CORK Bibliography: Brief MAST (Screening Test)

12 citations. January 1996 to present

Prepared: June 2007

Cherpitel CJ. Brief screening instruments for alcoholism. Alcohol Health and Research World 21(4): 348-351, 1997. (17 refs.)

This article summarizes brief screening instruments for alcoholism, as well as a set of questions to ascertain quantity and frequency of drinking to ascertain possible harmful use. The tests discussed include the CAGE; the Brief MAST; the Alcohol Use Disorders Identification Test (AUDIT); and the TWEAK. There is also an overview of their use with women and members of minority groups. The group for which these tests are least sensitive is African-American women. The author provides a new test, the Rapid Alcohol Problems Screen (RAPS) drawing upon the most sensitive items from other tests.

Cherpitel CJ. Differences in performance of screening instruments for problem drinking among blacks, whites and hispanics in an emergency room population. Journal of Studies on Alcohol 59(4): 420-426, 1998. (38 refs.)

Objective: The purpose of this study was to compare the performance of a number of standard screening instruments for alcohol dependence and harmful drinking/abuse by ethnicity (black, Hispanic and white) and by ethnicity and gender in an emergency room setting. Method: A probability sample of patients (N = 1,429) was breath analyzed and interviewed at the Santa Clara Valley Medical Center in San Jose, California. Sensitivity and specificity were analyzed among current drinkers (n = 857) for the CAGE, Brief MAST, AUDIT, TWEAK, RAPS and other items against combined ICD-10 or DSM-IV criteria for alcohol dependence and separately for alcohol dependence or harmful drinking or abuse. Results: Screening measures were not found to perform equally well by ethnicity or gender, with lower sensitivity found for women compared to men. Consistency in sensitivity of measures was found to vary considerably across ethnic and gender groups, with some measures (most notably the RAPS and the AUDIT) showing consistently high sensitivity across subgroups. None of the instruments performed nearly as well for identifying alcohol dependence or harmful drinking or abuse combined as for alcohol dependence alone. Conclusions: Analyses suggest that, while the RAPS may hold promise for identifying problem drinkers across ethnic and gender subgroups, it and other screening instruments currently in use require additional evaluation in a variety of settings to determine their usefulness for identifying those who could benefit from a brief intervention or referral for problem drinking.

Crowe RR; Kramer JR; Hesselbrock V; Manos G; Bucholz KK. The utility of the 'Brief MAST' and the 'CAGE' in identifying alcohol problems: Results from national high-risk and community samples. Archives of Family Medicine 6(5): 477-483, 1997. (30 refs.)

Background: The CAGE and the Brief MAST questionnaires are widely used to screen for alcohol problems. We tested the performance of these instruments in 2 population-based groups: a high-risk sample composed of relatives of alcoholic subjects and a community sample consisting of families not selected for alcoholism; i.e, alcohol dependence disorder). Methods: A total of 3435 relatives of alcoholics and 795 control subjects were interviewed with the Semi-Structured Assessment for the Generics of Alcoholism (SSAGA) semistructured interview in a multicenter collaborative study on the genetics of alcoholism. The performance of "CAGE" and "Brief MAST" equivalent items in the SSAGA was characterized by their positive predictive value, sensitivity, specificity, and percentage of the sample who screened positive. Results: Both questionnaires performed well in the highrisk sample, where the base rate of alcoholism was 35%. However, in the community sample, where the 16% rate of alcoholism was comparable to that of the US population (14%),an acceptable positive predictive value could be achieved only through a substantial reduction in sensitivity. Results were similar when men were compared with women and when lifetime alcoholics were compared with current alcoholics. Conclusion: The "Brief MAST" and "CAGE" can be effective instruments to screen for significant alcohol problems in both community and high-risk patients; as expected, their positive predictive value increases with the base rate of alcoholism in the population being screened.

Gutgesell ME; Schorling JB; Gressard CF. Runners' alcohol use and responses to the Brief MAST. Substance Abuse 17(2): 77-85, 1996. (29 refs.)

The authors assessed drinking habits and responses to the Brief Michigan Alcoholism Screening Test (BMAST) in runners (students and nonstudent) participating in a 10-mi race. Questionnaires were sent to 1445 race registrants: 483 nonstudent men, 153 student men, 154 nonstudent women, and 105 student women responded (62% total response rate). The authors compared the student runners' responses to BMAST questions, as well as binge rates and family history of problem drinking, to those of a reference college-student (slightly younger) population from the same state (n= 3726). The male student-runner binge drinking rate was 50% and the women student-runner rate was 47.6%, similar to those of the comparison group. There was no difference in rates of an "alcoholic score" on the BMAST among student runners (10.4% men, 5.1% women) compared to other runners. Student runners were more likely to have sought help for their drinking compared to nonrunner students. Nearly 20% of subjects in the student groups (runners and nonrunners) reported at least one parent with problem drinking, significantly lower than the 28% reported by nonstudent runners. These data suggest that running may be a healthy substitute for drinking and warrant further investigation.

