A hierarchical (by hospital unit) logistic regression was performed and receiver-operating characteristics were examined on those developing AWS after admission and randomly selected controls. Because those diagnosing AWS were not blinded to the AUDIT-PC scores, a sensitivity analysis was performed. The study cohort included all patients age ≥18 years admitted to any medical or surgical units in a single health care system from 6 October 2009 to 7 October 2010. After exclusions, 414 patients were identified with AWS. The 223 (53.9 %) who developed AWS after admission were compared to 466 randomly selected controls without AWS. An AUDIT-PC score ≥4 at admission provides 91.0 % sensitivity and 89.7 % specificity (AUC=0.95; 95 % CI, 0.94-0.97) for AWS, and maximizes the correct classification while resulting in 17 false positives for every true positive identified. Performance remained excellent on sensitivity analysis (AUC=0.92; 95 % CI, 0.90-0.93). Increasing AUDIT-PC scores were associated with an increased risk of AWS (OR=1.68, 95 % CI 1.55-1.82, p<0.001). The admission AUDIT-PC score is an excellent discriminator of AWS and could be an important component of future clinical prediction rules. Calibration and further validation on a large prospective cohort is indicated. Via Publisher
Peng, C.-Z., Wilsnack, R.W., Kristjanson, A.F., Benson, P., Wilsnack, S.C.
Gender differences in the factor structure of the Alcohol Use Disorders Identification Test in multinational general population surveys. Drug and Alcohol Dependence, Volume 124, Issue 1-2, 1 July 2012, Pages 50-56
2012 English Background: Most gender-specific studies of the Alcohol Use Disorders Identification Test (AUDIT) have focused on gender differences in thresholds for hazardous drinking. This study examines gender differences in the factor structure of the AUDIT in general-population surveys. Results: CFA revealed that the fit indices of 2-factor or 3-factor models were consistently better than fit indices for a 1-factor model in 14 of 15 countries. Comparisons of BIC values indicated that the 2-factor solution was the best fitted model. Factorial invariance tests in data from 3 countries indicated that the factor loadings and thresholds of the AUDIT were invariant across gender. The internal reliability and concurrent validity of AUDIT and its subscales were acceptable in both genders. Conclusions: A two-factor model best describes AUDIT responses across general-population surveys in 12 of 15 countries, with acceptable internal reliability and concurrent validity, and supports a gender-invariant structure in at least three of those countries.  Via Publisher
Pérula De Torres, L.A., Fernández-García, J.A., Arias-Vega, R., (...), Márquez-Rebollo, E., Ruiz-Moral, R.
Validation of the AUDIT test for identifying risk consumption and alcohol use disorders in women | [Validación del cuestionario AUDIT para la identificación del consumo de riesgo y de los trastornos por el uso de alcohol en mujeres]. Atencion Primaria Volume 36, Issue 9, 30 November 2005, Article number 100.705, Pages 499-506
2005 Spanish Objective. To validate the AUDIT test for identifying women with excess alcohol consumption and/or dependency syndrome (DS). Design. Descriptive study to validate a test. Setting. Two primary care centres and a county drug-dependency centre. Participants. 414 women from 18 to 75 recruited at the clinic. Interventions. Social and personal details were obtained through personal interview, their alcohol consumption was quantified and the AUDITand MALT questionnaires were filled in. Then the semi-structured SCAN interview was conducted (gold standard; DSM-IV and CIE-10 criteria), and analyses were requested (GGT, GOT, GPT, VCM). 186 patients were given a follow-up appointment three-four weeks later (retest). Main measurements. Intra-observer reliability was evaluated with the Kappa index, internal consistency with Cronbach's alpha, and the validity of criteria with indexes of sensitivity and specificity, predictive values and probability quotients. To evaluate the diagnostic performance of the test and the most effective cut-off point, a ROC analysis was run. Results. 11.4% (95% CI, 8.98-13.81) were diagnosed with alcohol abuse (0.5%) or DS (10.9%). The Kappa coefficients of the AUDIT items ranged between 0.685 and 0.795 (P<.001). Internal reliability, with Cronbach's alpha, was 0.932 (95% CI, 0.921-0.941). Test sensitivity was 89.6% (95% CI, 76.11-96.02) and specificity was 95.07% (95% CI, 92.18-96.97). The most effective cut-off point was at 6 points. Conclusions. The AUDIT is a questionnaire with good psycho-measurement properties. It is reliable and valid for the detection of risk consumption and DS in women. Open Access
Pérula-De Torres, L.Á., Fernández-García, J.Á., Arias-Vega, R., (...), Márquez-Rebollo, E., Ruiz-Moral, R.
Validity of AUDIT test for detection of disorders related with alcohol consumption in women | [Validez del cuestionario AUDIT para la detección de problemas relacionados con el consumo de alcohol en mujeres]. Medicina Clinica, Volume 125, Issue 19, 26 November 2005, Article number 100.085, Pages 727-730
2005 Spanish BACKGROUND AND OBJECTIVE: Early detection of patients with alcohol problems is important in clinical practice. The AUDIT (Alcohol Use Disorders Identification Test) questionnaire is a valid tool for this aim, especially in the male population. The objective of this study was to validate how useful is this questionnaire in females patients and to assess their test cutt-off point for the diagnosis of alcohol problems in women. PATIENTS AND METHOD: 414 woman were recruited in 2 health center and specialized center for addiction treatment. The AUDIT test and a semistructrured interview (SCAN as gold standard) were performed to all patients. Internal consistence and criteria validity was assessed. RESULTS: Cronbach alpha was 0.93 (95% confidence interval [CI], 0.921-0.941). When the DSM-IV was taken as reference the most useful cutt-off point was 6 points, with 89.6% (95% CI, 76.11-96.02) sensitivity and 95.07% (95% CI, 92.18-96.97) specificity. When CIE-10 was taken as reference the sensitivity was 89.58% (95% CI, 76.56-96.10) and the specificity was 95.33% (95% CI, 92.48-97.17). CONCLUSIONS: AUDIT is a questionnaire with good psychometrics properties and is valid for detecting dependence and risk alcohol consumption in women. Via Publisher
Reoux, J.P., Malte, C.A., Kivlahan, D.R., Saxon, A.J.
The Alcohol Use Disorders Identification Test (AUDIT) predicts alcohol withdrawal symptoms during inpatient detoxification. Journal of Addictive Diseases, Volume 21, Issue 4, 2002, Pages 81-91
2002 English We evaluated whether the Alcohol Use Disorders Identification Test (AUDIT) predicted clinically meaningful alcohol withdrawal syndrome (AWS) in 118 alcohol dependent patients without a history of seizures. Patients were monitored by serial administration of the revised Clinical Institute Withdrawal Assessment Scale for Alcohol (CIWA-Ar) during inpatient detoxification. Patients (N = 55) who reached threshold level of AWS for receiving medication (CIWA-Ar > 9) scored significantly higher (p < .001) on the AUDIT total score, the dependence sub-scale, and the single item on morning drinking. Sensitivity, specificity, positive and negative predictive power, and screening efficiency showed the value of the AUDIT for identifying patients who developed AWS. The AUDIT should be explored alone and in combination with other parameters to improve screening for clinically meaningful AWS in other settings. Via Publisher
Rial Boubeta, A., Golpe Ferreiro, S., Araujo Gallego, M., Braña Tobío, T., Varela Mallou, J.
