Technical Report

Validation of Problem Drinking Screening

Instruments for DWI Offenders

John H. Lacey

Ralph K. Jones

Connie H. Wiliszowski

May 1999

Prepared for:

U.S. Department of Transportation

National Highway Traffic Safety Administration

Washington, DC 20590

Contract Number DTNH22-90-C-07287
Technical Report Documentation Page 

1. Report No. 2. Government Accession No. 3. Recipients Catalog No. 

DOT HS 808 881 

4. Title and Subtitle Report ate 

May 1999 Validation of Problem Drinking Screening Instruments 

for DWI Offenders 

6. Performing Organization Code 

7. Author(s) 8. a orming rganization eport o. 

Lacey, J.H.; Jones, R.K. and Wiliszowski, C.H. 

9. Performing Organization Name and Address 10. Work Unit No. (TRAIS) 

Mid-America Research Institute 

611 Main Street 11. Contract or rant No. 

Winchester, MA 01832 DTNH22-90-C-07287 

12. Sponsoring Agency Name and Address 13. Type of Report and eno Covered 

National Highway Traffic Safety Administration Final Report 

Office of Research and Traffic Records 14. Sponsoring Agency Code 

4007 h Street, S.W., Washington, DC 20590 

15. Supplementary Notes 

Dr. James Frank was the COTR for this project. 

16. Abstract 

This document summarizes the results of a validation study for five adult screening instruments in use fo 

preliminary screening of DWI offenders for problem drinking. The instruments were the Driver Risk Inventor) 

(DRI), the Michigan Alcohol Screening Test (MAST), Mortimer-Filkins Questionnaire (without the interview 

and the Substance Abuse/Life Circumstance Evaluation (SALCE). As an additional task, the project was aske 

to validate a combination of the consumption questions from the Alcohol Clinical Index and the four CAGE 

questions. A criterion instrument (the Comprehensive Adult Interview) was developed during the project b 

a panel of acknowledged leaders in the field of problem drinking assessment. All of the screening instrument 

(six total) were administered to 609 consenting adult DWI program participants in Pennsylvania an 

Massachusetts. The assessment instruments correctly identified problem drinkers, as classified by the criterio 

instrument, across a range of 72% to 92% of the time. In general, the more sensitive an instrument was, th 

less specific it tended to be. In other words, a cost of identifying a higher proportion of the problem drinker 

was that more persons who were not problem drinkers were incorrectly classified as such. 

17. Key ors 18. Distribution Statement 

problem drinkers, DRI, MAST, SALCE, This report is available from the National Technical 

Mortimer-Filkins, CAGE, ACI, assessment, Information Service, Springfield, Virginia 

impaired driving, DWI (703) 487-4650. 

19. Security Classif. (of this report) ecuriy Classif. (of t is page No. of ages 22. Price 

136 

Form DOT F 1700.7 (8-72) Reproduction of completed page authorized 
ACKNOWLEDGMENTS 

The authors are grateful to the many individuals who worked on this project. We 

would like to acknowledge Dr. Adele Harrell at the Urban Institute who was 

instrumental in conducting the expert panel meetings and in developing data 

collection procedures. 

The authors would especially like to thank the following individuals, listed below 

in no particular order, for promoting the implementation of the study in their 

respective locations: 

n Donna Laurnavich, DUI Administrator, Allegheny County Alcohol Highway 

Safety Program, Pittsburgh, Pennsylvania 

n Betty McBride, Center for Substance Abuse, McKeesport, Pennsylvania 

n Cynthia Kovacevic, Center for Chemical Dependency Treatment, St. Francis 

Medical Center, Pittsburgh, Pennsylvania 

n Precious Roberts, Alternatives DUI Program, Pittsburgh, Pennsylvania 

n Dennis McCarty, former Director of the Bureau of Substance Abuse Services 

for the Commonwealth of Massachusetts. 

n Vic Gregoire, Thayer Institute, Worcester, Massachusetts 

n Lavinia DeStefano, Director of Boston ASAP, Boston, Massachusetts 

n Arthur Carvalho, Assistant Director of Boston ASAP, Boston, Massachusetts 

n Charles Leventis, CAB/CASP, Salem, Massachusetts 

n Eric Brungard, Middlesex County DUIL, Waltham, Massachusetts 

n Michael Kennedy, Middlesex County DUIL, Waltham, Massachusetts 

iii 
A

TABLE OF CONTENTS

ACKNOWLEDGMENTS ......................................... iii

1- INTRODUCTION ............................................. 1

BACKGROUND ............................................... 1

BASIC APPROACH ............................................ 1

Criterion Measure ...........................................1

Instruments Studied .......................................... 2

Data Collection Sites ......................................... 2

Data Collection Approach ..................................... 2

Analysis Approach ........................................... 3

Discussion and Recommendations ............................... 3

ORGANIZATION OF THE REPORT .............................. 3

2 - IDENTIFICATION AND RECRUITMENT OF EXPERT PANEL ..... 5

SPECIFIC CRITERIA FOR PANEL SELECTION .................... 6

Specialized Subject-Area Knowledge ............................ 6

Comprehensive Knowledge of Problem-Drinker Assessment .......... 7

Knowledge About Pertinent Databases ........................... 8

Professional Reputation and Credentials ......................... 8

Effectiveness as a Panel Member ................................ 9

PROCEDURES FOR RATING POTENTIAL PANELISTS ............. 9

SELECTED PANELISTS ......................................... 9

3 - CRITERION DEVELOPMENT ............................. I 12

SPECIFIC DOMAINS .......................................... 13

Consumption ofAlcohol ...................................... 13

Alcohol Dependence .... 13

Consequences of Drinking .................................... 13

Vulnerability .............................................. 14

SOURCES ................................................... 14

PROBLEM DRINKER DEFINITION .............................. 15

DRAFT QUESTIONNAIRES .................................... 16

4 - INSTRUMENTS SELECTED FOR VALIDATION ................ 17

MICHIGAN ALCOHOL SCREENING TEST (MAST) ................ 17

MORTIMER FILKINS ......................................... 19

SUBSTANCE ABUSE LIFE CIRCUMSTANCES EVALUATION (SALCE)

DRIVER RISK INVENTORY (DRI) .............................. 23

V 
CAGE .......................................................25

5 -DATA COLLECTION METHODS .............................. 28

BASIC APPROACH ............................................ 28

Assembly of Survey Packets ................................... 28

General Interview Procedures ................................. 29

Collateral Interviews ........................................ 31

Compilation of Survey Forms ................................. 32

SPECIFIC DATA COLLECTION PROCEDURES ................... 32

Pittsburgh Area ............................................ 32

Site Description ......................................... 32

Data Collection Procedures Specific to the Pennsylvania Sites ..... 33

Sample Size ............................................ 33

Boston Area ............................................... 33

Site Description ......................... .............. 33

Data Collection Procedures Specific to the Massachusetts Sites .... 34

Sample Size ............................................ 34

6- ANALYSIS .................................. ..............35

DATA ANALYSIS APPROACH ................................ 35

Operationalizing a Classification Scheme for the Criterion Instrument

Operationalizing the Classification Schemes for the Screening Instruments 

Computing Each Instrument's Classification of Each Subject ........ 36

Comparing the Classifications ................................. 36

RESULTS ................................................... 37

7 - CONCLUSIONS AND RECOMMENDATIONS ................... 39

REFERENCES .................................................. 41

APPENDIX A - TABLES ......................................... 43

APPENDIX B - ADULT CRITERION INSTRUMENT ................ 53

APPENDIX C - ADOLESCENT CRITERION INSTRUMENT ......... 69

APPENDIX D - DRAFT ADULT CRITERION INSTRUMENT CONTAINING

SOURCES ................................................... 89

APPENDIX E - DRAFT ADOLESCENT

CRITERION INSTRUMENT CONTAINING SOURCES .......... 105

vi 
TABLES 

Table 1: Sources of Items in Assessment Instruments .................. 15

Table 2: Minimum Domain Scores for Establishing Various Drinking-Problem

Risk Levels .................................................. 16

Table 3: Positive BACs of Clients At Time of Project Participation By Fre­

quency ...................................................... 30

Table 4: Outcomes of Attempts to Conduct Collateral Interviews by Frequency

32

Table 5: 2x2 Table for Comparing a Given Instrument ................ 37

Table 6: Comparison of the Performance of Various Screening Instruments

37

Table 7: Percentage of Subjects Correctly Diagnosed by Various Screening

Instruments .................................................. 38

Table A-1: Adult Problem Drinkers, Criterion Rating Means as a Function of

Criterion and Criterion Group .................................. 44

Table A-2: Adult Problem Drinkers, Criterion Rating Means as a Function of

Criterion and Criterion Group (Continued) ....................... 45

Table A-3: Adult Problem Drinkers, Rating Means Sorted by Discriminability

Mean as a Function of Criterion and Criterion Group .............. 46

Table A-4: Adult Problem Drinkers, Rating Means Sorted by Discriminability

Mean as a Function of Criterion and Criterion Group (Continued) ... 47

Table A-5: Means of Criterion Ratings, Adult Problem Drinkers by Criterion

Group ...................................................... 48

Table A-6: Sources of Items - Consumption .......................... 49

Table A-7: Sources of Items - Dependence ........................... 50

Table A-8: Sources of Items - Consequences .......................... 51

Table A-9: Sources of Items - Vulnerability .......................... 52

Table A-10: Other Sources ........................................ 52

A 

s 

vii 
1- INTRODUCTION

This report describes a validation study of several problem drinker screening 

instruments which are in widespread use by courts to determine the need for further 

assessment and treatment of DWI offenders for problem drinking. The project 

entitled "Problem Drinker Assessment Instrument Validation" was conducted under 

contract number DTNH22-90-C-07287 for the National Highway Traffic Safety 

Administration (NHTSA). 

BACKGROUND 

Throughout the United States there is a growing trend for courts to conduct a 

preliminary screening of DWI offenders for alcohol problems either prior to 

sentencing or as a component of the sentence. This screening typically takes the form 

of the administration of a relatively brief screening instrument. The results of that test 

are used to help decide whether the DWI offender is sent on to further assessment 

and treatment as a part of the sentence for DWI. Among the findings of an earlier 

study conducted for NHTSA, "Assessment of Classification Instruments Designed 

to Detect Alcohol Abuse" (DOT HS 807 475) were that: the instruments were 

administered by persons with a wide variety of qualifications; that in some cases the 

results from the screening instruments were used to make the final determination of 

whether an offender received treatment; and that most instruments in widespread use 

had not been independently validated against an objective criterion measure. 

This study is intended to address the last observation noted above by developing 

a criterion measure and subjecting some of the more widely used screening 

instruments to an independent validation study using a criterion measure which could 

be replicated. 

BASIC APPROACH 

Criterion Measure 

Most validation studies of instruments of this nature have used as criterion 

measures either a clinician's opinion or another widely used instrument. NHTSA 

desired that a new criterion measure be developed which could be administered in 

a standardized manner so that other similar validation studies could be conducted. 

To that end, a panel of acknowledged leaders in the field of problem drinking 

assessment was convened to guide the development of a criterion measure which 

might be considered a "gold standard" for these purposes. They helped develop two 

quantifiable criterion measures (one for adults and one for adolescents) which could 

be supplemented by queries of other persons (collaterals), official records and a 

measure of breath alcohol concentration of the persons being assessed. The adult 

I 
Validation of Problem Drinking Screening Instruments for DWI Offenders 

tool (Appendix A - Comprehensive Adult Interview) was used as the criterion 

measure for this study and is discussed in greater detail later in the report. The 

adolescent criterion instrument appears in Appendix C. 

Instruments Studied 

Four screening instruments for adults were selected for this validation study. 

Because resources were available to study only four screening instruments, an 

attempt was made to identify from among the many instruments in current use ones 

which, based on the earlier study, were known to be in widespread use and were 

constructed using sound psychometric procedures. Additionally, we wished to 

examine both hand-scored and computer-scored instruments. This essentially 

translated into ones which were in the public domain and thus fairly inexpensive to 

obtain (hand-scored) and proprietary instruments which had somewhat higher costs 

associated with them (computer-scored). The expert panel was asked to review the 

list of possible instruments and make recommendations. The four DWI adult 

screening instruments studied were the Michigan Alcohol Screening Test (MAST), 

the Mortimer-Filkins Questionnaire(without the interview), the Driver Risk Inventory 

(DRI) and the Substance Abuse/Life Circumstance Evaluation (SALCE). 

As an additional task, NHTSA requested that we validate a combination of the 

consumption questions from the Alcohol Clinical Index and the four CAGE 

questions. These questions were suggested by the expert panel as a possible 

shorthand way of identifying problem drinkers on a telephone questionnaire NHTSA 

was developing. 

Data Collection Sites 

Data were collected from adult subjects in DWI programs in Allegheny County 

(Pittsburgh), Pennsylvania and the Greater Boston, Massachusetts area. These sites 

were selected primarily because they generated a sufficient number of DWI offenders 

to satisfy our sample size needs, they served a heterogeneous population of offenders, 

and program administrators expressed interest in the project and a willingness to 

allow their staff or graduate students to administer the instruments and criterion 

measure. 

Data Collection Approach 

All of the screening instruments were administered to 609 consenting adult DWI 

program participants. A mix of first and multiple offenders participated. Anonymity 

was assured and the instruments were administered by persons who did not have 

direct responsibility for the subject's program activity. The order of administration 

of instruments was counterbalanced to obviate any possible order effect. 

2 
Introduction 

Analysis Approach 

Each instrument was scored according to its scoring instructions to categorize 

each individual as problem drinker or non-problem drinker. These results were then 

compared with that obtained using the criterion measure. Tables were presented 

showing the degree of agreement, proportion of false positives and false negatives 

for each instrument in comparison with the criterion measure. 

Discussion and Recommendations 

The instruments correctly identified problem drinkers, as determined by the 

criterion measure, across a range of 72 to 92 percent of the time. They also varied 

in terms of specificity. In general, the more sensitive an instrument was, the less 

specific it tended to be. In other words, a cost of identifying a higher proportion of 

the problem drinkers was that more persons who were not problem drinkers were 

incorrectly classified as such. 

ORGANIZATION OF THE REPORT 

Chapter 2 details the identification of the expert panel and development of the 

criterion measure. Chapter 3 explains the development of the criterion instrument. 

Chapter 4 discusses the instruments selected for validation. Chapter 5 addresses the 

data collection and processing procedures used to compile the information obtained 

from the interviews. Chapter 6 presents the analysis approach and results. Chapter 

7 contains discussion and recommendations of this report. 

3 
Validation of Problem Drinking Screening Instruments for DWI Offenders 

4 
2 - IDENTIFICATION AND RECRUITMENT OF EXPERT PANEL 

It was NHTSA's desire to develop a criterion measure which could be objectively 

applied and was thus readily replicable. Thus the more traditional criterion measure 

for such validation studies, a clinical evaluation by a mental health professional, was 

not appropriate to this study. Rather, it was decided that a measure developed with 

the advice and assistance of a number of acknowledged leaders in the field of 

problem drinking assessment should be created. The first step in this process was to 

assemble an expert panel. This chapter describes that process. 

It was vital to the development of the criterion measure that the expert panel be 

comprised of acknowledged leaders in the field with impeccable credentials and 

which, as a group, had expertise in all of the areas required. The identification of 

these individuals was a multi-step process. We first developed a list of required areas 

of expertise and desired panelist attributes. We then identified a number of 

individuals who had expertise in the field. The next step was to recruit other persons 

with knowledge of the field and familiarity with the practitioners in the field to rate 

potential panelists. Once ratings were received and the desired panelists identified, 

they were recruited to the task. 

The major charge to the panel was to develop criteria that could be used in the 

validation of screening instruments intended to identify problem drinkers within the 

DWI population. 

Two types of experts were needed on the panel, those with expertise in the 

various specialties involved in formulating criteria for assessing problem drinking, 

and those with comprehensive knowledge and experience in developing and 

administering such protocols. The former type of individual was considered more 

important to this phase of the project, because we were developing validation criteria 

rather than a protocol. The latter type of individual was needed to help ensure that 

the validation criteria were practical and could be applied in an operational setting. 

For panel members who had developed instruments, it was important to identify 

persons who would strive to serve project goals rather than particular interests. 

Additionally, we tried to identify persons who did not have a financial interest in the 

sale of instruments. 

We also needed members who were knowledgeable in certain ancillary areas that 

supported the development of practical criteria. For example, the panel needed to 

include some (but not necessarily all) members with knowledge of databases that 

related to pertinent specialties. For instance, data in driving records could be used 

in a particular validation criterion, so one or more panel members needed to be 

familiar with the nature, validity, accessibility, and cost of such records. 

The criteria recommended by the panel would be subject to considerable scrutiny 

by a wide range of constituencies. Thus, we needed panel members who had a high 

level of professional credibility in their areas of specialty and well-established 

reputations. Members who were primarily researchers conducted research projects 

5 
Validation of Problem Drinking Screening Instruments for DWI Offenders 

and published widely in pertinent areas. Further, panel members had to be willing 

to expend enough time to work on this project, and be able to participate in a 

consensus-building process. 

Because a number of skills were necessary to the panel and the number of 

panelists was limited, we endeavored to identify potential panelists who had multiple 

skills that were pertinent to the panel activities. Most potential panelists had 

expertise in at least two or three specific areas that were critical to developing 

validation criteria for problem-drinker assessment instruments. 

SPECIFIC CRITERIA FOR PANEL SELECTION 

Specialized Subject-Area Knowledge 

Knowledge and experience in the following areas were deemed essential. 

Drinking Practices 

Definitions of Problem Drinking 

Knowledge of the several approaches to defining problem drinking provided 

useful information in developing the criteria, which in effect formed an 

operational definition of problem drinking. The criteria-setting process had 

to take into account the thinking of the research communities on this issue. 

Patterns of Problem Drinking in Various Populations 

The initial charge in this project was to develop operational criteria for two 

broad sub-populations; adult and adolescent problem drinkers within the 

DWI population. Additionally, it was necessary to have insights into whether 

criteria that were developed would be appropriate across ethnic groups within 

these two sub-populations. 

Correlates of Problem Drinking 

The criteria developed would, in essence, be a set of correlates of problem 

drinking. It was essential that the panel have members who had studied this 

area. 
Identification and Recruitment of Expert Panel 

Alcohol Effects on People 

Physiological 

A group of potential criteria fell into the general category of biological 

markers of problem drinking. The panel needed the capability of addressing 

two basic issues here: specific physiological criteria that would be appropriate; and feasibility of gathering such information from likely study populations. 

Behavioral 

Many of the potential criterion measures were indicators of the social 

behavioral effects of problem alcohol consumption. Such indicators might 

include contacts with criminal justice system agencies and contacts with 

mental health agencies, among others. It was essential that expertise in this 

area be present on the panel. 

Treatment of Alcoholism and Alcohol Abuse 

Symptoms and Diagnosis 

Knowledge of the symptoms of problem drinking and skills in diagnosing a 

subject with a given set of symptoms were required for identifying problem 

drinking in the clinical setting. Objectively measurable factors in this process 

were likely to be components of the assessment validation criteria. 

Selection of Treatment 

The charge of the instruments was to identify problem drinkers within the 

DWI population for whom traditional sanctions (e.g., fines, jail, etc.) were 

not sufficient and thus treatment was indicated. Therefore, it was important 

that the panel contain members expert in identification of appropriate 

treatment for problem drinkers, particularly those encountered in the DWI 

population. Knowledge in this area would provide insight about the 

characteristics of patients for whom treatment would be effective. 

Comprehensive Knowledge of Problem-Drinker Assessment 

Construction and Validation of Psychometric Tests 

Persons with experience in this area would be able to provide valuable input 

about some of the barriers and solutions to obtaining appropriate validation 

7 
Validation of Problem Drinking Screening Instruments for DWI Offenders 

criterion information and could provide input on how those steps might affect 

methodological issues. 

Developing and Administering Specific Assessment Protocols 

Familiarity with the process and pitfalls of field tests of criterion variable validity 

and diagnostic practices was useful in identifying problems the project might 

have encountered in measuring a criterion designed to be an independent and 

superior measure of the need for treatment. 

Knowledge About Pertinent Databases 

It was possible that many of the criterion variables considered would be available 

from official or medical databases. Therefore, it was important that the panel contain 

persons with expertise in the potential database areas listed below. It was highly 

unlikely that such individuals would be records specialists. They were more likely 

to have acquired their database knowledge in the course of their primary research and 

professional activities. 

Motor Vehicle Department Records 

Traffic Accident Records

Driver Records

Medical Records

Addiction Treatment Agency Records

Criminal Justice System Records

Police Agency Records

Court Records

Sanctioning Agency Records

Social Service A egncy Records 

Other criteria which were important to the credibility of the panel and its 

functioning were: 

Professional Reputation and Credentials 

Academic degrees

Research activities

Publications

Work experience

8 
Identification and Recruitment of Expert Panel 

Effectiveness as a Panel Member 

Ability to work as a member of the group 

Willingness to put forth the necessary time and effort 

Required areas of expertise 

The following procedures were used to rate potential panelists against the 

selection criteria outlined above. 

PROCEDURES FOR RATING POTENTIAL PANELISTS 

Four experts in the field: two from granting agencies and two senior researchers 

in the field who would not be available to participate in the panel activities were first 

asked to rate each of several potential nominees on their level of expertise or 

qualifications in each of the above areas. They were also asked to suggest additional 

nominees and rate them. A grid was developed and provided for these purposes. For 

each of the additional nominees, the other expert raters were polled by phone by 

project staff for their ratings. 

After the first round of ratings, a shorter list of nominees was prepared and the 

expert raters were again polled and asked to provide opinions about potential 

panelists' overall knowledge and reputation separately on groupings of categories of 

expertise. These were: definitions of problem drinking; patterns of problem 

drinking; correlates of problem drinking; symptoms of problem drinking; and 

treatment for problem drinking. 

The results of this series of ratings were reviewed by project staff. A list of 

recommended panelists, along with supporting documentation, was submitted to 

NHTSA for review. After NHTSA approval, project staff recruited panel members. 

Fortunately, all of those identified agreed to serve. 

SELECTED PANELISTS 

Brief biographical sketches (current in 1992) of the selected panel members panel 

appear below. 

Thomas F. Babor, Ph.D. 

Ph.D. 1971 in Social Psychology from the University of Arizona. He was the 

Director of the Alcohol Research Center at the University of Connecticut Health 

Center and a professor in the School of Medicine at the University of Connecticut, 

Framingham. As director ofthe large, multi-site National Institute on Alcohol Abuse 

and Alcoholism (NIAAA) study of client treatment matching, he brought to the panel 

in-depth understanding of the symptoms of alcohol abuse requiring intervention. 

9
Validation of Problem Drinking Screening Instruments for DWI Offenders 

Howard Blane, Ph.D. 

Ph.D. in Clinical Psychology from Clark University. He was the Director of 

Research at the Institute of Research in Psychology, SUNY, Buffalo, and has been 

a leading figure in alcohol research for the past 30 years. He was Principal 

Investigator of an NIAAA alcohol research center. He has worked extensively on 

epidemiologic studies of problem drinking and correlates. 

John E. Donovan, Ph.D. 

Ph.D. in Social Psychology from the University of Colorado. From 1977 - 1993 

he was a Research Associate in the Research Program in Problem Behavior, Institute 

of Behavioral Science, University of Colorado. His research interests have focused 

on alcohol and drug use among adolescents and young adults. He has also conducted 

a study on drunk driving and risky driving among adolescents. He currently directs 

a research program in that area at the Western Psychiatric Institute in Pittsburgh, 

Pennsylvania. 

Roger H Peters, Ph.D. 

Ph.D. in Clinical Psychology from Florida State University. Assistant Professor, 

University of South Florida, Florida Mental Health Institute. His research has 

included evaluation of national model in jail drug and alcohol treatment programs 

for the Bureau of Justice Assistance and an evaluation of the State of Florida 

assessment and treatment programs for DWI offenders. 

Harvey Skinner, Ph.D. 

Ph.D. in Psychometrics from the University of West Ontario. He is considered 

a Health Psychologist. Since 1989 he has been chair and professor of the Department 

of Behavioral Sciences at the University of Toronto, Ontario. From 1976-1988, he 

was a senior scientist with the Addiction Research Foundation. He was one of the 

first to advance the argument for two-step screening for alcohol problems to save 

resources and expenses in identifying clients appropriate for treatment. His special 

interests are diagnostics and assessment. 

Ken Winters, Ph.D. 

Ph.D. in Clinical Psychology from SUNY, Stony Brook. Since 1985, he has been 

Director of the Chemical Dependency Adolescent Assessment Project supported by 

the Amherst Wilder Foundation, St. Paul, Minnesota. He has extensive experience 

in developing and field testing screening instruments for determining chemical 

10 
Identification and Recruitment of Expert Panel 

dependency in adolescents. His interests are in drug and alcohol abuse and applied 

clinical research. 

