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Biomedical subjects

John R Knight

Publications and source records attributed to John R Knight.

At least 19 recordsLinked to original sources
PubMed2006

Drug testing of adolescents in ambulatory medicine: physician practices and knowledge.

OBJECTIVE: To determine physicians' knowledge of urine drug testing and usual practices when performing drug testing on adolescent patients at a time when interest in drug testing of adolescents is on the rise and physicians may be consulted for advice and requests to perform tests. DESIGN AND PARTICIPANTS: Multimodal survey conducted April to July 2004 consisting of 42 forced-choice response items. Participants were practicing physicians randomly selected from the national membership rolls of the American Academy of Pediatrics, Society of Adolescent Medicine, and American Academy of Family Physicians who provided care for 10 or more adolescents per week. We computed simple frequencies and sample design-adjusted 95% confidence intervals for each item. RESULTS: The survey was completed by 359 eligible physicians (response rate, 42%). More than 95% of respondents had ever ordered urine drug tests. Only 23% used an effective urine sample collection procedure, and only 7% used specific gravity and measurement of urine creatinine level to ensure validity of the sample, as recommended. When asked which drugs can be detected in routine panels, only 10% answered all items correctly, 47% did not know for 1 or more items, and 75% responded incorrectly for 1 or more items. CONCLUSIONS: Primary care physicians do not always use proper urine sample collection and validation procedures, and they are not aware of important limitations of drug testing. The primary care workforce is not prepared to assist with drug testing programs. Physicians who order these tests need more training and access to consultation with experts.

Adolescent↗
PubMed2006

Prescription drug misuse: a growing national problem.

Misuse of prescription drugs has been a growing problem in the United States affecting all age groups, including adolescents. Recent years have produced many advances in medical management of chronic pain, depression and anxiety, and attention-deficit/hyperactivity disorder. Many of the medications used to treat these disorders, such as the opioids, benzodiazepines, and psychostimulants, also have potential for abuse and dependence. The challenge for the clinician today is to maximize safe and effective treatment with available medication, while preventing the diversion of prescribed medication or the development of substance-related disorders in patients receiving these medications.

Adolescent↗
PubMed2006

Drug testing of adolescents in general medical clinics, in school and at home: physician attitudes and practices.

PURPOSE: To determine (1) whether physicians agree with recommendations for home and school drug screening, (2) under what circumstances physicians recommend urine drug tests for adolescents, and (3) how physicians manage adolescent patients with positive results. Few clinical practice guidelines have been published on urine drug testing of adolescents, and it is not known when physicians recommend this procedure or how they manage positive results. METHODS: Multi-modal survey of a nationally representative sample of physicians conducted April-July 2004. We computed simple frequencies and used backwards selection logistical regression to determine if there were differences in agreement or practices among physicians from different specialties (pediatrics, family medicine, adolescent medicine) or by demographic factors (physician age, gender, practice type or location). RESULTS: A total of 359 physicians (43% after eliminating ineligibles) completed the survey. Thirty-eight percent would recommend a drug test if were required to return to school, 41% if a parent was concerned, and 46% based on history (without a parent's concern). Forty-eight percent of physicians would share a positive drug test result with parents. A large majority (83%) disagreed with high school drug testing programs. CONCLUSIONS: There is little consensus among physicians regarding the indications for drug testing in the general medical clinic. However, most disagree with school drug testing programs. There is little consistency among physicians in how to proceed when a urine drug test is positive. Professional organizations should consider publishing clinical practice guidelines in order to assist physicians in using this procedure effectively.

Adolescent↗
PubMed2005

Nonmedical use of prescription opioids among U.S. college students: prevalence and correlates from a national survey.

OBJECTIVES: This study examined the prevalence rates and correlates of nonmedical use of prescription opioid analgesics among U.S. college students in terms of student and college characteristics. METHODS: This study analyzed data from a nationally representative sample of 10,904 randomly selected students attending 119 four-year colleges in 2001. RESULTS: The lifetime prevalence of nonmedical prescription opioid use was 12% and the past year prevalence was 7%. Approximately one in every four colleges had a prevalence of 10% or higher for past year nonmedical use of prescription opioids. Multivariate regression analyses indicated nonmedical use was more likely to occur among college students who were white, residents of fraternity and sorority houses, attended more competitive colleges, earned lower grade point averages, and reported higher rates of substance use and other risky behaviors. CONCLUSIONS: This study provides evidence that the nonmedical use of prescription opioids represents a problem on college campuses. These findings have important implications for developing prevention efforts and therapeutic strategies aimed at reducing the nonmedical use of prescription opioid analgesics among college students while not hindering necessary medication management for pain.

