Institute of Clinical Physiology of the Italian National Research Council, Via Moruzzi 1, Pisa, Italy.
Addict Behav. 2013 Apr;38(4):2060-7. doi: 10.1016/j.addbeh.2012.12.016. Epub 2012 Dec 28.
Psychometric and screening properties of the Cannabis Abuse Screening Test (CAST) and of the Severity Dependence Scale (SDS) were investigated using DSM-IV diagnoses of cannabis dependence (CD) as external criteria. Performance of the SDS and of the CAST were compared.
Cross-sectional European School Survey Project on Alcohol and Other Drugs (ESPAD) was carried out in Italy in 2009. The sample consisted of 5787 Italian adolescents aged 15-19 who reported cannabis last year use. Uni-dimensionality, internal reliability, external validity, and optimal scaling of the 6 items for CAST and 5 items for SDS were performed. The Munich Composite International Diagnostic Interview (M-CIDI) was used as a gold standard for DSM-IV diagnoses, and all outputs were assessed by 10-fold cross validation procedure.
Both scales were uni-dimensional and Cronbach's α was 0.74 for SDS and 0.78 for CAST. High and comparable area under curve (AUC) values indicate a good ability of both scales to discriminate between individuals with and without dependence diagnosis. Based on balanced sensitivity and specificity, the optimal cut-off scores for problematic use disorders were 7 for CAST MCA and 4 for SDS MCA. Both CAST and SDS overestimated CD prevalence.
The CAST and SDS are equally useful for screening for problematic cannabis use disorders. Both clinical and research applications of the scales are possible.
本研究旨在以 DSM-IV 对大麻依赖的诊断作为外部标准，对大麻滥用筛查测试（CAST）和严重依赖量表（SDS）的心理测量学和筛查特性进行调查，并对 SDS 和 CAST 的性能进行比较。
2009 年，在意大利进行了欧洲学校酒精和其他药物调查项目（ESPAD）的横断面研究。该样本包括 5787 名过去一年曾使用大麻的 15-19 岁意大利青少年。对 CAST 的 6 项和 SDS 的 5 项进行了单维性、内部可靠性、外部有效性和最优定标分析。使用慕尼黑复合国际诊断访谈（M-CIDI）作为 DSM-IV 诊断的金标准，所有结果均通过 10 倍交叉验证程序进行评估。
这两个量表都是单维的，SDS 的克朗巴赫 α 系数为 0.74，CAST 的克朗巴赫 α 系数为 0.78。高且可比的曲线下面积（AUC）值表明，这两个量表都有很好的能力来区分有和没有依赖诊断的个体。基于平衡的敏感性和特异性，CAST-MCA 和 SDS-MCA 的最佳截断值分别为 7 和 4，用于识别有问题的大麻使用障碍。CAST 和 SDS 都高估了 CD 的患病率。
CAST 和 SDS 均可用于筛查有问题的大麻使用障碍。这两种量表都可用于临床和研究应用。