Additionally, Patricia F. Waller, Director of the University of Michigan 

Transportation Institute agreed to moderate the panel meetings. 

Patricia F. Waller 

Ph.D. in Psychology from the University of North Carolina, she worked as a 

clinical psychologist in North Carolina, Virginia and Massachusetts, and taught and 

conducted research at the University of North Carolina (UNC) and elsewhere. She 

served as Associate Director for Driver Studies for the UNC Highway Safety 

Research Center. She served as founding director (1987-1989) of the UNC Injury 

Prevention Research Center, one of the first five centers of excellence in injury 

prevention research funded by the Centers for Disease Control. In 1989 she left UNC 

to become director of The University of Michigan Transportation Research Institute 

(UMTRI). She holds academic appointments in The University of Michigan School 

of Medicine, School of Public Health, and Department of Psychology. 

11 
3 - CRITERION DEVELOPMENT

The panel carried out its work in three sessions held in Washington, DC at 

approximately two month intervals. At the first meeting, the panel was given its 

basic charge of developing a criterion measure which would identify problem 

drinkers whose level of drinking and associated problems indicated either a need for 

treatment or a thorough diagnostic assessment. To assist the panel in their 

deliberations, alternative criterion measures suggested by a review of the literature 

were provided before the first meeting. The criterion measures were grouped into 

four categories according to the source of the data: self-report measures, official 

records, biochemical tests and collateral reports. 

Self-report measures included alcohol consumption levels (quantity), frequency 

of alcohol consumption, and negative consequences such as family problems and 

trouble with the law. Official records such as criminal records, driving history, 

health care providers for services or benefits were other sources of data which could 

be used to identify alcohol abusers. Biochemical tests could be collected as part of 

a court's investigation of a case or when available from existing medical records. 

Simultaneous use of two or more conventional laboratory markers generally has been 

proven more successful than the use of a single marker. Laboratory findings from the 

following list could represent objective chemical markers of problem drinking and 

alcoholism in uncooperative patients who denied any drinking problem. 

1.Blood alcohol concentration (BAC) / Blood Alcohol Level (BAL). This 

requires measurement within a short time of arrest, and may be difficult to 

obtain for all offenders. Detects only current use, not chronic abuse. 

2.GGT assay-blood levels of Gammaglutamyltransferase. The enzyme has 

been found to be a relatively sensitive index of liver damage in clinical 

studies of alcoholics and heavy drinkers. 

3.

Urinary dolichols (substances involved in the formation of certain proteincarbohydrate compounds) have been reported to be significantly more 

sensitive than GGT for detecting alcoholism. 

4.

Analysis of carbohydrate-deficient transferrin (CDT). A new technique 

permitting rapid detection and measurement. Excessive alcohol consumption 

has been associated with increasing levels of the carbohydrate-deficient form 

of transferrin, a protein that transports iron. 

5.

Blood level of the mitochondrial liver enzyme aspartateaminotransferase 

(AST) and its ratio with total AST has been found effective in discriminating 

between alcoholics and other subjects, and in detecting excessive drinking. 

6.

Examination of the use of acetaldehyde (ACH), the major metabolite of 

alcohol. All known pathways of alcohol metabolism result in producing 

ACH. ACH binds to certain proteins to form acetaldehyde adducts (Aas), 

which may prove to have strong diagnostic relevance. 

12 
Criterion Development 

Collateral reports provide the last criterion measure category. These are reports 

which might be obtained from relatives, friends or co-workers. Because problem 

drinkers tend to deny that they have a problem or deliberately under-report their 

consumption, reports from others who have the opportunity to observe the offenders' 

drinking behavior and consequences have been used in the past. Supervisors and coworkers of employed offenders could be asked about on-the-job drinking or 

impairment, while spouse/partners or friends could be asked about weekend and 

evening consumption and impairment. 

SPECIFIC DOMAINS 

The panel discussion at the first meeting focused on the specific domains which 

were to be addressed by the criterion measure and sources of test items which could 

be used to tap those domains. The four domains the panel members identified are 

described below: 

1. Consumption ofAlcohol 

Excessive use of alcohol as indicated by such criteria as a high BAC at arrest 

or in an emergency room; reports of heavy drinking; heavy drinking 

symptoms at arrest; rapid drinking; inappropriate drinking contexts; early 

onset of drinking and drinking related problems; recent use of other drugs; 

prior problems with drugs; and biological markers indicating heavy drinking. 

2. Alcohol Dependence 

Physical and/or psychological dependence on alcohol, including symptoms 

set forth in DSM-IIIR (e.g., withdrawal, tolerance, pre-occupation with 

drinking, loss of control of drinking, and persistence in drinking despite 

consequences); a history of dependence as indicated by prior episodes of 

delirium tremens (DTs) and treatment for alcohol abuse; medical problems 

associated with dependence such as gross tremor, nystagmus, and impaired 

cognitive function, and acute abstinence syndrome. 

3. Consequences of Drinking 

Indications that a person has experienced the consequences of alcohol abuse. 

Two types of such consequences were identified, psychosocial and biomedical. Psychosocial consequences include arrests for DWI and chemical test 

refusal; arrests for certain non-traffic offenses such as domestic violence; 

contacts with social service agencies; and life role dysfunctions involving the 

workplace, family, marital relations, finances, legal matters, drugs, psychiat13 
Validation of Problem Drinking Screening Instruments for DWI Offenders 

ric problems, and psychosocial distress. Biomedical consequences include 

a history of trauma; impaired liver function; gastro-intestinal problems; 

hypertension; cardiopulmonary problems; impaired sexual function; and 

blackouts and hangovers. 

4. Vulnerability 

The presence of factors indicating a vulnerability or predisposition to alcohol 

abuse. Such factors include a family history of alcohol abuse, substance 

abuse, or personality disorders; a history of anti-social behavior; and a high 

level of childhood risk factors, both organic and environmental. 

Panelists rated the adult problem drinking criterion variables. The results of the 

ratings are presented in a series of tables in Appendix A. The first tables (Table A-1 

and Table A-2) provide mean ratings for all variables combined within each general 

category. The higher the mean, the better. Thus for cost, the higher the mean, the 

lower the cost. Tables A-3 and A-4 provide the mean value on discriminability, 

obtainability, feasibility and cost for each variable, presented in the sequence they 

appear on the form. Table A-5 provides the same information with the variables 

sorted in order of mean discriminability score. The information was used to decide 

what variables were most appropriate for the criterion measure. 

The panelists then discussed sources of questionnaire items to measure these 

domains. 

SOURCES 

Project staff gathered and tabulated those items which could be obtained during 

the first meeting and they were reviewed by the expert panel. Certain items were 

selected as likely being appropriate for the criterion measure and others were drafted. 

The panel came to the opinion that sufficient information could be obtained to make 

a determination of problem drinking through official traffic records, questionnaire 

responses supplemented by information to be gathered from collaterals (friends, 

relatives, etc.), and a BAC measurement at time of testing. 

The development of the criterion instrument began with a review of existing 

assessment instruments. Portions of several of those instruments were identified as 

potential components for the proposed criterion instrument. The chart below outlines 

the abbreviations for the various assessment instruments. 

14 
Criterion Development 

Table 1: Sources of Items in Assessment Instruments 

Abbreviation Full Name 

AEQ Alcohol Expectancy Questionnaire 

ADI Adolescent Diagnostic Interview 

APSI Adolescent Problem Severity 

Index 

ASI Addiction Severity Index 

CDP Comprehensive Drinking Profile 

DIS Diagnostic Interview Schedule 

Form 90C Form 90C 

HAP Health Attitudes and Practices 

IAP Individual Assessment Profile 

RDC Research Diagnostic Criteria 

TS Trauma Scale 

Items were categorized by each criterion topic (Consumption, Dependence, 

Consequences and Vulnerability) and sources of questions on existing assessment 

instruments were identified. The four tables in Appendix A (Tables A-6, A-7, A-8 

and A-9) outline these items separated by Self Report and Collateral and further by 

Adult and Adolescents. The last table (Table A- 10) identifies sources of information 

other than existing assessment instruments, such as records and biochemical tests. 

PROBLEM DRINKER DEFINITION 

Panel members were asked to help identify persons within the convicted DWI 

population who should be categorized as problem drinkers. As indicated in the 

previous section, the expert panel identified four critical domains which contribute 

to the classification of a DWI offender as a problem drinker. Again, these are alcohol 

consumption, consequences of alcohol consumption, dependance on alcohol and 

history of alcohol treatment. The definition below incorporates each of those 

domains. 

A problem drinker is a person who: 

n consumes five or more drinks per day on eight or more days each month; 

or 

n has experienced five or more adverse consequences of drinking such as 

job loss, arrests, family or health problems or the like; or 

15 
Validation of Problem Drinking Screening Instruments for DWI Offenders 

n	 exhibits three or more symptoms of dependance such as needing to drink 

more in order to have an effect, withdrawal symptoms or the like; or 

n	 had treatment for alcohol problems two or more times. 

Persons who exhibit the characteristics described above to a lesser degree in two 

or more of the categories would also be categorized as problem drinkers. The 

thresholds for categorization as a problem drinker requiring two or more domains 

are: 

n	 consumes five or more drinks per day on from four to seven days per month; 

n	 has experienced three or four adverse consequences of drinking; 

n	 exhibits one or two symptoms of alcohol dependance; 

• and has had previous treatment for alcohol problems. 

Table 2: Minimum Domain Scores for Establishing Various Drinking-Problem Risk 

Levels 

Consumption Consumption Conse- Dependance Psychological, Previous BAC at 

Level Alcohol' Drugs' quences' Criteria' Vulnerability5 Treat- Interview 

menu 

Major 5+ = 8+ days 1 + for Alcohol 5+ 3+ 2+ .05+

per month + Drugs

Minor 5+ = 4-7 Some 3-4 1-20-1 0<BAC<.05 

At 5+ = 1-3 0 1-2 0 1+ 0 0

Risk

No 5+=0; 0 0 0 0 0 0

Risk 3-4 < 4

"5+ = 8+ days per month" indicates 5 or more drinks 8 or more days per month, etc. 2

"1+ alcohol + drugs" indicates 1 or more occasions per month.

Number of positive responses to consequences questions.

Number of positive scores on dependence criteria.

5 Number of positive responses to psychological / vulnerability questions.

6 Number of detoxifications undergone.

DRAFT QUESTIONNAIRES 

Between the first panel meeting and the second, project staff gathered additional 

items from sources indicated by the panel and prepared listings of all items for 

further consideration by the panel. Their ratings of items were scored and provided 

to the panelists at the second panel meeting. At the second panel meeting, draft 

criterion questionnaires were constructed which contained acompilation of items 

from existing instruments. Complete copies of the adult draft questionnaire and the 

adolescent draft questionnaire appear in Appendices D and E. 

16
4 - INSTRUMENTS SELECTED FOR VALIDATION

The basic selection criteria which qualified instruments for inclusion in the 

validation study were that the instruments be in widespread use, that the developers 

had used sound psychometric techniques, and that the tests selected represented both 

hand and computer administration and scoring techniques. We initially examined the 

results of the review of instruments and survey of states from Popkin, Kannenberg, 

Lacey and Waller (1988) to identify instruments which met these criteria. A list of 

candidate instruments was prepared and supplemented with information about more 

recently developed instruments. This listing was presented to the expert panelists 

and they assisted in the selection of four instruments for the adult validation study. 

These four instruments were the Michigan Alcohol Screening Test (MAST), the 

Mortimer-Filkins Questionnaire, the Substance Abuse Life Circumstances Evaluation 

(SALCE), and the Driver Risk Inventory (DRI). 

In addition, during the project NHTSA requested that we suggest a limited 

number of questions which could be included on a telephone interview which could 

be used to classify respondents as problem drinkers. We queried the panel and they 

suggested using the CAGE (Ewing, 1984) questionnaire combined with six 

consumption questions from the Alcohol Clinical Index (Skinner and Holt, 1987). 

NHTSA requested that we also include that set of questions in the validation study. 

Descriptions of the instruments from the 1988 report follow, along with tabular 

summaries of pertinent characteristics of the instruments. The actual questionnaires 

appear in Appendices. 

MICHIGAN ALCOHOL SCREENING TEST (MAST) 

The MAST, at the time of this study, was one of the most widely used instruments for screening for alcohol problems, and consequently, there was considerable 

information available on it. However, there were a number of problems with its use. 

First, it could easily be "faked" by anyone trying to look "too good" or "too bad," and 

there were no validation scales included. Second, it was developed simply by "eye 

balling" the way in which items differentiated between two groups of subjects, so 

that there were questions concerning the levels at which different items were 

weighted. 

Like other screening instruments, it was designed for use in conjunction with an 

interview by a counselor. Because of the obvious nature of the questions, there was 

some indication that this instrument might be useful in detecting persons who 

acknowledge having an alcohol problem, a use that might not be particularly 

applicable when dealing with convicted impaired drivers, especially young convicted 

drunken drivers. There was data becoming available on female subjects, which 

might increase the instrument's versatility. 

17 
Validation of Problem Drinking Screening Instruments for DWI Offenders 

The ease and low cost of administering the MAST, as well as the number of 

studies in which it was used, suggested that it might be a useful instrument so long 

as its limitations were recognized. 

MICHIGAN ALCOHOL SCREENING TEST (MAST) 

GENERAL 

Developed by Melvin Selzer (1971) at the University of Michigan 

n Available from Melvin Selzer, 6967 Paseo Laredo, La Jolla, CA 92037 

n 10-15 minutes to administer 

n $5 charge for a copy of the MAST at the time of this study; no fee for its use 

DESCRIPTION 

n 24 items (Y/N), self or counselor-administered (latter more valid) 

n 3 categories: no drinking problem, possible problem, alcoholism 

n Another instrument, NDP (Numerical Drinking Profile) includes the 

MAST along with personal data items 

EVALUATION 

n Quick, inexpensive, easy to score and interpret 

n High face validity may interfere with self-report accuracy. (May be more 

appropriate for self-acknowledged alcoholics or for ranking respondents 

along a continuum of alcohol involvement/deterioration.) 

n High rate of false positives (33%, see Jacobson, 1983) 

n Norms based on initial validation sample (n=526) of hospitalized alcoholics, 

DWIs, Drunk & Disorderlies, drivers with excessive violations, and 

controls (Selzer, 1971); subsequent studies provide information on female 

norms (see Jacobson, 1983) 

n	 Reliability 

Internal consistency: ranges between r=0.83 and 0.95 (Mischke and Venneri, 

1987) 

n	 Validity 

Concurrent: r+0.65 w/alcoholism counselor decisions (Mischke and Venneri, 

1987). Significantly more repeat offenders than first offenders were 

identified as alcoholic by the MAST (Yoder and Moore, 1973) 

Internal: 71 % of items significantly discriminated between problem and nonproblem drinkers (Mischke and Venneri, 1987) 

18 
Instruments Selected for Validation 

MORTIMER FILKINS 

This instrument, unlike most of those reviewed in this report, was developed and 

specifically designed for assessing DWI offenders. Developed in 1971, it has been 

used far more widely than most of the other instruments reviewed, yet there were not 

a great deal of published data available. Different studies reported divergent findings 

in terms of its accuracy in differentiating between problem drinkers and controls, 

DWI recidivists and controls, or test scores and counselor judgements. There were 

no truthfulness scales to detect faking "good" or "bad." 

While the instrument appeared to be psychometrically sound, its administration 

and scoring procedures are lengthy. It requires 45 to 90 minutes to administer, 

depending on whether the questionnaire is administered alone or in conjunction with 

an interview, as is intended. Many evaluation programs can not allocate so much 

time. 

19 
Validation of Problem Drinking Screening Instruments for DWI Offenders 

MORTIMER-FILKINS QUESTIONNAIRE 

GENERAL 

n Developed by R. Mortimer and L. Filkins, University of Michigan Highway 

Safety Research Institute, 1971 

n Available through the National Highway Traffic Safety Administration, 

Traffic Safety Programs, Office of Traffic Injury Control Programs (NTS-11) 

400 Seventh St., N.W. Washington, D.C. 20590 

n 45-90 min to administer 

n No cost for the instrument, manual, and scoring keys; user bears only the cost 

of reproducing the instrument 

DESCRIPTION 

n 58 item (T/F, YIN, short answer) questionnaire plus interview; individual or 

group administration 

n 3 categories: social drinker, presumptive problem drinker, problem drinker 

n Specifically designed for court assessment of DWI/DUI offenders; used 

extensively by many states for evaluation of drinking drivers 

EVALUATION 

n Time consuming to administer; validity may be compromised when interview 

is omitted due to time constraints 

n Normed on sample of alcoholic inpatients, outpatients, and incarcerated 

offenders and a sociographically heterogeneous sample of controls 

n	 Reliability 

Internal consistency: questionnaire- r=0.95, interview- r=0.97, total scorer=0.98 (Mortimer et at., 1971) 

n	 Validity 

Concurrent: Initial validation study (192 problem drinkers vs. 297 controls) 

yielded 92% hits, 99% correct rejections; correlations between scores and 

criterion group membership: questionnaire- r=0.85, interview- r=0.91, total 

score- r=0.92 (Mortimer et al., 1971) 

Study of DWI recidivists vs controls (n=1800) reported unacceptably high 

false positive (19%) and false negative (70%) rates (Wendling and Kolody, 

1982) 

r=0.46 between test scores and counselor decisions (Mischke & Venneri, 

1987) 

MF's criterion-related validity seems to depend on cutoff score used for 

problem drinker classification 

Internal: 67% of items significantly discriminated between criterion groups 

in DWI sample (Mischke & Venneri, 1987) 

20 
Instruments Selected for Validation 

SUBSTANCE ABUSE LIFE CIRCUMSTANCES EVALUATION (SALCE) 

The initial version of the SALCE was adapted from the Criteria for the Diagnosis 

of Alcoholism developed by the Criteria Committee of the National Council on 

Alcoholism. It was not designed to differentiate alcoholics from non-alcoholics but 

rather to "characterize an individual's need to alter his/her use of alcohol or other 

drugs. More specifically, the test's function is to identify behavioral, attitudinal and 

clinical indicators of this need." It was developed especially for use with DWI 

offenders and attempted "to assess drinking behavior on a continuum from 

`nonproblem social drinking' to `severe problem drinking' and/or `alcohol addiction'." 

The test was designed to be used in conjunction with an interview. The test 

developers reported validation studies comparing the SALCE with professional 

assessments and with the Mortimer-Filkins. Using five assessment categories of 

drinking, they reported a high level of agreement between the SALCE and the ratings 

by the professional assessors. Compared to the Mortimer-Filkins, the SALCE 

identified a higher proportion of DWI offenders as problem drinkers rather than 

social or presumptive problem drinkers. Thus, the SALCE tended to classify the 

same respondents as having more serious drinking problems than did the MortimerFilkins. 

21 
Validation of Problem Drinking Screening Instruments for DWI Offenders 

SUBSTANCE ABUSE LIFE CIRCUMSTANCES EVALUATION (SALCE) 

GENERAL 

n ADE, Inc, 1983,1986 

n Located at 20 West Washington St. - Suite 12B, Clarkston, MI 48016 

n 15 min (+ 5 min computer [IBM] analysis + 20 min interview) 

n $10/test (= $450 one-time administration fee) at the time of this study 

DESCRIPTION 

n 85 T/F and scaled items, self-administered 

n 5 categories: (D I-no use; D2- use with no reported problems; D3- substance 

use with minimal problems; D4- substance use with problems; D5- substance 

use with physical or psychological symptoms of addiction) 

n Combines former ADE (Automated Drinking Evaluation) instrument with a 

Life Circumstances rating 

EVALUATION 

n Easily administered and scored (computerized evaluation) 

n Includes measure of test-taking attitude 

n Flags responses to critical items 

n Includes treatment recommendations 

n Normed on DWI population; annual updating on demographics 

n Reliability 

Internal consistency: r=.93 

n	 Validity 

Concurrent: 61% perfect agreement (93% within one category) between 

SALCE assessments and assessments based on personal interview (by 

probation officers, ADETS staff, hospital staff and counselors [n=2000]) 

SALCE scores are generally consistent with MAST scores but SALCE 

identifies more problem drinkers. 

22 
Instruments Selected for Validation 

DRIVER RISK INVENTORY (DRI) 

This instrument appears to be the most carefully constructed from a psychometric 

standpoint. It was developed specifically for screening convicted impaired drivers, 

presumably for purposes of disposition decisions. Reliability is well established and 

validity is based on the instrument's relationship to other established measures. Data 

from respondents are retrieved from users to update norms annually while allowing 

additional specification of norms for particular geographic or demographic 

subgroups. 

The instrument consists of 131 items that can be read by someone who has passed 

the written driver's license examination. The test provides results on five measures, 

including one on alcohol. For each measure, the testee is classified according to risk 

level along a four point scale ranging from low risk to high risk. A truthfulness scale 

alerts the evaluator to the presence of response bias in the protocol. One of the scales 

is designed to detect irresponsible driving and provides an assessment of driver risk, 

a particularly useful feature for evaluating the DWI offender that does not exist in 

any other instrument we reviewed. Automated scoring provides a written summary 

of the findings, in addition to the actual scores on the scales and the items. The 

results also include recommendations for disposition. 

In settings where it has been adopted as the primary screening instrument for 

processing convicted impaired drivers, substance abuse counselors have reported that 

it improved the quality of their decisions while making the task less time-intensive. 

The documentation does not include information on outcome measures, that is, there 

are no studies to report how effectively the instrument identifies persons who 

subsequently benefit from one type or another of treatment or disposition. 

Nevertheless, of the instruments reviewed (in the 1988 report), this test was the 

most carefully constructed. However, there remains the need for careful follow-up. 

validation research to determine whether it truly achieves what its developers 

purport. More information is also needed assessing the usefulness of the various 

dispositions employed. 

23 
Validation of Problem Drinking Screening Instruments for DWI Offenders 

DRIVER RISK INVENTORY (DRI) 

GENERAL 

n Developed by Lindeman and Scrimgeour, Behavior Data Systems, Ltd. 

(Copyright 1987) PO Box 32308, Phoenix, AZ 85064 

n 20 min (+ 5 min scoring, automated only [IBM compatible]) 

n Approximately $10/test, discounts for volume purchases and for participation 

in DRI research 

DESCRIPTION 

n 131 items (empirically selected via item analysis) 

n Individual or group self-administration, on-line or paper-&-pencil 

n Appropriate for men & women; Spanish version available 

n 5 independent scales, each with risk level classification (normed on DWI 

population: I. Truthfulness; II. Alcohol; III. Drugs; IV. Driver Risk; V. Stress 

Quotient) 

EVALUATION 

n Easily administered and scored (computerized evaluation) 

n Uses direct, non-offensive, uncomplicated language 

n Truthfulness measure adjusts DRI scale scores 

n Includes treatment recommendations 

n Flags responses to critical items 

n Report (3-page summary) may be tailored for the courts, treatment provider, 

and/or the offender 

n Normed on DWI population; some scales have sex-specific norms. - Annual 

updating on demographics. 

n Reliability 

Internal consistency: r=0.74 - 0.90 across scales 

n	 Validity 

Concurrent: r= 0.44 - 0.63 between DRI scale scores & DWI 

screener/evaluator ratings. Significant correlation between Alcohol scale & 

BAC, r = 0.24 (p<.001) and between Driver Risk scale & prior violations and 

crashes, r =0.16 (p<.02) to r= 0.37 (p<.001). 

Significant correlations between DRI scales (especially Alcohol) and other 

tests (MAST, Mortimer-Filkins, and Sandler) 

24 
Instruments Selected for Validation 

CAGE 

This instrument was initially designed for use by general practitioners to screen 

for possible alcohol problems. It is especially simple to use and has the advantage 

that it is apparently non-threatening to the testee. Whether this characteristic would 

still hold true for convicted impaired drivers is not clear. The CAGE consists of four 

items, and the name of the test derives from the key drinking-related concept 

measures within each item, namely, Cut down, Annoyed, Guilty, Eye-opener. 

The CAGE is much too brief to serve as a comprehensive diagnostic tool. 

Nevertheless, in a study of DWI offenders by Mischke and Venneri (1987), the 

CAGE showed higher agreement with counselor decisions than did either the MAST 

or the Mortimer-Filkins. In spite of the high level of agreement, Mischke and 

Venneri concluded that "The overall performance of the CAGE in this study suggests 

little support for its use in DWI assessment." The support for this conclusion was not 

clearly stated. 

The authors of the 1988 report agreed that the brevity of the CAGE precluded its 

use other than as a tool in preliminary screening of convicted impaired drivers. 

However, it should be cautioned that it has not been demonstrated what effect, if any, 

the judicial aspect of the impaired driving system may have on client response. The 

Mischke and Venneri study combined both pre- and post-conviction offenders and 

made no attempt to isolate the influence of conviction status. The point is of 

particular significance in that the CAGE includes no validation scales, and at least 

some authors express the opinion that the DWI population "attempts to avoid 

detection of an alcohol-related problem..." (Mischke and Venneri, 1987). 

