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.

Beresford TP: Alcoholism assessment on an orthopaedic surgery service. J Bone Joint Surg 1982;64:730-733.
Beresford TP, Blow FC, Hill E, Lucey MR: Comparison of CAGE questionnaire and computer-assisted laboratory profiles in screening for covert alcoholism. Lancet 1990;336:482–485.
Bernadt MW, Mumford J, Taylor C, Smith B, Murray RM: Comparison of questionnaire and laboratory tests in the detection of excessive drinking and alcoholism. Lancet 1982; ii:325–329.
Aertgeerts B, Buntinx F, Ansoms S, Fevery J: Screening properties of questionnaires and laboratory tests for the detection of alcohol abuse or dependence in a general practice population. Br J Gen Pract 2001;51:172–173.
Comasco E, Nordquist N, Leppert J, Oreland L, Kronstrand R, Alling C, Nilsson KW: Adolescent alcohol consumption: biomarkers PEth and FAEE in relation to interview and questionnaire data. J Stud Alcohol Drugs 2009;70:797–804.
Ewing JA: Detecting alcoholism: the CAGE questionnaire. J Am Med Assoc 1984;252:1905–1907.
Cook RL, Chung T, Kelly TM, Clark DB: Alcohol screening in young persons attending a sexually transmitted disease clinic. Comparison of AUDIT, CRAFFT, CAGE, instruments. J Gen Intern Med 2005;20:1–6.
Knight JR, Sherritt L, Harris SK, Gates EC, Chang G: Validity of brief alcohol screening tests among adolescents: a comparison of the AUDIT, POSIT, CAGE, and CRAFFT. Alcohol Clin Exp Res 2003;27:67–73.
Chung T, Colby SM, Barnett NP, Rohsenow DJ, Spirito A, Monti PM: Screening adolescents for problem drinking: Performance of brief screenings against DSM-IV alcohol diagnoses. J Stud Alcohol 2000;61:579–587.
Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG: The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care, ed 2. Geneva, World Health Organization, 2001.
Reinert DF, Allen JP: The Alcohol Use Disorders Identification Test: An update of research findings. Alcohol Clin Exp Res 2007;31:185–199.
Santis R, Garmendia ML, Acuna G, Alvarado ME, Arteaga O: The Alcohol Use Disorders Identification Test AUDIT as a screening instrument for adolescents. Drug Alcohol Depend 2009;103:155–158.
Shields AL, Campfield DC, Miller CS, Howell RT, Wallace K, Weiss RD: Score reliability of adolescent alcohol screening measures: a meta-analytic inquiry. J Child Adolesc Substance Abuse 2008;17:75–97.
Knight JR, Shrier LA, Bravender TD, Farrell M, Vander Bilt J, Shaffer HJ: A new brief screen for adolescent substance abuse. Arch Pediatr Adolesc Med 1999;153:591–596.
Knight JR, Sherritt L, Shrier LA, Harris SK, Chang G: Validity of the CRAFFT substance abuse screening test among adolescent clinic patients. Arch Pediatr Adolesc Med 2002;156:607–614.
Rahdert ER (ed): The Adolescent Assessment/Referral System Manual. Washington, US Department of Health and Human Services (PHS) Alcohol, Drug Abuse, and Mental Health Services Administration, 1991.
Subramaniam M, Cheok C, Verma S, Wong J, Chong SA: Validity of a brief screen- ing instrument-CRAFFT in a multiethnic Asian population. Addict Behav 2010;35:1102–1104.
Latimer WW, O’Brien MS, McDouall J, Toussova O, Floyd LJ, Vazquez M: Screening for ‘substance abuse’ among school-based youth in mexico using the Problem Oriented Screening Instrument (POSIT) for Teenagers. Substance Use Misuse 2004;39:307–329.
Knight JR, Goodman E, Pulerwitz T, DuRant RH: Reliability of the Problem Oriented Screening Instrument for Teenagers (POSIT) in adolescent medical practice. J Adolesc Health 2001;29:125–130.
Kim Y: Korean version of the revised Problem-Oriented Screening Instrument for Teenagers Substance Use/Abuse scale: a validation study. J Soc Serv Res 2010;36:37–45.
Tossmann P, Kasten L, Lang P, Struber E: Determination of the concurrent validity of the CRAFFT-D-a screening instrument for problematic alcohol consumption. Z Kinder- Jugendpsychiatr Psychother 2009;37:451–459.
Karila L, Legleye S, Beck F, Corruble E, Falissard B, Reynaud M: Validation of a questionnaire to screen for harmful use of alcohol and cannabis in the general population: CRAFFT-ADOSPA. Presse Méd 2007;36:582–590.
