Using the AUDIT in a College Sample

Hazardous
drinking is common among college students, and its early detection
and intervention can prevent serious consequences. This
study assessed the validity of the Alcohol Use Disorders Identification
Test (AUDIT), a 10-item screening tool for hazardous use, alcohol
abuse, and dependence, among college students by comparing it with
well-established reference standards (a validated calendar method
for consumption and a diagnostic interview).

• Among a sample of 302 college students (61% female), the AUDIT performed
  best as a screen for hazardous drinking amounts with a cut-off
  of 6 having a sensitivity of 91% and specificity of 60%. Hazardous
  amounts were defined as follows: for men, 4 or more times when >=5
  drinks were consumed in 1 sitting, or >=57 drinks over the past
  28 days; and for women, 4 or more times when >=4 drinks were
  consumed in 1 sitting, or >=29 drinks over the past 28 days.
• The
  AUDIT performed less well in detecting current alcohol abuse or
  dependence (sensitivity 78%, specificity 57%) and lifetime abuse
  or dependence (sensitivity 71%, specificity 61%).

Comments:

Using well-established reference standards, the authors demonstrated
that the AUDIT performs well as a screen for hazardous
drinking amounts and less well for alcohol abuse or dependence in
college students. Researchers should study ways
to improve the sensitivity of the AUDIT in the college
population, as they have in other groups. But for
now, using a lower cut-off on the AUDIT than is standard
for adults seems a reasonable approach to early identification
of hazardous drinking in college students.

Joseph Conigliaro, MD, MPH

Reference:

Kokotailo
PK, Egan J, Gangnon R, et al. Validity of the Alcohol
Use Disorders Identification Test in College Students. Alcohol
Clin Exp Res. 2004;28(6):914–920.
(view
abstract)