SCREENING FOR DRUG-ABUSE AMONG ADOLESCENTS IN CLINICAL AND CORRECTIONAL SETTINGS USING THE PROBLEM-ORIENTED SCREENING INSTRUMENT FOR TEENAGERS

Recent research has indicated high rates of substance abuse among adol escents with emotional and behavioral disorders. Moreover, adolescents in clinical and correctional settings found to have comorbid disorder s involving substance abuse experience higher morbidity and mortality rates when compared to adolescents having one or no condition. The pre sent study examines the ability of the Problem-Oriented Screening Inst rument for Teenagers (POSIT) to identify DSM-III-R-defined psychoactiv e substance use disorders among 342 adolescents aged 12-19 years. Part icipants were sampled from school, clinical, and correctional settings . Optimal-scale cut scores for drug abuse diagnosis classification wer e derived by a minimum loss function method that minimized false class ifications. When using the optimal cut score of two for the total samp le, the standard POSIT substance use/abuse scale obtained a drug abuse diagnosis classification accuracy of 84% with sensitivity and specifi city ratios of 95 % and 79%, respectively. The internal validity of th e 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 shor tened scale could be developed and yet retain acceptable classificatio n accuracy. When using the optimal cut score of two for the total samp le, the revised Ii-item scale obtained a drug abuse diagnosis classifi cation 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 fur ther drug abuse assessment.