Screening for Substance Abuse Among Adolescents Validity of the CAGE-AID in Youth Mental Health Care

Abstract

Objective: To examine the diagnostic accuracy of the four-item self-report and parent-report versions of the CAGE-AID as a screen for substance-use disorders (SUD) among adolescents in mental health care. Method: Patients were 190 Dutch treatment-seeking adolescents (12–18 years old, mean age 15.5 years, 53% boys) and their parents who completed the CAGE-AID questionnaire during intake. DSM-IV clinical diagnoses were used as gold standard in receiver operating characteristic analyses to determine psychometric properties. Results: Psychometric properties for both the self-report and the parent-report versions showed the CAGE-AID's excellent diagnostic accuracy in predicting SUD. Conclusions: The CAGE-AID seems to be a brief and valid instrument for detecting SUD among adolescents in mental health care. However, denial may play a role in both the CAGE-AID and the clinical interviews. More research is needed to further establish the CAGE-AID's usefulness in other settings. The study's limitations have been noted.

Keywords:

• substance use and misuse
• mental health sample
• CAGE-AID
• adolescents
• screening

Notes

¹The 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.

²Treatment can be briefly and usefully defined as a planned, goal directed change process of necessary quality, appropriateness, and conditions (endogenous and exogenous), which is “bounded” (culture, place, time, etc.) and can be categorized into professional-based, tradition-based, mutual-help based (AA, NA, etc.) and self-help (“natural recovery”) models. There are no unique models or techniques used with substance users, of whatever types, which aren't also used with non-substance users. In the West, with the relatively new ideology of “harm reduction” and the even newer Quality of Life (QOL) treatment-driven model there are now a new set of goals in addition to those derived from/associated with the older tradition of abstinence driven models. Editor's note.