The major useful contribution of the CAGE appears to lie in its potential as a 

simple, inexpensive, non-threatening screening instrument that could provide the 

basis for further evaluation where indicated. However, for the purposes of this study, 

the CAGE was evaluated as a component for a potential telephone interview. 

25 
Validation of Problem Drinking Screening Instruments for DWI Offenders 

CAGE (Cut down, Annoyed, Guilty, Eye-opener) 

GENERAL 

n Developed by Ewing and Rouse in 1970 (see Ewing, 1984) 

n Available from Center for Alcohol Studies, UNC School of Medicine, CB# 

7140, Chapel Hill, NC 27599 

n Time varies depending on length of interview or questionnaire in which 

questions are embedded 

n Cost of personnel time to administer interview 

DESCRIPTION 

n 4 items (Y/N) embedded in (social history) interview or questionnaire 

n 1 positive response merits further investigation of a problem 

n 2-4 positive responses indicate high likelihood of alcoholism 

n Each letter in name represents a word in one of the 4 items: 

3 Have you ever felt the need to Cut down on your drinking? 

3 Have people Annoyed you by criticizing your drinking? 

3 Have you ever felt badly or Guilty about your drinking? 

3 Have you ever had a drink first thing in the morning (Eye-opener)? 

EVALUATION 

n Brief, simple, non-threatening instrument 

n May be performing as a unidimensional cumulative scale 

n Should not be used as a single index of problem drinking w/DWIs (Mischke 

& Venneri, 1987) 

n No norms data other than validation studies 

n Reliability 

Internal consistency: r = 0.71 (Mischke & Venneri, 1987) 

n	 Validity 

Concurrent: range ofr = 0.50 (sample of DWI offenders; Mischke & Venneri, 

1987) to 0.89 (sample of hospitalized psychiatric patients; Mayfield et al., 

1974) between test scores and counselor decisions. 

True positives = 85%, true negatives = 89%; n = 521 inpatients (Bush et al., 

1987) 

Internal: all four items significantly discriminated between criterion groups 

(Mischke & Venneri, 1987) 

As can be seen from the reviews above, from the earlier report, and in the opinion 

of the expert panel, all of the instruments, with the exception of the CAGE, were 

26 
Instruments Selected for Validation 

perceived to have promise for identifying problem drinkers from within the DWI 

population. The MAST and the Mortimer-Filkins instruments were by far receiving 

the most widespread use in the DWI screening field and, though subjected to some 

validation studies, were in need of further validation. The DRI and SALCE, more 

recently developed instruments, had not been independently validated. However, 

they were in increasingly widespread use and thus in need of an objective validation. 

Though the Mortimer-Filkins can be administered as a questionnaire supplemented by an interview, we found that many jurisdictions were administering the 

questionnaire alone. Additionally, many of the jurisdictions which were also 

conducting the interview had modified it to suit what were perceived to be local 

needs. Since both whether and how the accompanying interview was being used was 

not at all uniform throughout the country, it was most appropriate to validate the 

questionnaire as a stand alone instrument. 

The CAGE was studied because it was being incorporated into NHTSA telephone 

surveys to categorize respondents as problem drinkers or not. For this study, the 

CAGE was supplemented by six alcohol consumption questions taken from the 

Alcohol Clinical Index (Skinner and Holt, 1987). 

For the DRI and the SALCE, we used the most current version of the instrument 

and scoring algorithm as provided by the developers. In the case of these proprietary 

instruments, both developers graciously provided the instruments to the project free 

of charge. 

27 
5 -DATA COLLECTION METHODS 

BASIC APPROACH 

The objective of the field test was to evaluate five instruments against the adult 

criterion measure developed by the panel of experts. The five instruments (DRI, 

MAST, Mortimer-Filkins, SALCE, and CAGE plus consumption questions) and the 

criterion measure (Comprehensive Adult Interview) were administered to DWI 

clients who volunteered to participate in the study. None of the clients received any 

money, but other incentives (discussed under each site description) were sometimes 

offered to encourage participation. The clients were at least 22 years of age and had 

been convicted of at least one DWI offense. All of the study participants signed 

consent forms which stated they understood all of the information collected as part 

of the study would be kept confidential and that their participation would in no way 

affect the services they were receiving at their program or the way their case would 

be handled by the courts. Mid-America certified that there would be no way 

individuals could be identified. In fact, in several of the programs, numbers only 

were used to identify individuals. 

The Comprehensive Adult Interview was administered by trained, qualified 

interviewers from the seven participating programs. All interviewers were required 

to sign a staff confidentiality pledge promising not to disclose confidential 

information obtained from the study to anyone except authorized Mid-America staff. 

Program management agreed to allow the interviewers to withhold any incriminating 

information about the clients that might have been discovered during the course of 

this study. All study participants were assured of privacy in accordance with 

generally accepted measures for protection of human subjects. 

Assembly of Survey Packets 

Individual survey packets were assembled at Mid-America Research for each 

study participant. A cover sheet to record background and collateral information on 

the client was pasted on the outside of a large manila envelope. Information obtained 

from the cover sheet included the research site, the client number (the number 

assigned by Mid-America to each packet), the random order sequence of survey 

forms (discussed next), the date, the client's name (if the program allowed), date of 

birth, arrest date, court date, state of license, BAC at time of most recent arrest, 

number of previous DWI offenses, and if the client had given consent for a collateral 

(i.e., relative, friend or co-worker presumably familiar with the client's drinking 

habits) to be interviewed by Mid-America staff. 

One copy of the questionnaires (DRI, MAST, Mortimer-Filkins, SALCE, and 

CAGE + consumption questions) were placed inside the individual manila envelopes. 

There was concern that when the clients completed the five written survey 

instruments, the order of completion might affect the information reported on 

28 
Data Collection Methods 

individual survey forms. For example, fatigue or impatience might affect a client's 

responses. To counter these possible effects, the instruments were random ordered 

inside the individual packets. All of the instruments were coded as to their order 

within a packet. Clients were instructed to complete the instruments in the order in 

which they appeared in the packet. Each instrument within a packet contained the 

same client number but a different letter. The letter signified the order in which each 

survey instrument should be completed. The first instrument in each packet to be 

completed was lettered "A," the second "B," and so forth, so if a client dropped or 

shuffled papers by mistake, he/she would still know the order in which to complete 

each instrument. By random ordering the instruments, each instrument received an 

equal chance of being completed first as second, third, etc. Thus no instrument 

received any advantage or disadvantage from the order in which it was completed. 

General Interview Procedures 

At most of the sites, clients were not told about the study beforehand; the study 

took the place of a regularly scheduled treatment or education program session. 

Groups of clients were assembled and everyone completed the written surveys 

together in a room supervised by a monitor. The purpose of the study was explained 

to clients by the monitor and information sheets and consent forms were handed out 

to the participants. Packets were given to clients with instructions to not open the 

packet, but to complete the form on the front of the envelope packet. It was 

explained that each person would be completing identical surveys, but in a different 

order. They were told that as they worked on completing the surveys, they would be 

called out individually and asked to take a confidential breath test and then they 

would be interviewed. The length of time required of each client to participate in the 

study normally ranged from 1-1 /4 hours to 2 hours. 

The clients were instructed by the monitor to complete the five written 

instruments in the order they were arranged inside the packet, and to answer each 

question honestly and to the best of their ability. It was explained that they would 

be answering similar questions repeatedly, and they were asked to be patient in 

dealing with the redundancy. As was expected, individual personalities played a part 

in how clients reacted to the time and efforts required by this study. However, it was 

interesting to note that most of the clients who were irritated initially at the length of 

time required to complete the forms, relaxed during the one-on-one interviews and 

generally became more cooperative. 

Qualified individuals at each location were trained by Mid-America staff to 

conduct the Comprehensive Adult Interview. Interviewers were instructed to not 

elaborate on the questions being asked to each client. The Comprehensive Adult 

Interview was conducted randomly throughout the time the clients were completing 

the other five instruments. Some clients were interviewed before they began 

completing the written instruments, some were interrupted at various times while 

they were working on the written instruments, and some had completed all of the 

written instruments before they were interviewed. 

29 
Validation of Problem Drinking Screening Instruments for DWI Offenders 

The Comprehensive Adult form was completed by an interviewer during a oneon-one interview with the client. An interviewer asked a client to bring the packet 

of surveys he or she was working on and accompany the interviewer to a separate 

location where the oral interview could be conducted privately. The interviewer 

recorded the client number from the individual packet on the Comprehensive Adult 

Interview form, so that the adult form could be inserted into the corresponding 

envelope after the session. 

Before each individual interview, the interviewer asked the client to blow into a 

PBT (portable breath tester). Clients were assured the BAC readings would be kept 

confidential and used only for the research project. All of our clients for this study 

were already participating in treatment or educational programs; because of this, the 

consumption of alcoholic beverages was prohibited. Nonetheless, thirteen people 

registered BAC levels between .02 and .12 when tested. 

Table 3: Positive BACs of Clients At Time 

of Project Participation By Frequency 

BAC Number of 

Level Participants 

0.12 2 

0.11 1 

0.10 1 

.080-.090 1 

.060-.070 1 

.050-.059 2 

.040-.049 1 

.030-.039 1 

.020-.029 3 

Interviewers were instructed to speak clearly and take whatever time was 

necessary to administer the oral adult interview, but they were instructed not to 

elaborate on the questions. At the end of each interview, the client was personally 

thanked by the interviewer for participating in the study and the client was then asked 

to return to the group and continue to complete the five written surveys. The 

interviewer spent a few minutes alone checking the form, writing observations, and 

then returned the completed form to the monitor and asked another client to 

accompany him/her for an interview. It was the responsibility of the monitor to 

check and make certain the interviewer had recorded the client number on the adult 

30 
Data Collection Methods 

form. Study participants handed completed packets to the monitor before leaving. 

The monitor placed the Comprehensive Adult questionnaires inside the corresponding packets at the end of each group session and forwarded completed packets to 

Mid-America. 

Slight variations of the procedures discussed above are addressed later under 

SPECIFIC DATA COLLECTION PROCEDURES sections found under both the 

Pittsburgh Area and Boston Area sections of this chapter. 

Collateral Interviews 

Study participants were asked to complete a background and collateral 

information sheet located on the front of their individual packet. This form contained 

two questions regarding collateral information: 

Is there a family member or significant other familiar with your use of alcohol? Y N 

Would you be willing to have them interviewed for research purposes? Y N 

If study participants left this section blank, or if they answered yes to the first 

question, but no to the second question, the interviewers were instructed to discuss 

the collateral interview after the oral interview had been completed. The interviewer 

explained a "collateral" was someone who knows the client, i.e. best friend, 

employer, co-worker, spouse, girl/boyfriend, or parent. As a final part of the research 

study, a Mid-America staff member would contact this person and ask them 

approximately 20 questions about the collateral's perceptions of the client's use of 

alcohol or drugs. It was explained that the entire interview would take no more than 

five minutes and the information would be held in strictest confidence. 

Several of the programs supported our efforts to conduct collateral interviews 

while others did not, based on privacy issues. Without any compulsory means, 

project staff were generally unable to persuade clients to provide collateral 

information. All 609 clients were asked and 106 consented to provide us with the 

name and telephone number of a collateral. However, Mid-America staff members 

confronted many problems when attempting to conduct the telephone interviews. 

When contacted, many of the collaterals said either the person did not drink, or they 

did not feel comfortable discussing the issue, or they did not know the client or 

his/her habits well enough to answer questions. Three people refused to be 

interviewed; one said the client had changed his mind about allowing the collateral 

interview. In addition, some of the telephone numbers provided were wrong and 

several of the collaterals had moved and the phone numbers were not in service. As 

names of clients had been separated from their data collection forms in compliance 

with privacy guarantees, we had no way of contacting them to verify information 

they had provided or request additional collaterals. In the end, only 16 collateral 

interviews were completed. 

31 
Validation of Problem Drinking Screening Instruments for DWI Offenders 

Table 4: Outcomes of Attempts to Conduct Collateral Interviews by 

Frequency 

Category Frequency 

Completed Interviews 16 

Reasons for not Completing Interviews: 

Claims client does not drink or does 56 

not know client's habits 

Unable to contact collateral 22 

Wrong or disconnected numbers 8 

Collateral refused to cooperate 3 

Client listed himself as the collateral 1 

Compilation of Survey Forms 

When completed packets arrived back at Mid-America, each one was opened, the 

contents were verified and logged before the instruments were separated for data 

entry. This assured that each piece of each packet was properly coded and could be 

identified for analysis purposes. 

Databases were created to enter background information from the cover sheets 

on the envelopes, and responses from the Comprehensive Adult surveys, MAST, 

Mortimer-Filkins, and the CAGE plus ACI consumption items. Behavior Data 

Systems provided the program to handle the DRI data; ADE, Inc. provided the 

program to enter the SALCE information. 

SPECIFIC DATA COLLECTION PROCEDURES 

Pittsburgh Area 

Site Description 

Pittsburgh, a city with a 1992 population of approximately 370,000, is located 

in Allegheny County, Pennsylvania (population 1.3 million in 1992). All DUI 

offenders in Allegheny County are screened by counselors at the Allegheny County 

Alcohol Highway Safety Program. An average of 60 DUI offenders are screened per 

week. After screening, offenders are ordered by the court to participate in education 

and treatment programs in their local areas. Three of these local programs agreed to 

participate in this study: 

32 
Data Collection Methods 

Programs 

The Center for Substance Abuse McKeesport, PA 

Alternatives DUI Program Pittsburgh, PA 

The Center for Chemical Dependency 

Treatment-Alcohol Safety Program 

at St. Francis Medical Center Pittsburgh, PA 

There were counselors at all three locations available to administer the Comprehensive Adult Interview. All of the facilities had separate areas where the one-onone interviews could be conducted privately. 

Data Collection Procedures Specific to the Pennsylvania Sites 

Two of the three programs in the Pittsburgh area used the group approach 

outlined in the General Interviews Procedure section above; the third location 

administered all of the instruments individually. 

None of the clients who participated in this study received monetary compensation. The Alternatives DUI Program offered individuals an incentive to participate 

which consisted of reduced time (several hours) in one section of their program. 

Sample Size 

A total of 408 clients from the Pittsburgh area participated in this study, or 67% 

of the total sample size of 609. 

Boston Area 

Site Description 

Massachusetts had a population just over 6 million in 1992. The populations of 

the cities included in this study are listed below. Four Boston area treatment and 

educational programs offered the use of their facilities and access to their clients for 

this study. Those programs were: 

Programs City Population 

Boston Alcohol & Substance Abuse Program (ASAP) Boston 574,000 

Center for Addictive Behaviors (CAB) Salem 38,000 

Middlesex County DUIL Waltham 58,000 

Thayer Institute, DUI Second Offenders Worcester 170,000 

33 
Validation of Problem Drinking Screening Instruments for DWI Offenders 

Three of the local programs had staff members who were qualified and available 

to administer the Comprehensive Adult Interview. Mid-America hired graduate 

students to administer this interview at the Boston Alcohol & Substance Abuse 

Program (ASAP). Two of the programs (Middlesex County DULL and the Thayer 

Institute program) were residential treatment programs. 

Data Collection Procedures Specific to the Massachusetts Sites 

The Salem CAB program followed the group approach outlined in the General 

Interview Procedure section discussed earlier in this chapter. Boston ASAP 

followed the group approach but scheduled separate sessions for the study. 

Normally, if individuals at that program missed a certain number of program 

sessions, they had to pay a fine. Participation in the research study was offered in 

lieu of the fine. The Middlesex County DUIL program is a residential program. 

Treatment counselors administered the oral instrument and participants completed 

the written surveys individually. The Thayer Institute's DUI Second Offenders 

program is a residential program. Thayer counselors followed the group approach 

and assembled clients the day after they had checked into the Thayer program to 

complete all of the study materials. 

Sample Size 

A total of 201 clients from the Boston area participated in this study, or 33% of 

the total sample size of 609. 

34 
6 - ANALYSIS

The basic study design provided for testing the validity of five assessment 

instruments against a criterion instrument developed in this project in consultation 

with the project's expert panel. The individuals tested were over the age of 21. 

The five instruments studied were the DRI, the SALCE, the Mortimer-Filkins 

Questionnaire, the MAST and a combination of the CAGE and six questions dealing 

with alcohol consumption. 

DATA ANALYSIS APPROACH 

The general objective of the analysis was to validate the five screening 

instruments used to identify problem drinkers by comparing the determination of 

each of them with the assessment obtained using the panel's criteria as reflected in 

the criterion measure. The main comparison was between the yes/no classifications, 

that is, whether the subject was or was not classified as a problem drinker. 

The database consisted of cases, each case representing one subject. For each 

case, the responses i on instrument j are indicated, xj, and the decision yy reached on 

the basis of instrument j. Both the x, and the y, are categorical with two categories 

for y, "problem drinker" (coded "I") and "not problem drinker" coded "0." 

The analysis for each group of subjects involved the following four steps: 

I .­ operationalizing a classification scheme for the criterion instrument from 

input provided by the expert panel, 

2.­ operationalizing the classification schemes for the screening instruments, 

3.­ computing each instrument's classification of each subject using the 

above schemes, and 

4.­ comparing the criterion instrument classifications with the classifications 

of each screening instrument. 

Each of these steps is discussed below. 

Operationalizing a Classification Scheme for the Criterion Instrument 

The scheme developed by the project's expert panel classifies a subject as a 

problem drinker when that subject exhibits at least one of the following characteristics: 

n consumes five or more drinks per day on eight or more days each month. 

n has experienced five or more adverse consequences of drinking such as job 

loss, arrests, family or health problems or the like. 

35 
Validation of Problem Drinking Screening Instruments for DWI Offenders 

n exhibits three or more symptoms of dependance such as needing to drink 

more in order to have an effect, withdrawal symptoms or the like. 

n has had treatment for alcohol problems two or more times. 

Persons who exhibit two or more of the following characteristics are also 

categorized as problem drinkers: 

n consumes five or more drinks per day on from four to seven days per month; 

n has experienced three or four adverse consequences of drinking; 

n exhibits one or two symptoms of alcohol dependance; and 

n has had previous treatment for alcohol problems. 

This step of the analysis involved translating the variables contained in the 

criterion instrument into variables reflecting the above characteristics and then 

writing a computer program for yC f11erion imposing the pertinent conditions. 

Operationalizing the Classification Schemes for the Screening Instruments 

Each screening instrument to be validated had a classification scheme that 

enabled a subject to be classified according to the problem-drinker / no-problemdrinker dichotomy. This step involved developing procedures for applying those 

schemes to the data collected in this project. Computerized scoring routines were 

developed for the Mortimer-Filkins, MAST and CAGE plus consumption instruments, as appropriate to a particular instrument. Two of the instruments, the DRI and 

the SALCE, had a computerized classification procedure. Mid-America was 

furnished the programs for performing the classifications by the developers of the 

instruments and they were applied. 

Computing Each Instrument's Classification of Each Subject 

The classifications yy were computed in this step. For the criterion instrument, 

the computations were straightforward, involving simply running the program 

indicated above. The DRI and SALCE required examination of the assessment 

output for those schemes and recoding that output. For example, the SALCE 

assessment output is a three-to-four page printout that was examined manually to 

determine whether or not the subject was considered to be a problem drinker 

according to the developer's criteria. 

Comparing the Classifications 

This final step of the analysis was undertaken to determine how each screening 

instrument's classification compared with the criterion instrument's classification. 

36 
Analysis 

An overall summary of the comparison for a given instrument could be presented in 

the form of a 2x2 table as follows: 

Table 5: 2x2 Table for Comparing a Given Instrument 

Screening Criterion Instrument 

Instrument 

0 1 Total 

0 x00 x01 x0+ 

1 x10 x11 x1+ 

Total x+0 x+, x++ 

RESULTS 

The criterion instrument categorized 53.5% of the 609 subjects as problem 

drinkers. Table 2 shows how each of the instruments fared against the criterion 

measure in terms of true classifications (classifications that agreed with the criterion 

measure) and false classifications (those that did not agree with the criterion 

measure). 

Table 6: Comparison of the Performance of Various Screening Instruments 

Screening Instrument 

Item 

MAST M-F DRI SALCE CAGE+6 CAGE+C 

True Classifications 

Positives 42.3 41.7 42.9 48.5 48.6 35.6 

Negatives 39.4 30.6 30.6 27.1 12.0 35.8 

All 81.7 72.3 73.5 75.6 60.6 71.4 

False Classifications 

Positives 7.1 15.7 16.8 20.2 34.8 11.0 

Negatives 11.2 11.9 9.7 4.2 4.7 17.6 

All 18.3 27.6 26.5 24.4 39.5 28.6 

Note: Numbers are percentages 

37 
Validation of Problem Drinking Screening Instruments for DWI Offenders 

"CAGE+6" includes the four CAGE questions plus the six questions relating to 

daily consumption of alcohol in grams. The additional "screening instrument," 

identified as "CAGE+C" includes the four CAGE questions plus five of the six 

consumption questions. 

It is seen that for MAST, which was correct on 81.7 percent of subjects, 42.3 

percent of the true classifications were positives (problem drinkers) and 39.4 percent 

were negatives (not problem drinkers). For the 18.3 percent that were incorrectly 

classified by MAST, 7.1 percent were false positives and 11.2 percent were false 

negatives. Thus, from the table, if one were to measure success solely on overall 

agreement with the criterion measure, the MAST and SALCE would appear to be the 

most successful, the DRI, Mortimer-Filkins, and CAGE+C somewhat less successful, 

and the full "CAGE+6" the least successful. 

Another way of examining the same data appears in Table 3. In this table, the 

two rows represent respectively the percentage of problem drinkers categorized as 

problem drinkers by the screening instrument and the percentage of non-problem 

drinkers categorized as non-problem drinkers. Thus, the MAST correctly identified 

79 percent of all problem drinkers and 85 percent of non-problem drinkers. This type 

of table could be useful to program administrators in identifying the "optimal" 

screening instrument for their use. For instance, the SALCE was clearly the most 

sensitive instrument, identifying 92 percent of all problem drinkers. However, it was 

also clearly not very specific in that 43 percent of non-problem drinkers are 

incorrectly identified as problem drinkers. Nevertheless, a program that makes 

treatment decisions solely on the basis of the screening instrument and also offers a 

relatively inexpensive treatment program, might choose to use the SALCE and accept 

the likelihood that many people not needing treatment will be sent to treatment. This 

table can be used to help support these types of considerations. 

Table 7: Percentage of Subjects Correctly Diagnosed by Various Screening 

Instruments 

Screening Instrument 

Criterion Instrument 

Diagnosis MAST M-F DRI SALCE CAGE+6 CAGE+C 

Problem Drinker 79 78 82 92 83 72 

Not Problem Drinker 85 66 65 57 26 76

38 
7 - CONCLUSIONS AND RECOMMENDATIONS

This project was a validation study for four adult screening instruments in use for 

preliminary screening of DWI offenders for problem drinking. An additional task 

involved the validation of a small group of questions to be added to a telephone 

questionnaire to assist in identifying problem drinkers among respondents. 

All of the assessment instruments were effective in identifying problem drinkers 

as classified by the criterion instrument. The most sensitive instrument, the SALCE, 

which correctly identified 92% of problem drinkers was, not surprisingly, the least 

discerning of the instruments studied, only identifying 57% of non-problem drinkers 

correctly. Thus an implicit cost of using this instrument to identify problem drinkers 

for further examination or treatment is that the program would be dealing with a 

greater number of persons presumably not in need of this further action. 

The other three adult instruments studied, the MAST, Mortimer-Filkins and DRI 

were all somewhat less sensitive than the SALCE, correctly identifying about 80% 

of problem drinkers with fewer false positives. The Mortimer-Filkins and DRI 

correctly identified approximately two-thirds of non-problem drinkers and the MAST 

was accurate 85% of the time. This finding is somewhat surprising in that the MAST 

is a much shorter instrument with a good deal of face validity and one might expect 

that problem drinkers not wishing to be detected could fairly easily trick it. 

Additionally, the even shorter CAGE plus consumption calculation correctly 

identified non-problem drinkers 76% of the time. 

That the MAST and CAGE did so well may be an artifact of our experimental 

design. Though the instruments were administered to DWI offenders in their 

treatment programs, they were assured that the data would be used only for research 

purposes. This may have led to more truthful responses on both the instruments 

being studied and the criterion. An improvement over this design in future studies 

might be to conduct the validation study in programs using the instrument under 

study for the actual classification and administering the criterion measure with 

assurances of confidentiality. This was not feasible in this study because of 

NHTSA's desire to study several instruments simultaneously. 

Another problem we encountered was in obtaining information from collaterals. 

