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A Comparison of the Alcohol Dependence Scale and Clinical Diagnosis of Alcohol Dependence in Male Medical Outpatients
Author(s) -
Willenbring Mark L.,
Bielinski John B.
Publication year - 1994
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/j.1530-0277.1994.tb00936.x
Subject(s) - alcohol , alcohol dependence , scale (ratio) , psychology , psychiatry , medicine , clinical psychology , physics , chemistry , organic chemistry , quantum mechanics
The Alcohol Dependence Scale (ADS) is a brief self‐report instrument designed to assess the alcohol dependence syndrome. Although previous studies have reported its validity, it has only been studied in populations who were presenting for assessment or treatment of alcohol problems, and recent studies have shown lower mean scores than would be expected. To assess its utility in a primary medical setting, we retrospectively examined our experience in two groups of medical outpatients: an early intervention group and a group of medically ill alcoholics. We administered the ADS to 61 male veterans being referred to a special clinic for alcohol‐related medical problems. Subjects were also assessed for alcohol dependence by experienced clinicians using a DSM‐III‐R checklist. ADS scores overall were much lower than would be expected, especially in the medically ill alcoholics. When subjects were dichotomized into dependent or nondependent, there was poor agreement between the two methods. The correlation between the scores was significant, however, end lowering the cut‐point on the ADS from 13/14 to 213 improved agreement. Medically ill alcoholics who are not presenting for assessment or treatment of alcohol problems may either lack insight into their drinking habits or may be reluctant to disclose them. Although conclusions from this study are tentative until more formal studies are done, it may be most prudent to use other instruments, such as the Michigan Alcoholism Screening Test, in medical outpatients. If the ADS is used, lowering the cut‐score to 213 may reduce false negatives. Further research on the use of the ADS in different settings and with different populations is clearly needed.