Validation of the Alcohol Use Disorders Identification Test (AUDIT) among Spanish adolescent population | [Validación del “Test de identificación de trastornos por consumo de alcohol” (audit) en población adolescente española]. Behavioral Psychology/Psicologia Conductual, Volume 25, Issue 2, 2017, Pages 371-386
2017 Spanish One of the instruments for the screening of problematic alcohol consumption with more empirical evidence is the Alcohol Use Disorders Identification Test (AUDIT). However there is no study in Spain that reports its psychometric properties among adolescents. This has been the aim of this paper. A correlational method was used by administering an individual interview to a sample of 569 adolescents aged between 12 and 18 years (M= 14.71, SD= 1.79). A subscale for the diagnosis of alcohol use disorder of the Adolescent Diagnostic Interview (ADI) was included as well as the subscale of Substance use and abuse of the Problem Oriented Screening Instrument for Teenagers (POSIT) and the CRAFFT Substance Abuse Screening Test. The AUDIT presents an adequate psychometric behavior when it is applied to adolescents, both in terms of internal consistency (Α=.82), as well as sensitivity (86.4%) and specificity (89.8%), using "4" as cut-off point. Factorial analysis has confirmed two factors as the most satisfactory solution. Henceforth, the AUDIT may be used in Spain with adolescents with psychometric guarantees. Via Publisher
Rist, F., Glöckner-Rist, A., Demmel, R.
The Alcohol Use Disorders Identification Test revisited: Establishing its structure using nonlinear factor analysis and identifying subgroups of respondents using latent class factor analysis. Drug and Alcohol Dependence Volume 100, Issue 1-2, 1 February 2009, Pages 71-82
2009 English Background: Previous research used principal components as well as exploratory and confirmatory factor analysis to establish continuous dimensions underlying answers to the 10-items of the Alcohol Use Disorders Identification Test (AUDIT). The majority of these studies conclude that one consumption dimension and an adverse consequences dimension explain the answers to the AUDIT sufficiently. However, most of the methods used presuppose normal answer distributions and linear relations between indicators and constructs, which are unrealistic assumptions for AUDIT answer. Objectives: First, to investigate the continuous factor analytic structure underlying the answers to all AUDIT items. Second and third, to assess the impact of consumption as well as age and gender on AUDIT consequences dimension. Fourth and fifth, to categorize respondents into subgroups based on the AUDIT consequences items and adjusting the subgroups for differences in consumption, age and gender. Sixth, to describe the subgroups with respect to further adverse consequences of drinking. Conclusions: The AUDIT items cover three separable domains, i.e. consumption, harmful and dependent use, as originally intended. Hence, assessment of alcohol use does not substitute for assessing adverse consequences, as assumed in short versions of the AUDIT comprising only the AUDIT consumption items. Further, the dimensional as well as the LCFA subgroup solution imply that the respondents cannot be ordered along a single severity dimension without loss of information. Via Publisher
Roberts, A.M., Marshall, E.J., Macdonald, A.J.D.
Which screening test for alcohol consumption is best associated with 'at risk' drinking in older primary care attenders? Primary Care Mental Health, Volume 3, Issue 2, 2005, Pages 131-138
2005 English Aims: To measure the criterion validity of the AUDIT (Alcohol Use Disorders Screening Test) and SMAST-G (Short Michigan Alcoholism Screening Test-Geriatric Version) in older people in primary care against Royal College of Psychiatrists' criteria for 'at risk' drinking, and to compare older 'at risk' drinkers in primary care with normal drinkers. Method: Surgery attendees in primary care in South East London aged over 65 years completed a questionnaire including the AUDIT and SMAST-G, and questions about alcohol consumption. Age, sex, marital status and ethnicity were recorded. Receiver operating characteristic (ROC) analysis was carried out on the AUDIT and SMAST-G questionnaires against drinking in excess of Royal College guidelines. Those drinking above and below Royal College guidelines were compared. Results: A total of 500 participants completed questionnaires; 33 (6.6%) admitted drinking above Royal College guidelines: 23 (4.6%) were AUDIT positive and 52 (10.4%) SMAST-G positive. 'At risk' drinking was associated with being male, younger and not being widowed. The area under the curves was 0.96 for the AUDIT and 0.83 for the SMAST-G, indicating significantly better criterion validity for the former. Best cut-off points for men (5/6) and women (3/4) were lower than for younger people. Conclusions: The AUDIT performed significantly better than the SMAST-G against UK Royal College of Psychiatrists' guidelines on safe levels of alcohol consumption in this sample of 500 primary care attendees aged over 65 years. Although the AUDIT was not designed specifically as a screening questionnaire for 'at risk' drinking in older people, our study suggests that it performs well in older adult populations using different cut-off points for men and women Open Access
Rubin, A., Migneault, J.P., Marks, L., (...), Ludena, K., Friedman, R.H.
Automated telephone screening for problem drinking. Journal of Studies on Alcohol and Drugs. Volume 67, Issue 3, May 2006, Pages 454-457
2006 English Objective: This study assessed test-retest reliability and criterion validity for an automated version of the Alcohol Use Disorders Identification Test (AUDIT), a screening tool for alcohol-related problems. Participants' willingness to use such a system to learn about and change their drinking behavior was also assessed. Results: Test-retest reliability was assessed in 102 participants; the intraclass correlation of AUDIT scores between both administrations was .87; κ for nonproblem versus problem drinking (AUDIT score of 8 or above) was .89. The validity study compared the TLC-AUDIT scores of the next 100 participants to AUDIT questions administered by a human interviewer. The intraclass correlation was .94; κ was .75. Seventy-five percent of all participants who screened positive for problem drinking agreed they would "talk to a computer again to learn more about your drinking pattern and how to deal with it." Conclusions: Automated telephone technology can be used to administer the AUDIT instrument with high levels of reliability and validity. This technology could be used to deliver behavioral change interventions. Via Publisher
Rubinsky, A.D., Dawson, D.A., Williams, E.C., Kivlahan, D.R., Bradley, K.A.
AUDIT-C scores as a scaled marker of mean daily drinking, alcohol use disorder severity, and probability of alcohol dependence in a U.S. general population sample of drinkers. Alcoholism: Clinical and Experimental Research, Volume 37, Issue 8, August 2013, Pages 1380-1390
2013 English Background: Brief alcohol screening questionnaires are increasingly used to identify alcohol misuse in routine care, but clinicians also need to assess the level of consumption and the severity of misuse so that appropriate intervention can be offered. Information provided by a patient's alcohol screening score might provide a practical tool for assessing the level of consumption and severity of misuse. Methods: This post hoc analysis of data from the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) included 26,546 U.S. adults who reported drinking in the past year and answered additional questions about their consumption, including Alcohol Use Disorders Identification Test-Consumption questionnaire (AUDIT-C) alcohol screening. Linear or logistic regression models and postestimation methods were used to estimate mean daily drinking, the number of endorsed alcohol use disorder (AUD) criteria ("AUD severity"), and the probability of alcohol dependence associated with each individual AUDIT-C score (1 to 12), after testing for effect modification by gender and age. Results: Among eligible past-year drinkers, mean daily drinking, AUD severity, and the probability of alcohol dependence increased exponentially across increasing AUDIT-C scores. Mean daily drinking ranged from < 0.1 to 18.0 drinks/d, AUD severity ranged from < 0.1 to 5.1 endorsed AUD criteria, and probability of alcohol dependence ranged from < 1 to 65% across scores 1 to 12. AUD severity increased more steeply across AUDIT-C scores among women than men. Both AUD severity and mean daily drinking increased more steeply across AUDIT-C scores among younger versus older age groups. Conclusions: Results of this study could be used to estimate patient-specific consumption and severity based on age, gender, and alcohol screening score. This information could be integrated into electronic decision support systems to help providers estimate and provide feedback about patient-specific risks and identify those patients most likely to benefit from further diagnostic assessment.  Via Publisher
Rubinsky, A.D., Sun, H., Blough, D.K., (...), Kivlahan, D.R., Bradley, K.A.
