Abstract: Psychometric Validation of the Gain Short-Screener in a Large National Sample of Emerging Adults (Society for Social Work and Research 21st Annual Conference - Ensure Healthy Development for all Youth)

Schedule:

Sunday, January 15, 2017: 8:40 AM

Balconies L (New Orleans Marriott)

* noted as presenting author

Kyle Bennett, MSW, PhD Student, University of Illinois at Urbana-Champaign, Urbana, IL

Doug Smith, PhD, Assistant Professor, University of Illinois at Urbana-Champaign, Urbana, IL

Michael L. Dennis, Senior Research Scientist and Director, GAIN Coordinating Center, Chestnut Health Systems, Normal, IL

Rod Funk, Research Associate, Chestnut Health Systems, Normal, ID

Objectives

Substance use disorder (SUD) research with emerging adults (ages 18-29) remains understudied. National epidemiological surveys show the prevalence of substance use and substance use disorders is higher among emerging adults than any other U.S. demographic. The ability of many screeners to efficiently identify substance use disorders among emerging adults has not been analyzed sufficiently. Additionally a majority of studies that utilize substance use assessment and screening tools do so with primarily adolescent or adult samples. Therefore the primary purpose of this study is, by using particular subscales of the GAIN-1 and GAIN-Q as proxies, to validate the Gain Short-Screener (GAIN-SS) as an appropriate tool for identifying SUD among emerging adults in the United States.

Methods

We analyzed data from emerging adults in a large clinical sample (n = 9,808) who completed both the five-item Substance Disorder Screener (SDScrY, α = .85) and the full criteria set for DSM IV Substance Use Disorders. The SDScrY consists of five items drawn from the 20-item GAIN-Q. We calculated the sensitivity and specificity for the SDScrY in predicting whether an emerging adult had any past year substance use diagnosis (sensitivity = the ability of a screener to correctly identify true positive cases, specificity = the ability of a screener to correctly identify true negative cases). Additionally we examined Receiver Operator Curves (ROC) at different cutoffs to determine which had the largest Area Under the Curve (AUC). Such analyses aided identifying the optimal emerging adult-specific cutoffs for the screener with the best balance between sensitivity and specificity.

Results

Analyses revealed a high correlation between the SDScrY screener and its longer parent scale (r = .95, p < .001). Sensitivity (83%) and specificity (95%) were highest at a cutoff score of two (AUC = 94%) on the SDScrY for any alcohol or other drug disorder in the past year. Sensitivity scores (85%) were high at a cutoff score of two on the SDScrY for any past year alcohol disorder as well.

Conclusions

The five-item Substance Use Disorder Screener exhibits high sensitivity and specificity in predicting past year substance use disorders for emerging adults at a cutoff score of two or higher. The SDScrY is suitable for use in emerging-adult focused Screening, Brief Intervention, and Referral to Treatment (SBIRT) interventions, which are becoming more widely used in integrated care settings. Given emerging adults’ low exposure to substance use disorder treatments, having screeners validated specifically for emerging adults is an important part of implementing SBIRT interventions with this population.