Hwu HG; Gorenc KD; Peredo S; Hwang TJ; Abreu LF; Chen CC. Brief alcoholism screening questionnaire: Establishment and validity in Taiwanese. Journal of the Formosan Medical Association 102(4): 250-256, 2003. (28 refs.)

Background and Purpose: There has been a marked increase in the prevalence of alcoholism in the Taiwanese population over the past 6 decades. This study was designed to establish a Taiwanese Brief Alcoholism Screening Questionnaire (BASQ) for use in early detection in medical and public health settings. Methods: Interview data were collected from the database of the Taiwan Psychiatric Epidemiological Project (TPEP). The TPEP interviews had been conducted using the Chinese-modified version of the Diagnostic Interview Schedule (DIS-CM) that included a section on alcoholism diagnosis. Data collected from a community sample of 13,373 subjects was used in this study. Twenty nine DIS-CM items for alcoholism diagnosis were entered into an analytic model with 7 statistical filters to identify cross-cultural items. A brief alcoholism screening questionnaire was constructed using these selected items. The validity of the questionnaire was tested in subjects (n = 457) recruited from a local medical center, a hospital clinic, and an alcoholism clinic of a psychiatric center. Results: Four cross-cultural items were identified and the BASQ was constructed. This BASQ had a best cut-off point of 3 with adequate sensitivity (0.86 to 0.88), specificity (0.88 to 0.89), and positive prediction rate (0.90 to 0.91). It detected a varying prevalence of alcoholism (10.1 to 90.3 %) in diverse clinical settings. Conclusions: A 4-item BASQ was established with adequate validity for clinical and public health application in the early detection of alcoholism in Taiwanese subjects.

Lennings CJ. The Brisbane North Alcohol and Drug Service Comorbidity Symposium. Part 2. The development of a methodology: Drug use and emotional state in university students. IN: Alcohol and Drug Foundation. Drugs: Policies, Programs and People. 1996 Conference Papers. Spring Hill, Queensland Australia: Alcohol and Drug Foundation, 1996. pp. 142-149. (9 refs.)

This paper reports efforts to investigate the psychometric properties of some screening tests used in a study of the association between emotional disturbance and problematic alcohol use. Previous study suggested that ther is an interaction of mental health factors and alcohol use among college students, (Carnatta and Nogoshi), but whether the relationship was causal could not be ascertained. The measures examined here included the AUDIT, Leeds Dependency Scale, the Faagestrom Index, the Brief MAST, the CAGE, and a 10 item comorbidity scale developed for this research.

Markianos M; Lykouras L; Moussas G; Hatzimanolis J. Changes in dopamine receptor responsivity during alcohol detoxification may predict relapse. Drug and Alcohol Dependence 64(3): 363-365, 2001. (29 refs.)

In the search for clinical and biological variables that may predict relapse of alcohol dependent patients after detoxification, we followed up for 1 year male patients that had undergone successful detoxification. The patients had been tested earlier during their usual alcohol consumption and immediately after detoxification for the responsivity of D2 dopamine receptors (as measured by the increases in prolactin plasma levels caused by intramuscular administration of 5 mg of the dopamine receptor blocker haloperidol). Of the 18 patients, eight had not consumed alcohol for more than 6 months, and ten had relapsed within 6 months. Comparison of the clinical and neuroendocrine data for the two subgroups revealed no significant differences in age, amount of alcohol consumed during alcohol abuse, score in the Beck Depression Inventory, score in the Brief Michigan Alcoholism Screening Test, or prolactin responses to haloperidol before detoxification. in patients who relapsed, the duration of alcoholism was marginally shorter (P = 0.055). Patients who did not relapse had significantly higher (P = 0.003) prolactin responses to haloperidol in the test performed after detoxification as compared with patients who did relapse, and their responses were similar to those of a group of healthy male subjects. The results show that the increase in dopamine receptor responsivity that occurs after detoxification is a favourable factor for non-relapse; it may reflect recovery from down-regulation of the dopaminergic reward system caused by alcohol consumption.

Markianos M; Moussas G; Lykouras L; Hatzimanolis J. Dopamine receptor responsivity in alcoholic patients before and after detoxification. Drug and Alcohol Dependence 57(3): 261-265, 2000. (24 refs.)

Objective: To assess central dopamine receptor responsivity in alcoholic patients during their usual alcohol consumption and after detoxification. Method: plasma prolactin levels were measured at 0, 30, 60, and 90 min after administration of 5 mg haloperidol i.m. in 21 hospitalized male alcoholic patients during usual alcohol consumption, and 13 days later (mean, range 7-17 days), after detoxification. The test was also performed in seven healthy male volunteers. The patterns of prolactin responses were compared using repeated measures analysis of variance. Results: The prolactin responses to haloperidol increased significantly after detoxification compared to those during usual alcohol consumption (state x time interaction P < 0.01; planned comparisons for times 0 and 90 min between states P = 0.03). Compared to controls, the responses of the patients before detoxification were lower (group-time interaction P = 0.001), and the difference was not significant after detoxification (P = 0.19). The magnitude of plasma prolactin (PRL) responses were not related to duration of alcohol abuse, score in the Brief Michigan Alcoholism Screening Test (BMAST) scale, or family history of alcoholism. Conclusions: Alcohol detoxification is accompanied by a normalization of the low responsivity of central dopaminergic receptors during alcohol abuse. The data support the hypothesis of a participation of the central dopaminergic system in alcohol dependence.