AUDIT-C alcohol screening results and postoperative inpatient health care use. Journal of the American College of Surgeons, Volume 214, Issue 3, March 2012, Pages 296-305.e1
2012 English Background: Alcohol screening scores ≥5 on the Alcohol Use Disorders Identification TestConsumption (AUDIT-C) up to a year before surgery have been associated with postoperative complications, but the association with postoperative health care use is unknown. This study evaluated whether AUDIT-C scores in the year before surgery were associated with postoperative hospital length of stay, total ICU days, return to the operating room, and hospital readmission. Study Design: This cohort study included male Veterans Affairs patients who completed the AUDIT-C on mailed surveys (October 2003 through September 2006) and were hospitalized for nonemergent noncardiac major operations in the following year. Postoperative health care use was evaluated across 4 AUDIT-C risk groups (scores 0, 1 to 4, 5 to 8, and 9 to 12) using linear or logistic regression models adjusted for sociodemographics, smoking status, surgical category, relative value unit, and time from AUDIT-C to surgery. Patients with AUDIT-C scores indicating low-risk drinking (scores 1 to 4) were the referent group. Results: Adjusted analyses revealed that among eligible surgical patients (n = 5,171), those with the highest AUDIT-C scores (ie, 9 to 12) had longer postoperative hospital length of stay (5.8 [95% CI, 5.0-6.7] vs 5.0 [95% CI, 4.7-5.3] days), more ICU days (4.5 [95% CI, 3.2-5.8] vs 2.8 [95% CI, 2.6-3.1] days), and increased probability of return to the operating room (10% [95% CI, 6-13%] vs 5% [95% CI, 4-6%]) in the 30 days after surgery, but not increased hospital readmission within 30 days postdischarge, relative to the low-risk group. Conclusions: AUDIT-C screening results could be used to identify patients at risk for increased postoperative health care use who might benefit from preoperative alcohol interventions.  Open Access
Rubio Valladolid, G., Bermejo Vicedo, J., Caballero Sánchez-Serrano, M.C., Santo-Domingo Carrasco, J.
Validation of the Alcohol Use Disorders Identification Test (AUDIT) in Primary Care. [Validación de la prueba para la identificación de trastornos por uso de alcohol (AUDIT) en Atención Primaria] Revista Clinica Espanola, Volume 198, Issue 1, January 1998, Pages 11-14
1998 Spanish The results of the validation for the AUDIT (Alcohol Use Disorders Identification Test) in Primary Care are here reported. A total of 326 patients who attended two primary care centers were interviewed. In a first interview they answered the AUDIT questions and later were classified on the basis of disturbances caused by alcohol use: abuse or dependency. The diagnosis of abuse or dependency was obtained with the structured interview for DSM-III-R. Reliability was determined by the test-retest correlation and internal consistency by Cronbach's alpha coefficient. Efficacy was calculated by means of the area under the curve (receiver operating characteristics). A quarter of the interviewed patients were diagnosed of some disturbance caused by alcohol use. The internal reliability of the test was acceptable (Cronbach's alpha coefficient 0.86). The test-retest correlation coefficient was 0.90. All the questions acceptably correlated with the total in the scale. A cut-off point of 8 was the most efficient for the whole sample (90% sensitivity and 90% specificity). For females, the most efficient cut-off point was 6. For patients aged over 60 years, the most efficient cut-off point was 5 for both sexes. This study confirms the usefulness of AUDIT for screening alcohol-related problems in Primary Care. Via Publisher
Rumpf, H.-J., Wohlert, T., Freyer-Adam, J., Grothues, J., Bischof, G.
Screening questionnaires for problem drinking in adolescents: Performance of AUDIT, AUDIT-C, CRAFFT and POSIT. European Addiction Research, Volume 19, Issue 3, April 2013, Pages 121-127
2013 English Background/Aims: Only rather few data on the validity of screening questionnaires to detect problem drinking in adolescents exist. The aim of this study was to compare the performance of the Alcohol Use Disorders Identification Test (AUDIT), its short form AUDIT-C, the Substance Module of the Problem Oriented Screening Instrument for Teenagers (POSIT), and CRAFFT (acronym for car, relax, alone, forget, family, and friends). Methods: The questionnaires were filled in by 9th and 10th graders from two comprehensive schools. All students received an interview using the alcohol section of the Composite International Diagnostic Interview. Alcohol abuse and alcohol dependence according to DSM-IV as well as episodic heavy drinking served as criteria to validate the screening instruments. Results: All 9th and 10th graders (n = 225) of both schools participated. No significant differences were found for areas under the receiver operating characteristic curves ranging from 0.810 to 0.872. Cronbach's alpha was satisfactory (0.77-0.80) but poor for CRAFFT (0.64). Different cut-offs are discussed. Conclusions: Considering validity as well as reliability, AUDIT, AUDIT-C and POSIT performed well; however, the POSIT is quite lengthy. AUDIT-C showed good psychometric properties and has clear advantages because of its brevity Via Publisher
Ryou, Y.I., Kim, J.S., Jung, J.G., Kim, S.S., Choi, D.H.
Usefulness of alcohol-screening instruments in detecting problem drinking among elderly male drinkers. Korean Journal of Family Medicine, Volume 33, Issue 3, May 2012, Pages 126-133
2012 English Background: In Korea, few studies have been performed on screening instruments for the detection of at-risk drinking and alcohol use disorders in the elderly. This study evaluated the validity of three screening instruments in elderly male drinkers. Methods: The subjects were 242 Korean men aged ≥ 65 years. Face-to-face interviews were used to identify at-risk drinking and alcohol use disorders. At-risk drinking was defined according to the criteria for heavy or binge drinking of the National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorder was diagnosed using the criteria of the Diagnostic and Statistical Manual of Mental Disorders IV-text revision. The Alcohol Use Disorder Identification Test (AUDIT), Short Michigan Alcoholism Screening Test-geriatric version (SMAST-G), and cut down, annoyed, guilty, eye-opener (CAGE) questionnaire were used as the alcohol-screening instruments. Based on the diagnostic interview results, sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) of the instruments were compared. Results: For identification of at-risk drinking, the AUDIT AUROC demonstrated greater diagnostic power than did those of SMAST-G and CAGE (both P < 0.001). In screening for alcohol use disorders, the AUDIT AUROC was also significantly higher than those of SMAST-G and CAGE (both P < 0.001). The sensitivity and specificity of screening for at-risk drinking with an AUDIT score ≥ 7 were 77.3% and 85.1%, respectively, whereas those for the alcohol use disorders with an AUDIT score ≥ 11 were 91.3% and 90.8%, respectively. Conclusion: The results suggest that the AUDIT is the most effective tool in identifying problem drinkers among elderly male drinkers.  Open Access
Salcedo, V.V., Collazos, M.V., Icaza, M.E.M.-M., García, F.J.
Validation of the Alcohol Use Disorders Identification Test (AUDIT) in Mexican patients with schizophrenia | [Validación de la prueba de identificación de trastornos derivados del consumo de alcohol (AUDIT) en pacientes mexicanos con esquizofrenia]. Revista Panamericana de Salud Publica/Pan American Journal of Public Health, Volume 26, Issue 4, October 2009, Pages 283-289
2009 Spanish Objectives. To validate the Alcohol Use Disorders Identification Test (AUDIT) in schizophrenic patients. Methods. The Composite International Diagnostic Interview (CIDI v. 1) and the AUDIT were administered to 80 subjects with schizophrenia, of both sexes, more than 16 years of age, from the outpatient services at the National Institute of Psychiatry in Mexico City. Results. Of the 80 schizophrenic patients, 57 were men and 23 women, with a mean age of 30.5 years and 34.3 years, respectively; the age at schizophrenia onset was 22 years for men, and 26 years for women; 35 subjects (43.7%) were consumers of alcohol at the time of the study. The AUDIT scale showed high internal consistency with a Cronbach's alpha of 0.812; for this population, the cutoff point for the full AUDIT scale was 4 points or more; cutoff points for the AUDIT "rapid test" and the "psychosocial issues and probable alcohol dependence" were based on benchmarking against the CIDI (DSM-IIIR and ICD-10). Conclusions. The AUDIT validation showed it to be a useful and sensitive screening tool for identifying schizophrenic patients at risk for alcohol abuse and dependence; therefore, it is recommended for use in clinical and epidemiological studies in Latin America. Open Access
Santis, R., Garmendia, M.L., Acuña, G., Alvarado, M.E., Arteaga, O.
