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Toward Efficient Screening for DSM-5 Alcohol Use Disorders in College Students

Performance of the Audit-C

Hagman, Brett T. PhD

Addictive Disorders & Their Treatment: March 2015 - Volume 14 - Issue 1 - p 1–15
doi: 10.1097/ADT.0000000000000038
Original Articles

Objectives: The newly implemented Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 Alcohol Use Disorder (AUD) criteria may significantly alter how AUDs are identified in our alcohol screening efforts. The Alcohol Use Disorders and Identification Test-Consumption (AUDIT-C) is a 3-item alcohol screening instrument that has been used extensively to identify those at-risk for an AUD. At present, research on the AUDIT-C to screen for AUDs in college students using the new DSM-5 guidelines has received no attention. The present study evaluated the performance of the AUDIT-C in screening for DSM-5 AUDs in college students.

Methods and Materials: Participants (N=1697) were past-year drinkers and recruited from 3 universities in the Southeastern, United States.

Results: The AUDIT-C performed slightly better in the detection of DSM-5 AUDs [areas under receiving operating characteristic curve (AUROC)=0.764; SE=0.014] in comparison with DSM-IV AUDs (AUROC=0.734; SE=0.014). Alternatively, the AUDIT-C performed most optimally in the detection of heavy binge drinking (AUROC=0.913; SE=0.008) and any binge drinking (AUROC=0.862; SE=0.009) in comparison with the detection of DSM-5 AUDs. Sex differences emerged in the identification of optimal AUDIT-C cut-off scores for detecting DSM-5 AUDs.

Conclusions: Overall, preliminary findings indicate that the AUDIT-C provides reasonably good discrimination in the detection of DSM-5 AUDs in college students. Continued research is warranted to ensure the stability of the current study findings.

Division of Treatment and Recovery Research, National Institute of Alcohol Abuse and Alcoholism, Bethesda, MD

Supported by contract #LD966 from the Florida Department of Children and Families.

The contents of this manuscript only reflect the views of the authors and not those of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) or National Institutes of Health.

The author declares no conflict of interest.

Reprints: Brett T. Hagman, PhD, Division of Treatment and Recovery Research, National Institute of Alcohol Abuse and Alcoholism, Bethesda, MD 20892 (e-mail:

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