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，有可能显著减少青少年的酒精和大麻问题。然而，大多数屏幕表现不佳，或者没有在年轻人中得到验证，或者太长和笨拙，不能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，这种筛查按发育程度分级，非常简短，既可以检测当前的实质性问题，也可以检测未来问题的风险。一个主要的例子是NIAAA的新的儿童和青少年酒精筛查指南，它使用关于饮酒频率和朋友饮酒的问题来识别有酒精问题或有酒精问题风险的年轻人。饮酒频率问题的年龄分级分界点是根据基于DSM-IV的结果对12-18岁的受访者进行的具有代表性的横断面全国调查分析得出的。然而，需要更多的工作来研究这种基于消费的筛查的并发和预测性有效性。我们建议在五项研究(其中三项具有长期纵向数据)中进行二次数据分析，以表征基于消费的酒精和大麻筛查在8至20岁青年中的有效性。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年轻人的研究，研究酒精和大麻消费筛查问题在儿童、青少年和年轻人中的表现。我们将研究基于消费的筛查是否因种族不同而不变。我们将在DSM-5酒精和大麻使用障碍拟议标准的背景下研究筛查切入点，但将重点放在较温和形式的物质问题上，这些问题在年轻人中更常见。我们将通过使新的筛查产品易于通过网站访问来传播我们的结果。我们的结果将为NIAAA正在进行的基于指南开发在线CME课程和交互式移动网络筛选应用程序的努力提供参考。这一项目意义重大，因为它将极大地增加科学知识，支持在青年中使用以短暂消费为基础的酒精和大麻筛查。

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.