Dhalla Shayesta, Zumbo Bruno D, Poole Gary
University of British Columbia, Vancouver, British Columbia, Canada.
Curr Drug Abuse Rev. 2011 Mar;4(1):57-64. doi: 10.2174/1874473711104010057.
Alcohol (AUD) and other substance use disorders (SUD) are common among adolescents. The CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble, 1999) was developed as a brief screening instrument for adolescents to measure AUD and SUD. This systematic review examines the psychometric properties of the CRAFFT.
We performed a systematic review using Cochrane Database for Systematic Reviews, Pubmed/Medline, Embase (1980 to present), PsycInfo, and Google Scholar using the keywords "CRAFFT", "CRAFFT questionnaire", "alcohol misuse", "alcohol abuse", "alcohol dependence" "alcohol", "substance misuse", and "substance abuse" and "substance dependence".
We report 11 studies on validity and six studies on reliability. Populations examined were clinic patients including hospital-based clinic patients, primary care patients, emergency room patients, Native-Americans, sexually transmitted diseases clinic patients, substance users, a general population group, and enlisting military concripts. In general, the CRAFFT was found to be a good screening instrument for gradations of alcohol and substance misuse including problem use, abuse, and dependence. At optimal cut-points, sensitivities of the CRAFFT ranged from 0.61 to 1.00, and specificities ranged from 0.33 to 0.97. The CRAFFT showed modest to adequate internal consistency values ranging from 0.65 to 0.86, and high test-retest reliability.
The CRAFFT has adequate psychometric properties for detecting AUD and SUD in adolescents. However, more studies of the psychometric properties of the CRAFFT need to be carried out to further assess and improve generalizability to other populations. Gender and ethnic differences also require further examination, as do versions that are adapted for different languages and cultures.
酒精使用障碍（AUD）和其他物质使用障碍（SUD）在青少年中很常见。CRAFFT（汽车、放松、独处、遗忘、朋友、麻烦，1999年）被开发为一种用于青少年的简短筛查工具，以测量酒精使用障碍和物质使用障碍。本系统评价考察了CRAFFT的心理测量特性。
我们使用Cochrane系统评价数据库、Pubmed/Medline、Embase（1980年至今）、PsycInfo和谷歌学术进行系统评价，使用的关键词有“CRAFFT”、“CRAFFT问卷”、“酒精滥用”、“酒精成瘾”、“酒精依赖”、“酒精”、“物质滥用”、“物质成瘾”和“物质依赖”。
我们报告了11项关于效度的研究和6项关于信度的研究。所研究的人群包括临床患者，如医院门诊患者、初级保健患者、急诊室患者、美国原住民、性传播疾病门诊患者、物质使用者、普通人群以及应征入伍者。总体而言，CRAFFT被认为是一种用于筛查酒精和物质滥用不同程度（包括问题使用、成瘾和依赖）的良好工具。在最佳切点时，CRAFFT的灵敏度范围为0.61至1.00，特异度范围为0.33至0.97。CRAFFT的内部一致性值适中至良好，范围为0.65至0.86，重测信度高。
CRAFFT在检测青少年酒精使用障碍和物质使用障碍方面具有足够的心理测量特性。然而，需要对CRAFFT的心理测量特性进行更多研究，以进一步评估并提高其对其他人群的可推广性。性别和种族差异以及适用于不同语言和文化的版本也需要进一步研究。