Kelly TM, Donovan JE, Chung T, Bukstein OG, Cornelius JR: Brief screens for detecting alcohol use disorder among 18–20 year old young adults in emergency departments: comparing AUDIT-C, CRAFFT, RAPS4-QF, FAST, RUFT-Cut, and DSM-IV 2-item scale. Addict Behav 2009;34:668–674.
Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA: The Audit Alcohol Consumption Questions AUDIT-C. An effective brief screening test for problem drinking. Arch Intern Med 1998;158:1789–1795.
Wittchen H-U, Beloch E, Garczynski E, Holly A, Lachner G, Perkonigg A, Vodermaier A, Vossen A, Wunderlich U, Zieglgänsberger S: Münchener Composite International Diagnostic Interview (M-CIDI), version 2.2. München, Max-Planck-Institut für Psychiatrie, 1995.
Rumpf H-J, Meyer C, Hapke U, John U: Deutsche Version des Alcohol Use Disorders Identification Test (AUDIT); in Glöckner-Rist A, Rist F (eds): Elektronisches Handbuch zu Erhebungsinstrumenten im Suchtbereich (EHES) version 10. Mannheim,, Zentrum für Umfragen, Methoden und Analysen, 2001.
Rumpf H-J, Hapke U, Meyer C, John U: Screening for alcohol use disorders and at-risk drinking in the general population: psychometric performance of three questionnaires. Alcohol Alcohol 2002;37:261–268.
Dybek I, Bischof G, Grothues J, Reinhardt S, Meyer C, Hapke U, John U, Broocks A, Hohagen F, Rumpf HJ: The reliability and validity of the Alcohol Use Disorders Identification Test (AUDIT) in a German general practice population sample. J Stud Alcohol 2006;67:473–481.
Reinert DF, Allen JP: The Alcohol Use Disorders Identification Test (AUDIT): a review of recent research. Alcohol Clin Exp Res 2002;26:272–279.
Berner MM, Kriston L, Bentele M, Harter M: The Alcohol Use Disorders Identification Test for detecting at-risk drinking: a systematic review and meta-analysis. J Stud Alcohol Drugs 2007;68:461–473.
Kriston L, Holzel L, Weiser AK, Berner MM, Harter M: Meta-analysis: are 3 questions enough to detect unhealthy alcohol use? Ann Intern Med 2008;149:879–888.
Rist F, Glockner-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 Alcohol Depend 2009;100:71–82.
Levy S, Sherritt L, Harris SK, Gates EC, Holder DW, Kulig JW, Knight JR: Test-retest reliability of adolescents’ self-report of substance use. Alcohol Clin Exp Res 2004;28:1236–1241.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 4, international version. Washington, American Psychiatric Association, 1995.
Robins LN, Wing J, Wittchen HU: The Composite International Diagnostic Interview: an epidemiological instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Arch Gen Psychiatry 1988;45:1069–1077.
Wittchen H-U, Lachner G, Wunderlich U: Test-retest reliability of the computerized DSM-IV version of the Munich-Composite International Diagnostic Interview (M-CIDI). Soc Psychiatry Psychiatr Epidemiol 1998;33:568–578.
McClish DK: Combining and comparing area estimates across studies or strata. Med Decision Making 1991;12:274–279.
Bundeszentrale für gesundheitliche Aufklärung: Entwicklung des Alkoholkonsums bei Jugendlichen unter besonderer Berücksichtigung der Konsumgewohnheiten von Alkopops. Eine Befragung der Bundeszentrale für gesundheitliche Aufklärung. Kurzbericht. Köln, Bundeszentrale für gesundheitliche Aufklärung, 2005.
Holly A, Türk D, Nelson CB, Pfister H, Wittchen H-U: Prävalenz von Alkoholkonsum, Alkoholmißbrauch und -Abhängigkeit bei Jugendlichen und jungen Erwachsenen. Z Klin Psychol 1997;26:171–178.
Meyer C, Rumpf H-J, Hapke U, John U: Regionale Unterschiede in der Prävalenz riskanten Alkoholkonsums: Sekundäranalyse des Gesundheitssurvey Ost-West. Gesundheitswesen 1998;60:486–492.
Caetano R, Babor TF: Diagnosis of alcohol dependence in epidemiological surveys: an epidemic of youthful alcohol dependence or a case of measurement error? Addiction 2006;101:111–114.
Pabst A, Kraus L, Piontek D, Baumeister SE: Age differences in diagnostic criteria of DSM-IV alcohol dependence among adults with similar drinking behaviour. Addiction 2011;107:331–338.
Hasin D, Paykin A, Endicott J, Grant B: The validity of DSM-IV alcohol abuse: drunk drivers versus all others. J Stud Alcohol 1999;60:746–755.
American Psychiatric Association: DSM-5 Development, 2012,; accessed October 31, 2012.
Rojas NL, Sherrit L, Harris S, Knight JR: The role of parental consent in adolescent substance use research. J Adolesc Health 2008;42:192–197.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.