The Alcohol Use Disorders Identification Test (AUDIT) as a screening instrument for adolescents. Drug and Alcohol Dependence, Volume 103, Issue 3, 1 August 2009, Pages 155-158
2009 English Background: The Alcohol Use Disorders Identification Test (AUDIT) is an international screening instrument extensively employed in adult target groups. However, there is scarce information on screening with the AUDIT in adolescent populations. The purpose of this study was to determine the cut-off point for hazardous, harmful, and dependent alcohol use through the validation of the AUDIT in a Chilean adolescent sample. Results: A total of 42 female and 53 male adolescents (mean age: 15.9 [SD = 1.2]) completed the AUDIT, with a mean score of 4.3. Reliability according to Cronbach's alpha was 0.83. Test–retest correlation was also satisfactory (intra-class correlation 0.81 [95% CI 0.73–0.87]). Analysis of the receiver operating characteristic (ROC) curve yielded cut-off points for hazardous, harmful, and dependent alcohol use of 3, 5, and 7 points, respectively. Conclusions: The Chilean version of the AUDIT is a valid and reliable tool for identifying adolescents with hazardous, harmful, and dependent alcohol use. The suggested cut-off points make screening with the AUDIT more accurate for adolescent populations. Via Publisher
Satyanarayana, V.A., Vaddiparti, K., Chandra, P.S., (...), Benegal, V., Cottler, L.B.
Problem drinking among married men in India: Comparison between husband's and wife's reports. Drug and Alcohol Review, Volume 29, Issue 5, September 2010, Pages 557-562
2010 English Introduction and Aims. This study compared the husband's report and wife's report of her husband's problem drinking, among residents of an urban slum in Bangalore, India. Design and Methods. The data come from a feasibility study to prevent HIV infection among at-risk women in Bangalore. Household enumeration was carried out (n = 509) to choose 100 married men between 18 and 50 years who reported problem drinking (scores 8 and above) on the Alcohol Use Disorder Identification Test (AUDIT). Wives of these married men, considered to be at risk for HIV because of their husband's hazardous drinking, were subsequently recruited for the study (n = 100). Written informed consent was obtained; wives were asked about the drinking history of their husbands through the AUDIT-WR (Wife's Report) developed for the present study. Results. Prevalence of problem drinking in the enumerated sample (n = 509) was high (n = 186;37%). The husband's report and his wife's report of his problem drinking was concordant (r = 0.57-0.75) on eight out of 10 items, and the total AUDIT score. Discussion and Conclusions. The AUDIT-WR is a reliable and culturally relevant measure of husband's problem drinking. In India, men with problem drinking are hard to reach. Therefore, proxy report of the wife may be useful when the husband is either unavailable or uncooperative for assessment.  Via Publisher
Schmidt, A., Barry, K.L., Fleming, M.F.
Detection of problem drinkers: The Alcohol Use Disorders Identification Test (AUDIT). Southern Medical Journal. Volume 88, Issue 1, January 1995, Pages 52-59
1995 English This study was conducted to test the predictive validity of a new alcohol screening test, the Alcohol Use Disorders Identification Test (AUDIT), in a general medicine teaching clinic and to assess physician recognition and treatment of alcohol and drug disorders. The research procedures included completion of the AUDIT, a standardized diagnostic alcohol and drug assessment, an exit interview, and a chart review The random sample comprised 132 recruited subjects. The internal reliability of the AUDIT was .77. The optimal cutoff score for the AUDIT in this sample was 5, with a sensitivity of .61 and specificity of .84. The exit interviews revealed that physicians asked their patients about alcohol use and drug use with 20% (n = 26) and 17% (n = 23) of the sample, respectively. Five of the 28 patients who met DSM-IIIR criteria had a diagnosis recorded in the chart. Via Publisher
Searle, A.K., Van Hooff, M., Mcfarlane, A.C., (...), Benassi, H., Steele, N.
The validity of military screening for mental health problems: Diagnostic accuracy of the PCL, K10 and AUDIT scales in an entire military population. International Journal of Methods in Psychiatric Research, Volume 24, Issue 1, 1 March 2015, Pages 32-45
2015 English Depression, alcohol use disorders and post-traumatic stress disorder (PTSD) are serious issues among military personnel due to their impact on operational capability and individual well-being. Several military forces screen for these disorders using scales including the Kessler Psychological Distress Scale (K10), Alcohol Use Disorders Identification Test (AUDIT), and Post-traumatic Stress Disorder Checklist (PCL). However, it is unknown whether established cutoffs apply to military populations. This study is the first to test the diagnostic accuracy of these three scales in a population-based military cohort. A large sample of currently-serving Australian Defence Force (ADF) Navy, Army and Air Force personnel (n=24,481) completed the K10, AUDIT and PCL-C (civilian version). Then, a stratified sub-sample (n=1798) completed a structured diagnostic interview detecting 30-day disorder. Data were weighted to represent the ADF population (n=50,049). Receiver operating characteristic (ROC) analyses suggested all three scales had acceptable sensitivity and specificity, with areas under the curve from 0.75 to 0.93. AUDIT and K10 screening cutoffs closely paralleled established cutoffs, whereas the PCL-C screening cutoff resembled that recommended for US military personnel. These self-report scales represent a cost-effective and clinically-useful means of screening personnel for disorder. Military populations may need lower cutoffs than civilians to screen for PTSD. Via Publisher
Selin, K.H.
Test-retest reliability of the Alcohol Use Disorder Identification Test in a general population sample. Alcoholism: Clinical and Experimental Research, Volume 27, Issue 9, 1 September 2003, Pages 1428-1435
2003 English A number of different screening tests are frequently used in alcohol research, but our knowledge about the reliability of many of them is quite limited. Recently, this problem has received more attention. This article examines the test‐retest reliability of one of these instruments—the Alcohol Use Disorder Identification Test (AUDIT)—in a general population sample. Conclusions: According to these results, the test‐retest reliability of AUDIT is high. The next step might be to examine to what extent the findings apply within health‐care settings, which is what the test originally was designed for. Via Publisher
Seppä, K., Mäkelä, R., Sillanaukee, P.
Effectiveness of the Alcohol Use Disorders Identification Test in Occupational Health Screenings. Alcoholism: Clinical and Experimental Research. Volume 19, Issue 4, August 1995, Pages 999-1003
1995 English This study evaluated the effectiveness of the 10‐item Alcohol Use Disorders Identification Test (AUDIT) among occupational health screenings. AUDIT was available from 32 male and 93 female employees, mainly of academic organizations; 22 alcoholic men reporting to treatment at a detoxification clinic served as a reference group. Two other structured questionnaires, the Malmö modified Michigan Alcoholism Screening Test (Mm‐MAST) and the CAGE, were compared with the AUDIT, and comparisons were also made to the self‐reported weekly alcohol consumption. The AUDIT was significantly more often accurate than the two other questionnaires, especially among female employees in detecting suspect early‐phase heavy drinkers and thus seems to be suitable for health screenings. Via Publisher
Shevlin, M., Smith, G.W.
