CORK Bibliography: DAST (Drug Abuse Screening)

17 citations. 1996 to present

Prepared: June 2007

Alexander D; Leung P. The Marijuana Screening Inventory (MSI-X): Concurrent, convergent and discriminant validity with multiple measures. American Journal of Drug and Alcohol Abuse 32(3): 351-378, 2006. (48 refs.)

This study evaluates the concurrent, convergent and discriminant validity between the MSI-X and five other instruments completed by 107 adults. Pearson correlation analysis with follow-up t-tests found concurrent validity between the MSI-X, Drug Abuse Screening Test (DAST-20), five Substance Abuse Subtle Screening Inventory (SASSI-3) subscales, a Diagnostic Statistical Manual (DSM) IV-TR Guided Marijuana Inventory, and two Addiction Severity Index variables. As evidence of MSI-X discriminant validity, no correlations were found with three alcohol measures. Convergent validity, determined by t-test associations between MSI-X total problems with SASSI-3 substance dependence scores, supported the MSI-X >= 6 scoring cutoff. Overall, the findings support MSI-X concurrent, convergent and discriminant validity.

Bedregal LE; Sobell LC; Sobell MB; Simco E. Psychometric characteristics of a Spanish version of the DAST-10 and the RAGS. Addictive Behaviors 31(2): 309-319, 2006. (44 refs.)

Although Hispanics/Latinos constitute the largest ethnic minority group in the United States, there are few culturally and linguistically valid Spanish language clinical assessment instruments. This shortage is even more critical in the addictions field. This article presents the psychometric characteristics of two drug abuse screening instruments; the Drug Abuse Screening Test (DAST-10), and the Reduce Annoyed Guilty Start (RAGS) test that were translated into Spanish. Participants included 60 drug abusers, 35 alcohol abusers, and 127 individuals with no alcohol and/or drug problem. Results indicated that the Spanish versions of the two drug abuse screening instruments were reliable and unidimensional and differentiated drug abusers from non-substance abusers and from alcohol abusers.

Boyd CJ; McCabe SE; Cranford JA; Young A. Adolescents' motivations to abuse prescription medications. Pediatrics 118(6): 2472-2480, 2006. (27 refs.)

OBJECTIVES. Our goals were to (1) determine adolescents' motivations (reasons) for engaging in the nonmedical (illicit) use of 4 classes of prescription medications and (2) examine whether motivations were associated with a higher risk for substance abuse problems. RESPONDENTS. The 2005 sample (N = 1086) was derived from one ethnically diverse school district in southeastern Michigan and included 7th-through 12th-grade students. METHODS. Data were collected by using a self-administered, Web-based survey that included questions about drug use and the motivations to engage in nonmedical use of prescription medication. RESULTS. Twelve percent of the respondents had engaged in nonmedical use of opioid pain medications in the past year: 3% for sleeping, 2% as a sedative and/or for anxiety, and 2% as stimulants. The reasons for engaging in the nonmedical use of prescription medications varied by drug classification. For opioid analgesics, when the number of motives increased, so too did the likelihood of a positive Drug Abuse Screening Test score. For every additional motive endorsed, the Drug Abuse Screening Test increased by a factor of 1.8. Two groups of students were compared (at-risk versus self-treatment); those who endorsed multiple motivations for nonmedical use of opioids (at-risk group) were significantly more likely to have elevated Drug Abuse Screening Test scores when compared with those who were in the self- treatment group. Those in the at-risk group also were significantly more likely to engage in marijuana and alcohol use. CONCLUSION. The findings from this exploratory study warrant additional research because several motivations for the nonmedical use of prescription medications seem associated with a greater likelihood of substance abuse problems.

Carey KB; Carey MP; Chandra PS. Psychometric evaluation of the Alcohol Use Disorders Identification Test and Short Drug Abuse Screening Test with psychiatric patients in India. Journal of Clinical Psychiatry 64(7): 767-774, 2003. (35 refs.)