This may be feasible within a formal treatment protocol where repeated follow-up 

with the patient is possible. However, in this study we had only one contact with 

each subject and assured them of anonymity. Thus if they provided us with 

inaccurate phone numbers for collaterals or the collaterals were unwilling to 

cooperate we had no recourse. Additionally a substantial number of subjects refused 

to provide collateral contact information and we could not compel them to do so. 

One important point the reader should bear in mind is that the instruments studied 

were designed as screening instruments, not the final diagnostic tool. Ideally, 

persons testing positive on the instruments should move on to a further, independent 

clinical assessment which confirms or rejects the screening instrument results and in 

39 
Validation of Problem Drinking Screening Instruments for DWI Offenders 

which the appropriate treatment regimen is identified. Of course, there are 

jurisdictions where such resources are not available and the screening instrument is 

used to decide the intensity of the program to which a DWI offender is sentenced. 

In those less than ideal instances, program administrators may use the results of this 

study to identify the screening instrument which best meets their needs. 

The adolescent criterion measure (Appendix C) developed during this project was 

not validated during this project and is available to the research community. The 

adult criterion measure (Appendix B) developed during this study is also available 

for use in other studies. 

We believe that future research in this specific area should focus on refining the 

criterion measure, including a prospective validity study. One criticism of the 

criterion measure is that it is the best product of a group of experts but that it is just 

the result of their thinking and has not been verified. A prospective validity study 

could put that criticism to rest by establishing how accurately the criterion measure 

identifies persons in whom problem drinking is further manifested. 

A further recommendation is that future validation studies validate instruments 

being used in their natural context. 

In the meantime, program administrators using any of the instruments studied 

here can be confident that they are identifying a large proportion of the problem 

drinkers in their client pool for further assessment or treatment. 

40 
REFERENCES

Jacobson, G.R. Detection, assessment, and diagnosis of alcoholism: Current 

techniques. In M. Galanter (ed.), Recent developments in alcoholism, Vol. 1; 

New York: Plenum Press, 1983. 

Mischke, H.D. and Venneri, R.L. Reliability and Validity of the MAST, MortimerFilkins Questionnaire and CAGE in DWI assessment. Journal of Studies on 

Alcohol, 1987, 48, 492-501. 

Selzer, M.L. The Michigan Alcoholism Screening Test: The quest for a new 

diagnostic instrument. American Journal of Psychiatry, 1971,127, 89-94. 

Yoder, R.D., and Moore, R.A. Characteristics of convicted drunken drivers, 

Quarterly Journal of Studies on Alcohol, 1973, 34, 927-936. 

Mortimer, R.G., Filkins, L.D., and Lower, J.S. Court Procedures for Identifying 

Problem Drinkers: Final Report. DOT Contract FH-11-7615, Highway Safety 

Research Institute, University of Michigan, Ann Arbor, 1971. 

Wendling, A., and Kolody, B. Evaluation of the Mortimer-Filkins as a predictor of 

alcohol-impaired driving recidivism. Journal of Studies on Alcohol, 1982, 43, 

751-766. 

Bush, B., Shaw, S. And Clearly, P. Screening for alcohol abuse using the CAGE 

questionnaire. American Journal of Medicine, 1987, 82, 231-235. 

Ewing, J.A. Detecting alcoholism: The CAGE questionnaire. Journal of the 

American Medical Association, 1984, 252, 1905-1907. 

Mayfield, D., McLeod, G., and Hall, P. The CAGE questionnaire: Validation of a 

new alcoholism screening instrument. American Journal of Psychiatry, 1974, 

131, 1121-1123. 

Skinner, H.D. and Holt, S. The Alcohol Clinical Index: Strategies for Identifying 

Patients with Alcohol Problems. Toronto, Addiction Research Foundation, 1987. 

Popkin, C.L., Kannenberg, C.H., Lacey, J.H. and Waller, P.F. Assessment of 

Classification Instruments Designed to Detect Alcohol Abuse, Chapel Hill, NC, 

University of North Carolina Highway Safety Research Center, 1988. 

41 
Validation of Problem Drinking Screening Instruments for DWI Offenders 

42 
APPENDIX A - TABLES

43 
--------------------------------------------------------------------------------------------------

Table A-1: Adult Problem Drinkers, Criterion Rating Means as a Function of Criterion and 

Criterion Group 

Criterion Mean, Mean, Mean, Mean, 

Criterion Group Discrim Obtain Feas Cost 

Recent Use, Alcohol on breath, PBT Consumption 2.57143 2.71429 3.00000 3.00000 

Recent Use, BAC at arrest, Breath Consumption 2.28571 2.85714 3.00000 3.00000 

Recent Use, BAC at ER, Blood Consumption 2.28571 1.57143 2.00000 2.60000 

Recent Use, SAC at prior arrest, Breath Consumption 1.57143 2.28571 2.66667 3.00000 

Recent Use, BAC test refusal, Log Consumption 2.20000 2.66667 3.00000 3.00000 

Recent Use, Drug metabolites, Urine Consumption 1.57143 1.50000 1.40000 2.33333 

Recent Use, Drug metabolites, Hair Consumption 1.33333 1.83333 1.50000 1.80000 

Recent Use, Drug metabolites, Blood Consumption 1.57143 1.33333 1.20000 1.66667 

Symp 61 arr, Speech impairment, FT Consumption 2.28571 2.50000 2.20000 2.57143 

Symp a arr, Alcohol on breath, FT Consumption 2.00000 2.50000 2.20000 2.57143 

Symp 51 arr, Gait, FT Consumption 2.50000 2.50000 2.20000 2.57143 

Symp 51 arr, Field sobr test, FT Consumption 2.50000 2.50000 2.20000 2.57143 

Parapherna, Evidence in veh, Fl Consumption 1.66667 2.28571 1.80000 3.00000 

Heavy drnk, Q-F by beverage, Colt Consumption 2.66667 2.66667 3.00000 2.66667 

Heavy drnk, Q-F by beverage, SR Consumption 3.00000 2.80000 3.00000 3.00000 

Chron drnk, Duration, Cott Consumption 2.85714 2.28571 2.66667 2.57143 

Chron drnk, Duration, SR Consumption 2.80000 2.60000 2.80000 2.80000 

Chron drnk, Years of drnk, Colt Consumption 2.71429 2.28571 2.66667 2.57143 

Chron drnk, Years of drnk, SR Consumption 2.50000 2.75000 2.75000 2.75000 

Chron drnk, Years of abst, Colt Consumption 2.42857 2.28571 2.66667 2.57143 

Chron drnk, Years of abst, SR Consumption 2.75000 2.75000 2.75000 2.75000 

Drnk+drugs, Other drug use, Coll Consumption 2.33333 2.16667 2.40000 2.66667 

Drnk+drugs, Other drug use, SR Consumption 2.40000 2.80000 2.80000 2.80000 

Rapid drnk, Speed of drnk, Colt Consumption 2.00000 2.00000 2.00000 2.80000 

Rapid drnk, Speed of drnk, SR Consumption 2.60000 2.40000 2.20000 2.60000 

Inapp cont, Time of day, Colt Consumption 2.50000 2.16667 2.40000 2.66667 

Inapp cont, Time of day, SR Consumption 2.60000 2.60000 2.80000 2.80000 

Inapp cont, Places of drnk, Colt Consumption 2.33333 2.16667 2.40000 2.66667 

Inapp cont, Places of drnk, SR Consumption 2.20000 2.60000 2.80000 2.80000 

Early onset, Age b1 1st drnk, Colt Consumption 2.66667 2.16667 2.40000 2.66667 

Early onset, Age bl 1st drnk, SR Consumption 2.50000 2.50000 2.66667 2.83333 

Early onset, Age 61 1st prbtm, Colt Consumption 2.83333 2.16667 2.40000 2.66667 

Early onset, Age a 1st prbtm, SR Consumption 2.83333 2.50000 2.66667 2.83333 

Early onset, Age fit 1st help, Colt Consumption 2.83333 2.16667 2.40000 2.66667 

Early onset, Age l 1st help, SR Consumption 2.83333 2.50000 2.66667 2.83333 

Biol marker, Gamma GT, Blood Consumption 2.50000 2.00000 1.40000 1.50000 

Biol marker, Urin dolic, Urine Consumption 2.60000 2.40000 1.75000 1.60000 

Biol marker, CDT, * Consumption 2.40000 2.20000 1.33333 1.50000 

Biot marker, AST, Blood Consumption 2.20000 2.20000 1.50000 1.60000 

Biot marker, MCV, Blood Consumption 2.40000 2.20000 1.50000 1.60000 

Biol marker, ACH, * Consumption 2.50000 2.25000 1.33333 1.50000 

Tobacco inv, Smoking, SR Consumption 1.28571 2.28571 2.83333 2.85714 

Tobacco inv, Chewing, SR Consumption 1.16667 2.28571 2.83333 2.85714 

Rec drg use, Q-F by drug, SR Consumption 2.71429 2.42857 2.66667 2.85714 

Rec drg use, Top drug, SR Consumption 2.71429 2.42857 2.66667 2.85714 

Rec drg use, Pattern, SR Consumption 2.71429 2.42857 2.66667 2.85714 

Rec drg use, Setting drugs, SR Consumption 2.66667 2.42857 2.50000 2.85714 

Pr drg prbL, Age 51 1st use, SR Consumption 2.42857 2.57143 2.50000 2.85714 

Pr drg prbl, Age a 1st prbtm, SR Consumption 2.57143 2.57143 2.50000 2.85714 

Pr drg prbl, Age 51 1st help, SR Consumption 2.57143 2.57143 2.50000 2.85714 

Pr drg prbl, Time day/day wk, SR Consumption 2.42857 2.57143 2.50000 2.85714 

Pr drg prbl, Past drg scrns, Archives Consumption 2.42857 1.83333 2.40000 2.42857 

DSM IIIR symp, Withdrawal, SR Dependence 3.00000 2.57143 2.33333 2.42857 

DSM IIIR symp, Withdrawal, Colt Dependence 2.80000 2.20000 2.00000 2.20000 

DSM IIIR symp, Tolerance, SR Dependence 3.00000 2.57143 2.33333 2.42857 

DSM IIIR symp, Tolerance, Colt Dependence 2.80000 2.20000 2.00000 2.20000 

DSM IIIR symp, Preoccupation, SR Dependence 3.00000 2.57143 2.33333 2.42857 

DSM IIIR symp, Preoccupation, Colt Dependence 2.80000 2.20000 2.00000 2.20000 

DSM IIIR symp, Loss cntrl, SR Dependence 3.00000 2.57143 2.33333 2.42857 

DSM IIIR symp, Loss cntrl, Colt Dependence 2.80000 2.20000 2.00000 2.20000 

DSM IIIR symp, Persistence, SR Dependence 3.00000 2.57143 2.33333 2.42857 

DSM IIIR symp, Persistence, Colt Dependence 2.80000 2.20000 2.00000 2.20000 

44 
-------------------------------------------------------------------------------------------------------------------------------------------------

Table A-2: Adult Problem Drinkers, Criterion Rating Means as a Function of Criterion and 

Criterion Group (Continued) 

Criterion Mean, Mean, Mean, Mean,

Criterion Group Discrim Obtain Feas Cost

Hist of dpnd, DTs, Med hist Dependence 2.85714 1.85714 1.66667 2.28571 

Hist of dpnd, # trt epis, Med hist Dependence 3.00000 1.66667 1.80000 2.50000 

Hist of dpnd, # detox, Med hist Dependence 3.00000 1.66667 1.50000 2.66667 

Med problems, Gross tremor, Dependence 2.33333 1.66667 1.60000 1.80000 

Med problems, Nystagmus, * Dependence 2.40000 1.60000 1.50000 1.80000 

Med problems, Imp cogn func, Dependence 2.20000 1.80000 1.50000 1.80000 

Med problems, Acute abst synd, ARF index Dependence 2.57143 2.14286 2.00000 2.00000 

Med problems, Alc withdrawal, ARF index Dependence 2.50000 2.16667 2.00000 2.14286 

Elev BAC iJ arr, BAC, Breath Dependence 2.00000 2.33333 2.60000 2.66667 

Pr traff off, DWI arrests, Consequences 3.00000 2.50000 2.80000 2.83333 

Pr traff off, 0th drug-rel arr, * Consequences 2.50000 2.40000 2.50000 2.80000 

Pr traff off, BAC test ref, * Consequences 2.83333 2.40000 2.50000 2.83333 

Non-traff off, Domest viol arr, * Consequences 2.16667 2.14286 2.33333 2.83333 

Soc serv cont, *, * Consequences 2.50000 1.75000 1.25000 1.33333 

Life rote, Workplace, * Consequences 2.28571 2.71429 2.66667 2.85714 

Life rote, School, Consequences 2.42857 2.71429 2.66667 2.85714 

Life role, Marital, Consequences 2.42857 2.71429 2.66667 2.85714 

Life rote, Financial, * Consequences 2.42857 2.71429 2.66667 2.85714 

Life rote, Legal, * Consequences 2.42857 2.71429 2.66667 2.85714 

Life rote, Drugs, * Consequences 2.42857 2.71429 2.66667 2.85714 

Life rote, Psychiatric, Consequences 2.42857 2.71429 2.66667 2.85714 

Life role, Psycosociat distress, * Consequences 2.42857 2.71429 2.66667 2.85714 

Hist of trauma, MV inj, * Consequences 2.33333 2.28571 2.33333 2.83333 

Hist of trauma, 0th acc inj, * Consequences 2.60000 2.16667 2.20000 2.80000 

Hist of trauma, Intentional inj, * Consequences 2.20000 2.16667 2.00000 2.60000 

Hist of trauma, Suicide attempts, Consequences 2.20000 2.16667 2.00000 2.60000 

Liver function, CGT, * Consequences 2.25000 1.40000 1.66667 2.00000 

Liver function, Diagn of cirrhosis, Consequences 2.25000 2.00000 1.66667 1.50000 

GI problems, *, Consequences 1.50000 1.83333 1.40000 2.00000 

Hypertension, Consequences 1.50000 1.83333 1.40000 2.00000 

Cardioput prbtms, *, Consequences 1.50000 1.83333 1.40000 2.33333 

impaired sexual func, Consequences 1.42857 2.00000 1.83333 2.60000 

Blackouts, hangovers, Consequences 2.71429 2.57143 2.50000 2.83333 

Acute intox syndrome, Consequences 3.00000 2.57143 2.50000 2.83333 

Neurolog symptoms, Consequences 2.14286 2.16667 1.80000 1.80000 

STD, *, * Consequences 1.83333 2.00000 1.66667 2.16667 

Family hist atc abuse, Vulnerability 2.42857 2.85714 2.85714 2.57143 

Substance abuse, *, * Vulnerability 2.28571 2.57143 2.83333 2.83333 

Personality disorder, Vulnerability 1.85714 2.14286 -2.50000 2.66667 

Anti-social history, *, Vulnerability 2.00000 2.28571 2.50000 2.66667 

Hi risk fact in child - gent, Vulnerability 2.16667 2.16667 2.20000 2.60000 

Hi risk fact in child - ADD, Vulnerability 2.00000 2.28571 2.33333 2.66667 

Hi risk fact in child - Hyper, Vulnerability 2.00000 2.28571 2.33333 2.66667 

Hi risk fact in child - Sex abuse, Vulnerability 2.00000 2.28571 2.33333 2.66667 

Hi risk fact in child - cond disord, Vulnerability 2.00000 2.28571 2.33333 2.66667 

Other, Self-medic mood enhanc, SR Vulnerability 2.20000 2.40000 2.60000 2.60000 

Other, Reasons for drinking, SR Vulnerability 2.20000 2.20000 2.40000 2.60000 

Other, Expect of drnk benefit, SR Vulnerability 2.00000 2.20000 2.40000 2.60000 

45 
Table A-3: Adult Problem Drinkers, Rating Means Sorted by Discriminability Mean as a

Function of Criterion and Criterion Group

Criterion Mean, Mean, Mean, Mean,

Criterion Group Discrim Obtain Feas Cost

------------------------------------------------ ---------

Heavy drnk, Q-F by beverage, SR Consumption 3.00000 2.80000 3.00000 3.00000

DSM IIIR symp, Withdrawal, SR Dependence 3.00000 2.57143 2.33333 2.42857

DSM IIIR symp, Tolerance, SR Dependence 3.00000 2.57143 2.33333 2.42857

DSM IIIR symp, Preoccupation, SR Dependence 3.00000 2.57143 2.33333 2.42857

DSM IIIR symp, Loss cntrl, SR Dependence 3.00000 2.57143 2.33333 2.42857

DSM IIIR symp, Persistence, SR Dependence 3.00000 2.57143 2.33333 2.42857

Hist of dpnd, # trt epis, Med hist Dependence 3.00000 1.66667 1.80000 2.50000

Hist of dpnd, # detox, Med hist Dependence 3.00000 1.66667 1.50000 2.66667

Pr traff off, DWI arrests, Consequences 3.00000 2.50000 2.80000 2.83333

Acute intox syndrome, *, * Consequences 3.00000 2.57143 2.50000 2.83333

Chron drnk, Duration, Colt Consumption 2.85714 2.28571 2.66667 2.57143

Hist of dpnd, DTs, Med hist Dependence 2.85714 1.85714 1.66667 2.28571

Early onset, Age fil 1st prblm, Colt Consumption 2.83333 2.16667 2.40000 2.66667

Early onset, Age 51 1st prblm, SR Consumption 2.83333 2.50000 2.66667 2.83333

Early onset, Age bl 1st help, Cott Consumption 2.83333 2.16667 2.40000 2.66667

Early onset, Age a 1st help, SR Consumption 2.83333 2.50000 2.66667 2.83333

Pr traff off, BAC test ref, Consequences 2.83333 2.40000 2.50000 2.83333

Chron drnk, Duration, SR Consumption 2.80000 2.60000 2.80000 2.80000

DSM IIIR symp, Withdrawal, Colt Dependence 2.80000 2.20000 2.00000 2.20000

DSM IIIR symp, Tolerance, Colt Dependence 2.80000 2.20000 2.00000 2.20000

DSM IIIR symp, Preoccupation, Colt Dependence 2.80000 2.20000 2.00000 2.20000

DSM IIIR symp, Loss cntrt, Colt Dependence 2.80000 2.20000 2.00000 2.20000

DSM IIIR symp, Persistence, Colt Dependence 2.80000 2.20000 2.00000 2.20000

Chron drnk, Years of abst, SR Consumption 2.75000 2.75000 2.75000 2.75000

Chron drnk, Years of drnk, Colt Consumption 2.71429 2.28571 2.66667 2.57143

Rec drg use, Q-F by drug, SR Consumption 2.71429 2.42857 2.66667 2.85714

Rec drg use, Top drug, SR Consumption 2.71429 2.42857 2.66667 2.85714

Rec drg use, Pattern, SR Consumption 2.71429 2.42857 2.66667 2.85714

Blackouts, hangovers, *, * Consequences 2.71429 2.57143 2.50000 2.83333

Heavy drnk, Q-F by beverage, Cott Consumption 2.66667 2.66667 3.00000 2.66667

Early onset, Age 51 1st drnk, Colt Consumption 2.66667 2.16667 2.40000 2.66667

Rec drg use, Setting drugs, SR Consumption 2.66667 2.42857 2.50000 2.85714

Rapid drnk, Speed of drnk, SR Consumption 2.60000 2.40000 2.20000 2.60000

Inapp cont, Time of day, SR Consumption 2.60000 2.60000 2.80000 2.80000

Biol marker, Urin dotic, Urine Consumption 2.60000 2.40000 1.75000 1.60000

Hist of trauma, Oth acc inj, * Consequences 2.60000 2.16667 2.20000 2.80000

Recent Use, Alcohol on breath, PBT Consumption 2.571.43 2.71429 3.00000 3.00000

Pr drg prbt, Age fil 1st prbtm, SR Consumption 2.57143. 2.57143 2.50000 2.85714

Pr drg prbt, Age a 1st help, SR Consumption 2.57143 2.57143 2.50000 2.85714

Med problems, Acute abst synd, ARF index Dependence 2.57143 2.14286 2.00000 2.00000

Symp 51 arr, Gait, FT Consumption 2.50000 2.50000 2.20000 2.57143

Symp 51 arr, Field sobr test, FT Consumption 2.50000 2.50000 2.20000 2.57143

Chron drnk, Years of drnk, SR Consumption 2.50000 2.75000 2.75000 2.75000

Inapp cont, Time of day, Colt Consumption 2.50000 2.16667 2.40000 2.66667

Early onset, Age a 1st drnk, SR Consumption 2.50000 2.50000 2.66667 2.83333

Biot marker, Gamma GT, Blood Consumption 2.50000 2.00000 1.40000 1.50000

Biot marker, ACH, * Consumption 2.50000 2.25000 1.33333 1.50000

Med problems, Atc withdrawal, ARF index Dependence 2.50000 2.16667 2.00000 2.14286

Pr traff off, 0th drug-rel arr, Consequences 2.50000 2.40000 2.50000 2.80000

Soc serv cont, *, * Consequences 2.50000 1.75000 1.25000 1.33333

Chron drnk, Years of abst, Colt Consumption 2.42857 2.28571 2.66667 2.57143

Pr drg prbl, Age 1 1st use, SR Consumption 2.42857 2.57143 2.50000 2.85714

Pr drg prbl, Time day/day wk, SR Consumption 2.42857 2.57143 2.50000 2.85714

Pr drg prbl, Past drg scrns, Archives Consumption 2.42857 1.83333 2.40000 2.42857

Life role, School, * Consequences 2.42857 2.71429 2.66667 2.85714

Life role, Marital, Consequences 2.42857 2.71429 2.66667 2.85714

Life role, Financial, * Consequences 2.42857 2.71429 2.66667 2.85714

Life role, Legal, * Consequences 2.42857 2.71429 2.66667 2.85714

Life role, Drugs, * Consequences 2.42857 2.71429 2.66667 2.85714

Life role, Psychiatric, Consequences 2.42857 2.71429 2.66667 2.85714

46
Table A-4: Adult Problem Drinkers, Rating Means Sorted by Discriminability Mean as a 

Function of Criterion and Criterion Group (Continued) 

Criterion Mean, Mean, Mean, Mean, 

Criterion Group Discrim Obtain Feas Cost 

Drnk+drugs, other drug use, SR Consumption 2.40000 2.80000 2.80000 2.80000 

Biol marker, CDT, * Consumption 2.40000 2.20000 1.33333 1.50000 

Biol marker, MCV, Blood Consumption 2.40000 2.20000 1.50000 1.60000 

Med problems, Nystagmus, Dependence 2.40000 1.60000 1.50000 1.80000 

Drnk+drugs, Other drug use, Coll Consumption 2.33333 2.16667 2.40000 2.66667 

Inapp cont, Places of drnk, Colt Consumption 2.33333 2.16667 2.40000 2.66667 

Med problems, Gross tremor, Dependence 2.33333 1.66667 1.60000 1.80000 

Hist of trauma, MV inj, * Consequences 2.33333 2.28571 2.33333 2.83333 

Recent Use, BAC at arrest, Breath Consumption 2.28571 2.85714 3.00000 3.00000 

Recent Use, BAC at ER, Blood Consumption 2.28571 1.57143 2.00000 2.60000 

Symp 61 arr, Speech impairment, FT Consumption 2.28571 2.50000 2.20000 2.57143 

Life role, Workplace, Consequences 2.28571 2.71429 2.66667 2.85714 

Substance abuse, *, * Vulnerability 2.28571 2.57143 2.83333 2.83333 

Liver function, CGT, Consequences 2.25000 1.40000 1.66667 2.00000 

Liver function, Diagn of cirrhosis, Consequences 2.25000 2.00000 1.66667 1.50000 

Recent Use, BAC test refusal, Log Consumption 2.20000 2.66667 3.00000 3.00000 

Inapp cont, Places of drnk, SR Consumption 2.20000 2.60000 2.80000 2.80000 

Biol marker, AST, Blood Consumption 2.20000 2.20000 1.50000 1.60000 

Med problems, Imp cogn func, Dependence 2.20000 1.80000 1.50000 1.80000 

Hist of trauma, Intentional inj, Consequences 2.20000 2.16667 2.00000 2.60000 

Hist of trauma, Suicide attempts, Consequences 2.20000 2.16667 2.00000 2.60000 

Other, Self-medic mood enhanc, SR Vulnerability 2.20000 2.40000 2.60000 2.60000 

Other, Reasons for drinking, SR Vulnerability 2.20000 2.20000 2.40000 2.60000 

Non-traff off, Domest viol arr, Consequences 2.16667 2.14286 2.33333 2.83333 

Hi risk fact in child - gent, Vulnerability 2.16667 2.16667 2.20000 2.60000 

Neurotog symptoms, *, Consequences 2.14286 2.16667 1.80000 1.80000 

Symp bl arr, Alcohol on breath, FT Consumption 2.00000 2.50000 2.20000 2.57143 

Rapid drnk, Speed of drnk, Colt Consumption 2.00000 2.00000 2.00000 2.80000 

Elev BAC a arr, BAC, Breath Dependence 2.00000 2.33333 2.60000 2.66667 

Anti-social history, *, * Vulnerability 2.00000 2.28571 2.50000 2.66667 

Hi risk fact in child - ADD, Vulnerability 2.00000 2.28571 2.33333 2.66667 

Hi risk fact in child - Hyper, Vulnerability 2.00000 2.28571 2.33333 2.66667 

Hi risk fact in child - Sex abuse, Vulnerability 2.00000 2.28571 2.33333 2.66667 

Hi risk fact in child - cond disord, Vulnerability 2.00000 2.28571 2.33333 2.66667 