The factor structure and concurrent validity of the Alcohol Use Disorders Identification Test based on a nationally representative UK sample. Alcohol and Alcoholism, Volume 42, Issue 6, November 2007, Pages 582-587
2007 English Aims: To assess the psychometric structure and construct validity of the Alcohol Use Disorders Identification test (AUDIT) in a Great Britain population sample. Results: A two factor solution was deemed to appropriately fit the data, measuring alcohol consumption and alcohol related problems. Correlations between the two factors on demographic, wellbeing, neurosis and psychosis symptomology were significantly different. Conclusions: The two factor solution suggests an advantage to investigating factor specific cut off scores for both consumption and alcohol related problems given their difference in predictive validity on both health and demographic variables. Open Access
Shields, A.L., Caruso, J.C.
Reliability generalization of the Alcohol Use Disorders Identification Test. Educational and Psychological Measurement, Volume 63, Issue 3, June 2003, Pages 404-413
2003 English The present study evaluated the reliability of scores from the Alcohol Use Disorders Identification Test (AUDIT) in a reliability generalization study. This reliability generalization had two primary goals: (a) to characterize the typical reliability of scores for the AUDIT, and (b) to examine factors that may be related to the reliability of AUDIT scores. The median internal consistency reliability across 24 samples was .81, with a range of .59 to .91. Results suggest that the AUDIT is capable of generating generally reliable scores across some varied sample conditions. After controlling for score variability, no sample characteristic was a statistically significantly predictor of score reliability and effects were small. Only 17 of 104 empirical journal articles contained adequate psychometric information to be included in the present study. Via Publisher
Shields, A.L., Guttmannova, K., Caruso, J.C.
An examination of the factor structure of the Alcohol Use Disorders Identification Test in two high-risk samples. Substance Use and Misuse, Volume 39, Issue 7, 2004, Pages 1161-1182
2004 English The Alcohol Use Disorders Identification Test (AUDIT) was examined by employing confirmatory factor analytic techniques to data from two samples collected 1998-1999: college students (n = 465) and court-referred, substance use treatment outpatients (clinical sample; n = 135). Despite the fact that the AUDIT was originally designed as a three-factor measure (consumption, dependence, and consequences), previous studies have lent support to one- and two-factor models. The results of this study support a two-factor model (alcohol consumption and dependence/consequences) in both samples. As further evidence that the two-factor model is appropriate, a psychometric evaluation suggested that the AUDIT generated reliable scores in both groups when used as either a one- or two-factor measure, but not when three scores are derived in the student sample. Via Publisher
Skipsey, K., Burleson, J.A., Kranzler, H.R.
Utility of the AUDIT for identification of hazardous or harmful drinking in drug-dependent patients. Drug and Alcohol Dependence, Volume 45, Issue 3, 2 May 1997, Pages 157-163
1997 English We evaluated the psychometric properties of the alcohol use disorders identification test (AUDIT), a ten-item screening test for identification of hazardous drinkers, in a sample of 82 patients with DSM-III-R drug dependence. AUDIT showed good internal consistency (α = 0.94) and a unitary factor structure. Receiver operating characteristics analysis showed the AUDIT to be comparable to the Michigan alcoholism screening test (MAST) in identifying individuals with a current alcohol use disorder and superior to the MAST for those who are hazardous drinkers. In this patient sample, AUDIT performed well at the recommended cut-off score of ≥ 8. We recommend use of the AUDIT for identification of hazardous and harmful drinking among individuals with a drug use disorder. Via Publisher
Soderstrom, C.A., Dischinger, P.C., Kerns, T.J., (...), Gorelick, D.A., Smith, G.S.
Screening trauma patients for alcoholism according to NIAAA guidelines with Alcohol Use Disorders Identification Test questions. Alcoholism: Clinical and Experimental Research, Volume 22, Issue 7, October 1998, Pages 1470-1475
1998 English Drinking pattern criteria (drinking frequency and number of drinks per occasion) issued by the National Institute on Alcohol and Abuse and Alcoholism (NIAAA) to screen primary practice patients for alcohol problems were evaluated in 1216 injured patients treated in a regional trauma center. Vehicular crash victims predominated (50.2%, of whom 64.5% were drivers), followed by victims of violence (31.2%) and nonviolent-injury victims (18.5%). Alcohol Use Disorders Identification Test (AUDIT) questions 1 (drinking frequency) and 2 (drinks/day) were used to assess the patients for current alcohol dependence (CAD). AUDIT responses roughly approximating NIAAA guidelines (high threshold: drinks ≥ 4 times/week, ≥5 drinks/day) and those indicating less drinking (low threshold: drinks ≥2-3 times/week, ≥3 drinks/day) were chosen. Comparisons were made relative to sensitivity and specificity of responses in detecting CAD. When low threshold responses were used for either question, sensitivity to detect CAD increased overall (1 from 0.53 to 0.80, 2 from 0.62 to 0.88) as well as among the subgroups of patients, whereas specificity remained high or at acceptable levels overall (1 from 0.95 to 0.82, 2 from 0.92 to 0.71) and among the subgroups of patients. Study findings suggest that, among injured drivers and other groups of trauma center patients, lesser amounts of drinking should be used as screening criteria for CAD than are used for the general population. Via Publisher
Sovinová, H., Csémy, L.
The Czech AUDIT: Internal consistency, latent structure and identification of risky alcohol consumption. Central European Journal of Public Health, Volume 18, Issue 3, September 2010, Pages 127-131
2010 English Aim: The primary aim of the study is to examine the psychometric properties and the structure of the Czech version of the Alcohol Use Disorders Identification Test (AUDIT), and to estimate the rate of risky, harmful and problematic alcohol consumers. Methods and sample: Two large data sets were analyzed. The first was based on the application of the AUDIT as a part of a general population survey (N=1.326; age range 18-64), the second represents data gathered by general practitioners (GPs) in the context of a pilot screening and brief advice (SBA) project in the area of Greater Prague (N=2.589). Results: Analyses of reliability showed satisfying internal consistency of the AUDIT (Cronbach's α=0.83 for population survey and 0.77 for survey based on SBA). Principal component analyses suggest two factor solutions where one factor represents drinking patterns and the second alcohol-related problems or symptoms of dependence. The principal component analyses of both data sets led to similar factor formation. A total of 19% of the general population sample was classified as risky or harmful drinkers and 2% as problem drinkers. These figures were slightly lower in the sample of patients of general practitioners. Conclusions: The Czech version of the AUDIT seems to be a plausible screening instrument. The properties of the instrument suggest usefulness of the summery score for identification of the level of risk. Open Access
Strauss, S.M., Rindskopf, D.M.
Screening patients in busy hospital-based HIV care centers for hazardous and harmful drinking patterns: The identification of an optimal screening tool. Journal of the International Association of Physicians in AIDS Care, Volume 8, Issue 6, November 2009, Pages 347-353
2009 English Because many HIV care providers fail to detect patients' hazardous drinking, we examined the potential use of the AUDIT-C, the first 3 of the 10 items comprising the Alcohol Use Disorders Identification Test (AUDIT), to efficiently screen patients for alcohol abuse. To perform this examination, we used Item Response Theory (IRT) involving individual AUDIT items and AUDIT instruments completed by patients (N = 400) at a Designated AIDS Center (DAC) in New York City. At various AUDIT-C cutoff scores, specificities and sensitivities were then examined using the AUDIT as a "gold standard." For cutoff scores on the AUDIT from 4 to 8, cutoff scores on the AUDIT-C of 3 and 4, respectively, resulted in sensitivities between.94-.98 and.81-.89, respectively, and specificities between.82-.91 and.91-1.0, respectively. In busy HIV care centers, the AUDIT-C with cutoff scores of 3 or 4 is a reasonable alternative to the full AUDIT as an alcohol screening instrument. Open Access
Sung, J., Lee, K., Song, Y.-M., Kim, J.-H.
