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Using Item Response Theory to Improve Alcohol Dependence Screening for African American and White Male and Female College Students

Northrup, Thomas F. PhD*; Malone, Patrick S. PhD*; Follingstad, Diane PhD*; Stotts, Angela L. PhD

Addictive Disorders & Their Treatment: June 2013 - Volume 12 - Issue 2 - p 99–109
doi: 10.1097/ADT.0b013e3182627431
Original Articles
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Background: Alcohol-dependent college students rarely seek treatment, despite the availability of efficacious interventions. Overly simplistic screening procedures, failing to account for differential patterns across demographic groupings, exacerbate this when students in need of intervention are not identified.

Objective: The criterion validity of the Alcohol Use Disorders Identification Test was evaluated, emphasizing sex-related and race-related invariance.

Methods: Item Response Theory was used to evaluate data (collected: 2008 to 2009) from 1500 lifetime-drinking, southeastern US college students, across sex and self-identified race (ie, White, non-Hispanic and Black/African American). Alcohol dependence criteria were used in the sensitivity/specificity analyses.

Results: Item Response Theory results led to item 9’s removal (for race-related noninvariance) and a cut score of 4 (problems/dependence subscale) offered more balanced intergroup scoring.

Discussion: Optimal college student screening may differ by sex and race.

*Department of Psychology, University of South Carolina, Columbia, SC

Department of Family and Community Medicine, University of Texas Medical School at Houston, Houston, TX

Present address: Thomas F.Northrup, Department of Family and Community Medicine, University of Texas Medical School at Houston, Houston, TX 77030.

Present address: Diane Follingstad, Department of Psychiatry, University of Kentucky College of Medicine, Lexington, KY 40509.

T.F.N. received support from the University of South Carolina, Department of Psychology, Laura Griffin Student Research Development Fund. P.S.M. was supported by NIH Grant 1K01DA024116 from the National Institute on Drug Abuse during the conduct of this research.

The authors declare no conflict of interest.

Reprints: Thomas F. Northrup, PhD, Department of Family and Community Medicine, University of Texas Medical School at Houston, 6431 Fannin, JJL 328, Houston, TX 77030 (e-mail: thomas.f.northrup@uth.tmc.edu).

© 2013 by Lippincott Williams & Wilkins