Adolescent↗
PubMed2005

Adolescent cigarette smoking and mental health symptoms.

PURPOSE: Adolescent cigarette smoking has been reported to be associated with substance use and depression. Less is known about the association between smoking and other mental health symptoms, or the impact of mental health treatment on cigarette smoking and psychiatric morbidity including the substance use disorders. The purpose of this study is to examine the association among adolescent cigarette smoking, mental health symptoms including substance use disorders, and mental health treatment among adolescents treated at a large, hospital-based young adult clinic. METHODS: Observational study of 486 adolescent patients presenting for routine medical care. RESULTS: Participants were two-thirds female with an average age of 16.6 years and of diverse ethnic background; 129 (28.6%) reported ever-using tobacco products, and 68 (14%) were current smokers who had an average of 2 cigarettes per day. Current smoking was associated with significantly increased odds of having mental health symptoms and substance use disorders, even after controlling for age and previous mental health treatment, and in both boys and girls. CONCLUSIONS: This study supports the increasing appreciation that adolescent tobacco use is clinically important, even at apparently low levels. Adolescent cigarette smoking is generally more common than alcohol and illicit drug use, and these results highlight its multifarious linkages with use of other substances and mental health symptoms. Thus, early identification and intervention of adolescent cigarette smoking may help not only to avert later daily smoking, but also may assist in identifying patients at increased risk for substance use and psychiatric problems.

Adolescent↗
PubMed2005

Motivational interviewing for adolescent substance use: a pilot study.

We developed and pilot tested a 2-session motivational interviewing intervention for substance use among 14- to 18-year-old medical patients. Recruitment and retention were more challenging than anticipated. A substantial number of completers reduced their use of substances and risk of driving after drinking during the 3-month follow-up period.

Adolescent↗
PubMed2005

Non-medical use of prescription stimulants among US college students: prevalence and correlates from a national survey.

AIMS: To examine the prevalence rates and correlates of non-medical use of prescription stimulants (Ritalin, Dexedrine or Adderall) among US college students in terms of student and college characteristics. DESIGN: A self-administered mail survey. SETTING: One hundred and nineteen nationally representative 4-year colleges in the United States. PARTICIPANTS: A representative sample of 10 904 randomly selected college students in 2001. MEASUREMENTS: Self-reports of non-medical use of prescription stimulants and other substance use behaviors. FINDINGS: The life-time prevalence of non-medical prescription stimulant use was 6.9%, past year prevalence was 4.1% and past month prevalence was 2.1%. Past year rates of non-medical use ranged from zero to 25% at individual colleges. Multivariate regression analyses indicated non-medical use was higher among college students who were male, white, members of fraternities and sororities and earned lower grade point averages. Rates were higher at colleges located in the north-eastern region of the US and colleges with more competitive admission standards. Non-medical prescription stimulant users were more likely to report use of alcohol, cigarettes, marijuana, ecstasy, cocaine and other risky behaviors. CONCLUSIONS: The findings of the present study provide evidence that non-medical use of prescription stimulants is more prevalent among particular subgroups of US college students and types of colleges. The non-medical use of prescription stimulants represents a high-risk behavior that should be monitored further and intervention efforts are needed to curb this form of drug use.

Adult↗
PubMed2005

Teaching paediatric residents about learning disorders: use of standardised case discussion versus multimedia computer tutorial.

