Evaluating brief screeners to discriminate between drug use disorders in a sample of treatment-seeking adults.
Abstract
OBJECTIVE:The objective was to identify a potential core set of brief screeners for
the detection of individuals with a substance use disorder (SUD) in medical settings.
METHOD:Data were from two multisite studies that evaluated stimulant use outcomes
of an abstinence-based contingency management intervention as an addition to usual
care (National Drug Abuse Treatment Clinical Trials Network trials 006-007). The sample
comprised 847 substance-using adults who were recruited from 12 outpatient substance
abuse treatment settings across the United States. Alcohol and drug use disorders
were assessed by the Diagnostic and Statistical Manual of Mental Disorders, Fourth
Edition, Checklist. Data were analyzed by factor analysis, item response theory (IRT),
sensitivity and specificity procedures. RESULTS:Comparatively prevalent symptoms of
dependence, especially inability to cut down for all substances, showed high sensitivity
for detecting an SUD (low rate of false negative). IRT-defined severe (infrequent)
and low discriminative items, especially withdrawal for alcohol, cannabis and cocaine,
had low sensitivity in identifying cases of an SUD. IRT-defined less severe (frequent)
and high discriminative items, including inability to cut down or taking larger amounts
than intended for all substances and withdrawal for amphetamines and opioids, showed
good-to-high values of area under the receiver operating characteristic curve in classifying
cases and noncases of an SUD. CONCLUSION:Findings suggest the feasibility of identifying
psychometrically reliable substance dependence symptoms to develop a two-item screen
for alcohol and drug disorders.
Type
Journal articleSubject
HumansSubstance-Related Disorders
Alcohol-Related Disorders
Amphetamine-Related Disorders
Cocaine-Related Disorders
Marijuana Abuse
Opioid-Related Disorders
Substance Withdrawal Syndrome
Mass Screening
Prevalence
Sensitivity and Specificity
ROC Curve
Psychometrics
Adolescent
Adult
Middle Aged
United States
Female
Male
Young Adult
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https://hdl.handle.net/10161/19963Published Version (Please cite this version)
10.1016/j.genhosppsych.2012.06.014Publication Info
Wu, Li-Tzy; Swartz, Marvin S; Pan, Jeng-Jong; Burchett, Bruce; Mannelli, Paolo; Yang,
Chongming; & Blazer, Dan G (2013). Evaluating brief screeners to discriminate between drug use disorders in a sample
of treatment-seeking adults. General hospital psychiatry, 35(1). pp. 74-82. 10.1016/j.genhosppsych.2012.06.014. Retrieved from https://hdl.handle.net/10161/19963.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Daniel German Blazer
J. P. Gibbons Distinguished Professor Emeritus of Psychiatry
I am currently semi-retired. Most of my recent work has been focused on roles with
the National Academy of Medicine (former Institute of Medicine). I have chaired three
committees during the past four years, one on the mental health and substance use workforce,
one on cognitive aging, and one on hearing loss in adults. I currently also chair
the Board on the Health of Select Populations for the National Academies. In the past
I have been PI on a number of research
Bruce Myatt Burchett
Assistant Professor in Psychiatry and Behavioral Sciences
This author no longer has a Scholars@Duke profile, so the information shown here reflects
their Duke status at the time this item was deposited.
Paolo Mannelli
Associate Professor of Psychiatry and Behavioral Sciences
Marvin Stanley Swartz
Professor of Psychiatry and Behavioral Sciences
My major research interest is in examining the effectiveness of services for severely
mentally ill individuals, including factors that improve or impede good outcomes.
Current research includes: the effectiveness of involuntary outpatient commitment,
psychiatric advance directives, criminal justice outcomes for persons with mental
illnesses, violence and mental illness and antipsychotic medications. I also served
as member of the MacArthur Foundation Research Network on Mandate
Li-Tzy Wu
Professor in Psychiatry and Behavioral Sciences
Education/Training: Pre- and post-doctoral training in mental health service research,
psychiatric epidemiology (NIMH T32), and addiction epidemiology (NIDA T32) from Johns
Hopkins University School of Public Health (Maryland); Fellow of the NIH Summer Institute
on the Design and Conduct of Randomized Clinical Trials.Director: Duke Community Based
Substance Use Disorder Research Program.Research interests: COVID-19, Opioid misuse,
Opioid overdose, Opioid use disorder
Alphabetical list of authors with Scholars@Duke profiles.

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