This study evaluated the factor structure, reliability, validity, and utility of the AUDIT and the DAST-10 in an Indian psychiatric hospital. Consecutive inpatient admissions from April to December 2001 were sampled. Patients were diagnosed with substance use disorders or psychiatric disorders according to ICD-10 criteria. All patients completed both the AUDIT and the DAST-10 during their intake evaluation. Of the 2286 admissions to the hospital, 1349 were enrolled in the study; 361 patients had primary substance use disorders and 988 patients had primary psychiatric disorders. Both the AUDIT and the DAST-10 were unidimensional and internally consistent. Total scores significantly differentiated the subsamples with primary substance use from those with primary psychiatric disorders (p < .001). Using cutoff scores equal to or greater than 8 on the AUDIT and equal to or greater than 3 on the DAST-10, 10% (n = 100) of the psychiatric subsample exceeded either cutoff, whereas 99% (n = 358) of the addiction treatment subsample exceeded 1 or both cutoffs. Within the psychiatric subsample, 77% (n = 65) of the patients who were identified as high risk on the AUDIT did not receive an additional alcohol use disorder diagnosis at discharge, and 59% (n = 16) of those identified as high risk on the DAST-10 did not receive an additional discharge diagnosis of drug use disorder. The AUDIT and the DAST-10 demonstrate strong psychometric properties when used in an Indian psychiatric hospital. Routine use of these brief screens can facilitate detection of substance use disorders among psychiatric patients.

Cocco KM; Carey KB. Psychometric properties of the Drug Abuse Screening Test in psychiatric outpatients. Psychological Assessment 10(4): 408-414, 1998. (33 refs.)

Individuals with a severe mental illness frequently have substance abuse and dependence problems, placing them at increased risk for poor treatment outcome. However, the reliability and validity of self- report measures assessing substance abuse and dependence remains understudied in this population. This investigation evaluates 2 versions of the Drug Abuse Screening Test (DAST; H. Skinner, 1982) as screening tools for an outpatient psychiatric sample. Participants were 73 men and 24 women who had been receiving treatment at a public psychiatric facility All participants completed the DAST along with other measures of substance use and psychiatric status. The DAST demonstrated adequate internal consistency and temporal stability in this sample. Factor analysis supports a multidimensional scale. We evaluated criterion-related, concurrent and discriminant evidence for validity, and we have concluded that both tested versions of the DAST have sound psychometric properties when used with psychiatric outpatients.

El-Bassel N; Gilbert L; Witte S; Wu E; Gaeta T; Schilling R; Wada T. Intimate partner violence and substance abuse among minority women receiving care from an inner-city emergency department. Women's Health Issues 13(1): 16-22, 2003. (13 refs.)

A woman's drug and alcohol use has been found to increase her risk of experiencing intimate partner violence (IPV). Objective. The study describes the rates of lifetime and current IPV among women awaiting care in an emergency department and explores the association between IPV and having a drug abuse problem, and IPV and having an alcohol abuse problem, after controlling for demographic factors and history of childhood victimization. Methods. Face-to-face interviews were conducted with 143 low-level triaged women recruited from an inner-city emergency department. Results. Nearly one-half reported ever experiencing IPV, and over 18% reported IPV during the year before the interview. A higher proportion of abused women reported a history of regular crack, cocaine, or heroin use and visiting shooting galleries or crack houses. Participants who were physically abused by their partner during the past year (15%, n = 21) were more likely than nonabused women (85%, n = 122) to report higher scores on the Alcohol Use Disorders Identification Test (AUDIT) (4.9 vs. 2.4), a measure of alcohol-related problems, and the Drug Abuse Severity Test (DAST) (3.0 vs. 1.3), a measure of drug-related problems. Sexually abused women (6%, n = 9) were more likely than their counterparts (94%, n = 134) to have significantly higher AUDIT scores (6.4 vs. 2.5). The findings have implications for how the intersecting public health problems of IPV and substance abuse should be taken into consideration in research and patient care protocols in emergency departments.

El-Bassel N; Schilling RF; Schinke S; Orlandi M; Sun WH; Back S. Assessing the utility of the Drug Abuse Screening Test in the workplace. Research on Social Work Practice 7(1): 99-114, 1997. (17 refs.)