BACKGROUND: We developed a standardised case-based educational exercise on the topic of childhood learning disorders, and a multimedia computerised adaptation of this exercise, as part of a national curriculum project based on the Bright Futures guidelines. OBJECTIVE: To explore resident perceptions of the facilitated case discussion (FCD) and the computerised tutorial (CT). DESIGN: Quasi-randomised comparison of two educational interventions. SETTING: Preclinic teaching conferences at a large urban children's hospital. PARTICIPANTS: A total of 46 paediatric residents years 1-3 assigned to either FCD (n = 21) or CT (n = 25). INTERVENTIONS: FCD residents met in groups of 8-12 with a trained facilitator for a structured case discussion, while CT residents worked in groups of 2-3 at a computer station linked to an interactive website. OUTCOME MEASURES: Participant responses during semistructured focus group interviews. ANALYSIS: Focus group transcripts, field notes and computer logs were analysed simultaneously using qualitative grounded theory methodology. RESULTS: Residents experienced CT as fun, offering flexibility, greater auditory and visual appeal and more opportunities for active learning. FCD allowed greater contact with expert faculty and made the material more relevant to clinical practice. FCD participants emphasised the clinical skills gleaned and stated that the learning experience would change their future patient management. Both groups reported that case discussion was more interactive than computer learning. Median time spent on learning was slightly shorter for the CT group. All groups of learners arrived at the correct final diagnosis. CONCLUSIONS: FCD and CT stimulate different types of learning among paediatric residents. Future studies are needed to determine how to integrate these two techniques to meet the learning needs of residents in diverse settings.

Boston↗
PubMed2005

Attention-deficit/hyperactivity disorder among adolescents: a review of the diagnosis, treatment, and clinical implications.

Attention-deficit/hyperactivity disorder (ADHD) is the most common mental disorder in childhood, and primary care clinicians provide a major component of the care for children with ADHD. However, because of limited available evidence, the American Academy of Pediatrics guidelines did not include adolescents and young adults. Contrary to previous beliefs, it has become clear that, in most cases, ADHD does not resolve once children enter puberty. This article reviews the current evidence about the diagnosis and treatment of adolescents and young adults with ADHD and describes how the information informs practice. It describes some of the unique characteristics observed among adolescents, as well as how the core symptoms change with maturity. The diagnostic process is discussed, as well as approaches to the care of adolescents to improve adherences. Both psychosocial and pharmacologic interventions are reviewed, and there is a discussion of these patients' transition into young adulthood. The article also indicates that research is needed to identify the unique adolescent characteristics of ADHD and effective psychosocial and pharmacologic treatments.

Adolescent↗
PubMed2004

Test-retest reliability of adolescents' self-report of substance use.

BACKGROUND: Adolescent substance abuse is a serious problem for which effective interventions are needed. To conduct trials of new therapies, investigators need reliable means of identifying potential participants and of measuring outcomes. The objective of this study was to determine the 1-week test-retest reliability of the CRAFFT screening test and of the timeline follow-back (TLFB) calendar method for measuring alcohol, cannabis, and other drug use. METHODS: Ninety-three 12- to 18-year-old patients presenting for routine medical care to three urban adolescent clinics were administered the CRAFFT screen in both lifetime and past-year versions and a 90-day TLFB. Both measures were completed on the day of the clinic visit and again 1 week later. We computed kappa coefficients and the intraclass correlation coefficient (ICC) for the CRAFFT and computed the ICC separately for TLFB self-reports of alcohol and cannabis. RESULTS: For the CRAFFT, kappa for individual items ranged from 0.31 to 0.86, and the ICC was 0.93 (95% confidence interval, 0.90-0.95). However, the total score of the lifetime CRAFFT at time 2 was significantly lower than at time 1; there was no difference in time 1 and time 2 total scores for the past-year version. The ICCs for past-90-days TLFB variables were as follows: drinking days, 0.92; drinks per occasion, 0.87; cannabis days, 0.83; and joints per occasion, 0.76. Past-30-day and past-60-day intervals compared favorably to past-90-day intervals. CONCLUSIONS: The CRAFFT screen is a reliable means of screening adolescents for substance abuse, although we recommend using the past-year version. The TLFB is a reliable method of quantifying adolescents' alcohol and cannabis use at intervals of 30, 60, or 90 days.

Adolescent↗
PubMed2004

Are clinical impressions of adolescent substance use accurate?

