A three-sample test of a masked alcohol screening questionnaire

Area of Science:

• Psychiatry and Behavioral Sciences
• Public Health
• Primary Care Medicine

Background:

• Screening instruments are crucial for identifying individuals with excessive alcohol consumption in clinical settings.
• The Wallace and Haines questionnaire provided a foundation for developing more comprehensive alcohol screening tools.
• Existing instruments require validation for reliability and construct validity across diverse populations.

Purpose of the Study:

• To evaluate the expanded Health Screening Survey (HSS) as a masked alcohol screening instrument.
• To assess the HSS's sensitivity and specificity in identifying alcohol use disorders.
• To examine potential gender differences in the validity of HSS subscales within a primary care sample.

Main Methods:

• The study utilized an expanded version of a masked alcohol screening instrument, incorporating subscales for CAGE, consumption, trauma, medical advice, past, and present alcohol-related problems.
• The HSS was administered to alcoholic patients from treatment centers and a community primary care sample meeting DSM-III criteria for alcohol abuse and/or dependence.
• Statistical analyses were performed to determine sensitivity and specificity, and to explore gender-based differences in subscale validity.

Main Results:

• The HSS demonstrated high sensitivity in identifying known alcoholics (0.96; 0.95) and adequate specificity (0.80; 0.70).
• In a primary care sample, the HSS correctly classified 78% of subjects meeting DSM-III criteria for alcohol abuse/dependence.
• Significant gender differences were observed, with alcoholic males reporting more problems on the questionnaire than alcoholic females.

Conclusions:

• The Health Screening Survey (HSS) shows promising validity and reliability for screening alcohol use disorders in both treatment and primary care settings.
• The HSS effectively identifies individuals with alcohol abuse and/or dependence, supporting its utility in clinical practice.
• The observed gender differences necessitate further refinement of the HSS to ensure equitable performance across genders.