Other, Expect of drnk benefit, SR Vulnerability 2.00000 2.20000 2.40000 2.60000 

Personality disorder, Vulnerability 1.85714 2.14286 2.50000 2.66667 

STD, *, * . Consequences 1.83333 2.00000 1.66667 2.16667 

Parapherna, Evidence in veh, F1 Consumption 1.66667 2.28571 1.80000 3.00000 

Recent Use, BAC at prior arrest, Breath Consumption 1.57143 2.28571 2.66667 3.00000 

Recent Use, Drug metabolites, Urine Consumption 1.57143 1.50000 1.40000 2.33333 

Recent Use, Drug metabolites, Blood Consumption 1.57143 1.33333 1.20000 1.66667 

GI problems, Consequences 1.50000 1.83333 1.40000 2.00000 

Hypertension, *, Consequences 1.50000 1.83333 1.40000 2.00000 

Cardiopul prblms, Consequences 1.50000 1.83333 1.40000 2.33333 

Impaired sexual func, Consequences 1.42857 2.00000 1.83333 2.60000 

Recent Use, Drug metabolites, Hair Consumption 1.33333 1.83333 1.50000 1.80000 

Tobacco inv, Smoking, SR Consumption 1.28571 2.28571 2.83333 2.85714 

Tobacco inv, Chewing, SR Consumption 1.16667 2.28571 2.83333 2.85714 

47 
------------------------------ ---------------------------------------------

Table A-5: Means of Criterion Ratings, Adult Problem Drinkers by 

Criterion Group 

GROUP N Obs Variable Label

Mean Std Error 

Consumption 364R1 Discriminability 2.371 0.040 

R2 ObtainabiLity 2.342 0.038 

R3 Feasibility 2.413 0.041 

R4 Cost 2.601 0.034 

Dependence 133

R1 Discriminability 2.743 0.051 

R2 Obtainability 2.167 0.077 

R3 Feasibility 2.021 0.064 

R4 Cost 2.274 0.058 

Consequences 189

R1 Discriminability 2.293 0.055 

R2 Obtainability 2.325 0.056 

R3 Feasibility 2.232 0.064 

R4 Cost 2.633 0.055 

Vulnerability 84R1 Discriminability 2.091 0.046 

R2 ObtainabiLity 2.338 0.054 

R3 Feasibility 2.478 0.076 

R4 Cost 2.652 0.061 

48 
Table A-6: Sources of Items - Consumption 

Self Report Collateral 

Item Adult Adolescents Adults Adolescents 

Q-F by beverage HAP, 36-47 ADI -- --

Chronic drinking, CDP ADI CDP ADI-P 

duration at current 

level 

Chronic drinking, years CDP ADI (months) CDP ADI-P 

of abstinence (months) 

Drug use by drug (fre- IAP, HAP ADI -- --

quency) 

Preferred drug IAP, ASI ADI -- --

Inappropriate context, CDP ADI CDP ADI-P 

time and place, alcohol 

Age at first drink IAP ADI --

Age at first drug use IAP ADI -- --

Context of drug use, CDP (mod), AD1 -- --

time and place HAP 

Drinking plus drug use, HAP (mod) HAP (mod) HAP (298 HAP (298 

other drug use rev) rev) 

Which drugs do you -- -- Form 90-C ADI-P 

think they use 

Which drugs most -- -- CDIP-C ADI-P 

frequently used, 

relative frequency 

Now long known -- -- CDIP-C Form 90-C 

respondent (at 

beginning) 

49 
Table A-7: Sources of Items - Dependence 

Self Report Collateral 

Item Adult Adolescents Adults Adolescents 

DSM-IIIR, withdrawal DIS ADI RDC, DIS ADI 

DSM-IIIR, tolerance DIS ADI -- -­

DSM-IIIR, pre-occupation DIS ADI -- -­

DSM-IIIR, loss of control DIS ADI RDC, DIS ADI 

DSM-IIIR, persistence DIS ADI RDC, DIS ADI 

History of dependence, no. of IAP or ASI ADI -- -­

treatment episodes 

History of dependence, no. of IAP or ASI ADI -- -­

detoxifications 

History of dependence, no. of DIS, CDP ADI -- --

DTs 

Impaired cognitive function ADI ADI -- -­

Age at first problem, alcohol CDP -- -- -­

Age at first help, alcohol CDP ADI -- -­

Age at first problem, drugs CDP (mod) -- -- -­

Age at first help, drugs CDP (mod) ADI -- -­

Gross tremor Observation -- -- -­

Have you ever had a problem ASI ASI -- -­

with alcohol? 

When was your last drink? ASI ASI -- -­

How troubled or bothered are IAP no. D23 IAP no. D23 -­

you by alcohol problems? 

How important to you is IAP no. D24 IAP no. D24 -- -­

treatment for your alcohol 

problem?

How severe is the subject's -- -- IAP no. D23 IAP no. D23

alcohol problem? (mod) (mod)

Does the subject need treatment -- -- IAP no. D24 IAP no. D24 

for an alcohol problem? (mod) (mod) 

50 
Table A-8: Sources of Items - Consequences 

Item 

History of trauma / medical 

history 

Accidental injuries 

Cirrhosis 

Hepatitis 

Intentional injury 

Suicide attempts 

DTs 

impaired cognitive 

function 

Memory problems 

Life role 

School 

Work 

Financial 

Legal, conduct 

disorders 

Psychiatric 

Psychosocial distress 

Peer relations 

Opposite sex 

Self Report Collateral 

Adult Adolescents Adults Adolescents 

TS expanded TS expanded TS expanded TS expanded 

(rev) (rev) 

TS expanded TS expanded TS expanded TS expanded 

(rev) (rev) 

TS expanded TS expanded TS expanded TS expanded 

(rev) (rev) 

TS expanded TS expanded TS expanded TS expanded 

(rev) (rev) 

TS expanded TS expanded TS expanded TS expanded 

(rev) (rev) 

DIS, CDP ADI DIS, CDP ADI (rev) 

(rev) 

ASI ASI ASI ASI 

ASI ASI ASI ASI 

ASI APSI ASI (rev) APSI (rev) 

ASI APSI ASI (rev) APSI (rev) 

ASI APSI ASI (rev) APSI (rev) 

ASI APSI ASI (rev) APSI (rev) 

ASI APSI ASI (rev) APSI (rev) 

ASI APSI ASI (rev) APSI (rev) 

ASI APSI ASI (rev) APSI (rev) 

ASI APSI ASI (rev) APSI (rev) 

51 
Table A-9: Sources of Items - Vulnerability 

Self Report Collateral 

Item Adult Adolescents Adults Adolescents 

Family history, sub- IAP (D22) ADI ADI -P 

stance abuse 

Self-medication, mood AEQ AEQ add 

enhancement 

Reasons for drinking AEQ, HAP AEQ (add) 

(83) 

Table A-10: Other Sources 

Source Item Criterion Category 

Driver History File Number of prior DWI arrests Consequences 

Number of prior BAC test refusal Consequences 

Number of prior moving violations Consequences 

Number of prior crashes Consequences 

Alcohol Incidence 

Report 

Symptoms at arrest, gait 

Symptoms at arrests, field sobriety test result 

Consumption 

Consumption 

Symptoms at arrest, nystagmus Consumption 

BAC at arrest Consumption 

Breath test refusal Consumption 

General demeanor Consumption 

Emergency Room BAC at admission (recent use) Consumption 

Records 

Breath Test Log BAC at arrest (recent use) Consumption 

BAC test refusal (recent use) Consumption 

Police Information Number of non-traffic offenses Consequences 

Network 

Urine Test Urine screen for drugs Consumption 

52 
APPENDIX B - ADULT CRITERION INSTRUMENT

53 
Interviewer 

Date of Interview 

Code Number FIELDU 

Comprehensive Adult Interview - Alcohol 

1.Name 

(first) (middle or maiden names) (last) 

(Any nicknames or other names) 

2. Current Address 

3. State of Drivers License4. Drivers License Number 

5.Social Security Number - - 6. Gender M F 

(circle one) 

7. Current Social Status (circle one): Married / Never Married / Divorced / Separated / Widowed 

8. Number of Children9. Respondent's Date of Birth: 

/ / 

Month Day Year 

10. Height

11. Weight 

12. Race (circle one) 

Response categories:

I = White (Not of Hispanic Origin)

2 = Black (Not of Hispanic Origin), African-American

3 = American Indian, Native American

4 = Alaskan Native

5 = Asian or Pacific Islander

6 = Hispanic American of Mexican origin

7 = Hispanic American of Puerto Rican origin

8 = Hispanic American of Cuban origin

9 = Other Hispanic

13. Breath test result 

Now I'd like to ask you a few questions about your reasons for drinking. 

54 
14. How important to you is (was) each of the following as a reason for drinking? 

Reason Not at all Somewhat Important Very Extremely Refuses 

Important important Important Important 

a. To become more social 

b. Because you like the 

taste 

c.­Because the people you 

know drink 

d. When you want to forget your problems 

e. Because it helps you 

relax 

f Because it helps you go 

to sleep 

g. Out of habit 

h. To celebrate special 

occasions 

i. Because it helps you 

forget your worries 

j. Because a small drink 

improves your 

appetite for food 

k.­ Because it is the 

polite thing to do in 

certain situations 

1. Because it helps 

cheer you up when 

you're in a bad mood 

m. Because it helps 

when you're tense 

and nervous 

n. Because it helps you 

when you're angry with 

someone 

15. How old were you the first time you used alcohol on about a monthly basis? (years) 

55 
Think about the days when you drank alcohol during the last 30 days: 

One standard drink is approximately: 

12 oz (341 ml) bottle or can of beer (5% alcohol) 

or 1.5 (43 ml) shot of liquor (40% alcohol) 

or 5 oz (142 ml) glass of wine (11% alcohol) 

or 3 oz (85 ml) glass of sherry, port or vermouth (18% alcohol) 

16. On how many days in the last month did 

you have 5 or more drinks? 

17. On how many days in the last month did 

you have only 3 or 4 drinks? 

18. On how many days in the last month did 

you have only 1 or 2 drinks? 

19. On how many days in the last month did 

you not have any alcoholic beverages to 

drink? 

TOTAL 30 days 

If one or more days to question #16, then ask (otherwise continue to next page): 

20. On the days during the last month when you had 5 or more drinks, 

how many drinks did you usually have per drinking day? drinks 

21. On the days during the last month when you had 5 or more drinks, 

what was the maximum number of drinks you had in one day? drinks 

22. On how many days during the last month did you have this number of drinks? days 

56 
Think about the days when you drank alcohol during the 30 days just before you were arrested: 

23.

On how many days in the month before your arrest days 

did you have 5 or more drinks? 

24.On how many days in the month before your arrest days 

did you have only 3 or 4 drinks? 

25.

On how many days in the last month did you have days 

only I or 2 drinks? 

26.

On how many days in the month before your arrest days 

did you not have any alcoholic beverages to drink? 

TOTAL

30 days 

If one or more days to question #23 then ask (otherwise skip to #38, next page): 

27.On the days during the month before your arrest when you had 5 or more drinks, how 

many drinks did you usually have per drinking day? drinks 

28.On the days during the month before your arrest when you had 5 or more drinks, what 

was the maximum number of drinks you had in one day? drinks 

29.On how many days during the month before your arrest did you have this number of 

drinks? days 

30.Was your drinking in this month (the 30 days before your arrest) typical of your drinking 

during the twelve months before your arrest? ONo L7 Yes 

31.

On how many days in a typical month do you have 

5 or more drinks? days 

32.On how many days in a typical month do you 

only 3 or 4 drinks? days 

33.

On how many days in a typical month do you have 

only 1 or 2 drinks? days 

34.On how many days in a typical month do you 

not have any alcoholic beverages to drink?

days 

TOTAL 30 days 

If one or more days to question #31, then ask (otherwise skip to #38): 

35.

On the days during a typical month when you had 5 or more drinks, how 

many drinks did you usually have per drinking day? drinks 

36.

On the days during a typical month when you had 5 or more drinks, what 

was the maximum number of drinks you had in one day? drinks 

37.

On how many days during atypical month did you have this number of drinks? days 

57 
38. When you drink, what do you usually drink:

a. beer ........................ q None q Some of the time q Most of the time q All of the time

b. liquor ....................... q None q Some of the time q Most of the time q All of the time

c. wine ........................ q None q Some of the time q Most of the time q All of the time

d. fortified wine ................. q None q Some of the time q Most of the time q All of the time

39. How many times in the past six months did you drink:

Never Once or Twice Three to Five 10 Times or

Times More

a. Beer

b. Liquor

c. Wine

d. Fortified

wine

40. How long have you been drinking at your current level? ............................... (years)

41. Do you think drinking is or was a problem for you? ................................... q No q Yes

If yes, ask:

42. At what age did you first become concerned about your drinking -- that is, when did drinking first begin

to be a problem for you?

1. Age at first problem

2. Denies that drinking is a problem

43. How troubled or bothered are you by alcohol problems .......................... Not at all troubled q*

Slightly troubled q

Moderately troubled q

Very troubled q

If not at all troubled, skip to question 47, otherwise continue.

58
44.

How confident are you that you can deal with your alcohol problems 

on your own? ........................................................... Not at all confident q 

Slightly confident q 

Moderately confident q 

Very confident q 

45. To what extent do you feel that you need treatment or help with your 

alcohol problems? ............................................................. None needed q 

A slight extent q 

A moderate extent q 

A great extent q 

46.

How important to you now is treatment or counseling for alcohol 

problems? .............................................................. Not at all important q 

Slightly important q 

Moderately important q 

Very important q 

47.

How many times in the past twelve months have you driven after you 

thought you had too much to drink? .................................................... Never q 

Once or Twice q 

Three to Five Times q 

10 or more times q 

48.

Have you ever on your own given up drinking? ....................................... q No q Yes

If yes, how many times? 

49.

What is the longest period of time that you have given up drinking? ............................ 

(indicate whether years, months, days) 

50.

How many nights in the past month have you spent in jail? ...................................

51.

How many nights in the past month have you spent in a hospital or treatment center? ..............

52. In the past 12 months have you ever had enough alcohol for your speech to get slurred 

or for you to feel unsteady on your feet? .................................................. 

53.

How old were you when you first drank enough for your speech to get thick or for you to 

feel unsteady on your feet? ........................................................... 

(in years, 99=refused) 

54.

Have you ever been on a drinking binge? ........................................... q No q Yes 

(very heavy drinking two or more days in a row) 

59 
Now I am going to ask you some questions about things that might have happened to you in the twelve months 

just before you were arrested. 

55. In the twelve months prior to your arrest, have you: 

(Ifyes, was it due to alcohol use or drug use or both?) 

O YES Related Related 

to Alco­ to Drug 

hol Use Use 

a Had legal problems such as being arrested, 

police called to your house, or lawsuits 

b.­ Gotten into fights or violent disputes with other 

people 

c.­ Felt severely depressed or really down 

d.­ Thought about killing yourself 

e.­ Had problems remembering things or concentrating 

f Had problems sleeping such as insomnia, early 

waking, or nightmares 

g.­ Felt tense or really anxious for days at a time 

h.­ Had problems with your spouse or partner 

i.­ Had problems with other family members 

j.­ Had problems with friends or coworkers 

k.­ Had problems with your boss 

1.­ Had sexual problems 

m. Had problems getting your work done well 

n.­ Had serious financial problems 

o.­ Experienced hallucinations 

60 
I 

Now I would like to ask you about some things that you may have experienced. 

56. Since your 18th birthday ... 

(If yes, was it due to alcohol use or drug use or both?) 

NO YES­ Related Related 

to Alco- to Drug 

hol Use Use 

a. Have you had any broken bones or dislocated joints? 

b. Have you been injured in a traffic accident? 

c. Have you injured your head? 

d. Have you been injured in a fight or assault (do not count during sports)? 

e. Have you been injured while or after drinking alcoholic beverages? 

57.­ Have you ever had liver disease related to alcohol or drugs? .............................. No q Yes q


58.­ Have you ever used alcohol repeatedly in situations in which it is physically hazardous, 

like driving a car, operating machinery, using a gun or a knife, or swimming, when you 

were under the influence of alcohol? ................................................ No q Yes q 

59.­ Have there been many days when you drank much more than you expected to when 

you began, or have you often continued drinking for more days in a row than 

you intended to? .................................................... ......... No q Yes q* 

60.­ Have you more than once wanted to quit or cut down on your drinking? ................... No q Yes q*

61.­ Did you find you couldn't quit or cut down? ........................................ No q Yes q*

62.­ Were you unable to quit or cut down more than once? ...:................................. No q Yes q *

63.­ Was there ever a period when you spent a great deal of time drinking or recovering 

from the effects of it? ........................................................... No q Yes q * 

64.­ Has your drinking or being hung over often kept you from working, taking care of 

children, or doing other things that were expected of you? .............................. No q Yes q* 

65.­ Have you ever given up or greatly reduced important activities in order to drink -­

like sports, work, or associating with friends or relatives? ............................... No q Yes q * 

66.­ Did you give up or cut down on important activities for a month or more, or several 

times, in order to drink? ......................................................... No q Yes q * 

67.­ Did you ever get tolerant to alcohol, that is you needed to drink a lot more in order 

to get an effect, or found that you could no longer get high on the amount you used 

to drink? ..................................................................... No q Yes q* 

61 
68. Some months or years after you started drinking, did you begin to be able to drink a 

lot more before you would get drunk (slurred speech or unsteady on your feet)? ............. No q Yes q * 

69. People who cut down or stop drinking after drinking for a considerable time often 

have withdrawal symptoms. Common ones are the "shakes" (hands tremble), being 

unable to sleep, feeling anxious or depressed, sweating, and heart beating fast. 

Have you had any problems like that when you stopped or cut down on drinking? ........... No q Yes q * 

70.

Have you had withdrawal symptoms several times? ................................... No q Yes q *

71.

Did you ever drink to avoid or relieve withdrawal symptoms? ........................... No q Yes q*

72.

Have you ever had fits or seizures after stopping or cutting down on drinking? .............. No q Yes q *

73.

Have you ever heard voices or seen things that weren't there after drinking? ................ No q Yes q*

74.

Did you continue to drink (more than once) knowing that drinking caused you 

to have a (health problem/injury)? ................................................. No q Yes q * 

75.

Have you continued to drink when you knew you had any (other) serious problem 

that might be made worse by drinking, such as problems with your spouse, 

employment, police, etc., or psychological problems like being depressed? ................. No q Yes q * 

76. Interviewershould review POSITIVE responses to questions dealing with the dependence/abuse diagnosis (59-72 

indicated by *) that contain UNDERSCORED phrases. The interviewer should say "you mentioned that in the 

past year you had (flll in positive responses). 

Did 3 or more of these occur at about the sometime in your life, for example, within the same month? 

Did 3 or more of these occur during the year prior to your arrest? Which ones?" 

Recapitulate and Code Positive Responses Ever Last Year

59 Drank more than expected

60, 61, 62 Unable to cut down

63 Time spent drinking

64 Role obligations interfered with

65, 66 Given up important activities

67, 68 Developed tolerance

69, 70 Developed withdrawal symptoms

71 Drank to relieve withdrawal symptoms

72, 73, 74, 75 Continued to use despite problems

62 
Now I am going to ask some questions about drugs. 

(Ask the next six questions for each drug in the chart on the next page. Use 0 if never, 99 if refused.) 

77.Have you ever used any of these drugs? (column 1) 

78.How old were you when you first used (name of drug)? (column 2) 

79.

On about how many days did you use (name of drug) during the past 30 days? (column 3) 

80.Which letter on this card indicates how often you used (name of drug) during the past 12 months? 

(column 4) 

Response Categories: 

1 = three or more times a day

2 = twice a day

3 = once a day

4 = twice a week

5 = or 4 times a week

6 = or 6 times a week

7 = once a week

8 = or 3 times a month

9 = once a month

10 = 3 or 4 times in past year

11 = once in past year

12 = not in past year

81.

When you used (name of drug) during the past year, did you ever use it at the same time, or within a couple of 

hours of when you drank beer, wine or liquor? (column 5) 

Response Cate oQ ries: 

I = Almost Never

2 = Some of the time

3 = Half of the time

4 = Most of the time

5 = Almost always

82.

Have you ever driven just after using this drug? (column 6) 

Response Catejzories: 

I = Never

2 = Once or twice

3 = Three to five times

4 = 10 or more times

63 
Interviewer lyes Age in years or # of days or l-three or more 1= almost 1= never 

Codes 

0=never 

99=refuse 

0-never 

99=refuse 

0=never 

99=refuse 

times a day 

2=twice a day 

never 

2= some 

2= once 

or 

3=once a day of the twice 

4=twice a week time 3= three 

5=or 4 times/week 3= half of to five 

6=or 6 times/week the times 

7=once a week time 4= 10 or 

8=or 3 times/mo. 4= most of more 

9=once a month the times 

10=3-4 times in time 

past year 5= almost 

11 Wince past yr always 

12=not in past yr 

77. Ever 78. Age at first 79. Number of days 80, How often 81. Used 82. Ever 

Drug Used? use? used in 30 days used in past with alco­ driven 

prior to arrest? year? hol? while under 

influence? 

a. Marijuana or 

hashish 

b. Cocaine 

c. Crack 

d. Heroin and/or 

other opiates 

e. Inhalants 

such as glue, 

amyl nitrite, 

"poppers," 

aerosol spray 

f. Hallucinogens 

such as LSD, 

PCP, peyote, 

mescaline 

g. Non-medical 

use of drugs 

including sedatives, tranquilizers, stimulants, or pain 

killers 

h. Other drugs 

i. More than one 

drug per day 

64 
83. How troubled or bothered are you by your drug use? ................................ Not a problem q 

A slight problem q 

A moderate problem q 

A major problem q 

84.­ At what age (how long ago) did using drugs begin to have an effect on your life which you did not approve of ­

when did using drugs first begin to be a problem for you? 

a.­ Age at first problem ............................................................

b.­ Years of problem duration (Age minus age at first problem) ............................

c.­ Denies that drug use is a problem .................................................

85.­ How confident are you that you can handle your drug problems 

on your own? .......................................................... Not at all confident q 

Slightly confident q 

Moderately confident q 

Very confident q 

86.­ To what extent do you feel that you need treatment or help with your 

drug problems? .............................................................. None needed q 

A slight extent q 

A moderate extent q 

A great extent q 

65 
87.

Have you ever received treatment for alcohol or drug problems? .......................... No 0 Yes 0 

If yes fill in table below in response to questions #88 and #89. 

88.

How many times have you received treatment at l ,b....) a for alcohol? # of times.

89.

How many times have you received treatment at a( .b....) for drugs? # of times? what drugs? 

Type Facility

Alcohol Drug-# Primary Drug 

-# of of 

Times Times 

a.

A therapeutic community or other long-term residential

treatment unit?

b.A short-term inpatient unit? 

c.

Any outpatient day hospital program or any intensive

outpatient program that is 2 or more hours of treatment

each day for at least 3 days every week?

d.Any outpatient program (1-2 times/week) 

e.

A detoxification unit in a hospital or free-standing

residential facility (24-hour services)?

f.

Detoxification services in an outpatient or ambulatory

setting?

g.AA, NA or other self-help program 

h.DWI programs (If yes, specify) 

i.

Any other (specify) 

90. If any previous treatment or self-help, how old were you when you first entered a 

treatment program or self-help program? ..................................... 

91.How many times have you been treated for any psychiatric or emotional problems? 

1.

In a hospital .................................................................... .

If any, age at first time ............................................................

2.As an outpatient ..................................................................

If any, age at first time ............................................................

66 
92.

Have you had a significant period that was not a direct result of drug/alcohol use in which you have: 

a. Experienced serious depression? ................................................. No q Yes q


b. Experienced serious anxiety or tension? ........................................... No q Yes q


c. Experienced hallucinations? ..................................................... No q Yes q


d. Experienced difficulty understanding, concentrating, or remembering? ................... No q Yes q


e. Experienced trouble controlling violent behavior? ................................... No q Yes q


f. Experienced serious thoughts of suicide? .......................................... No q Yes q


g. Attempted suicide? ............................................................ No q Yes q


h. Been prescribed medication for any psychological/emotional problem? .................. No q Yes q


i. Been sexually abused by someone inside or outside of your family? ..................... No q Yes q


j.

