Latimer W W, Winters K C, Stinchfield R D
Department of Pediatrics and Adolescent Health, UMHC, University of Minnesota, Minneapolis 55455, USA.
Am J Drug Alcohol Abuse. 1997 Feb;23(1):79-98. doi: 10.3109/00952999709001689.
Recent research has indicated high rates of substance abuse among adolescents with emotional and behavioral disorders. Moreover, adolescents in clinical and correctional settings found to have comorbid disorders involving substance abuse experience higher morbidity and mortality rates when compared to adolescents having one or no condition. The present study examines the ability of the Problem-Oriented Screening Instrument for Teenagers (POSIT) to identify DSM-III-R-defined psychoactive substance use disorders among 342 adolescents aged 12-19 years. Participants were sampled from school, clinical, and correctional settings. Optimal-scale cut scores for drug abuse diagnosis classification were derived by a minimum loss function method that minimized false classifications. When using the optimal cut score of two for the total sample, the standard POSIT substance use/abuse scale obtained a drug abuse diagnosis classification accuracy of 84% with sensitivity and specificity ratios of 95% and 79%, respectively. The internal validity of the standard 17-item substance use/abuse scale was subsequently examined by principle component analysis, item analysis, and coefficient alpha. The internal validity analyses were conducted to determine if a shortened scale could be developed and yet retain acceptable classification accuracy. When using the optimal cut score of two for the total sample, the revised 11-item scale obtained a drug abuse diagnosis classification accuracy of 85% with sensitivity and specificity ratios of 91% and 82%, respectively. The results suggest that the POSIT can serve as a useful first-gate instrument to identify adolescents in need of further drug abuse assessment.
近期研究表明，患有情绪和行为障碍的青少年中药物滥用率很高。此外，在临床和教养机构中的青少年若被发现患有涉及药物滥用的共病，与患有单一疾病或无疾病的青少年相比，其发病率和死亡率更高。本研究考察了青少年问题导向筛查工具（POSIT）在342名12至19岁青少年中识别出符合《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）定义的精神活性物质使用障碍的能力。参与者来自学校、临床和教养机构。通过最小化错误分类的最小损失函数法得出药物滥用诊断分类的最佳量表划界分数。对总样本使用最佳划界分数2时，标准POSIT物质使用/滥用量表获得的药物滥用诊断分类准确率为84%，敏感度和特异度分别为95%和79%。随后通过主成分分析、项目分析和α系数对标准的17项物质使用/滥用量表的内部效度进行了考察。进行内部效度分析是为了确定是否可以编制一个缩短版量表，同时保持可接受的分类准确率。对总样本使用最佳划界分数2时，修订后的11项量表获得的药物滥用诊断分类准确率为85%，敏感度和特异度分别为91%和82%。结果表明，POSIT可作为一种有用的初步筛查工具，用于识别需要进一步进行药物滥用评估的青少年。
