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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

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To examine among alcohol-dependent out-patient clients the concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) total score and ‘zones’ suggested by the World Health Organization for defining levels of severity of alcohol use problems. Design 

Participants were classified into AUDIT zones (AUDIT total score = 8–15, 16–19, 20–40) and compared on measures of demographics, treatment goals, alcohol consumption, alcohol-related consequences, severity of dependence, physiological dependence, tolerance, withdrawal and biomarkers of alcohol use. Setting 

Eleven out-patient academic clinical research centers across the United States. Participants 

Alcohol dependent individuals (n = 1335) entering out-patient treatment in the Combined Pharmacotherapies and Behavioral Interventions (COMBINE) study. Measurements 

The AUDIT was administered as part of an initial screening. Baseline measures used for concurrent validation included the Structured Clinical Interview for Diagnostic and Statistical Manual, 4th edition (DSM-IV) Disorders, the Alcohol Dependence Scale, the Drinker Inventory of Consequences, the Obsessive-Compulsive Drinking Scale, the University of Rhode Island Change Assessment, the Thoughts about Abstinence Scale, the Form-90, %carbohydrate-deficient transferrin and gamma-glutamyl transferase. Findings 

Indicators of severity of dependence and alcohol-related problems increased linearly with total score and differed significantly across AUDIT zones. The highest zone, with scores of 20 and above, was markedly different with respect to severity from the other two zones and members of this group endorsed an abstinence goal more strongly. Conclusions 

The AUDIT total score is a brief measure that appears to provide an index of severity of dependence in a sample of alcohol-dependent individuals seeking out-patient treatment, extending its potential utility beyond its more traditional role as a screening instrument in general populations.
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Keywords: AUDIT; AUDIT zones; Alcohol Use Disorders Identification Test; Alcohol dependence; assessment; screening; severity of dependence

Document Type: Research Article

Affiliations: 1: Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA, 2: Center for Alcohol and Addiction Studies and Department of Psychiatry and Human Behavior, Brown University, Providence, RI and 3: Alcohol and Drug Abuse Treatment Program, McLean Hospital, and Department of Psychiatry, Harvard Medical School, Boston, MA, USA

Publication date: 2006-12-01

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