Been hit by someone in your family? ............................................. No q Yes q


k.

If yes to j., was medical treatment sought? ......................................... No q Yes q


93.Have any of your relatives had what you would call a significant drinking, drug use or psychiatric problem? 

Relative

Alcohol Drug Psychiatric 

Father 

Mother 

Brother or sister 

Grandmother or Grandfather 

Other relatives 

94.

Have you ever been arrested other than your current DWI charge? ......................... No q Yes q


95.

How many times have you been convicted for: a. Possession of drugs? .........................

b. Traffic offenses? ............................

c. Delinquency? ..............................

d. Misdemeanor? .............................

e. Felony? ...................................

96. Since age 18, have you ever been under the supervision of a probation or parole officer? ....... No q Yes q


97.How many months have you been incarcerated in your life? ....................................

98.Have you ever broken into someone else's house, building, or car? ......................... No q Yes q


a. If yes, how often has this happened in the past 12 months? ..................................

99. Do you ever get into physical fights? ................................................ No q Yes q


a. If yes, how often has this happened in the past 12 months? ..................................

100. Have you ever used a weapon (knife, club, gun) in a fight? .............................. No q Yes q


a. If yes, how often did you do this in this past 12 months? ....................................

101.Have you ever stolen something from someone in front of them? ......................... No q Yes q 

(For example, a mugging, purse-snatching, or robbery.) 

67 
END OF FORMAL INTERVIEW

OBSERVATIONS AND IMPRESSIONS OF THE INTERVIEWER

102. Gross tremor? (Observation by interviewer) ........................................ Present q 

Not present q 

103. Interviewer's impressions 

Do you suspect that the information in this interview was distorted by the interviewee's: 

a. Dishonesty / misrepresentation? 

b. Inability to understand? 

c. Cooperativeness? 

d. Defensiveness/denial? 

. Language comprehension? 

f Phcal/Mental state? y

No Possibly Definitely 

104. Interviewer's instructions: 

If you indicated "definitely" for any of the categories in the last question, please elaborate and indicate the 

sections of the interview to which it applies. 

68 
APPENDIX C - ADOLESCENT CRITERION INSTRUMENT

69
Interviewer 

Date of Interview 

Code Number 

Comprehensive Young Adult Interview - Alcohol 

1.

Name 

(first) (middle or maiden names) (last) 

(Any nicknames or other names) 

2. Current Address 

3. State of Drivers License 

5. Social Security Number 

7. Current Social Status (circle one): 

8. Number of Children 

10. Height 

12.

Race (circle one) 

Response categories: 

4. Drivers License Number 

- - 6. Gender M F 

(circle one) 

Married / Never Married / Divorced / Separated / Widowed 

9.Respondent's Date of Birth: 

Month Day Year 

11. Weight 

I = White (Not of Hispanic Origin) 

2 = Black (Not of Hispanic Origin), African-American 

3 = American Indian, Native American 

4 = Alaskan Native 

5 = Asian or Pacific Islander 

6 = Hispanic American of Mexican origin 

7 = Hispanic American of Puerto Rican origin 

8 = Hispanic American of Cuban origin 

9 = Other Hispanic 

13. Breath test result 

70 
14.

This is a question about the effects of alcohol. Listen to each statement carefully and respond according to your 

own personal feelings, thoughts, and beliefs about alcohol now. 1 am interested in what you think about alcohol 

regardless of what other people might think. 

When the statements refer to drinking alcohol, you may think in terms of drinking any alcoholic beverage, such as 

beer, wine, whiskey, liquor, rum, scotch, vodka, gin, or various alcoholic mixed drinks. Whether or not you have 

had actual drinking experiences yourself, you are to answer in terms of your beliefs about alcohol. It is important 

that you respond to every question. 

PLEASE BE HONEST. REMEMBER, YOUR ANSWERS ARE CONFIDENTIAL. RESPOND TO THESE ITEMS 

ACCORDING TO WHAT YOU PERSONALLY BELIEVE ABOUT ALCOHOL. 

Ifyou think the statement is true, or mostly true, or true some of the time, then answer "AGREE". Ifyou think the 

statement is false, or mostly false then answer "DISAGREE". 

Agree Disagree 

1.People become harder to get along with after they have 

had a few drinks of alcohol .................................................. 0 O 

2.

Drinking alcohol creates problems ............................................ 0 0

3.

Drinking alcohol makes a bad impression on others .............................. 0 0

4.

People drive better after a few drinks of alcohol ................................. 0 0

5.

Teenagers drink alcohol in order to get attention ................................ 0 0

6.

Parties are not as much fun if people are drinking alcohol ......................... O 0

7.People feel more caring and giving after a few drinks of alcohol .................... 17 0

8.

It is easier to play sports after a few drinks of alcohol ............................. O 0

9.

A person can do things better after a few drinks of alcohol ......................... 0 0

10.

Drinking alcohol makes people more friendly ................................... 0 0

H.

Drinking alcohol is O.K. because it allows people to join in 

with others who are having fun ............................................... 0 0 

12.

When talking to people, words come to mind easier after a few drinks of alcohol ........ 0 0

13.

Drinking alcohol makes people feel more alert .................................. 0 0

14.

Sweet alcoholic drinks taste good ............................................. 0 0

15.

Most alcoholic drinks taste good ............................................. 0 0

16.

Most people think better after a few drinks of alcohol ............................. 0 0

17.

People understand things better when they are drinking alcohol .................... 0 0

18.

People act like better friends after a few drinks of alcohol ......................... 0 0

19.Most alcohol tastes terrible ................................................. 0 0

20.

Having a few drinks of alcohol is a nice way to enjoy the holidays ................... 0 0

21.It's fun to watch others act silly when they are drinking alcohol ..................... 0 0

22.

Teenagers drink alcohol because they feel forced to do so by their peers .............. 0 0

23.

People can control their anger better when they are drinking alcohol ................ 0 0

24.

Alcoholic beverages make parties more fun ..................................... 0 0

25.

Alcohol makes people better lovers ........................................... 0 0

26.

People get in better moods after drinking alcohol ................................ 0 O

27.Drinking alcohol helps teenagers do their homework ............................. 0 0

71 
15. How important to you is (was) each of the following as a reason for drinking? 

Reason­ Extremely Very Somewhat Not 

Important Important Important Important At All 

a. To become sociable 

b. Because you like that taste 

c. Because the people you know drink 

d. When you want to forget everything 

e. Because it helps you relax 

f Because it helps you go to sleep 

g. Out of habit 

h. To celebrate special occasions 

i. Because it helps you forget your wor­

ries

j. Because a small drink improves your

appetite for food

k. Because it is the polite thing to do in

certain, situations

L Because it helps cheer you up when

you're in a bad mood

m. Because it helps you when you are

tense and nervous

Now I want to ask you some questions about your drinking of alcoholic beverages. 

16. How old were you the first time you used alcohol on about a monthly basis? ................ (years)

One standard drink is approximately: 

12 oz. (341 ml) bottle or can of beer (5% alcohol)

or 1.5 oz. (43 ml) shot of liquor (40% alcohol)

or 4 oz. (142 ml) glass of wine (11% alcohol)

or 3 oz. (85 ml) glass of sherry, port or vermouth (18% alcohol)

72 
Think about the days when you drank alcohol during the last 30 days: 

17.

On how many days in the last month did you have 5 or more drinks? days 

(INTERVIEWER: If answer to ques. #17 equals 1 or more days, then ask:) 

17a.

On the days during the last month when you had 5 or more drinks, how

many drinks did you usually have per drinking day? ... drinks

17b. On the days during the last month when you had 5 or more drinks, what

was the maximum number of drinks you had in one day?

drinks

17c.On how many days during the last month did you have this number of

drinks? ....................................... days

18.

On how many days in the last month did you have only 3 or 4 drinks? days 

19.

On how many days in the last month did you have only 1 or 2 drinks? days 

20.

On how many days in the last month did you not have any alcoholic 

beverages to drink? days 

TOTAL OF QUESTIONS 17, 18, 19 AND 20

30 days 

Think about the days when you drank alcohol during the 30 days just before you were arrested: 

24.

On how many days in the month before your arrest did you have 

5 or more drinks? days 

25.On how many days in the month before your arrest did you have 

only 3 or 4 drinks? days 

26.

On how many days in the last month did you have only 1 or 2 drinks? days 

27.On how many days in the month before your arrest did you not have 

any alcoholic beverages to drink? days 

TOTAL OF QUESTIONS 24,25,26 AND 27

30 days 

73 
(INTERVIEWER INSTRUCTIONS: If one or more days to question #17c then continue, if 0, go to 35:) 

28.On the days during the month before your arrest when you had 5 or more drinks, how many drinks did you usually 

have per drinking day? .......................................................... drinks 

29.On the days during the month before your arrest when you had 5 or more drinks, what was the maximum number 

of drinks you had in one day? ..................................................... drinks 

30.On how many days during the month before your arrest did you have this number of drinks? .... days 

31.

Was your drinking in this month (the 30 days before your arrest) typical of your drinking during the twelve months 

before your arrest? ............................................................. q No q Yes 

(INTERVIEWER INSTRUCTIONS: If question 31 is no, then ask:) 

31a.

On how many days in a typical month do days 

you have 5 or more drinks? 

31b.

On how many days in a typical month do days 

you only 3 or 4 drinks? 

31c.

On how many days in a typical month do days 

you have only I or 2 drinks? 

31d.

On how many days in a typical month do days 

you not have any alcoholic beverages to 

drink? 

TOTAL OF QUESTIONS 31a, 31b, 31c AND 31d

30 days 

(INTERVIEWER INSTRUCTIONS: If one or more days to question #30, then ask following questions, otherwise 

proceed to question #35.) 

32.

On the days during a typical month when you had 5 or more drinks, how many drinks did you usually have per 

drinking day? ................................................................. drinks 

33.

On the days during a typical month when you had 5 or more drinks, what was the maximum number of drinks you 

had in one day? ................................................................ drinks 

34.

On how many days during a typical month did you have this number of drinks? .............. days

74 
35. When you drink, what do you usually drink: beer, liquor, wine or fortified wine? 

a. beer ........................ q None q Some of the time q Most of the time q All of the time 

b. liquor ....................... q None q Some of the time q Most of the time q All of the time 

c. wine ........................ q None q Some of the time q Most of the time q All of the time 

d. fortified wine ................. q None q Some of the time q Most of the time q All of the time 

36.How often have you driven just after drinking alcohol? q Never 

q Once or twice 

q Three to five times 

q 10 or more times 

37. When drinking, how often do you drink with friends? q Never 

q Occasionally 

q Sometimes 

q Often 

38.When drinking, how often do you drink with brothers or sisters? q Never 

q Occasionally 

q Sometimes 

q Often 

39.

Have you ever on your own given up drinking? ...................................... q No q Yes

If yes, how many times? ..........................................................

40.

What is the longest period of time that you have given up drinking? ........ (years/months/days)

41.How many nights in the past month have you spent in jail? .....................................

42.How many nights in the past month have you spent in a hospital or treatment center? ................

43. In the past 12 months have you ever had enough alcohol for your speech to get slurred or for you to feel unsteady 

on your feet? ................................................................. q No q Yes 

44.

How old were you when you first drank enough for your speech to get slurred or for you to feel unsteady on your 

feet? ............................................................ (in years, 99=refused) 

45.

Have you ever been on a drinking binge? (Very heavy drinking for two or more days in a row.) 

............................................................................ q No q Yes 

75 
Now I am going to ask you some questions about things that might have happened to you in the twelve 

months just before you were arrested. 

(INTERVIEWER INSTRUCTIONS: If respondent answers "YES" below, was it due to alcohol use or drug use 

or both? Indicate in the table.) 

46. In the twelve months prior to your arrest have you: 

NO YES ALCOHOL RUG USE 

USE RELATED 

RELA TED 

a.­ Had legal problems such as being arrested,

police called to your house, or lawsuits.

b.­ Gotten into fights or violent disputes with

other people.

c.­ Felt severely depressed or really down, 

d.­ Thought about killing yourself 

e.­ Had problems remembering things or concen­

trating.

f­ Had problems sleeping such as insomnia,

early waking, or nightmares.

g.­ Felt tense or really anxious for days at a time. 

h.­ Had problems with your spouse or partner. 

i.­ Had problems with other family members. 

j. Had problems with friends or co-workers.

k Had problems with your boss.

1.­ Had sexual problems. 

m.­ Had problems getting your work done well. 

n.­ Had serious financial problems. 

o.­ Experienced hallucinations. 

p.­ Had problems with school, such as poor

grades or trouble with teachers or principals.

q.­ Had problems with your girl/boy friend. , _L_ I _ I L_J 

76 
Now I would like to ask you about some things that you may have experienced. 

(INTERVIEWER INSTRUCTIONS: If respondent answers " YES" below, was it due to alcohol use or drug use, 

or both? Indicate in the table.) 

47. Since your 18th birthday ... 

NO YES Related To Related To 

Alcohol Use Drug Use 

a.

Have you had any broken bones or

dislocated joints?

b.

Have you been injured in a traffic

accident?

c.

Have you injured your head? 

d.

Have you been injured in a fight or

assault (do not count during sports)?

e.

Have you been injured while or after

drinking alcoholic beverages?

48.

Have you ever had liver disease related to alcohol or drugs? ............................ q No q Yes

****INTERVIEWER SHOULD LOCATE A 12-MONTH PERIOD THAT REPRESENTS THE 

SUBJECT'S RECENT HEAVIEST DRINKING PERIOD.**** 

49. Have you ever used alcohol at school or on the job? ................................... q No q Yes

How many times? ...................................................................

50.

During this 12-month period, have you gone to school or work while high 

from using alcohol? ............................................................. q No q Yes 

How many times? ...................................................................

51.

During this 12-month period, have you driven a car or motorcycle while high from 

using alcohol? ................................................................ q No q Yes 

How many times? ...................................................................

77 
52.

During this 12-month period, have you done anything else risky while high from using 

alcohol that could have led to danger or physical harm to you or someone else? ............. q No q Yes 

If yes, ask a and b 

a.

What did you do? 

b.

How many times did you do this? ...................................................

53. (IF FEMALE) During this 12-month period, have you been pregnant and continued 

to use alcohol even though you knew it was against medical advice? ...................... q No q Yes 

54.

During this 12-month period, have you had the "shakes" or tremors of your hands 

after stopping or cutting down on drinking, or had that feeling the 

morning after drinking? ......................................................... q No q Yes 

55.

During this 12-month period, have you had any fits or seizures? ......................... q No q Yes

56.

During this 12-month period, have you seen or heard things that weren't really there? ........ q No q Yes

57.

Do you find that you now must take much larger amounts of alcohol to get 

"high" or drunk? ............................................................... q No q Yes 

If yes, ask a, b, and c: 

a. What beverage do you usually drink when getting high? ............................... Beer q 

Wine q 

Hard liquor drinks q 

b.

Presently, how many drinks of that beverage do you need to get high? ...................

c.When you first started to use alcohol, how many drinks of the same 

beverage did it take to get high? ................................................ 

58.

Do you spend a lot of time getting or buying alcohol? .................................. q No q Yes

59.

Do you spend a lot of time drinking alcohol? ........................................ q No q Yes

60.

Do you spend a great deal of time recovering from heavy use of alcohol? .................. q No q Yes

61.

Have you stopped participating in a club, sports team, or other after school activity 

because it gets in the way of using alcohol? ......................................... q No q Yes 

62.Have you gone without important things you wanted or needed in order to get 

or pay for alcohol? ............................................................. q No q Yes 

63.

Have you spent less time in a hobby because it takes time away from using alcohol? ......... q No q Yes

64.Have you stopped doing anything else that used to be important to you because it 

gets in the way of using alcohol? .................................................. q No q Yes 

65.During this 12-month period, have you tried unsuccessfully to cut down or stop 

using alcohol? ................................................................ q No q Yes 

78
If yes, how many times? ..............................................................

66.

During this 12-month period, have you tried to control your use of alcohol by switching 

to another drug? ............................................................... q No q Yes 

How many times? ...................................................................

67.

Do you often wish you could control your use of alcohol? .............................. q No q Yes

68.

Have you continued to use alcohol when you knew you had a serious physical problem that 

might be made worse by using alcohol? ............................................ q No q Yes 

(MUST BE CHRONIC CONDITION OR SERIOUS ENOUGH TO REQUIRE MEDICAL CARE) 

69.

During this 12-month period, have you been told by a physician or a doctor that your 

use of alcohol has caused you a physical disability or problem? .......................... q No q Yes 

70.

Have you continued to use alcohol when you knew you had a serious mental or psychological 

problem that might be made worse by using alcohol? .................................. q No q Yes 

71.

During this 12-month period, have you been told by a physician or doctor that your use 

of alcohol has caused you to suffer a serious mental or psychological problem? ............. q No q Yes 

72.Have you continued to use alcohol even though you didn't do as well at school or work 

dropped because of using alcohol? ................................................ q No q Yes 

73.Has your use of alcohol upset any of your friends to the point where they no longer 

speak to you or associate with you? ................................................ q No q Yes 

(CANNOT BE MINOR DISAGREEMENT) 

74. Sometimes people experience the DT's when they quit drinking. During this 12-month 

period, have you had the DT's? ................................................... q No q Yes 

If yes ask: 

What symptoms did you experience? 

a.

Being very confused (e.g. not knowing place or time of day) . ........................ q No q Yes

b.

Rapid heart beat and breathing . ............................................... q No q Yes

c.

Fever . ................................................................... q No q Yes

d.

Sweating . ................................................................ q No q Yes

e.

Elevated blood pressure . ..................................................... q No q Yes

f.

Seeing or hearing things that are not really there . .................................. q No q Yes

79 
75.

How long have you been drinking at your current level of drinking? (years) 

76.

At what age did you first become concerned about your drinking -- that is, when did drinking first begin to be a 

problem for you? 

a. Age at first problem .............................................................

b. Denies that drinking is a problem ...................................................

77.

How troubled or bothered are you by alcohol problems? ........................... Not at all troubled q 

Slightly troubled q 

Moderately troubled q 

Very troubled q 

(INTERVIEWER INSTRUCTIONS: If troubled, then ask next three questions, but if"Not at all troubled", skip 

to "Now I am going to ask some questions about drugs." Question 81, next page.) 

78.How confident are you that you can deal with your alcohol problems 

on your own? ........................................................... Not at all confident q 

Slightly confident q 

Moderately confident q 

Very confident q 

79.

To what extent do you feel that you need treatment or help with your 

alcohol problems? ............................................................. None needed q 

A slight extent q 

A moderate extent q 

A great extent q 

80.

How important to you now is treatment or counseling for alcohol 

problems? .............................................................. Not at all important q 

Slightly important q 

Moderately important q 

Very important q 

80 
Now I am going to ask some questions about drugs. 

(INTERVIEWER INSTRUCTIONS: Ask the next six questions for each drug in the chart on the next page. Use 

0 if never, 99 if refused.) 

81.

Have you ever used any of these drugs? (column 1) 

82.How old were you when you first used (name of drug)? (column 2) 

83.On about how many days did you use (name of drug) during the past 30 days? (column 3) 

84.Which letter on this card indicates how often you used (name of drug) during the past 12 months? 

(column 4) 

Response Categories: 

1 = or more times a day

2 = twice a day

3 = once a day

4 = twice a week

5 = or 4 times a week

6 = or 6 times a week

7 = once a week

8 = or 3 times a month

9 = once a month

10 = 3 or 4 times in past year

11 = once in past year

12 = not in past year

85.When you used (name of drug) during the past year, did you ever use it at the same time, or within a couple of 

hours of when you drank beer, wine or liquor? (column 5) 

Response Categories: 

1 =Almost Never

2 = Some of the time

3 = Half of the time

4 = Most of the time

5 = Almost always

86.

Have you ever driven just after using this drug? (column 6) 

Response Categories: 

1 = Never

2 = Once or twice

3 = Three to five times

4 = 10 or more times

81 
Drug 

81. 

Ever 

Used? 

82. Age at 

first use? 

83. Number of 

days used in 30 

days prior to arrest? 

84. How of: 

ten used in 

past year? 

85. Used 

with alcohol? 

86. Ever 

driven 

while under influence? 

a. Marijuana 

or hashish 

b. Cocaine 

c. Crack 

d. Heroin 

and/or other 

opiates 

e. Inhalants 

such as glue, 

amyl nitrite, 

"poppers," 

aerosol spray 

f. Hallucinogens such as 

LSD, PCP, 

peyote, mescaline 

g. Non-medical use of 

drugs including sedatives, 

tranquilizers, 

stimulants, or 

pain killers 

h. Other drugs 

i. More than 

one drug per 

day 

82 
87.­ At what age (how long ago) did using drugs begin to have an effect on your life which you did not approve of ­

when did using drugs first begin to be a problem for you? 

a.­ Age at first problem ............................................................

b.­ Years of problem duration (Age minus age at first problem) ............................

c.­ Denies that drug use is a problem .................................................

88.­ How much of a problem have drugs been for you? 

a.­ In the past year .......................................................... Not a problem q 

A slight problem q 

A moderate problem­ q 

A major problem q 

b.­ In the past 30 days ....................................................... Not a problem q 

A slight problem q 

A moderate problem­ q 

A major problem q 

89.­ How confident are you that you can handle your drug problems 

on your own? .......................................................... Not at all confident q 

Slightly confident q 

Moderately confident­ q 

Very confident q 

90.­ To what extent do you feel that you need treatment or help with your drug problems? 

........................... ............................................... Not at all q 

Slightly q 

Moderately q 

Very much q 

83 
91. Did you ever receive treatment for drug or alcohol problems at ... 

Ever Number 

Type of Treatment Facility Treated? of Times Primary Drug 

(circle) (if yes) (if yes) 

a.A therapeutic community or other long-term residential No Yes 

treatment unit? 

b.A short-term inpatient unit? No Yes 

c.

Any outpatient day hospital program or any intensive No Yes 

outpatient program that is 2 or more hours of treatment 

each day for at least 3 days every week? 

d.

Any outpatient program (1-2 times/week) No Yes 

e.

A detoxification unit in a hospital or free-standing resi- No Yes 

dential facility (24-hour services)? 

f.

Detoxification services in an outpatient or ambulatory set- No Yes 

ting? 

g.AA, NA or other self-help program No Yes 

h.School-based drug prevention or drug intervention pro- No Yes 

gram 

i.

DWI programs (If yes, specify) No Yes 

j.

Any other (specify) No Yes 

92. If any previous treatment or self-help, how old were you when you first entered a treatment program or self-help 

program? ............................................................................ 

93.

How many times have you been treated for any psychological or emotional problems? 

1.

In a hospital ..................................................................... .

If any, age at first time .............................................................

2.

As an outpatient ...................................................................

If any, age at first time .............................................................

84 
94.

Have any of your relatives had what you would call a significant drinking, drug use or psychiatric problem - one 

that did or should have led to treatment? 

Relative Alcohol Drug Psychiatric 

a. Father 

b. Mother 

c. Brother or sister 

d.

Grandmother or 

Grandfather 

e. Other relatives 

95.

Now let's discuss how your life has been the past 12 months. I am going to read you a list of experiences or events, 

some are positive and some are negative. Tell me if you experienced the event in the past 12 months. Remember, 

I'm only interested in the past 12 months, so that would make it since last (SPECIFY MONTH). (INTERVIEWER 

INSTRUCTIONS: Skip down to the list and read each event, marking Yes or No for each item.) 

(INTERVIEWER INSTRUCTIONS: After the event list has been read and marked Yes or No, proceed to 

the next column and rank each Yes answer from 1 to 5.) Now let's find out how happy or unhappy you felt 

about the events you experienced. Think back to when the event occurred and try to recall how happy or unhappy 

the event made you feel at the time you experienced it. Rate the degree of happiness or unhappiness for each event 

by selecting a number from 1 to 5. A number 1 would mean you were very unhappy and a number 5 would mean 

you felt very happy. I will read each event you experienced in the past 12 months and you can tell me which rating 

to assign. 

(INTERVIEWER INSTRUCTIONS: Move to final column and code each category ranked 1 or 2 under 

Happy/Unhappy column. Code "0" for less than six months or "6" for more than six months.) Finally, I 

want to learn more about the events that you rated as very unhappy or unhanny. I want to know which of these 

events caused you to feel unhappy for more than six months. I will read each event you rated as very unhappy or 

imhappy,'and you can indicate whether you were this unhappy for less than or more than 6 months. 

How Happy/ More or Less 

Unhappy than 6 months 

1-5 6 or 0 

a. Your parents got divorced or separated q No q Yes 

b. You feared that someone might physically 

hurt you q No q Yes 

c. You feared that someone might make 

sexual advances towards you q No q Yes 

d. You broke up with someone you were dating 

on a regular basis q No q Yes 

e. (FOR GIRLS) You became pregnant or gave 

birth to a child or did not complete pregnancy q No q Yes 

f. (FOR BOYS) Your girlfriend became pregnant q No q Yes 

g. A close friend or family member died q No q Yes 

h. Your mother or father lost a job q No q Yes 

85 
96.

