Optimizing the US-AUDIT for Alcohol Screening in U.S. College Students

Area of Science:

• Psychology
• Public Health
• Clinical Medicine

Background:

• The Alcohol Use Disorders Identification Test (AUDIT) is a common screening tool.
• The US-AUDIT (2014) is adapted for U.S. standard drinks, but optimal cutoff scores for college students are unknown.
• College students are a population of interest for alcohol use screening.

Purpose of the Study:

• To determine optimal cutoff scores for the US-AUDIT in college students.
• To identify appropriate screening thresholds for at-risk drinking and likely alcohol use disorder.
• To provide empirical guidelines for US-AUDIT use in college settings.

Main Methods:

• 250 undergraduates completed the US-AUDIT.
• At-risk drinking was defined as at least four binge drinking episodes per week.
• Likely alcohol use disorder was assessed using a self-report diagnostic measure.
• The Youden method was used to calculate optimal cutoff scores for sensitivity and specificity.

Main Results:

• For at-risk drinkers, the ideal US-AUDIT cutoff was 5 for men (sensitivity=.93, specificity=.96) and 6 for women (sensitivity=.77, specificity=.86).
• For likely alcohol use disorder, the ideal US-AUDIT cutoff was 13 for men (sensitivity=.69, specificity=.81) and 8 for women (sensitivity=.83, specificity=.80).
• These optimal cutoffs are lower than the original AUDIT recommendations.

Conclusions:

• Gender-specific cutoff scores for the US-AUDIT are recommended for identifying likely alcohol use disorder in college students.
• These findings may reflect differences in drinking patterns between male and female college students.
• The study provides empirical guidelines to enhance alcohol screening and identification of at-risk college drinkers in various healthcare settings.