The purpose of this study was to determine the utility and assess the psychometric properties of the Drug Abuse Screening Test (DAST) in a sample of persons receiving services from an employee assistance program (EAP). Study participants (N = 176) were union members, including identified drug users and nonusers. As in other studies, the DAST was found to have a high internal consistency, test-retest reliability, and item-total scale correlation. Also consistent with previous reports, factor analysis identified 5 factors. The multifactor solution of the DAST underscores the importance of measuring and assessing substance use along a continuum of early recognition to its more advanced stages. DAST scores were correlated with family, financial status job performance, mental health problems, and alcohol abuse. Study findings lend support to the DAST as a practical screening tool for use by human resource workers who provide services for substance-using individuals who are receiving services in an EAP setting.

French MT; Roebuck MC; McGeary KA; Chitwood DD; McCoy CB. Using the Drug Abuse Screening Test (DAST-10) to analyze health services utilization and cost for substance users in a community-based setting. Substance Use & Misuse 36(6/7): 927-946, 2001. (44 refs.)

The dual purpose of this study was to: (1) determine whether problematic drug users, defined through the Drug Abuse Screening Test (DAST-10), exhibited differences in health services utilization and cost relative to a combined group of non-problematic drug users and non-drug users; and (2) assess whether the findings were similar to those for chronic drug users (CDUs) and injecting drug users (IDUs). Results showed that health services utilization and total cost were very similar for problematic drug users defined through quantity- frequency (i.e., CDU, IDU) and diagnostic (i.e., DAST-10) criteria. Findings suggest that quantity/frequency criteria, for problematic drug use were reasonable approximations for diagnostic-based measures.

Klamen DL; Miller NS. Undergraduate medical education in psychiatry and primary care. Psychiatric Annals 27(6): 436-439, 1997. (26 refs.)

It is estimated that 30% to 40% of patients presenting to primary are physicians will have a primary or secondary mental illness. Despite these large numbers, primary care providers under-diagnosis and under-treat those with identifiable psychiatric disorders. Inadequate mental health care adds a considerable amount of morbidity, as well as wasted time and money to health care expenditures. In order to better prepare the primary care provider, there must be an expanded involvement of psychiatry in the preclinical years. Both preclinical and clinical teaching are discussed. In preclinical training emphasis is placed upon, understanding normal human development; approaches to health maintenance and prevention; identification of stress related symptomatology, placing as much emphasis on psychosocial interventions as somatic interventions; covering the psychopathology of the most common mental disorders (depression, substance abuse, somatoform illness, anxiety disorders) longitudinal teaching methodologies, communication skills. In respect to clinical training, the authors emphasize the need for teaching screening examinations for a variety of mental disorders, namely the CAGE, DAST, and PRIME-MD, management approaches that include recognition of the need for and skills to accomplish referral, the use of outpatient and longitudinal teaching modalities.

Kush FR; Sowers W. Acute dually diagnosed inpatients: The use of self-report symptom severity instruments in persons with depressive disorders and cocaine dependence. Journal of Substance Abuse Treatment 14(1): 61-66, 1997. (21 refs.)

A total of 84 adult inpatient dual-diagnosis (cocaine dependence and unipolar depressive disorder) patients' charts were reviewed Patients were administered the BDI, SCL-90-R with Additional Items for Major Depressive Syndrome, and the DAST-20 within 5 days of admission as standard assessment practice in a hospital program. Depression scores for the BDI and the SCL-90-R were generally consistent, respectively, across each of the depressive disorder diagnostic groups with the exception of organic (cocaine-induced) mood disorder, which had lower mean scores on both instruments. BDI mean score differences were statistically significant, regarding the depressive and organic (substance-induced) patients, DAST-20 mean scores were consistent across the diagnostic groups (substantial drug abuse range). Results suggest potential discriminating ability of the BDI in particular in distinguishing genuine unipolar depressive disorders from organically (cocaine) induced mood symptomatology when assessments are done rapidly following cocaine cessation.