Have you ever been arrested other than your current DWI charge? ....................... q No q Yes 

(INTERVIEWER INSTRUCTIONS: If yes, then ask #97 and #98, if no skip to #99.) 

97. How many times have you been arrested on any of the following charges?

(INTERVIEWER INSTRUCTIONS: Read charges and record answers on table below.)

98. How many times were you convicted?

(INTERVIEWER INSTRUCTIONS: Record on table below.)

Charge No. ofArrests No. of Convictions 

a. Possession of drugs 

b. Traffic offenses 

c. Delinquency 

d. Other Misdemeanor 

e. Other felony 

99.

Since age 18, have you ever been under the supervision of a probation 

or parole officer? ........................................................... q No q Yes 

100.

How many months have you been incarcerated in your life? ................. .

101.

Have you ever broken into someone else's house, building, or car? .................... q No q Yes

a. If yes, how often has this happened in the past 12 months? ...............................

102.

Do you ever get into physical fights? ........................................... q No q Yes

a. If yes, how often has this happened in the past 12 months? ...............................

103.

Have you ever used a weapon in a fight? ................ .... q No q Yes

a. If yes, how often did you do this in this past 12 months? .................................

104.Have you ever robbed someone? 

(For example, a mugging, purse-snatching, or robbery.) ............................ q No q Yes 

105.

Are you a member of a street gang? ............................................ q No q Yes

END OF FORMAL INTERVIEW

(INTERVIEWER INSTRUCTIONS: COMPLETE BACK PAGE)

86 
OBSERVATIONS AND IMPRESSIONS OF THE INTERVIEWER

106.­ Gross tremor? ................................................................ Present q 

Not present 0 

107.­ Do you suspect that the information in this interview was distorted by the interviewee due to: 

1. Dishonesty/misrepresentation? ............................. q No q Possibly q Definitely

2. Inability to understand? .................................. q No q Possibly q Definitely

3. Cooperativeness? ....................................... q No q Possibly q Definitely

4. Defensiveness/denial? .................................... q No q Possibly q Definitely

5. Language comprehension? ................................ q No q Possibly q Definitely

6. Physical/Mental state? ................................... q No q Possibly q Definitely

108.­ If you indicated "definitely" for any of the categories in the last question, please elaborate and indicate the sections of the interview to which it applies. 

87 
88
APPENDIX D - DRAFT ADULT CRITERION INSTRUMENT CONTAINING 

SOURCES 

89 
ADULT SELF-REPORT DATA ITEMS - CONSUMPTION 

1. Q-F by beverage 

HAP, 36-47 indicated 

How often have (did) you generally drink BEER? 

a. 3 or more times a day e. twice a week i. 3 or 4 times a year 

b. twice a day f once a week j. once a year 

c. once a day g. 2 or 3 times a month k. never 

d. 3 or 4 times a week h. once a month 

How much BEER do (did) you generally drink at one sitting or session? Please answer in "bottles, " 

where each bottle is 12 ounces. 

a. 1 bottle h. 8 bottles o.25-30 bottles(5 six-packs) 

b. 2 bottles i. 9 bottles p.31 bottles or more 

c. 3 bottles j. 10 bottles 

d. 4 bottles k. 11 bottles 

e. 5 bottles 1. 12 bottles (2 six-packs) 

f 6 bottles in. 13-18 bottles (3 six-packs) 

g. 7 bottles n. 19-24 bottles (4 six-packs)

How much BEER do (did) you drink when you drank more than your usual amount of (of beer)?

a. 1 bottle h. 8 bottles o.25-30 bottles(5 six-packs)

b. 2 bottles i. 9 bottles p.31 bottles or more 

c. 3 bottles j. 10 bottles 

d. 4 bottles k. 11 bottles 

e. 5 bottles 1. 12 bottles (2 six-packs)

f 6 bottles M. 13-18 bottles (3 six-packs)

g. 7 bottles n. 19-24 bottles (4 six-packs) 

How often do (did) you generally drink more than your usual amount (of beer)? 

a. 3 or more times a day e. twice a week i. 3 or 4 times a year 

b. twice a day f once a week j. once a year 

c. once a day g. 2 or 3 times a month k. never 

d. 3 or 4 times a week h. once a month 

How often have (did) you generally drink WINE? 

a. 3 or more times a day e. twice a week i. 3 or 4 times a year 

b. twice a day f once a week j. once a year 

c. once a day g. 2 or 3 times a month k. never 

d. 3 or 4 times a week h. once a month 

How much WINE do (did) you generally drink at one sitting or session, a glass being 5 ounces? 

a. 1 wine glass (typical 5-ounce glass) i. 9 glasses 

b. 2 glasses j. 10 glasses (2 bottles, 1.5 liters) 

90 
C. 3 glasses k. 11 glasses 

d. 4 glasses 1. 12-15 bottles (3 bottles) 

e. 5 glasses m. 16-20 bottles (4 bottles; 3 liters) 

f 6 glasses n. 21-25 bottles (5 bottles; 4 liters; 

g. 7 glasses 1 gallon) 

h. 8 glasses 0. 26-30 bottles (6 bottles) 

P. 31 glasses or more 

How much WINE do (did) you generally drink on those occasions when you drink more than your 

usual amount (of wine)? 

a. 1 wine glass (typical 5-ounce glass) i. 9 glasses 

b. 2 glasses j. 10 glasses (2 bottles, 1.5 liters) 

C. 3 glasses k. 11 glasses

d. 4 glasses 1. 12-15 bottles (3 bottles) 

e. 5 glasses M. 16-20 bottles (4 bottles; 3 liters) 

f 6 glasses n. 21-25 bottles (5 bottles; 4 liters; 

g. 7 glasses 1 gallon) 

h. 8 glasses 0. 26-30 bottles (6 bottles) 

p. 31 glasses or more 

q. Always drink the same 

How often do (did) you generally drink more than your usual amount (of wine)? 

a. 3 or more times a day e. twice a week i. 3 or 4 times a year 

b. twice a day f once a week j. once a year 

c. once a day g. 2 or 3 times a month k. never 

d. 3 or 4 times a week h. once a month 

How often have (did) you generally drink LIQUOR? 

a. 3 or more times a day e. twice a week i. 3 or 4 times a year 

b. twice a day f once a week j. once a year 

c. once a day g. 2 or 3 times a month k. never 

d. 3 or 4 times a week h. once a month 

How much LIQUOR do (did) you generally drink at one sitting or session, where a typical shot is 

1 1/2 ounces and a typical drink would contain one shot? 

a. 1 shot (1 shot is about 1 1/12 ounces) j. 10 shots (1 pint) 

b. 2 shots k. 11 shots 

C. 3 shots 1. 12 shots 

d. 4 shots m. 13-17 shots (1 bottle; 

e. 5 shots 750 ml: I fifth) 

f 6 shots n. 18-22 shots (1 quart; 1 liter) 

9- 7 shots o. 23-27 shots 

h. 8 shots p. 28 shots or more 

i. 9 shots 

91 
How much LIQUOR do (did) you generally drink on those occasions when you drink more than your 

usual amount (of liquor)? 

a. 1 shot (1 shot is about 1 1/12 ounces) j. 10 shots (1 pint) 

b. 2 shots k. 11 shots 

c. 3 shots 1. 12 shots 

d. 4 shots m. 13-17 shots (1 bottle; 

e. 5 shots 750 ml: 1 fifth) 

f 6 shots n. 18-22 shots (1 quart; 1 liter) 

g. 7 shots 0. 23-27 shots 

h. 8 shots A 28 shots or more 

i. 9 shots q. always drink the same 

How often do (did) you generally drink more than your usual amount (of liquor)? 

a. 3 or more times a day e. twice a week i. 3 or 4 times a year 

b. twice a day f once a week j. once a year 

c. once a day g. 2 or 3 times a month k. never 

d. 3 or 4 times a week h. once a month 

2. Chronic drinking, duration at current level 

CDP indicated 

No question. Suggest: 

How long have you been drinking at your current level of drinking? years 

3. Chronic drinking, years of abstinence 

CDP indicated 

Use B40 and B41 

Since you first started drinking, what is the longest period of time that you have gone without taking 

a drink? years

When was the last time that you went for 2 or 3 days without drinking any alcohol? How long ago?

4. Drug use by drug (frequency) 

IAP indicated 

Use D1, D4, and D5 

Have you used (name the drug) more than 5 times? 

Thinking about the time when you were using (name the drug) the most (heaviest), about how often 

were you using it? 

92 
Which number on this card indicates how often you used (name the drug) during the past 12 months? 

00 Not used at all over the period 05 5-6 times per week

01 Used less than one time per month 06 Daily/1 time per day

02 1-3 times per month 07 2 or 3 times per day

03 1-2 times per week 08 4 or more times per day

04 3-4 times per week

HAP indicated 

Use Q301 

In the last year (of use) how often have (did) you used (use) (name the drug)? 

a. 3 or more times a day g. 2 or 3 times a month 

b. twice a day h. once a month 

c. once a day i. 3 or 4 times a year 

d. 3 or 4 times a week j. once a year 

e. twice a week k. once or twice in my life

f once a week

5. Preferred drug 

IAP indicated

Can be determined from item 4, above

ASI indicated

No question

6. Inappropriate context, time and place, alcohol 

CDP indicated 

Use B45-16, B46 and B47 

Do you ever drink before noon? 

Drinking Locations card sort.

(Indicate rank ordering: 1 = most frequent setting; 9 = least)

At Home (My own house, apartment or room) 

At Work 

In Other People's Homes 

Outdoors 

Private or Social Clubs 

Restaurants 

Social Events (such as Weddings, Parties, Dances) 

Tavern or Bar 

While Driving 

93 
Other places (f mentioned): 

TOTAL locations indicated as drinking locations 

Social Situations card sort 

(Indicate rank ordering: 1 = most frequent setting; 9 = least) 

I Drink Alone

I Drink with my Spouse (Husband, Wife, Companion)

I Drink with Relatives Other than my Spouse

I Drink with a Male Friend or Friends (No Females Present)

I Drink with a Female Friend or Friends (No Males Present)

I Drink with Friends of Both Sexes

I Drink with Strangers (or with People I Meet After I have started

drinking)

I Drink with Business Associates (for Business Purposes)

Other companions (f mentioned):

TOTAL situations indicated as drinking situations

7. Age at first drink 

IAP indicated 

Use D2, D16, D 16a, and D 16b 

How old were you the first time you used alcohol? years

Have you ever been drunk or had at least 5 drinks in one sitting?

How old were you when you first got drunk?

Have you ever been drunk for several days in a row?

8. Age at first drug use 

TAP indicated 

Use D2 

How old were you the first time you used (name the drug)? years 

9. Context of drug use, time and place 

CDP indicated 

Use B46 (mod) and B47 (mod) 

Drinking Locations card sort. 

(Indicate rank ordering: 1 = most frequent setting; 9 = least) 

At Home (My own house, apartment or room) 

At Work 

In Other People's Homes 

Outdoors 

94 
Private or Social Clubs 

Restaurants 

Social Events (such as Weddings, Parties, Dances) 

Tavern or Bar 

While Driving 

Other places (if mentioned): 

TOTAL locations indicated as drug use locations 

Social Situations card sort

(Indicate rank ordering: 1 = most frequent setting; 9 = least)

I Use Drugs Alone 

I Use Drugs with my Spouse (Husband, Wife, Companion) 

I Use Drugs with Relatives Other than my Spouse 

I Use Drugs with a Male Friend or Friends (No Females Present) 

I Use Drugs with a Female Friend or Friends (No Males Present) 

I Use Drugs with Friends of Both Sexes 

I Use Drugs with Strangers (or with People I Meet After I Have Started 

Using Drugs) 

I Use Drugs with Business Associates (for Business Purposes) 

Other companions (if mentioned): 

TOTAL situations indicated as drug use situations 

10. Drinking plus other drug use, other drug use 

HAP (mod) indicated 

Use Q298 

On the occasions that you use (name the drug) how often do you also use alcohol? 

a. Always 

b. Most of the time 

c. About half of the time 

d. Some of the time 

e. Never 

95 
ADULT SELF-REPORT DATA ITEMS - DEPENDENCE 

1. DSM-IIIR, withdrawal 

DIS indicated 

Use M21 

People who cut down or stop drinking after drinking for a considerable time often have withdrawal 

symptoms. Common ones are the 'shakes' (hands tremble), being unable to sleep, feeling anxious 

or depressed, sweating, heart beating fast or the DTs or seeing or hearing things that aren't really 

there. Have you had any problems like that when you stopped or cut down on drinking? 

Have you had withdrawal symptoms several times? 

2, DSM-IIIR, tolerance 

DIS indicated 

Use M7 

Did you ever get tolerant to alcohol, that is you needed to drink a lot more in order to get an effect,

or found that you could no longer get high on the amount you used to drink?

Some months or years after you started drinking, did you begin to be able to drink a lot more before

you would get drunk (that is, your speech would get thick or you would get unsteady on your feet)? 

Did your ability to drink more withoutfeeling these effects lastfor a month or more? 

3. DSM-IIIR, pre-occupation 

DIS indicated 

Use M12, M13, M28 

Have you ever i g venup or greatly reduced important activities in order to drink -- like sports, work, 

or associating with friends or relatives?

Did you give up or cut down on activities for a month or more, or several times, in order to drink?

Has your drinkin or being hung over often keep you from working or taking care of children? 

Have you often worked or taken care of children at a time when you had drunk enough alcohol to 

make your speech thick or to make you unsteady on your feet? 

Has there ever been a period in your life when you needed alcohol to help you function--that is, you 

could not do your work well unless you had something to drink? 

96 
When was the first/last) time you needed a drink in order to do your work well? 

4. DSM-IIIR, loss of control 

DIS indicated 

Use M8, M9, M10 

Has there been many days when you drank much more than you expected to when you began, or

have you often continued drinking for more days in a row than you intended to?

Have you more than once wanted to quit or cut down on your drinking?

Have you ever tried to quit or cut down on drinking?

Did you find you couldn't quit or cut down?

Were you unable to quit or cut down more than once?

5. DSM-IIIR, persistence 

DIS indicated 

M26, M27 

Did you continue to drink (more than once) knowing that drinking caused you to have a (health 

problem/injury)? 

Have you continued to drink when you knew you had any (other) serious physical illness that might

be made worse by drinking?

When was the (first/last) time you drank in spite of an illness that could be made worse by drinking?

6. History of dependence, no. of treatment episodes 

IAP indicated

Use the table on page H-1, columns H2 and H2a

97 
Did you ever receive treatment for drug or alcohol problems at ... 

Ever Number 

Treated? ofAdmissions 

a.

A short-term inpatient unit (28-day)? 

b.

A therapeutic community or other long

term residential treatment unit?

c.

Any outpatient methadone program? 

d.Any outpatient nonmethadone program or

any intensive outpatient program that is

2 or more hours of treatment each day

for at least 3 days every week? 

e.

A drug detoxification unit in a

hospital or free-standing residential

facility (24-hour services)?

f Detoxification services in an outpatient

or ambulatory setting?

g.Any other (Specify 

7. History of dependence, no. of detoxifications 

IAP indicated 

Use the table from item 6 (don't repeat here) 

ASI indicated

Use Q17, Q18

How many times in your life have you been treated for alcohol abuse?

How many of these were detox only?

8. History of dependence, no. of DTs 

DIS indicated 

Use M22 

Have you ever had fits or seizures after stopping or cutting down on drinking? 

CDP indicated 

Use Question B45, item 19 

Have you ever heard voices or seen things that weren't there after drinking? 

98 
9. Impaired cognitive function 

ADI indicated

Use G. Memory and Orientation Screen

I have some questions for you that will help me check your memory.

Can you tell me what day of the week this is?

What is the date today

Month Day (± 1) Year

(Note: assume correct response if within one day of actual day)

What season of the year is it now, spring, summer, fall, or winter?

Please tell me the month of the year in order. (CODE PERFORMANCE)

RECORD HERE:

Now I will ask you three things to remember, and in a few minutes I will ask you what they are. 

• The name of a man: John Smith 

• An address: 500 Minnesota Avenue 

• A color: green 

Please repeat those 3. (CODE PERFORMANCE) 

3 = Accurate

2 = Needs prompting

1 = Cannot repeat any

I want you to listen carefully and repeat these numbers after me.

(BEGIN WITH 1 AND CONTINUE UNTIL RESPONDENT FAILS; CODE LAST CORRECT

REPETITION)

1 = ............................. 3-9-6

2= ............................. 4-3-1-9

3 = ............................. 8-5- 1 -9-2

4= ............................. 9-3-5-2-8-6

5 = ............................. 7-5-8-3-9-2-4

99 
Please repeat these numbers backward. (BEGIN WITH 1 AND CONTINUE UNTIL FAILURE; 

CODE LAST CORRECT REPETITION) 

3 = ............................. 8-5-9-2

0 = Unable 

What were those three things I wanted you to remember? (CODE PERFORMANCE) 

CODE

4 = All three correct

3 =2outof3

2=1only

1' = None

Alternative: IAP H14 and H14a. 

In your life, did you have at least one period lasting 2 or more weeks when you had trouble 

understanding, concentrating, or remembering? 

When was the last time you had a period lasting at least 2 weeks when you had trouble understanding, concentrating, or remembering? 

10. Age at first problem, alcohol 

CDP indicated

Use Question B28 (first part only)

At what age (how long ago) did drinking begin to have an effect on your life which you did not 

approve of - when did drinking first begin to be a problem for you? 

Age at first problem­ Denies that drinking is a problem 

*Years of problem duration (Age minus age at first problem) 

11. Age at first help, alcohol 

CDP indicated

No question

12. Age at first problem, drugs 

CDP (mod) indicated 

Use Question B28 (first part only) re-phrase, substitute "using drugs" for "alcohol" 

At what age (how long ago) did using drugs begin to have an effect on your life which you did not 

approve of - when did using drugs first begin to be a problem for you?

Age at first problem Denies that using drugs is a problem

*Years of problem duration (Age minus age at first problem)

100 
13. Age at first help, drugs 

CDP (mod) indicated

No question

14. Gross tremor 

Observation by interviewer 

15. Have you ever had a problem with alcohol? 

ASI indicated

No question. Use:

Have you ever had a problem with alcohol?

16. When was your last drink? 

ASI indicated

No question. Suggest:

When was your last drink? (use appropriate units)

17. How troubled or bothered are you by alcohol problems? 

IAP indicated 

Use Question D23 

How troubled or bothered are you by alcohol problems? 

Not at all

Slightly

Moderately

Considerably

Extremely

18. How important to you is treatment for your alcohol problem? 

IAP indicated

Use Question D24

How important to you now is treatment or counseling for alcohol problems?

Not at all Moderately Extremely 

Slightly Considerably 

101 
ADULT SELF-REPORT DATA ITEMS - CONSEQUENCES 

1. History of trauma / medical history 

(Accidental injuries, cirrhosis, hepatitis, intentional injury, suicide attempts, DTs, impaired cognitive 

functioning, memory problems.) 

TS (expanded) indicated for all items except last 3. DIS and CDP for DTs, and ASI for impaired 

cognitive functioning and memory problems. ASI does not have indicated items. TS does not have 

cirrhosis, hepatitis, intentional injury, or suicide items. 

TS items: 

Since your 18th birthday ... 

1. Have you had any fractures or dislocations to your bones or joints? 

2. Have you been injured in a traffic accident? 

3. Have you injured your head? 

4. Have you been injured in a fight or assault (do not count during sports)? 

5. Have you been injured while or after drinking alcoholic beverages?

Alternative: Use IAP G7 for medical items. Also, H14 and H14a for last 2 items.

TAP G7

During the past 12 months did you have:

Cirrhosis of the liver? 

Hepatitis? 

ASI Psychiatric Status items 8 and 9 

Have you had a significant period (that was not a direct result of drug/alcohol use) in which you have: 

Experienced serious thoughts of suicide? past 30 days in your life

Attempted suicide? past 30 days in your life

TAP H14 and H14a 

In your life, did you have at least one period lasting 2 or more weeks when you had trouble 

understanding, concentrating, or remembering? 

When was the last time you had a period lasting at least 2 weeks when you had trouble understanding,

concentrating, or remembering?

Note: DTs addressed under Dependence, item 8.

102 
2. Life role 

(School, work, financial, legal, conduct disorders, psychiatric, psychosocial distress, peer relations, 

opposite sex.) 

ASI indicated for all items. ASI does not have these items. 

Alternative: Use CDP C75. 

Do you currently have any of the following problems? 

School problems 

Work problems 

Financial problems 

Conflicts with the law (being arrested, drunk driving, police visits, lawsuits, etc.) 

Aggression (fighting, anger, hostility) 

Depression (or negative self-concept) 

Problems with memory or concentration 

Problems with sleeping (insomnia, early waking, nightmares) 

Suicidal thoughts 

Tension or anxiety 

Family problems 

Problems with social contacts (sociability and meeting people, losing friends, loneliness) 

Sexual problems 

Are any of the these problems at least partly related to alcohol? 

103 
ADULT SELF-REPORT DATA ITEMS - VULNERABILITY 

1. Family history, substance abuse 

IAP indicated 

Use D22 

Did any ofyour (children or) relatives, includingparents, grandparents, aunts, uncles, brothers, and 

sisters, ever have a problem with drugs or alcohol? Just include those who are related to you by 

blood. 

2. Self-medication, mood enhancement; and 

3. Reasons for drinking 

AEQ indicated 

Use abbreviated AEQ, items 1-69 

This is a question about the effects of alcohol. Read each statement carefully and respond according 

to your own personal feelings, thoughts, and beliefs about alcohol now. I am interested in what yqu 

think about alcohol regardless of what other people might think. 

If you think the statement is true, or mostly true, or true some of the time, then mark the number 0, 

for "AGREE", on your computer sheet. If you think the statement is false, or mostly false, then mark 

the number 1, for "DISAGREE" on your computer sheet. When the statements refer to drinking 

alcohol, you may think in terms of drinking any alcoholic beverage, such as beer, wine, whiskey, 

liquor, rum, scotch, vodka, gin, or various alcoholic mixed drinks. Whether or not you have had 

actual drinking experiences yourself, you are to answer in terms of your beliefs about alcohol. It 

is important that you respond to every question. 

PLEASE BE HONEST REMEMBER, YOUR ANSWERS ARE CONFIDENTIAL. RESPOND TO 

THESE ITEMSACCORDING TO WHAT YOUPERSONALLYBELIEVEABOUTALCOHOL. [List] 

HAP indicated 

Use Q83 

How important to you is (was) each of the following as a reason for drinking? [List] 

Response categories: 

a. Extremely important d. Somewhat important 

b. Very important e. Not at all important 

c. Important 

104 
APPENDIX E - DRAFT ADOLESCENT

CRITERION INSTRUMENT CONTAINING SOURCES

105 
ADOLESCENT SELF-REPORT DATA ITEMS - CONSUMPTION

1.Q-F by beverage 

ADI indicated 

Use Q42-Q43 

A.

How many times in the past six months have you drunk enough alcohol to feel pretty high? 

1 = 0 - 5 times

2 = 6 - lO times

3 = 11 - 20 times

4=21-40 times

5 = 41 -100 times

6 = over 100 times

B.

How many times in the past year? C. In your life?

(CODE B. AND C. SEPARATELI9

1 =0-5times

2 = 6 - IO times

3 = 11 - 20 times

4 = 21 - 40 times

5 = 41 -100 times

6 = 100+ times

D.

Have you used alcohol regularly for at least a month? 

During the period when you drank re larlu how much alcohol did you usually drink at one time 

or sitting? 

1 = About 1 beer (12 oz.); 1 mixed drink; 1 glass of wine (3-4 oz.)

2 = 2-3 beers; 2-3 mixed drinks; 2-3 glasses of wine

3 = 4-9 drinks

4 = 10-17 drinks

5 = 3 six packs; a fifth; 3 bottles of wine; or more

2.

Chronic drinking, duration at current level 

ADI indicated 

No question. Suggest: 

How long have you been drinking at your current level of drinking? years 

3.

Chronic drinking, years of abstinence 

ADI indicated 

106 
No question. Suggest: 

CDP B40 and B41 

Since you first started drinking, what is the longest period of time that you have gone without taking 

a drink? months 

When was the last time that you went for 2 or 3 days without drinking any alcohol? How long ago? 

4.

Drug use by drug (frequency) 

ADI indicated

Use Q111-Q113,Q115-Q117B

Q111

A.

Now I want to discuss your experience with drugs other than alcohol. Have you ever used any 

drug on this list? (SHOW CARD B) 

B. Have you ever taken any other drugs to get high that are not on this list?

IF NOT TO BOTHA AND B, SKIP TO QXXX

Q112

Which drugs have you used 5 or more times in your life?

