Validating Consumption-Based Brief Screening for Youth Alcohol and Drug Problems

描述（由申请人提供）：筛查结合适当的干预和转介，有可能显着减少青少年的酒精和大麻问题。然而，大多数屏幕表现不佳或尚未在年轻人中得到验证，或者太长且笨重而无法在繁忙的临床环境中使用。人们对基于消费的青少年筛查非常感兴趣，这些筛查按发育分级且非常简短，可以检测当前的物质问题以及未来问题的风险。一个主要的例子是 NIAAA 的新儿童和青少年酒精筛查指南，该指南使用有关饮酒频率和朋友饮酒的问题来识别患有酒精问题或有酒精问题风险的青少年。饮酒频率问题的年龄分级切点是根据使用基于 DSM-IV 的结果的代表性横断面全国调查中对 12-18 岁受访者的分析得出的。然而，还需要做更多的工作来研究这种基于消费的筛查的并发和预测有效性。我们建议对五项研究（其中三项有长期纵向数据）进行二次数据分析，以表征 8 至 20 岁青少年中基于消费的酒精和大麻筛查的有效性。我们将使用流行病学样本以及对初级保健、成瘾治疗和进入大学的青少年的研究，研究儿童、青少年和年轻人中酒精和大麻消费筛查问题的表现。我们将研究基于消费的筛查是否因种族而不变。我们将在拟议的 DSM-5 酒精和大麻使用障碍标准的背景下研究筛查切点，但将强调在青少年中更常见的较温和形式的物质问题。我们将通过网站轻松访问新的筛查产品来传播我们的结果。我们的结果将为 NIAAA 持续努力开发在线 CME 课程和基于指南的交互式移动网络筛选应用程序提供信息。该项目非常重要，因为它将大大增加支持在青少年中进行短暂饮酒和大麻筛查的科学知识。

DESCRIPTION (provided by applicant): Screening, combined with appropriate intervention and referral, has the potential to significantly reduce alcohol and marijuana problems in youth. However, most screens perform poorly or have not been validated in youth, or are too long and unwieldy to be used in busy clinical settings. There is a great deal of interest in consumption-based youth screens that are developmentally graded and very brief, and that can detect both current substance problems as well as risk for future problems. A primary example is NIAAA's new Alcohol Screening Guide for Children and Adolescents, which uses questions about the frequency of alcohol use, and about friends' drinking, to identify youth that have or are at risk fr alcohol problems. Age-graded cut- points for the alcohol frequency question were derived from analyses of respondents age 12-18 in a representative, cross-sectional national survey using DSM-IV-based outcomes. However, much more work is needed to study the concurrent and predictive validity of such consumption- based screening. We propose to conduct secondary data analyses in five studies (three of which have long-term longitudinal data) to characterize the validity of consumption-based alcohol and marijuana screening in youth aged 8 to 20. We will study the performance of alcohol and marijuana consumption screening questions in children, adolescents and young adults, using epidemiologic samples, and studies of youth in primary care, in addictions treatment, and entering college. We will examine whether consumption-based screening is invariant by race- ethnicity. We will study screening cut-points in the context of proposed DSM-5 criteria for Alcohol and Cannabis Use Disorders, but will emphasize milder forms of substance problems that are more common in youth. We will disseminate our results by making new screening products easily accessed via a web site. Our results will inform NIAAA's ongoing efforts to develop an on-line CME course, and an interactive mobile web screening app, based on the Guide. This project is highly significant because it will greatly increase scientific knowledge supporting use of brief consumption-based alcohol and marijuana screening in youth.