Relationships between state and trait anxiety inventory and Alcohol Use Disorder Identification Test scores among Korean twins and families: The healthy twin study. Twin Research and Human Genetics, Volume 14, Issue 1, 2011, Pages 73-78
2011 English We explored heritabilities of the State and Trait Anxiety Inventory (STAI) and the Alcohol Use Disorders Identification Test (AUDIT), and associations including genetic and environmental correlations between the phenotypes among Korean twins and their families. We analyzed the data of 1,748 participants (835 men, 913 women, 656 individuals of monozygotic twins, 173 individuals of same-sexed dizygotic twins, 919 non-twin family members, age 30-79 years) from the Healthy Twin study. Heritabilities and bivariate analyses were assessed using the SOLAR package software. In the methods of generalized estimation equations, women in the 4th quartile of state and trait scores were 17% and 15%, respectively more likely to be hazardous alcohol users compared to women in the lower three quartiles (P < .05). However, there were no significant associations between these phenotypes in men. After adjusting for age and squared age, the heritability estimates were 0.26 in men and 0.34 in women for the state score; for the trait score, 0.35 in men and 0.31 in women; for the AUDIT score, 0.32 in men and 0.37 in women (P < .001). After adjusting for age and squared age, there was a significant genetic correlation between the trait score and the AUDIT score, and a significant non-genetic correlation between the state score and the AUDIT score in women, while there were no significant genetic or non-genetic correlations between these phenotypes in men. The STAI and AUDIT scores are heritable in Koreans and the relationships between these phenotypes may be inconsistent by sex. Open Access
Taylor, M., Knox, J., Chhagan, M.K., (...), Craib, M.H., Davidson, L.L.
Screening Caregivers of Children for Risky Drinking in KwaZulu-Natal, South Africa. Maternal and Child Health Journal, Volume 20, Issue 11, 1 November 2016, Pages 2392-2401
2016 English Background and Objectives: Alcohol abuse, a significant health problem in South Africa, affects the ability of adults to care for children. Little is known regarding risky alcohol use among child caregivers there. A large population-based study examined the prevalence of, and factors associated with, risky drinking among caregivers of young children in KwaZulu-Natal, South Africa comparing the use of the Alcohol Use Disorders Identification Test (AUDIT) and the AUDIT-C screens for hazardous or harmful drinking (referred to here as risky drinking). Methods: 83 % of child caregivers from five tribal areas were interviewed using the 10-question AUDIT to screen for risky drinking. The AUDIT-C screen, a subset of AUDIT questions, targets alcohol consumption and binge drinking. Factors associated with risky drinking were investigated using logistic regression. Results: 1434 caregivers participated, 98 % female. Sixteen percent reported ever drinking alcohol. Based on AUDIT criteria for risky drinking, 13 % of the sample scored as moderate drinkers, 2 % as hazardous users, and 1 % as harmful or dependent users (identifying 3 % as risky drinkers). Using AUDIT-C criteria to identify risky drinking significantly increased the proportion of caregivers identified as risky drinkers to 9 %. In multivariate analyses, factors associated with risky drinking were similar in both screens: partner violence, smoking, HIV-infection, caring for a child with disabilities. Conclusions for Practice: Since the AUDIT-C identified risky alcohol use not otherwise detected with the full AUDIT, and since resources for screening in health care settings is limited, the AUDIT-C may be a more appropriate screen in populations where binge drinking is common. Via Publisher
Thomas, E., Degenhardt, L., Alati, R., Kinner, S.
Predictive validity of the AUDIT for hazardous alcohol consumption in recently released prisoners. Drug and Alcohol Dependence, Volume 134, Issue 1, 1 January 2014, Pages 322-329
2014 English Background: This study aimed to assess the predictive validity of the Alcohol Use Disorders Identification Test (AUDIT) among adult prisoners with respect to hazardous drinking following release, and identify predictors of post-release hazardous drinking among prisoners screening positive for risk of alcohol-related harm on the AUDIT. Methods: Data came from a survey-based longitudinal study of 1325 sentenced adult prisoners in Queensland, Australia. Baseline interviews were conducted pre-release with follow-up at 3 and 6 months post-release. We calculated sensitivity, specificity and area under the receiver operating characteristic (AUROC) to quantify the predictive validity of the AUDIT administered at baseline with respect to post-release hazardous drinking. Other potential predictors of hazardous drinking were measured by self-report and their association with the outcome was examined using logistic regression. Results: At a cut-point of 8 or above, sensitivity of the AUDIT with respect to hazardous drinking at 3-month follow-up was 81.0% (95%CI: 77.9-84.6%) and specificity was 65.6% (95%CI: 60.6-70.3%). The AUROC was 0.78 (95%CI: 0.75-0.81), indicating moderate accuracy. Among those scoring 8 or above, high expectations to drink post-release (AOR: 2.49; 95%CI: 1.57-3.94) and past amphetamine-type stimulant (ATS) use (AOR: 1.64; 95%CI: 1.06-2.56) were significantly associated with hazardous drinking at 3 months post-release. Results were similar at 6 months. Conclusions: Among adult prisoners in our sample, pre-release AUDIT scores predicted hazardous drinking six months after release with acceptable accuracy, sensitivity and specificity. Among prisoners screening positive on the AUDIT, expectations of post-release drinking and ATS use are potential targets for intervention to reduce future hazardous drinking Via Publisher
Tsai, M.-C., Tsai, Y.-F., Chen, C.-Y., Liu, C.-Y.
Alcohol Use Disorders Identification Test (AUDIT): Establishment of cut-off scores in a hospitalized Chinese population. Alcoholism: Clinical and Experimental Research, Volume 29, Issue 1, January 2005, Pages 53-57
2005 English Background: Alcohol use has become a problem for Taiwanese society. Developing a brief, rapid, and flexible tool to screen an individual's alcohol consumption is important. Many countries use the Alcohol Use Disorders Identification Test (AUDIT) to screen for harmful and dangerous alcohol consumption. The psychometric characteristics of the AUDIT have not been examined in a Chinese population. Methods: Determination of the cutoff points for the AUDIT Chinese version included three stages: translating the questionnaire, expert review and formal testing on subjects. Participants (N = 112) were recruited from a medical research center of four gastroenterology wards in northern Taiwan. Conclusions: The Chinese version of the AUDIT gave the same cutoff point for harmful alcohol use by Taiwanese individuals as that set by the World Health Organization. This finding shows that this cutoff point is generally appropriate in screening for problem alcohol consumption. Moreover, the cutoff AUDIT score of 11 for alcohol dependence provides a reference for screening in Taiwanese clinics. Via Publisher
Tuliao, A.P., Landoy, B.V.N., McChargue, D.E.
Factor structure and invariance test of the Alcohol Use Disorder Identification Test (AUDIT): Comparison and further validation in a U.S. and Philippines college student sample. Journal of Ethnicity in Substance Abuse, Volume 15, Issue 2, 2 April 2016, Pages 127-143
2016 English The Alcohol Use Disorder Identification Test’s factor structure varies depending on population and culture. Because of this inconsistency, this article examined the factor structure of the test and conducted a factorial invariance test between a U.S. and a Philippines college sample. Confirmatory factor analyses indicated that a three-factor solution outperforms the one- and two-factor solution in both samples. Factorial invariance analyses further supports the confirmatory findings by showing that factor loadings were generally invariant across groups; however, item intercepts show non-invariance. Country differences between factors show that Filipino consumption factor mean scores were significantly lower than their U.S. counterparts. Via Publisher
Tuunanen, M., Aalto, M., Seppä, K.
