Windle Michael, Windle Rebecca C
Department of Behavioral Sciences and Health Education, Emory University, Atlanta, Georgia.
Alcohol Clin Exp Res. 2017 Feb;41(2):399-406. doi: 10.1111/acer.13301. Epub 2017 Jan 9.
A limited number of measures exist to assess alcohol problems during adolescence. Item response theory modeling was used to scale a measure of adolescent alcohol problems, including drinking and driving, and then related to alcohol and other psychiatric disorders that occurred over a 15-year period.
High school students (N = 832) completed the 13-item Alcohol Problems Index (API) at age 18 years as part of a long-term longitudinal study of predictors of alcohol use and alcohol disorders. Frequency of drinking and driving was also measured during adolescence. Lifetime psychiatric disorders, including alcohol disorders, were measured during young adulthood. Rasch modeling was used to scale the severity of alcohol problems, and the scaled total score was used to prospectively predict alcohol disorders. The area under the receiver operating characteristic (ROC) curve was also computed between the adolescent alcohol problems and alcohol and other psychiatric disorders across a 15-year period.
The prevalence of alcohol disorders was 38.7% (for alcohol dependence, it was 27.7%). Rasch modeling indicated that the API assessed a range of severity of alcohol problems and that drinking and driving were among the less severe indicators. Age 18 API scores significantly correlated with an alcohol diagnosis (0.34), and ROC curve analysis indicated that for adolescent alcohol problem scores, the diagnostic accuracy (or area under the curve) for an alcohol diagnosis by age 33 was 0.70.
Our findings supported the unidimensionality and reliability of the API, and statistically significant prospective prediction of young adult alcohol disorders. The measurement of alcohol problems during adolescence, in addition to drinking and driving, may be beneficial in understanding adverse consequences of drinking during adolescence as well as transitions in alcohol use and alcohol disorders across the lifespan.
用于评估青少年酒精问题的措施有限。采用项目反应理论模型对青少年酒精问题量表进行评分，该量表包括酒后驾车等问题，然后将其与15年内发生的酒精及其他精神障碍相关联。
作为一项关于酒精使用和酒精障碍预测因素的长期纵向研究的一部分，高中生（N = 832）在18岁时完成了13项酒精问题指数（API）。在青少年时期还测量了酒后驾车的频率。在青年期测量了包括酒精障碍在内的终生精神障碍。采用拉施模型对酒精问题的严重程度进行评分，并使用量表总分对酒精障碍进行前瞻性预测。还计算了15年间青少年酒精问题与酒精及其他精神障碍之间的受试者操作特征（ROC）曲线下面积。
酒精障碍的患病率为38.7%（酒精依赖为27.7%）。拉施模型表明，API评估了一系列酒精问题的严重程度，酒后驾车是较不严重的指标之一。18岁时的API得分与酒精诊断显著相关（0.34），ROC曲线分析表明，对于青少年酒精问题得分，33岁时酒精诊断的诊断准确性（或曲线下面积）为0.70。
我们的研究结果支持了API的单维性和可靠性，以及对青年酒精障碍具有统计学意义的前瞻性预测。除酒后驾车外，在青少年时期测量酒精问题可能有助于理解青少年饮酒的不良后果以及一生中酒精使用和酒精障碍的转变。
