Reliability and Concurrent Validity of the CAGE Screening Questions: A Comparison of Lesbians and Heterosexual Women

Abstract

Although lesbians are believed to be at heightened risk for alcohol abuse and alcohol dependency, the reliability and validity of currently available screening measures have yet to be explored in this population group. In this paper, we report the psychometric properties of the CAGE in a diverse sample of 63 lesbians and comparisons with a control group of 57 heterosexual women. Data were collected in Chicago during 1997–1998 using face-to-face interviews. Findings suggest that the CAGE has good reliability and concurrent validity among lesbians. One CAGE item, concerned with drinking in the morning, however, was found to be only weakly associated with the other items among lesbians. Although this pilot study is limited by the nonprobability sample, we conclude that evaluating the appropriateness of other alcohol and drug abuse measures in high-risk populations, such as lesbians, should be a research priority.

Keywords:

• sexual orientation
• alcohol use
• CAGE
• scale reliability
• scale validity

Notes

^aThe journal's style utilizes the category substance abuse as a diagnostic category. Substances are used or misused; living organisms are and can be abused. Editor's note.

Additional information

Notes on contributors

TIMOTHY P. JOHNSON

Timothy Johnson, Ph.D., is Director of the Survey Research Laboratory, Professor of Public Administration, and Research Professor of Epidemiology and Biostatistics at the University of Illinois at Chicago. Dr. Johnson teaches courses in sample design, research methodology, and multivariate statistical analysis. His main areas of research interest include cross-cultural sources of measurement error in survey research and the social epidemiology of substance abuse among vulnerable populations. He has previously received funding from the National Center for Health Statistics, the National Cancer Institute, and the National Institute on Drug Abuse. Dr. Johnson has also served on the editorial Board of Substance Use and Misuse for the past 8 years and is a faculty member of the Middle Eastern-Mediterranean Summer Institute on Drug Use.

TONDA L. HUGHES

Tonda Hughes, Ph.D., is Associate Professor in Nursing and Public Health at the University of Illinois at Chicago (UIC) where she teaches interdisciplinary graduate courses in women's health. She is also Director of Research for the UIC National Center of Excellence in Women's Health. Dr. Hughes is nationally recognized for her expertise in lesbian health, particularly in the area of lesbians' use of alcohol. She has published extensively in this area, including a recently edited book, “Mental Health Issues for Sexual Minority Women” (Haworth Press). She as conducted more than a dozen studies on women's use of alcohol and other drugs. Her current study, “Sexual Identity and Drinking: A Longitudinal Follow up” is funded by the National Institutes of Alcohol Abuse and Alcoholism. Dr. Hughes is a member of the Substance Use and Misuse editorial board. Dr. Hughes has served as consultant or advisory to a number of federal agencies, including the National Institute on Alcohol Abuse and Alcoholism (NIAAA), Centers for Disease Control (CDC), Center for Substance Abuse Prevention (CSAP), and the Center for Substance Abuse Treatment (CSAT). She provided expert testimony to the Institute of Medicine's Committee on Lesbian Health Research Priorities in the late 1990s and was a member of the substance abuse and mental health subcommittees for the companion document to Healthy People 2010 focusing on Lesbian, Gay, Bisexual, and Transgender health issues. Dr. Hughes is also a Fellow in the American Academy of Nursing and is a faculty member of the Middle Eastern-Mediterranean Summer Institute on Drug Use.