Coelho Sophie G, Hendershot Christian S, Quilty Lena C, Wardell Jeffrey D
Department of Psychology, York University, Canada.
Bowles Center for Alcohol Studies, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States; Department of Psychiatry, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States.
Addict Behav. 2024 Jan;148:107859. doi: 10.1016/j.addbeh.2023.107859. Epub 2023 Sep 9.
The Cannabis Use Disorders Identification Test Revised (CUDIT-R) is a widely used screening tool. However, its utility in screening for cannabis use disorder (CUD) among young adults requires further investigation. The current study evaluated the accuracy of the CUDIT-R in distinguishing between young adults with and without CUD. We also examined the individual item properties of the CUDIT-R in this sample. A community sample of young adults (N = 153, ages 19-26 years) who reported at least one lifetime period of regular cannabis use (i.e., twice or more per month for at least six months) completed the CUDIT-R and the Structured Clinical Interview for DSM-5 (SCID-5) Substance Use Module. The CUDIT-R showed good accuracy in distinguishing between young adults with and without CUD as determined by the SCID-5 (area under the receiver operating characteristic curve = 0.84). A cut-point of nine yielded 87.80 % sensitivity and 70.42 % specificity, with positive and negative predictive values of 77.42 % and 83.33 %, respectively. Item response theory analyses revealed that CUDIT-R items assessing impaired control, failure to meet expectations, time devoted to use, and memory and concentration problems displayed high discrimination and were relatively difficult, whereas items assessing frequency of use and attempts to reduce use showed moderate discrimination and relatively low difficulty. Items assessing hours high and use with potential for physical hazard displayed poor discrimination. The CUDIT-R appears to validly distinguish between young adults with and without CUD and may be useful in screening for CUD in this high-risk population. Further research considering individual item properties is needed to refine the CUDIT-R for use among young adults.
修订版大麻使用障碍识别测试（CUDIT-R）是一种广泛使用的筛查工具。然而，其在筛查年轻成年人中的大麻使用障碍（CUD）方面的效用仍需进一步研究。本研究评估了CUDIT-R在区分有和没有CUD的年轻成年人方面的准确性。我们还在该样本中检查了CUDIT-R的各个项目属性。一个社区样本的年轻成年人（N = 153，年龄在19 - 26岁之间），他们报告至少有过一个定期使用大麻的时期（即每月两次或更多，至少持续六个月），完成了CUDIT-R和DSM-5（SCID-5）物质使用模块的结构化临床访谈。由SCID-5确定，CUDIT-R在区分有和没有CUD的年轻成年人方面显示出良好的准确性（受试者操作特征曲线下面积 = 0.84）。截断值为9时，灵敏度为87.80%，特异性为70.42%，阳性预测值和阴性预测值分别为77.42%和83.33%。项目反应理论分析表明，评估控制受损、未达期望、使用时间以及记忆和注意力问题的CUDIT-R项目显示出高区分度且相对较难，而评估使用频率和减少使用尝试的项目显示出中等区分度且难度相对较低。评估兴奋时长和有身体危害风险的使用情况的项目显示出较差的区分度。CUDIT-R似乎能够有效地区分有和没有CUD的年轻成年人，并且可能有助于在这个高风险人群中筛查CUD。需要进一步考虑各个项目属性的研究来完善CUDIT-R，以便在年轻成年人中使用。