OBJECTIVE: To compare providers' impressions of adolescents' level of substance use with diagnostic classifications from a structured diagnostic interview. METHODS: Secondary analysis of data was conducted from a validation study of the CRAFFT substance abuse screening test of 14- to 18-year-old medical clinic patients (n = 533) and their corresponding medical care providers (n = 109) at an adolescent clinic affiliated with a large tertiary care pediatric hospital. Medical care providers completed a form that recorded their clinical impressions of patients' level of alcohol and drug involvement (none, minimal, problem, abuse, dependence) and demographic characteristics. The form included brief diagnostic descriptions for each level of use. After the medical visit, patients completed the Adolescent Diagnostic Interview (ADI), a structured diagnostic interview that yields diagnoses of abuse and dependence according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). On the basis of their past 12 months of alcohol and drug use on the ADI interview, adolescents were classified into 5 mutually exclusive diagnostic groups. "None" was defined by no reported use of alcohol or drugs during the past year. "Minimal use" was defined as use of alcohol or drugs but no report of any substance-related problems. "Problem use" was defined as reporting 1 or more substance-related problems but no diagnosis of abuse or dependence. "Abuse" was defined by meeting any 1 of 4 DSM-IV diagnostic criteria for either alcohol or drug abuse but no diagnosis of dependence. "Dependence" was defined by meeting any 3 of 7 diagnostic criteria for either alcohol or drug dependence, with or without a diagnosis of abuse. Proportions were compared using Fisher exact test. Agreement was assessed with the weighted kappa, and these analyses were stratified by substance used (ie, alcohol vs drug) and demographic characteristics. Sensitivity, specificity, and positive and negative predictive values were calculated from 2 x 2 tables. RESULTS: Compared with the criterion standard interview, providers identified significantly fewer patients with problem use and abuse and no patients with dependence. Of >100 patients whom the ADI classified with substance problem use, providers correctly identified 18. Of 50 patients who were classified with a diagnosis of alcohol or drug abuse, providers correctly identified 10. Of 36 patients who were classified with a diagnosis of alcohol or drug dependence, providers correctly identified none. For the 86 adolescents who were classified with a substance-related disorder (ie, abuse or dependence), providers' impressions were "none" (24.4%), "minimal use" (50%), "problem use" (15.1%), "abuse" (10.5%), and "dependence" (0%). There was only marginal agreement between providers' impressions and diagnoses related to alcohol use (kappa = .29), drug use (kappa = .31), and any substance use (kappa = .30). Kappa was not significantly affected by the patient's age, but it was by gender. Among boys, kappa was significantly higher for impressions of drug use versus alcohol use (kappa = .48 vs kappa = .27); and, among drug users, kappa was significantly higher among boys compared with girls (kappa = .48 vs kappa = .24). Kappa did not differ significantly across race/ethnicity subgroups, although there is a suggestive trend toward higher agreement for black non-Hispanic compared with white non-Hispanic adolescents (kappa = .35 vs kappa = .21). Kappa did not differ significantly on the basis of the visit type, but the size of this difference (kappa = .36 vs kappa = .24) suggests that the longer well-child visit yielded greater identification of substance-related pathology. Providers' impressions had a sensitivity of .63 for identifying use of alcohol or drugs. However, sensitivity was poor for identification of problem use (.14), abuse (.10), and dependence (0), whereas specificity and positive predictive values were high. Of the 86 adolescents with a diagnosis of abuse or dependence, 75.6% were correctly identified by providers as using substances; however, the level of use in 50% of these adolescents was reported by providers as minimal. CONCLUSIONS: In this study, clinical impressions of adolescents' alcohol/drug involvement underestimated substance-related pathology. When providers thought that use was present, there was a very high likelihood that a problem or disorder existed. The use of structured screening devices would likely improve identification of adolescents with substance-related pathology in primary care settings and should be considered for use with all adolescent patients, rather than only those who are perceived to be at higher risk.

Adolescent↗
PubMed2003

Body modification and substance use in adolescents: is there a link?

PURPOSE: To describe the characteristics of body modification among adolescents and to determine whether adolescents who engage in body modification are more likely to screen positive for alcohol and other drug problems than those who do not. METHODS: Adolescents aged 14 to 18 years presenting to an urban adolescent clinic for routine health care completed a questionnaire about body modification and a substance use assessment battery that included the 17-item Problem Oriented Screening Instrument for Teenagers Alcohol/Drug Use and Abuse Scale (POSIT-ADS). Body modification was defined as piercings (other than one pair of bilateral earlobe piercings in females), tattoos, scarification, and branding. Problem substance use was defined as a POSIT-ADS score > or =1. Data were analyzed using logistic regression to determine whether the presence of body modification was an independent predictor of problem substance use. RESULTS: The 210 participants had a mean (+/- SD) age of 16.0 (+/- 1.4) years and 63% were female. One hundred adolescents (48%) reported at least one body modification; girls were more likely than boys to have body modification (59% vs. 28%, p < or = .0005). Ninety (42%) reported piercings, 22 (10%) tattoos, 9 (4%) scarification, and 1 (< 1%) branding; 21 (10%) had more than one type of body modification. These were in a variety of locations, most commonly the ear and the nose (piercings) or the extremities (tattoos). One-third of the sample (33%) screened positive for problem substance use on the POSIT-ADS questionnaire. Controlling for age, adolescents with body modification had 3.1 times greater odds of problem substance use than those without body modification (95% CI 1.7, 5.8). CONCLUSIONS: Body modification was associated with self-reported problem alcohol and other drug use among middle adolescents presenting for primary care. More research is needed to determine the clinical and sociocultural significance of body modification and its relationship to substance use in this population.