Binge drinking and its detection among middle-aged men using AUDIT, AUDIT-C and AUDIT-3. Drug and Alcohol Review, Volume 26, Issue 3, May 2007, Pages 295-299
2007 English Binge (heavy episodic) drinking is common, but there is little knowledge on how this drinking pattern could be detected. This study compares three structured questionnaires among binge drinking middle-aged men. All 45-year-old men in the city of Tampere, Finland, were asked to fill in the Alcohol Use Disorders Identification Test (AUDIT). Based on the interview on their drinking the men were divided into non-binging moderate drinkers (n = 352), binging moderate drinkers (n = 130), non-binging heavy drinkers (n = 10) and binging heavy drinkers (n = 63). The complete AUDIT, AUDIT-C (first three AUDIT questions inquiring quantity-frequency) and AUDIT-3 (the third binging-frequency question of AUDIT) in detecting binge drinking were compared. The complete AUDIT was effective in detecting binge drinkers by a cut-off score of ≥8 or ≥7. The optimal cut-off score for AUDIT-C was ≥6 and that for AUDIT-3 ≥2. The area under the curve (AUC) among all risky drinkers (binging moderate and binging heavy and non-binging heavy drinkers) for AUDIT was 0.824 (95% CI 0.789-0.859), for AUDIT-C 0.829 (95% CI 0.795-0.864) and for AUDIT-3 0.779 (0.739-0.818). The complete AUDIT and its short versions are applicable in populations where binging is the dominant drinking pattern, but the cut-off scores should be tailored to individual cultures.  Via Publisher
Vissoci, J.R.N., Hertz, J., El-Gabri, D., (...), Mvungi, M., Staton, C.A.
Cross-cultural adaptation and psychometric properties of the AUDIT and CAGE questionnaires in Tanzanian Swahili for a traumatic brain injury population. Alcohol and Alcoholism, Volume 53, Issue 1, 1 January 2018, Pages 112-120
2018 English Aims: To develop Swahili versions of the Alcohol Use Disorders Identification Test (AUDIT) and CAGE questionnaires and evaluate their psychometric properties in a traumatic brain injury (TBI) population in Tanzania. Methods: Swahili versions of the AUDIT and CAGE were developed through translation and backtranslation by a panel of native speakers of both English and Swahili. The translated instruments were administered to a sample of Tanzanian adults from a TBI registry. The validity and reliability were analyzed using standard statistical methods. Results: The translated versions of both the AUDIT and CAGE questionnaires were found to have excellent language clarity and domain coherence. Reliability was acceptable ( > 0.85) for all tested versions. Confirmatory factor analysis of one, two and three factor solution for the AUDIT and one factor solution for the CAGE showed adequate results. AUDIT and CAGE scores were strongly correlated to each other (R > 0.80), and AUDIT scores were significantly lower in non-drinkers compared to drinkers. Conclusions: This article presents the first Swahili and Tanzanian adaptations of the AUDIT and CAGE instruments as well as the first validation of these questionnaires with TBI patients. Both instruments were found to have acceptable psychometric properties, resulting in two new useful tools for medical and social research in this setting. Open Access
Volk, R.J., Steinbauer, J.R., Cantor, S.B., Holzer III, C.E.
The Alcohol Use Disorders Identification Test (AUDIT) as a screen for at-risk drinking in primary care patients of different racial/ethnic backgrounds. Addiction, Volume 92, Issue 2, 1997, Pages 197-206
1997 English This study examined the operating characteristics a the Alcohol Use Disorders Identification Test (AUDIT) as a screen for 'at-risk' drinking in a multi-ethnic sample of primary care patients, from a family practice center located in the southwestern United States. A probability sample of 1333 family medicine patients, stratified by gender and racial/ethnic background (white, African-American and Mexican-American) completed the AUDIT, followed by the Alcohol Use Disorders and Associated Disabilities Interview Schedule (AUDADIS) to determine ICD-10 diagnoses. Indicators of hazardous alcohol use and alcohol-related problems were included as measures of 'at-risk' drinking. Despite differences in the spectrum of alcohol problems across patient subgroups, there was no evidence of gender or racial/ethnic bias in the AUDIT as indicated by Receiver Operating Characteristic Curve analysis. Excluding abstainers from the analysis had little impact on screening efficacy. In this patient population, the AUDIT appears to be an unbiased measure of 'at-risk' drinking. Via Publisher
von der Pahlen, B., Santtila, P., Witting, K., (...), Johansson, A., Sandnabba, N.K.
Factor structure of the Alcohol Use Disorders Identification Test (AUDIT) for men and women in different age groups. Journal of Studies on Alcohol and Drugs, Volume 69, Issue 4, July 2008, Pages 616-621
2008 English Objective: Our main aim was to investigate the factor structure of the Alcohol Use Disorders Identification Test (AUDIT) in a Finnish population sample. Method: The AUDIT was completed by 3,125 men (mean age = 26.2 years) and 6,006 women (mean age = 26.1 years). Results: At a cutoff score of 8 or more, 49.8% of the men and 23.9% of the women would be identified as potentially engaged in excessive alcohol use. Exploratory factor analyses suggested a two-factor solution for both men and women. However, the factor structure was not invariant between men and women or in the different age groups among men. Conclusions: This is one of the largest known general population studies on alcohol use in recent years in Finland. The findings support a two-factor solution, and it is suggested that the AUDIT cutoff scores should be tailored according to age, gender, and drinking culture. Via Publisher
Wade, D., Varker, T., O'Donnell, M., Forbes, D.
Examination of the latent factor structure of the Alcohol Use Disorders Identification Test in two independent trauma patient groups using confirmatory factor analysis. Journal of Substance Abuse Treatment, Volume 43, Issue 1, July 2012, Pages 123-128
2012 English Recent research on the factor structure of the Alcohol Use Disorders Identification Test (AUDIT) provides support for two underlying factors: consumption and consequences. The current study sought to extend these findings to two independent and diverse trauma populations: traumatic injury patients and military veterans treated for posttraumatic stress disorder. The 2- and 3-factor solutions provided the best fit to the data, but there was a very high correlation between the second and third factors of the 3-factor solution. Parsimony suggests that the 2-factor solution is the preferred model. The 2-factor model has implications for alcohol screening using the AUDIT and supports the goal of screening to identify those with hazardous drinking and alcohol use disorders. An algorithm is proposed to inform alcohol screening protocols in a range of health settings for trauma-exposed patient groups. Via Publisher
Wennberg, P., Källmén, H., Kraus, L.
The dimensional structure of the Alcohol Use Disorders Identification Test (book chapter). Advances in Psychology Research, Volume 99, July 01, 2014, Pages 143-148 (Nova Science Publishers, Inc.)
2014 English This study aimed at describing the dimensionality of the Alcohol Use Disorders Identification Test. The sample (n=3212) was an aggregate of four identical surveys conducted in the general Swedish population between 1997-2009. Unidimensionality was tested using Rasch analysis and the fit of one, two and three dimensional structures was tested with confirmatory factor analyses. Except for one item, the Rasch analys showed that all AUDIT items fit well to unidimensionality. Furthermore, the Rasch analysis indicated that the AUDIT scores could not reliably be stratified into more than 2-3 zones. The confirmatory factor analyses show that all three models (one, two or three latent factors) fit the data well. The two factor solution fits data slightly better than the other two alternatives but this difference was not statistically significant. While the AUDIT generally shows good psychometric properties, the cut-off levels and problem zones should be subject for forthcoming research and discussion. Via Publisher
Williams, E.C., Peytremann-Bridevaux, I., Fan, V.S., (...), Kivlahan, D.R., Bradley, K.A.
