Alcohol Use Disorders Identification Test
The Alcohol Use Disorders Identification Test (AUDIT) is a ten-question test developed by a World Health Organization-sponsored collaborative project to determine if a person may be at risk for alcohol abuse problems. The test was designed to be used internationally, and was validated in a study drawing patients from six countries. Several research studies have found that the AUDIT screening tool is a reliable and valid measure in identifying alcohol abuse problem behaviors. There is some evidence that the AUDIT works in adolescents and young adults; it appears less accurate in older adults. It appears well-suited for use with college students, and also with women and members of minority groups. The AUDIT alcohol consumption questions (AUDIT-C) is a 3-question screening test for problem drinking which can be used in a doctor's office.
Research studies have found a correlation between an increase in alcohol-related problems and an increase in the total score of the AUDIT. The AUDIT has also been found to be a valid indicator for severity of alcohol dependence, potentially expanding its utility beyond screening to also help with treatment planning. In a systematic review of screening tools for alcohol problems, the AUDIT was found to be the "most effective in identifying subjects with at-risk, hazardous, or harmful drinking" but less effective than the CAGE at detecting alcohol abuse and dependence. Research has also shown that the AUDIT's items are both reliable and highly responsive to change. Sensitivity and specificity for the AUDIT has been found to be high.
Question breakdown, scoring and interpretation
Scoring the AUDIT is based on a 0-4 point scale. Six of the ten questions ask about the frequency of certain alcohol abuse behaviors and are scored by the following responses:
- 0 points: "Never"
- 1 point: "Less than monthly"
- 2 points: "Monthly"
- 3 points: "Weekly"
- 4 points: "Daily, or almost daily"
The other four questions vary in participant response choice but are scored on a 0-4 point scale.
The questions measure different domains of alcohol consumption problems. The breakdown is as follows:
- 1-3: Measure frequency in alcohol consumption
- 4-6: Measure alcohol dependence
- 7-10: Measure alcohol related problems
Interpretation of scores
In order to score the AUDIT, point values of each answer choice are summed together and then interpreted based on the following criteria.
- A score of 8 or more in men (7 in women) indicates a strong likelihood of hazardous or harmful alcohol consumption.
- A score of 20 or more is suggestive of alcohol dependence (although some authors quote scores of more than 13 in women and 15 in men as indicating likely dependence).
- Substance abuse
- CAGE Questionnaire
- CRAFFT Screening Test
- Paddington Alcohol Test
- Severity of Alcohol Dependence Questionnaire
- List of diagnostic classification and rating scales used in psychiatry
The sequence of the AUDIT items has shown to have influenced the client’s report of their drinking patterns and symptoms of alcohol use disorders.
- Bohn, MJ; Babor, TF; Kranzler, HR (July 1995). "The Alcohol Use Disorders Identification Test (AUDIT): validation of a screening instrument for use in medical settings.". Journal of studies on alcohol. 56 (4): 423–32. doi:10.15288/jsa.1995.56.423. PMID 7674678.
- Kitchens, JM (14 December 1994). "Does this patient have an alcohol problem?". JAMA. 272 (22): 1782–7. doi:10.1001/jama.1994.03520220076034. PMID 7966928.
- Daeppen, JB; Yersin, B; Landry, U; Pécoud, A; Decrey, H (May 2000). "Reliability and validity of the Alcohol Use Disorders Identification Test (AUDIT) imbedded within a general health risk screening questionnaire: results of a survey in 332 primary care patients.". Alcoholism: Clinical and Experimental Research. 24 (5): 659–65. doi:10.1111/j.1530-0277.2000.tb02037.x. PMID 10832907.
- "Screening for alcohol use and alcohol related problems". NIAAA Publications. Retrieved 23 September 2015.
- Bush, K; Kivlahan, DR; McDonell, MB; Fihn, SD; Bradley, KA (14 September 1998). "The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test.". Archives of Internal Medicine. 158 (16): 1789–95. doi:10.1001/archinte.158.16.1789. PMID 9738608.
- Donovan, DM; Kivlahan, DR; Doyle, SR; Longabaugh, R; Greenfield, SF (December 2006). "Concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT zones in defining levels of severity among out-patients with alcohol dependence in the COMBINE study.". Addiction (Abingdon, England). 101 (12): 1696–704. doi:10.1111/j.1360-0443.2006.01606.x. PMID 17156168.
- Fiellin, DA; Reid, MC; O'Connor, PG (10 July 2000). "Screening for alcohol problems in primary care: a systematic review.". Archives of Internal Medicine. 160 (13): 1977–89. doi:10.1001/archinte.160.13.1977. PMID 10888972.
- Bradley, KA; McDonell, MB; Bush, K; Kivlahan, DR; Diehr, P; Fihn, SD (November 1998). "The AUDIT alcohol consumption questions: reliability, validity, and responsiveness to change in older male primary care patients.". Alcoholism: Clinical and Experimental Research. 22 (8): 1842–9. doi:10.1097/00000374-199811000-00034. PMID 9835306.
- Saunders, JB; Aasland, OG; Babor, TF; de la Fuente, JR; Grant, M (June 1993). "Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II.". Addiction (Abingdon, England). 88 (6): 791–804. doi:10.1111/j.1360-0443.1993.tb02093.x. PMID 8329970.
- AUDIT: The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care, second edition, by Thomas F. Babor, John C. Higgins-Biddle, John B. Saunders, and Maristela G. Monteiro. Retrieved June 24, 2006.
- Bischof, G (2005). "Effects of item sequence on the performance of the AUDIT in general practices". Drug and Alcohol Dependence. 79 (3): 373–377. doi:10.1016/j.drugalcdep.2005.03.002. PMID 16102379.
- Audit-C Test – United States Department of Veterans Affairs
- AUDIT – SAMHSA-HRSA Center for Integrated Health Solutions
- American Psychiatric Association Guidelines for Assessment and Treatment of Substance Use
- AACAP Practice parameters for the Assessment and Treatment of Children and Adolescents With Substance Use Disorders
- EffectiveChildTherapy.org page on substance abuse
- Behavioral Couples Therapy for Alcohol Use Disorders
- Moderate Drinking for Alcohol Use Disorders
- Motivational Interviewing, Motivational Enhancement Therapy (MET), and MET plus CBT for Mixed Substance Abuse/Dependence
- Prize-Based Contingency Management for Alcohol Use Disorders