Adolescent↗
PubMed2003

Validity of brief alcohol screening tests among adolescents: a comparison of the AUDIT, POSIT, CAGE, and CRAFFT.

BACKGROUND: Adolescents should be screened for alcohol misuse as part of routine care. The objective of this study was to compare the criterion validity of the Alcohol Use Disorders Identification Test (AUDIT), the Problem Oriented Screening Instrument for Teenagers substance use/abuse scale (POSIT), and the CAGE and CRAFFT questions among adolescents. METHODS: Fourteen- to 18-year-old patients arriving for routine healthcare at a large, hospital-based adolescent clinic completed the four screens and the criterion standard Adolescent Diagnostic Interview, which yields DSM-IV diagnoses of alcohol abuse and dependence. Receiver operating characteristic (ROC) curves were plotted to determine optimal cut-points. Areas under the ROC curves of the four screens were compared, and sensitivities and specificities were calculated. RESULTS: Participants' past 12-month alcohol diagnostic classifications were as follows: no use (58.6%), nonproblem use (13.0%), problem use (20.8%), abuse (5.4%), and dependence (2.2%). Optimal cut-points associated with problem use or higher were 2 for AUDIT, 1 for POSIT, 1 for CAGE, and 1 for CRAFFT. ROC curve area of the CAGE was significantly lower compared with areas of all other screens. Sensitivities (95% confidence intervals) were AUDIT 0.88 (0.83-0.93), POSIT 0.84 (0.79-0.90), CAGE 0.37 (0.29-0.44), and CRAFFT 0.92 (0.88-0.96); specificities were AUDIT 0.81 (0.77-0.85), POSIT 0.89 (0.86-0.92), CAGE 0.96 (0.94-0.98), and CRAFFT 0.64 (0.59-0.69). CONCLUSIONS: The AUDIT, POSIT, and CRAFFT have acceptable sensitivity for identifying alcohol problems or disorders in this age group. The CAGE is not recommended for use among adolescents.

Adolescent↗
PubMed2003

Heavy drinking and alcohol policy enforcement in a statewide public college system.

OBJECTIVE: To assess the association between heavy drinking and alcohol policy enforcement following the institution of a new system-wide alcohol policy at Massachusetts public colleges and universities. METHOD: Students (N = 1,252: 59% women) at 11 study schools completed a questionnaire that assessed drinking behaviors and alcohol-associated problems. College deans and campus security officers completed questionnaires assessing policy implementation and enforcement. We compared heavy drinking rates among the 11 schools and measured the association between schools' heavy episodic drinking rates and enforcement index scores based on deans' and security officers' reports of policy enforcement. RESULTS: Rates of heavy episodic drinking varied widely among the 11 schools (range: 36%-71%). The percentage of students reporting strict/very strict policy enforcement also varied widely (35%-90%). In this small sample of colleges, heavy drinking rates among students living on campus tended to be negatively associated with stricter alcohol policy enforcement reports by security officers (Pearson's r = -0.64. p < .05) and the association appeared to be linear. Heavy drinking was not associated with enforcement reports by deans (Pearson's r = 0.17, p = NS). CONCLUSIONS: Within this single state system, stricter enforcement by campus security officers of policies that limit underage drinking tends to be associated with lower rates of heavy drinking by students.

Adolescent↗
PubMed2003

Substance use problems and associated psychiatric symptoms among adolescents in primary care.