Maisto SA; Carey MP; Carey KB; Gordon CM; Gleason JR. Use of the AUDIT and the DAST-10 to identify alcohol and drug use disorders among adults with a severe and persistent mental illness. Psychological Assessment 12(2): 186-192, 2000. (31 refs.)

State Psychiatric Hospital outpatients (93 men, 69 women) diagnosed with a serious persistent mental illness (SPMI) completed the Alcohol Use Disorders Identification Test (AUDIT) and Drug Abuse Screening Test (DAST-10) by interview as part of a general health/behavior screening instrument Responses to the AUDIT and DAST-10 were compared with criteria of current diagnosis and occurrence of symptoms in the last year for both alcohol and drug use disorders, respectively. Results showed that for both diagnosis and symptoms, AUDIT cutpoints of 7 and 8 had good sensitivity and specificity, and DAST-10 cutpoint of 2 was identified for both criteria. These and other findings suggest that both instruments have promising clinical utility when used with individuals diagnosed with an SPMI.

Martino S; Grilo CM; Fehon DC. Development of the Drug Abuse Screening Test for Adolescents (DAST-A). Addictive Behaviors 25(1): 57-70, 2000. (60 refs.)

The development and initial validation of the Drug Abuse Screening Test for Adolescents (DAST-A) is summarized. The DAST-A, derived from a modification of the original adult version called the Drug Abuse Screening Test (DAST; Skinner, 1982) was psychometrically tested in a study group of adolescent inpatients. The DAST-A demonstrated good internal consistency, high test-retest reliability, unidimensional factor structure, and good concurrent validity. Using the classification system of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association 1994), DAST-A scores of greater than 6 yielded sensitivity, specificity, and positive predictive powers of 78.6%, 84.5%, and 82.3%, respectively, in differentiating adolescent psychiatric inpatients with and without drug-related disorders. These findings suggest that the DAST-A holds promise as a drug abuse screening measure in psychiatrically impaired adolescent populations.

McCann BS; Simpson TL; Ries R; Roy-Byrne P. Reliability and validity of screening instruments for drug and alcohol abuse in adults seeking evaluation for Attention-Deficit/Hyperactivity Disorder. American Journal on Addictions 9(1): 1 -9, 2000. (22 refs.)

A growing number of adults are seeking evaluation for Attention-Deficit/Hyperactivity Disorder (ADHD). Screening for substance use disorders should be included as part of any comprehensive ADHD evaluation. We describe the validity and reliability of the Drug Abuse Screening Test (DAST) and the Alcohol Use Disorders Identification Test (AUDIT) in adults seeking evaluation for ADHD. Internal reliability estimates were excellent for both instruments. Scores on the DAST and AUDIT were higher among patients with a DSM-IV diagnosis of current drug abuse or dependence or current alcohol abuse or dependence, respectively. A cutoff score of 6 or above appears to be optimal for identifying individuals who are current drug abusers. A cutoff score of 6 or above on the AUDIT is suggested for detection of current alcohol abuse in this population. Comparable rates of substance use disorders were observed in ADHD and non-ADHD patients. Both measures are valid and reliable instruments for screening for alcohol and drug abuse among adults seeking evaluation for ADHD

Nakashian MR; Moore EA. Identifying Substance Abuse among TANF-eligible Families. Rockville MD: Department of Health and Human Services, 2001. (131 refs.)

This document was prepared to help Temporary Assistance to Needy Families (TANF) officials address the needs of families in their caseloads who are not succeeding, partly because of substance use. The publication is primarily for welfare administrators, who have final responsibility for meeting the goals and requirements of the Personal Responsibility and Work Opportunity Reconciliation Act of 1995 (welfare reform act). The document has for goals: to improve the capacity of welfare agencies, substance abuse treatment providers, job training agencies, and other public and private agencies to identify substance abuse in TANF families; to help these organizations respond better to substance abuse and its related problems among TANF recipients; to help welfare agencies broaden their concept of "identification" to cover multiple activities, including aggressive outreach and marketing campaigns; and to provide welfare officials a framework for creating an organizational culture that makes it safe for welfare recipients to discuss substance abuse. A number of substance abuse screening instruments are described, including the Alcohol Use Disorders Identification Test (AUDIT), CAGE (an acronym for four questions), CAGE-AID (expanded version of the CAGE to include questions about alcohol or drugs), Drug Abuse Screening Test (DAST 10), Michigan Alcoholism Screening Test (MAST), Substance Abuse Subtle Screening Inventory (SASSI), and Addiction Severity Index (ASI)

