Cristina Catsicaris

Transcultural adaptation and validation of the CRAFFT as a screening test for problematic alcohol and substance use, abuse and dependence in a group of Argentine adolescents

INTRODUCTION Substance use and abuse and their consequences are a major problem among adolescents. The screening for problematic alcohol and substance use, abuse and dependence should be part of the case-taking process for adolescents. The Problem Oriented Screening Instrument for Teenagers (POSIT) and the Car, Relax, Alone, Forget, Family/Friends, Trouble questionnaire (CRAFFT) are used to this end. POSIT 17 items corresponding to substance use and abuse (POSITsua); it has been validated in Spanish. CRAFFT six questions; it has not been validated in Argentina. OBJECTIVE To assess the validity of a version of the CRAFFT screening test adapted to Spanish in a group of Argentine adolescents using the POSITsua test as reference. POPULATION AND METHODS The CRAFFTa and the POSITsua tests were administered to 14-20 year-old adolescents. An affirmative answer was scored as 1, and a negative answer, as 0. An individual was considered to have an increased risk of problematic use, abuse and dependence if he/she scored >2 in the CRAFFTa and POSITsua tests. RESULTS Two hundred and eighty-six adolescents were included; 52% were female; mean age: 16.6 years old. The CRAFFTa score was >2 for 29%, while the POSIT score was >2 for 37%. CRAFFTa sensitivity: 59%; specificity: 88%. CRAFFTa positive predictive value: 0.74; negative predictive value: 0.78. The area under the curve was 0.73. In the linear regression, the R for the six CRAFFT questions was 0.60. Gender and age did not modify results. Cronbachs alpha was 0.64. CONCLUSION CRAFFTa sensitivity was 59%, and its specificity was 88%, compared to the POSITsua test as a screening tool for problematic alcohol and substance use, abuse and dependence among Argentine adolescents.