OBJECTIVE: Substance use disorders (SUDs) are associated with other mental disorders in adolescence, but it is unclear whether less severe substance use problems (SUPs) also increase risk. Because youths with SUPs are most likely to present first to their site of primary care, it is important to establish the presence and patterns of psychiatric comorbidity among adolescent primary care patients with subdiagnostic use of alcohol or other drugs. The objective of this study was to determine the association between level of substance use and psychiatric symptoms among adolescents in a primary care setting. METHODS: Patients who were aged 14 to 18 years and receiving routine care at a hospital-based adolescent clinic were eligible. Participants completed the Problem Oriented Screening Instrument for Teenagers Substance Use/Abuse scale, which is designed to detect social and legal problems associated with alcohol and other drugs, and the Adolescent Diagnostic Interview, which evaluates for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnoses of substance abuse/dependence and 8 types of psychiatric symptoms. We examined gender-specific associations of no/nonproblematic substance use (NSU), SUP, and SUD with psychiatric symptom presence (any symptoms within each type), score (symptom scores summed across all types), and number of types (number of different symptom types endorsed). RESULTS: Of 538 adolescents (68% female; mean +/- standard deviation age: 16.6 +/- 1.4 years), 66% were classified with NSU, 18% with SUP, and 16% with SUD, and 80% reported having at least 1 type of psychiatric symptom in the previous 12 months. Symptoms of anxiety were most common (60% of both boys and girls), followed by symptoms of depression among girls (51%) and symptoms of attention-deficit disorder (ADD) among boys (47%). Compared with those with NSU, youths with SUP and those with SUD were more likely to report symptom presence for several types of psychiatric symptoms. Girls with SUP or SUD had increased odds of reporting symptoms of mania, ADD, and conduct disorder; girls with SUD were at increased risk for symptoms of depression, eating disorders, and hallucinations or delusions. Boys with SUP had increased odds of ADD symptoms, whereas boys with SUD had increased odds of reporting hallucinations or delusions. Boys with SUP or SUD had increased odds of reporting symptoms of conduct disorder. Youths with SUP and SUD also had higher psychiatric symptom scores and reported a wider range of psychiatric symptom types (number of types) compared with youths with NSU. CONCLUSIONS: Like those with SUD, adolescents with subdiagnostic SUP were at increased risk for experiencing a greater number of psychiatric symptoms and a wider range of psychiatric symptom types than youths with NSU. Specifically, adolescents with SUP are at increased risk for symptoms of mood (girls) and disruptive behavior disorders (girls and boys). These findings suggest the clinical importance of SUP and support the concept of a continuum between subthreshold and diagnostic substance use among adolescents in primary care. Identification of youths with SUP may allow for intervention before either the substance use or any associated psychiatric problems progress to more severe levels.

Adolescent↗
PubMed2002

Validity of the CRAFFT substance abuse screening test among adolescent clinic patients.

OBJECTIVE: To determine the accuracy of the CRAFFT substance abuse screening test. DESIGN: Criterion standard validation study comparing the score on the 6-item CRAFFT test with screening categories determined by a concurrently administered substance-use problem scale and a structured psychiatric diagnostic interview. Screening categories were "any problem" (ie, problem use, abuse, or dependence), "any disorder" (ie, abuse or dependence), and "dependence." SETTING: A large, hospital-based adolescent clinic. PARTICIPANTS: Patients aged 14 to 18 years arriving for routine health care. MAIN OUTCOME MEASURES: The CRAFFT receiver operating characteristic curve, sensitivity, specificity, positive predictive value, and negative predictive value. RESULTS: Of the 538 participants, 68.4% were female, and 75.8% were from racial and ethnic minority groups. Diagnostic classifications for substance use during the past 12 months were no use (49.6%), occasional use (23.6%), problem use (10.6%), abuse (9.5%), and dependence (6.7%). Classifications were strongly correlated with the CRAFFT score (Spearman rho, 0.72; P<.001). A CRAFFT score of 2 or higher was optimal for identifying any problem (sensitivity, 0.76; specificity, 0.94; positive predictive value, 0.83; and negative predictive value, 0.91), any disorder (sensitivity, 0.80; specificity, 0.86; positive predictive value, 0.53; and negative predictive value, 0.96) and dependence (sensitivity, 0.92; specificity, 0.80; positive predictive value, 0.25; and negative predictive value 0.99). Approximately one fourth of participants had a CRAFFT score of 2 or higher. Validity was not significantly affected by age, sex, or race. CONCLUSION: The CRAFFT test is a valid means of screening adolescents for substance-related problems and disorders, which may be common in some general clinic populations.

Adolescent↗