Sklar SM; Annis HM; Turner NE. Development and validation of the Drug-Taking Confidence Questionnaire: A measure of coping self-efficacy. Addictive Behaviors 22(5): 655-670, 1997. (62 refs.)

The Drug-Taking Confidence Questionnaire (DTCQ; Annis and Martin, 1985) is a 50-item self-report questionnaire developed to assess situation-specific coping self-efficacy for use of a particular substance of abuse (e.g., cocaine, heroin, alcohol, cannabis, etc.). Results from exploratory and confirmatory factor analyses of the DTCQ on 713 clients seeking treatment at an addiction treatment facility provided strong evidence for the situation-specificity of efficacy beliefs. An 8-factor first-order model, based on the eight high-risk categories for relapse identified by G.A. Marlatt (Marlatt & Gordon, 1980) and a 3-factor second-order model (i.e., negative situations, positive situations, and temptation situations) provided the best fit to the data. All eight subscales of the DTCQ were shown to have good reliability (alphas .79 to .95). Extensive convergent and discriminant validity analyses for the DTCQ and its subscales in relation to ADS, DAST, OES, DRIE, SCQ, SCL-90R BDI, HS, and SOCRATES substantiate that the DTCQ is a promising tool for further research and clinical application.

Teplin D; Raz B; Daiter J; Varenbut M; Tyrrell M. Screening for substance use patterns among patients referred for a variety of sleep complaints. American Journal of Drug and Alcohol Abuse 32(1): 111-120, 2006. (53 refs.)

Virtually all psychiatric and substance use disorders are associated with sleep disruption. Studies indicate that psychiatric disorders are related closely to chronic insomnia and that psychoactive substances have acute and chronic effects on sleep architecture. Several aspects of sleep are compromised in individuals taking these substances, ranging from difficulty initiating sleep to difficulty maintaining sleep and hypersomnia. Sleep disturbances are apparent in person taking psychoactive drugs or alcohol and have been found to persist long after withdrawing from these drugs. For some, sleep disturbance can be so severe as to reverse treatment success and precipitate relapse to addiction or dependence. There is increasing evidence that primary insomnia without a concurrent psychiatric disorder is a risk factor for later developing substance use disorders. Patients were asked to complete two brief screening tools, the Michigan Alcohol Screening Test and Drug Abuse Screening Test, to examine substance use patterns among patients referred for a variety of sleep complaints in a sleep disorders clinic. We found that patients who demonstrated a variety of sleep complaints were more likely to have alcohol and drug problems than those in the general populations.

Yudko E; Lozhkina O; Fouts A. A comprehensive review of the psychometric properties of the Drug Abuse Screening Test. Journal of Substance Abuse Treatment 32(2): 189-198, 2007. (24 refs.)

This article reviews the reliability and the validity of the (10-, 20-, and 28-item) Drug Abuse Screening Test (DAST). The reliability and the validity of the adolescent version of the DAST are also reviewed. An extensive literature review was conducted using the Medline and Psychinfo databases from the years 1982 to 2005. All articles that addressed the reliability and the validity of the DAST were examined. Publications in which the DAST was used as a screening tool but had no data on its psychometric properties were not included. Descriptive information about each version of the test, as well as discussion of the empirical literature that has explored measures of the reliability and the validity of the DAST, has been included. The DAST tended to have moderate to high levels of test-retest, interitem, and item-total reliabilities. The DAST also tended to have moderate to high levels of validity, sensitivity, and specificity. In general, all versions of the DAST yield satisfactory measures of reliability and validity for use as clinical or research tools. Furthermore, these tests are easy to administer and have been used in a variety of populations.