Department of Psychology, Louisiana State University, Baton Rouge, Louisiana 70803, USA.
Subst Use Misuse. 2012 Jun;47(7):847-60. doi: 10.3109/10826084.2012.674166. Epub 2012 Apr 12.
This study sought to evaluate the clinical utility of a brief assessment interview in accurately classifying inmates manifesting an alcohol use disorder (AUD) based on a structured diagnostic assessment interview. Data were derived from routine clinical assessments of 7,672 inmates (89.6% male) incarcerated in the Minnesota Department of Corrections state prison system. An automated version of the Substance Use Disorder Diagnostic Schedule-IV (SUDDS-IV), which included a subset of the items comprising the Triage Assessment for Addictive Disorders (TAAD), was administered to all inmates from 2000 to 2003. Approximately 99% of the DSM-IV dependence and no diagnosis cases were appropriately classified by the TAAD. Although the TAAD identified nearly all cases with any diagnosis, 20%-24% of cases classified as abuse by the TAAD were found to be dependent by the longer instrument. Similar findings were noted when DSM-5 criteria were applied. The TAAD has the potential to provide a more clinically defensible means of identifying AUDs than brief screens when time constraints may preclude a comprehensive assessment. Limitations and implications for routine clinical practice are discussed.
本研究旨在评估简短评估访谈在根据结构化诊断评估访谈准确分类表现出酒精使用障碍 (AUD) 的囚犯方面的临床实用性。数据来自明尼苏达州惩教署州立监狱系统中 7672 名囚犯(89.6%为男性)的常规临床评估。从 2000 年到 2003 年,对所有囚犯都进行了物质使用障碍诊断时间表-IV(SUDDS-IV)的自动版本的测试,其中包括构成吸毒成瘾障碍评估(TAAD)的一部分项目。大约 99%的 DSM-IV 依赖和无诊断病例被 TAAD 正确分类。尽管 TAAD 识别了几乎所有有任何诊断的病例,但通过更长的工具,被 TAAD 归类为滥用的病例中有 20%-24%被发现依赖。当应用 DSM-5 标准时,也观察到了类似的发现。当时间限制可能排除全面评估时,TAAD 有可能比简短筛查更能提供一种更具临床辩护性的方法来识别 AUD。讨论了限制和对常规临床实践的影响。