Is frequency of drinking an indicator of problem drinking? A psychometric analysis of a modified version of the alcohol use disorders identification test in Switzerland

Background: To study the psychometric properties of a modified Alcohol Use Disorders Identification Test in the multilingual context of Switzerland. M ethods: Data were obtained from the most extensive health survey to date in Switzerland, with a response rate of 69%. Seven core items of AUDIT were u sed. The first two items of AUDIT (frequency of drinking, quantity of drink ing) were not used in their original form, but reconstructed from a quantit y-frequency instrument (QF) measuring alcohol consumption, and categorized according to the AUDIT. The third AUDIT item (frequency of binge drinking) was similarly not used in its original form, but 8+ drinks instead of 6+ dr inks was used. All 10 items of the modified AUDIT were completed by 10 321 subjects - 6677 in the German-speaking region and 3644 in the Latin-languag e (French, Italian) regions. The dimensionality of the modified AUDIT was m odelled by confirmatory factor analysis. The contribution of each item to t he total modified AUDIT score was investigated by the prevalence of positiv ely screened subjects when items were deleted, and factor loadings of the u nidimensional model. Results: In Switzerland the modified AUDIT fitted neit her a unidimensional nor the hypothesized tri-dimensional model. Consumptio n items, especially frequency of drinking, showed almost no correlation wit h items measuring alcohol-related problems, but the latent constructs 'harm ful drinking' and 'alcohol dependence' were highly correlated, indicating a shared underlying factor. Frequency of drinking was the item that most inf luenced whether an individual screened positively or not. Except for the co rrelation of frequency and binge drinking, results were almost identical fo r both linguistic regions. Conclusions: The current form of the modified AU DIT may have to be changed for screening in Switzerland, as the study raise d questions about the suitability of the frequency-of-drinking item as an i ndicator of a screening device for alcohol-related problems in this country . (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.