Soderstrom CA; Smith GS; Kufera JA; Dischinger PC; Hebel JR; McDuff DR et al. The accuracy of the CAGE, the Brief Michigan Alcoholism Screening Test, and the Alcohol Use Disorders Identification Test in screening trauma center patients for alcoholism. Journal of Trauma 43(6): 962-969, 1997. (56 refs.)

Objective: To evaluate the accuracy of questionnaire screening instruments to identify lifetime alcohol dependence among trauma center patients. Methods: The study was conducted at a Level I trauma center between September 1994 and November 1996, Patients meeting eligibility requirements (greater than or equal to 18 years old, admission from injury scene, greater than or equal to 2 days of hospitalization, intact cognition) were evaluated for alcohol abuse and dependence. Screening instruments consisted of the CAGE, the Brief Michigan Alcoholism Screening Test, and the Alcohol Use Disorders Identification Test. Screening results were compared with lifetime alcohol dependence diagnoses made using the in-depth Psychoactive Substance Use Disorders section of the Structured Clinical Interview. Accuracy was quantified as sensitivity, specificity, positive/negative predictive values, and receiver operating characteristic curves (used to calculate area under the curve). Results: Of the 1,118 patients studied, lifetime alcohol dependence was diagnosed by Structured Clinical Interview in 397 (35.5%), and abuse was diagnosed in 90 (8.1%) others. The CAGE, was the best predictor of lifetime alcohol dependence, i.e., had the largest area under the curve (93%) and the highest sensitivity (84%), specificity (90%), positive predictive value (82%), and negative predictive value (91%). Among patients testing positive for alcohol, 63% had a lifetime alcohol dependence diagnosis. Conclusion: The CAGE is an efficient screening test to detect alcohol dependence in trauma center populations, It should be used in combination with alcohol testing to identify patients at risk of alcohol use problems.

Stasiewicz PR; Bradizza CM; Maisto SA. Alcohol problem resolution in the severely mentally ill: A preliminary investigation. Journal of Substance Abuse 9: 209-222, 1997. (25 refs.)

Participants (N = 25) with a severe mental illness who were receiving mental health outpatient treatment at a state psychiatric hospital were interviewed regarding the resolution of their alcohol problem. Resolution was defined as abstinence or non-hazardous, consequence-free drinking for a minimum of 1 year. Participants were interviewed regarding their drinking history (Brief Michigan Alcoholism Screening Test and Lifetime Drinking History interview), life events, reasons for change, and factors maintaining change. The results reveal that negative life events and weighing the pros and cons of drinking are more often associated with entry into treatment than positive life events and advice or warnings from others. In addition, resolution occurs with and without a history of alcohol-specific treatment and included both abstinent and non-abstinent drinking outcomes. Although preliminary, these results are consistent with previous research investigating the resolution of alcohol problems in individuals with only a diagnosis of alcohol abuse or dependence. Unique to this population is the finding that control of psychological symptoms was identified as an important maintenance factor during the first 12 months following the resolution date. The limitations of the current study and the implications of these findings for future research investigating processes of change in the severely mentally ill are discussed.

Watkins JP; Eisele GR; Matthews KO. Occupational medical program alcohol screening: Utility of the CAGE and BMAST. Journal of Substance Abuse Treatment 19(1): 51-57, 2000. (23 refs.)

Alcohol consumption is a primary or secondary factor in many work- related accidents, suicides, homicides, violent crimes, and motor vehicle accidents. The absentee rate in alcoholics is 3.8 to 8.3 times greater than that for nonalcoholic workers. The purpose of this research was to evaluate the effectiveness of two interview questionnaires-the Brief Michigan Alcoholism Screening Test (BMAST) and the CAGE (cut down, annoyed by criticism, guilty about drinking, and eye-opener drinks). The validity of the BMAST and the CAGE as screening tools for alcohol problems has been verified in a number of nonworkplace settings. If they prove to be as effective for screening workers in an occupational medical setting, follow-up definitive diagnoses could result in earlier detection of alcohol problems and allow prompt intervention. Positive outcomes could include a safer workplace, less absenteeism, improved worker productivity, and a reduction in personal and family problems caused by drinking.

Wilson D. Routine screening tests for alcoholism. South African Medical Journal 89(9): 949-951, 1999. (0 refs.)

In a column the "test of the month", screening tests for alcohol problems are reprinted -- the CAGE, the Brief MAST, The Trauma Scale and the AUDIT. The diagnostic criteria for Alcohol Dependence and Alcohol Abuse are also highlighted.