AA. Marijuana

*A. Amphetamines/Stimulants

*B. Sedatives/Hypnotics

C. Cocaine

*D. Opiods

E. Hallucinogens 

F. PCP 

G. Inhalants 

H. Other ( )

IF NO TO ENTIRE LIST, SKIP TO QXXX, IF YES TO * DRUGS, ASK Q113

Q113 

A. Were any of these drugs you were taking prescribed to you by a doctor? 

a. Amphetamines/Stimulants 

b. Sedatives/Hypnotics 

c. Opiods

IF YES TOANYABOVE DRUG, ASK B

107 
B. Were you taking more of the drug than was prescribed, or more often? 

a. Amphetamines/Stimulants 

b. Sedatives/Hypnotics 

c. Opiods 

5. Preferred drug 

ADI indicated

Can be determined from item 4, above

6. Inappropriate context, time and place, alcohol 

ADI indicated

Use Q47-Q51

Q47

Have you ever used alcohol at school or on the job?

How many times?

Q48 

Have you ever gone to school or to work while high from using alcohol?

How many times?

Q49 

Have you ever driven a car or motorcycle while high from using alcohol?

How many times?

Q50 

Have you ever done anything else risky while high from using alcohol that could have lead to danger

or physical harm to you or someone else?

(IF YES, ASKA AND B)

A. What did you do? 

B. How many times did you do this? 

Q51 

(IF FEMALE) Have you ever been pregnant and continued to use alcohol even though you knew it 

was against medical advice? 

108 
7. Age at first drink 

ADI indicated 

Use Q38-Q41 

Q38 

Have you ever drunk alcohol? 

Q39 

Have you used alcohol more than 5 times? 

Q40 

How old were you the first time you ever drank to the point of getting pretty high? 

Q41 

How long has it been since you last used alcohol to get high? 

CODE 

I = within last day

2 = within last 2 days

3 = within last 1 week

4 = within last 2 weeks

5 = within last month

6 = within last 6 months

7 = more than 6 months ago

8 = more than 1 year ago

8. Age at first drug use 

ADI indicated

Use Q114

How old were you when you first used (dru ? (CODE AGE)

AA.Maryuana 

A. Amphetamines/Stimulants 

B. Sedatives/Hypnotics 

C. Cocaine 

D. Opiods 

E. Hallucinogens 

F. PCP 

G. Inhalants 

H. Other ( 

109 
9. Context of drug use, time and place 

ADI indicated

Use Q121-Q125

Q121 

Have you ever used (dru at school or on the job? (How many times?) 

AA. Marijuana 

A. Amphetamines/Stimulants 

B. Sedatives/Hypnotics 

C. Cocaine 

D. Opiods 

E. Hallucinogens 

F. PCP 

G. Inhalants 

H. Other 

Q122

Have you ever gone to school or to work high from using (dru ?How many times?

AA. Marijuana

A. Amphetamines/Stimulants 

B. Sedatives/Hypnotics 

C. Cocaine 

D. Opiods 

E. Hallucinogens 

F. PCP 

G. Inhalants 

H. Other 

Q123 

Have you ever driven a car or motorcycle while high from using (drug)? How many times? 

AA.Maryuana 

A. Amphetamines/Stimulants 

B. Sedatives/Hypnotics 

C. Cocaine 

D. Opiods 

E. Hallucinogens 

F. PCP 

G. Inhalants 

H. Other 

Q124 

While high from using (drug), have you ever done anything else risky that could have lead to danger 

or physical harm to you or someone else? How many times? 

110 
AA. Marijuana 

A. Amphetamines/Stimulants 

B. Sedatives/Hypnotics 

C. Cocaine 

D. Opiods 

E. Hallucinogens 

F. PCP 

G. Inhalants 

H. Other 

(IF YES, ASK A)

What did you do? SPECIFY.­

Q125 

(IF FEMALE) Have you ever been pregnant and continued to use (dru even though you knew it 

was against medical advice? 

AA. Mar^juana 

A. Amphetamines/Stimulants 

B. Sedatives/Hypnotics 

C. Cocaine 

D. Opiods 

E. Hallucinogens 

F. PCP 

G. Inhalants 

H. Other ( 

10. Drinking plus other drug use, other drug use 

HAP (mod) indicated 

Use Q298 

On the occasions that you use (name the drug) how often do you also use alcohol? 

a. Always 

b. Most of the time 

c. About half of the time 

d. Some of the time 

e. Never 

111 
ADOLESCENT SELF-REPORT DATA ITEMS - DEPENDENCE

1. DSM-IIIR, withdrawal 

ADI indicated

Use Q73-Q75

Q73 

Have you ever had the "shakes" or tremors of your hands after stopping or cutting down on 

drinking, or had that feeling the morning after drinking? 

Q74 

Have you ever had any fits or seizures? 

Q75 

Have you ever seen or heard things that weren't really there? 

2. DSM-IIIR, tolerance 

ADI indicated

Use Q70-Q72

Q70 

Do youfind that you now must take much larger amounts of alcohol to get "high" or drunk? 

IF YES, ASK Q71 AND Q72 

Q71 

Presently, how many drinks do you need to get high? 

(CODE NUMBER) 

Q72 

When you first started to use alcohol, how many drinks of the same beverage did it take to get high? 

(CODE NUMBER) 

INTERVIEWER: CODE TYPE OF BEVERAGE REFERRED TO IN ABOVE QUESTIONS 

1 = Beer 

2 = Wine 

3 = Hard liquor drinks 

3. DSM-IIIR, pre-occupation 

ADI indicated

Q52-Q58

112 
Q52 

Do you spend a lot of time getting or buying alcohol? 

Q53 

Do you spend a lot of time drinking alcohol? 

Q54 

Do you spend a great deal of time recovering from heavy use of alcohol? 

Q55 

Have you stopped participating in a club, sports team, or other after school activity because it gets 

in the way of using alcohol? 

Q56 

Have you gone without important things you wanted or needed in order to get or pay for alcohol? 

Q57 

Have you spent less time in a hobby because it takes time away from using alcohol? 

Q58 

Have you stopped doing anything else that used to be important to you because it gets in the way of 

using alcohol? 

SPECIFY 

4. DSM-IIIR, loss of control 

ADI indicated 

Use Q44-Q46 

Q44 

Have you ever tried unsuccessfully to cut down or stop using alcohol? 

How many times?

Q45

Have you ever tried to control your use of alcohol by switching to another drug?

How many times?

Q46

Do you often wish you could control your use of alcohol?

113 
5. DSM-IIIR, persistence 

ADI indicated

Use Q64-Q69

Q64 

Have you continued to use alcohol when you knew you had a serious physical problem that might 

be made worse by using alcohol? (MUST BE CHRONIC CONDITION OR SERIOUS 

ENOUGH TO REQUIRE MEDICAL CARE) 

Q65 

Have you ever been told by a physician or a doctor that your use of alcohol has caused you a 

physical disability or problem? 

Q66 

Have you continued to use alcohol when you knew you had a serious mental or psychological 

problem that might be made worse by using alcohol? 

Q67 

Have you ever been told by a physician or doctor that your use of alcohol has caused you to suffer 

a serious mental or psychological problem? 

Q68 

Have you contained to use alcohol even though you know that your grades have dropped because 

of using alcohol? 

Q69 

Has your use of alcohol upset any of your friends to the point where they no longer speak to you or 

associate with you? (CANNOT BE MINOR DISAGREEMENT) 

DETAILS: 

6. History of dependence, no. of treatment episodes 

ADI indicated

Use Q34

Have you ever been in treatment for alcohol problems? 

A. How old were you when that happened the first time? 

B. How old were you when that happened the last time? 

C. How many separate times have you been admitted to a program for treatment? 

114 
7. History of dependence, no. of detoxifications 

ADI indicated

Contained in item 6

8. History of dependence, no. of DTs 

ADI indicated

Use Q76

Sometimes people experience the DT's when they quit drinking. Have you ever had the DT's? 

IF YES ASK: WHAT SYMPTOMS DID YOU EXPERIENCE? 

YES NO 

Being very confused (e.g. not knowing place or time of day) 

Rapid heart beat and breathing 

.

Fever 

Sweating 

Elevated blood pressure 

Seeing or hearing things that are not really there 

9. Impaired cognitive function 

ADI indicated 

Use G. Memory and Orientation Screen 

I have some questions for you that will help me check your memory. 

Can you tell me what day of the week this is? 

What is the date today 

Month Day (+ 1) Year 

(Note: assume correct response if within one day of actual day) 

What season of the year is it now, spring, summer, fall, or winter? 

Please tell me the month of the year in order. (CODE PERFORMANCE) a 

RECORD HERE: 

115 
Now I will ask you three things to remember, and in a few minutes I will ask you what they are. 

• The name of a man: John Smith 

• An address: 500 Minnesota Avenue 

• A color: green 

Please repeat those 3. (CODE PERFORMANCE) 

3 = Accurate

2 = Needs prompting

1 = Cannot repeat any

I want you to listen carefully and repeat these numbers after me.

(BEGIN WITH 1 AND CONTINUE UNTIL RESPONDENT FAILS; CODE LAST CORRECT

REPETITION)

2 = ............................. 4-3- 1 -9

3 = ............................. 8-5- 1-9-2

4 = ............................. 9-3-5-2-8-6

5 = ............................. 7-5-8-3-9-2-4

Please repeat these numbers backward. (BEGIN WITH 1 AND CONTINUE UNTIL FAILURE; 

CODE LAST CORRECT REPETITION) 

1 = ............................. 9-1

2 = ............................. 4-7-3

3 = ............................. 8- 5- 9-2

4= ............................. 6-2-4-7-1

0 = Unable

What were those three things I wanted you to remember? (CODE PERFORMANCE) 

CODE 

4 = All three correct

3 =2outof3

2 = 1 only

1 = None

10. Age at first problem, alcohol 

Not indicated for adolescents 

11. Age at first help, alcohol 

ADI indicated

Contained in item 6., above

12. Age at first problem, drugs 

116 
13. Not indicated for adolescents

14. Age at first help, drugs

ADI indicated

Use Q34. Substitute "drugs" for "alcohol."

Have you ever been in treatment for drugs?

A. How old were you when that happened the first time?

B. How old were you when that happened the last time?

C. How many separate times have you been admitted to a program for treatment?

15. Gross tremor

Observation by interviewer

16. Have you ever had a problem with alcohol?

ASI indicated

No question. Use:

Have you ever had a problem with alcohol?

17. When was your last drink?

ASI indicated

No question. Suggest:

When was your last drink? (use appropriate units)

18. How troubled or bothered are you by alcohol problems?

IAP indicated

Use Question D23

How troubled or bothered are you by alcohol problems?

Not at all

Slightly

Moderately

Considerably

Extremely

19. How important to you is treatment for your alcohol problem?

IAP indicated

Use Question D24

117
How important to you now is treatment or counseling for alcohol problems? 

Not at all 

Slightly 

Moderately 

Considerably 

Extremely 

118 
ADOLESCENT SELF-REPORT DATA ITEMS - CONSEQUENCES 

1. History of trauma / medical history 

(Accidental injuries, cirrhosis, hepatitis, intentional injury, suicide attempts, DTs, impaired cognitive 

functioning, memory problems.) 

TS (expanded) indicated for all items except last 3. ADI for others. TS does not have cirrhosis, 

hepatitis, intentional injury, or suicide items. ADI does not have cirrhosis or hepatitis items. 

TS items: 

Since your 13th birthday;.. 

1. Have you had any fractures or dislocations to your bones or joints? 

2. Have you been injured in a traffic accident? 

3. Have you injured your head? 

4. Have you been injured in a fight or assault (do not count during sports)? 

5. Have you been injured while or after drinking alcoholic beverages? 

Alternative: Use IAP G7 for medical items. 

IAP G7 

During the past 12 months did you have:

Cirrhosis of the liver?

Hepatitis?

Note: 1. DTs addressed under Dependence, item 8. 

2. Concentration and memory addressed under Dependence, item 9. 

3. Suicide addressed under 2., below. 

2. Life role 

(School, work, financial, legal, conduct disorders, psychiatric, psychosocial distress, peer relations; 

opposite sex.) 

ADI indicated for all items.

Q159, Q160, Q156, Q148-Q155, Q157, Q158. Also, Q37 for psychosocial stressors.

Q159 

I want to ask some questions about school in the past year. (USE CODE BELOW)

CODE

4 = Good

3 = O.K

2 = Not so good

1 =Bad

A. How did you feel about school in the past year? 

B. How did you feel about your school work? 

C. How did you feel about your teachers? 

D. How did your teachers feel about you? 

119 
E.

What about the other kids in school, how did you get along with them? 

F.

Have any of these school problems happened to you in the past year. 

a. being sent to the principal? 

b. had a family conference? 

c. Been suspended? 

d. Been expelled? 

Q160 

In the past year, what kinds of grades did you get in these classes? (USE CODE BELOW) 

CODE 

4 = Above average (A's and B's) 

3 = Average (C's) 

2 = Below Average (D's) 

1 = Fail (F's) 

0 = N/A - Not applicable 

A.

Reading/English 

B.

Math/Arithmetic 

C.

Science 

D.

Social Studies 

E.() 

Q 156 

A.

Have you been in trouble with the law in the last year? 

B.

(IF YES) Were you arrested? 

C. '(IF YES) What were you charged with? 

D.

Do you have any current charges pending for

status offense?

misdemeanor?

felony? 

E.

Are you currently under the supervision of a

probation officer?

social worker?

Q148 

Depression 

A.

Has there been a continuous two-week period when you felt sad or down most of the time and felt 

as if you didn't care anymore about anything? 

B.

Have you ever felt like crying for several days in a row? 

C.

Have you ever had difficulty sleeping for many days on end? 

D.

Have you ever felt so down that you felt like ending your life? 

E.

Have you ever actually attempted suicide? 

F.

(If yes to any above) Did you experience these problems in the past 12 months? 

120 
Q149 

Mania 

Has there ever been a period of at least several days when you were not using drugs but felt 

(differentiate from feeling good after depression, normal excitement or happiness) 

A.

On top of the world and felt like you had superhuman talents? 

B.

Did you feel that you had limitless energy? 

C.

Did you feel that your thoughts were racing? 

D.

Could you go for a long period without sleep? 

E.

This high feeling gets you into trouble? 

F.

(If yes to any above) Did you experience these problems in the past 12 months? 

Q150 

Eating Disorder 

A.

Have you ever eaten so much food in a short period of time that you felt out of control and would 

be embarrassed if others saw you? 

B.

Have you ever made yourself vomit after eating in order to lose weight? 

C.

Have you ever used laxatives to make yourself lose weight? 

D.

Have you ever lost a lot of weight by dieting and were told by others that you looked too thin? 

E.

(If yes to any above) Did you experience these problems in the past 12 months? 

Q151 

For Q151 & Q152 do not count as positive if subject was physically ill, dreaming, in a half awake state, 

intoxicated, or withdrawing from drug use, or if beliefs are part of shared religious or subcultural belief 

system. 

Delusions 

Have you ever had ideas or beliefs that other people found difficult to understand, such as: 

A.

That people are harassing or persecuting you for some strange reason? 

B.

That someone if controlling your mind to the point that you feel like a robot? 

C.

That your thoughts are being broadcast to other people without your control? 

D. If yes to A, B, or C, tell me about these ideas. 

E. Past 12 months? 

121 
Q152 

Hallucinations 

A.

Has your imagination ever played tricks on you where you heard voices talking to you yet no one 

was actually there? 

B.

Have you ever seen things that other people couldn't see? 

C.

If yes to A or B, can you tell me about these experiences? 

D.

Past 12 months? 

Q153 

ADD

Do you find that you are the type of person that:

A.

Starts one task, then drops it to do something else? 

B.

Often gets complaints from parents or teachers that you don't listen to instructions or directions? 

C.

Often acts before thinking? 

D.

Has difficulty waiting for your turn in games or when with other kids? 

E.

Finds it difficult to sit still or fidgets a lot? 

F.

Have you ever been told that you were hyperactive, or have been prescribed medication for 

hyperactivity? 

G.

Past 12 months? 

Q154 

Anxie 

A.

Do you worry a great deal when you are away from home that something bad might happen to your 

parents? 

B.

Have you ever refused to go to school because you were afraid that something bad might happen 

to your parents or some other important person? 

C.

Do you worry a great deal about how well you are performing as a student or whether you have 

enough friends? 

D.

Do you worry excessively about how future events will turn out? 

E.

Past 12 months? 

Q155 

Conduct Disorder 

A.

Are you often truant from or skip school? 

B.

Have you ever broken into someone's house, building, or car? 

C.

Do you often start physical fights? 

D.

Have you ever used a weapon in a fight? 

E.

Have you ever stolen something from someone in front of them?

(For example, a mugging, purse-snatching, or robbery.)

F.

(If yes to any of above) Did you do any of these things in the past 12 months? 

122 
Q157 

Peer 

I am going to read you a statement and I want you to indicate for me "how true" the statement describes 

your life in the past year. (USE CODE BELOW) 

CODE 

4 = Very much true 

3 = Somewhat true 

2 = Only slightly true 

1 = Not at all true 

A. I got along well with other kids in the past year. 

B. I made new friends in the past year. 

C. Kids often called on me to do things. 

D. I was a popular person with my friends last year. 

E. I spent a lot of time with a best friend or two. d 

i 

5 

F. I spent a lot of time with a steady group of friends during the past year. 

G. I was the kind of person that other friends would follow along. 

H. I used alcohol or other drugs with friends. 

Q158 

OOpyosite Sex 

I want to ask you about your dating in the past year (USE CODE BELOW) 

CODE 

4 = Very much true 

3 = Somewhat true 

2 = Only slightly true 

1 = Not at all true 

A. I have a lot of friends who are (opposite sex). 

B. I enjoyed spending time with (opposite sex) in the past year. 

C. I often went to school dances, parties, or other kinds of social activities that include (opposite sex). 

D. I had a boyfriend/gir friend during the past year. 

E. I often used alcohol or other drugs with a boyfriend/girlfriend. 

Q37 

Now let's discuss how your life has been the past 12 months. I am going to read you a list of experiences 

or events, some are positive and some are negative. Tell me if you experienced the event in the past 12 

months. Remember, I'm only interested in the past 12 months. so that would make it since last (SPECIFY 

MONTH). (READ THE EVENT LIST TO SUBJECT AND CIRCLE THE LETTER NEXT TO THOSE 

EVENTS INDICATED AS PRESENT) 

123 
(AFTER THE EVENTLISTHASBEENREADAND MARKED) Now let's find out how happy or unhappy 

you felt about the events you experienced. Think back to when the event occurred and try to recall how 

happy or unhappy the event made you feel at the time you experienced it. Rate the degree of happiness 

or unhappiness for each event by selecting a number on this 5 -point scale. (GIVE CARD A TO 

SUBJECT) I will read each event and you can tell me which rating to assign. (CODE RATING IN THE 

SPACE PROVIDED TO THE NEAR LEFT OF ITEM 

(AFTER EVENTS HAVE BEEN RATED FOR HAPPINESS AND UNHAPPINESS) Finally, I want to 

learn more about the events that you rated as very unhappy or unha . I want to know which of these 

events caused you to feel unhappy for more than six months. I will read each event you rated as 

unhappy, and you can indicate whether it was less than or more than 6 months. (CODE "0"FOR LESS 

THAN SIX MONTHS OR "6" FOR MORE THAN SIX MONTHS IN SPACE TO THE FAR LEFT OF 

ITEM) 

Oor6 1-5 

A. An important friend left you 

B. You changed schools 

C. Your parents argued or fought with each other 

D. One or both of your parents got remarried 

E. You met a teacher you liked a lot 

F. You became heavily involved in religion 

G. Your parents got divorced or separated 

H. There were serious money problems at home 

I. A family member had a serious accident or illness that worried you 

J. Someone in your family had a drinking or drug problem 

K You started earning your own money 

L. You feared that someone might physically hurt you 

M. You feared that someone might make sexual advances towards you 

N. A brother or sister was born into the family 

0. You found a new group of friends 

P. You took a vacation with kids your own age 

Q. You broke up with someone you were dating on a regular basis 

R.a. (FOR GIRLS) You became pregnant or gave birth to a child or did not 

complete pregnancy 

b. (FOR BOYS) Your girlfriend became pregnant 

S. You moved to a new home or neighborhood 

T. You got poor grades in school 

U. You had problems at work 

V. You had a serious accident or illness 

W. You started dating regularly 

X. You fell in love 

Y. You had sexual intercourse for the first time 

Z. You got your own stereo or TV 

AA. You got in trouble with the law 

BB. You were expelled or suspended from school 

CC. You gained a lot of weight 

DD. You had a sexual experience with someone of your own sex 

EE. A close friend died 

FF. You thought about hurting or killing yourself 

GG. You had trouble with a brother or sister 

124 
HH. Your mother or father lost a job 

11. A brother or sister moved out 

JJ. You had trouble with a school teacher 

KK. You were not selected for an extracurricular activity that you wanted to be 

involved in 

LL. Someone in your family died 

MM. You were bothered by a lack of affection and kindness toward you by one or 

both of your parents 

NN. You were placed in a new living situation, for example, in a foster home, 

residential setting, or institution 

00. A close friend became seriously ill or had serious medical problems 

PP. You were given medication by a physician 

QQ. You became heavily involved in a new hobby 

RR. You stole something valuable 

SS. One or both of your parents changed jobs 

TT. You made a decision about college 

UU. You started seeing a therapist or counselor because of personal problems 

W. You ran away from home 

e WW. You joined a club or group 

XX. You had trouble with classmates 

125 
ADOLESCENT SELF-REPORT DATA ITEMS - VULNERABILITY 

1. Family history, substance abuse 

ADI indicated

Use Q19, Q20, Q21, Q22, Q23, Q32, Q33

Q19, Q20, Q21, Q22

At any point in time, has your

birth mother had a problem with alcohol or drugs?

birth father had a problem with alcohol or drugs? 

(step/adoptive/foster) mother had a problem with alcohol or drugs? 

(step/adoptive/foster) father had a problem with alcohol or drugs? 

DETAILS: 

Q23 

(IF YES IN Q19 - Q22) Have they ever been in treatment or attended AA? 

Natural Mother

Natural Father

(Step/Adoptive/Foster) Mother

(Step/Adoptive/Foster) Father

DETAILS: 

Q32

Have any of your brothers or sisters ever had a problem with alcohol or drugs?

A. Brother(s) 

B. Sister(s) 

C. (Step/Hal, f) Brother(s) 

D. (Step/Half) Sister(s)

DETAILS:

Q33

(IF YES IN Q32) Have they been in treatment or attended AA?

126 
A. Brother(s) 

B. Sister(s) 

C. (Step/Half) Brother(s) 

D. (Step/Ha f) Sister(s) _ 

DETAILS: 

2. Self-medication, mood enhancement; and 

3. Reasons for drinking 

AEQ indicated 

Use abbreviated AEQ, items 70-97 

This is a question about the effects of alcohol. Read each statement carefully and respond according 

to your own personal feelings, thoughts, and beliefs about alcohol now. I am interested in what yQu 

think about alcohol regardless of what other people might think. 

If you think the statement is true, or mostly true, or true some of the time, then mark the number 0, 

for "AGREE", on your computer sheet. If you think the statement is false, or mostly false, then mark 

the number 1, for "DISAGREE" on your computer sheet. When the statements refer to drinking 

alcohol, you may think in terms of drinking any alcoholic beverage, such as beer, wine, whiskey, 

liquor, rum, scotch, vodka, gin, or various alcoholic mixed drinks. Whether or not you have had 

actual drinking experiences yourself,' you are to answer in terms of your beliefs about alcohol. It 

is important that you respond to every question. 

PLEASE BE HONEST REMEMBER, YOUR ANSWERS ARE CONFIDENTIAL. RESPOND TO 

THESE ITEMS ACCORDING TO WHAT YOUPERSONALLYBELIEVEABOUTALCOHOL. 

[List] 

TEENHAP indicated 

Use Q49 (next page) 

127 
How important to you is (was) each of the following as a reason for drinking? 

To become sociable 

Because you like the taste 

Because the people you know drink 

When you want to forget everything 

Because it helps you relax 

Because it helps you go to sleep 

Out of habit 

To celebrate special occasions 

Because it helps you forget your worries 

Because a small drink improves your appetite for food 

Because it is the polite thing to do in certain situations 

Because it helps cheer you up when you're in a bad mood 

Because it helps you when you are tense and nervous 

Response cate off, ries: 

a. Extremely important 

b. Very important 

c. Important 

d. Somewhat important 

e. Not at all important 

128 

3 
DOT HS 808 881

May 1999

N 

U.S, Department 

of Transportation 

National Highway People Saving People Traffic Safety http://www.nhtsa.dot.gov Administration