The association between alcohol screening scores and health status in male veterans. Journal of Addiction Medicine, Volume 4, Issue 1, March 2010, Pages 27-37
2010 English Objectives: Alcohol use is associated with self-reported health status. However, little is known about the concurrent association between alcohol screening scores and patient perception of health. We evaluated this association in a sample of primarily older male veterans. Methods: This secondary, cross-sectional analysis included male general medicine outpatients from 7 VA medical centers who returned mailed questionnaires. Screening scores from the Alcohol Use Disorders Identification Test Consumption (AUDIT-C) questionnaire were divided into 6 categories (0, 1-3, 4-5, 6-7, 8-9, and 10-12). Outcomes included scores on the 8 subscales and 2 component scores of the 36-item Short Form Health Survey (SF-36). Unadjusted and adjusted linear regression models were fit to characterize the association between AUDIT-C categories and SF-36 scores. Models were adjusted for demographic characteristics, smoking, and site-both alone and in combination with 14 selfreported comorbid conditions. Results: Male respondents (n = 24,531; mean age = 63.6 years) represented 69% of those surveyed with the SF-36. After adjustment, a quadratic (inverted U-shaped) relationship was demonstrated between AUDIT-C categories and all SF-36 scores such that patients with AUDIT-C scores 4-5 or 6-7 reported the highest health status, and patients with AUDIT-C scores 0, 8-9, and ≥10 reported the lowest health status. Conclusions: Across all measures of health status, patients with the most severe alcohol misuse had significantly poorer health status than those who screened positive for alcohol misuse at mild or moderate levels of severity. The relatively good health status reported by patients with mild-moderate alcohol misuse might interfere with clinicians' acceptance and adoption of guidelines recommending that they counsel these patients about their drinking.  Via Publisher
Wu, S.-I., Huang, H.-C., Liu, S.-I., (...), Shih, S.-C., Jeng, K.-S.
Validation and comparison of alcohol-screening instruments for identifying hazardous drinking in hospitalized patients in Taiwan. Alcohol and Alcoholism, Volume 43, Issue 5, 2008, Pages 577-582
2008 English Aim: The aim of this study was to validate the Mandarin Chinese version of different screening instruments and compare their performances for identifying hazardous drinkers in Taiwan. Methods: We compared the performance of the Mandarin Chinese versions of AUDIT, AUDIT-C (AUDIT items 1, 2 and 3), AUDIT-4 (AUDIT items 1, 2, 3 and 10), AUDIT-3 (AUDIT item 3), TWEAK, SMAST and CAGE to detect hazardous drinking in hospitalized patients in Taiwan. The results of the test instruments were blindly compared with the reference standard Schedule for Clinical Assessments in Neuropsychiatry (SCAN). Results: Of 404 patients evaluated, 100 were identified as having a hazardous drinking pattern. All screening instruments showed acceptable sensitivities (ranging from 85 to 93%) and specificities (ranging from 72 to 92%), but AUDIT and its short forms performed consistently better than the other instruments. Conclusions: The Mandarin Chinese versions of AUDIT and its derivatives perform well in screening hospitalized Taiwanese patients for hazardous drinking.  Open Access
Wurst, F.M., Kelso, E., Weinmann, W., (...), Yegles, M., Sundström Poromaa, I.
Measurement of direct ethanol metabolites suggests higher rate of alcohol use among pregnant women than found with the AUDIT-a pilot study in a population-based sample of Swedish women. American Journal of Obstetrics and Gynecology, Volume 198, Issue 4, April 2008, Pages 407.e1-407.e5
2008 English Objectives: The objective of the study was to investigate whether biomarkers of alcohol consumption would provide additional information to the use of a validated alcohol questionnaire in pregnant women. Study Design: One hundred three pregnant women were included in the study. The women completed the Alcohol Use Disorders Identification Test (AUDIT) questionnaire, and a urine and hair sample was collected.Conclusion: The combined use of the AUDIT questionnaire and direct ethanol metabolites appear to identify more potential alcohol consumers among pregnant women than does the sole use of the AUDITquestionnaire.  Via Publisher
Yee, A., Adlan, A.S.A., Rashid, R.R., Habil, H., Kamali, K.
Validation of the Alcohol Use Disorders Identification Test (AUDIT)-Bahasa Malaysia version among a group of alcohol users. Journal of Substance Use, Volume 20, Issue 4, 1 August 2015, Pages 229-233
2015 English Background: The Alcohol Use Disorder Identification Test (AUDIT) developed by the WHO is designed to identify individuals along the full spectrum of alcohol misuse. This study aimed to develop and validate a Bahasa Malaysia language version (AUDIT-M) of the AUDIT. Methods: AUDIT was translated to Bahasa and back translated to English. The first version was pilot tested. The final version was administered to all the patients who were identified as alcohol users from the outpatient psychiatric clinic, or were admitted to the psychiatric ward of the University Malaya Medical Centre. Patients completed a demographic questionnaire, English and Bahasa Malaysia versions of AUDIT, M.I.N.I., CAGE, and the Bahasa Malaysia version of the WHOQoL-Bref-M. Results: Factor analysis of AUDIT-M yielded two factors similar to the factor structure of the English version. The Cronbach α coefficients for the total AUDIT-M was 0.823; and 0.816 and 0.68 for the two AUDIT-M factors. There was a significant correlation between the AUDIT and AUDIT-M scores (Spearman's ρ=0.979, p<0.01). The test-retest reliability coefficient was also high (Spearman's ρ=0.955, p<0.01). The total AUDIT-M had a significant positive correlated with the CAGE (p<0.01) and inversely correlated with the four subscales of WHOQoL-Bref-M. Conclusion: The AUDIT-M questionnaire has acceptable psychometric properties and is suitable for the assessment and identification of AUD in Malaysia. Via Publisher
Young, C., Mayson, T.
The Alcohol Use Disorders Identification Scale (AUDIT) normative scores for a multiracial sample of Rhodes University residence students. Journal of Child and Adolescent Mental Health, Volume 22, Issue 1, 2010, Pages 15-23
2010 English Objective: The objective of this research is to obtain accurate drinking norms for students living in the university residences in preparation for future social norms interventions that would allow individual students to compare their drinking to an appropriate reference group. Method: Random cluster sampling was used to obtain data from 318 residence students who completed the Alcohol Use Disorders Identification Test (AUDIT), a brief, reliable and valid screening measure designed by the World Health Organisation (Babor et al. 2001). Results: The Cronbach alpha coefficient of 0.83 reported for this multicultural sample is high, suggesting that the AUDIT may be reliably used in this and similar contexts. Normative scores are reported in the form of percentiles. Comparisons between the portions of students drinking safely and hazardously according to race and gender indicate that while male students are drinking no more hazardously than female students, white students drink far more hazardously than black students. Conclusions: These differences suggest that both race- and gender-specific norms would be essential for an effective social norms intervention in this multicultural South African context. Finally, the racialised drinking patterns might reflect an informal segregation of social space at Rhodes University. Via Publisher
Zamboanga, B.L., Horton, N.J., Tyler, K.M.B., (...), Calvert, B.D., McCollum, E.C.
The Utility of the AUDIT in Screening for Drinking Game Involvement among Female College Students. Journal of Adolescent Health, Volume 40, Issue 4, April 2007, Pages 359-361
2007 English Drinking games (DG) facilitate heavy alcohol consumption in a short period and are associated with negative experiences. We examined the utility of Alcohol Use Disorders Identification Test (AUDIT) cut-off scores to identify DG involvement. Findings indicated an AUDIT score of at least 5 is needed to identify gamers among students at a women's college. Prevention implications are discussed. Via Publisher