Institut national des études démographiques (INED), Paris, France.
Eur Addict Res. 2012;18(4):193-200. doi: 10.1159/000336553. Epub 2012 Mar 31.
The present study aims at validating the Cannabis Abuse Screening Test (CAST) in a clinical sample of adolescent and young adult cannabis users seeking treatment. Applying a classical test theory approach using DSM-IV diagnoses as gold standard, two versions of the CAST questionnaire are compared. The sample consisted of 140 subjects aged 15-26 years (mean 18.9) recruited from two cannabis treatment centers. Gold standard diagnoses were assessed using the Adolescent Diagnostic Interview-Light. Internal structure and consistency of the CAST were assessed by principal component analysis and Cronbach's α. Optimal thresholds were defined using receiver operating characteristic analysis. Both the binary and the full test version revealed unidimensional structures with moderate to satisfactory internal consistency (α = 0.66 and 0.73). Screening properties were unsatisfactory when the CAST was compared against cannabis dependence. With regard to cannabis use disorders, both test versions yielded comparable and good sensitivity and specificity at cut-off 3 (binary: 92.2%, 66.7%) and 6 (full: 93.0%, 66.7%). Overall, the full CAST may be used for screening cannabis use disorders in clinical settings. Further research may use validation methods that do without gold standard.
本研究旨在通过对寻求治疗的青少年和年轻成年大麻使用者的临床样本进行验证，以确定大麻滥用筛查测试（CAST）的有效性。本研究采用经典测试理论方法，以 DSM-IV 诊断为金标准，比较了 CAST 问卷的两个版本。该样本由来自两个大麻治疗中心的 140 名年龄在 15-26 岁之间的受试者组成（平均年龄为 18.9 岁）。使用青少年诊断访谈轻版评估金标准诊断。通过主成分分析和 Cronbach 的 α 评估 CAST 的内部结构和一致性。使用接收者操作特征分析定义最佳阈值。二元和完整测试版本均显示出具有中等至良好内部一致性的单维结构（α=0.66 和 0.73）。与大麻依赖相比，当 CAST 进行比较时，筛查性能不佳。关于大麻使用障碍，两种测试版本在截止值为 3（二元：92.2%，66.7%）和 6（完整：93.0%，66.7%）时均具有可比且良好的敏感性和特异性。总体而言，完整的 CAST 可用于临床环境中筛查大麻使用障碍。进一步的研究可以使用不需要金标准的验证方法。
