Prospective screening of substance dependence: the advantages of directness

This study evaluated the ability of several subtle and direct alcoholism screening scales to identify DSM-III-R-defined substance dependence in a university setting. Study participants were university students (N = 495) who completed the substance use disorder modules of the Diagnostic Interview Schedule along with the Michigan Alcoholism Screening Test (MAST), the Substance Abuse Subtle Screening Inventory (SASSI), and five direct screening questions concerning the consequences of alcohol and drug use. Results indicated that the SASSI had no appreciable ability to identify the 57 study participants who met criteria for a substance use disorder. The MAST also demonstrated limited predictive ability, and results suggested that this is because many MAST items assess the more advanced features of alcoholism, features less common in the substance abuse found among university students. The five direct screening questions were modestly useful, and it is argued that there are advantages to directness when screening for substance use disorders.