The most widely used direct assessment tests are the Alcohol Severity Index and Addiciton Severity Index or their modified shortened versions. In the past the most popular instrument was The Michigan Alcoholism Screening Test (MAST) Questionnaire. It was developed in 1971 by Selzer and updated n 1980 and 1981.
Table 5-12. The Michigan Alcoholism Screening Test (MAST) Questionnaire |
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Points | Questions | |
2 | *1. |
Do you feel you are a normal drinker? |
2 | 2. |
Have you ever awakened the morning after some drinking and found that you could not remember a part of the evening before? |
1 | 3. |
Does your wife (husband), girlfriend (boyfriend), and/or parents ever worry or complain about your drinking? |
2 | *4. |
Can you stop drinking without a struggle after one or two drinks? |
1 | 5. |
Do you ever feel guilty about your drinking? |
2 | 6. |
Do your friends or relatives think you are a normal drinker? |
7. |
Do you ever try to limit your drinking to certain times of the day or to certain places? | |
2 | *8. |
Are you always able to stop drinking when you want to? |
5 | 9. |
Have you ever attended a meeting of Alcoholics Anonymous (AA) because of your own drinking? |
1 | 10. |
Have you gotten into fights when drinking? |
2 | 11. |
Has drinking ever created problems with you and your wife (husband) or girlfriend (boyfriend)? |
2 | 12. |
Has your wife (husband), girlfriend (boyfriend), or other family member ever gone to anyone for help about your drinking? |
2 | 13. |
Have you ever lost friends because of your drinking? |
2 | 14. |
Have you ever gotten into trouble at work because of drinking? |
2 | 15. |
Have you ever lost a job because of drinking? |
2 | 16. |
Have you ever neglected your obligations, your family, or your work for two or more days in a row because you were drinking? |
1 | 17. |
Do you ever drink in the morning? |
2 | 18. |
Have you ever been told you have liver trouble? Cirrhosis? |
5 | 19. |
Have you ever had delirium tremens (DTs), severe shaking, heard voices, or seen things after heavy drinking? |
5 | 20. |
Have you ever gone to anyone for help about your drinking? |
5 | 21. |
Have you ever been in a hospital because of drinking? |
2 | 22. |
Have you ever been seen at a psychiatric hospital or on a psychiatric ward of a general hospital where drinking was part of the problem? |
5 | 23. |
Have you ever been seen at a psychiatric or mental health clinic, or gone to any doctor, social worker, or clergyman for help with an emotional problem related to drinking? |
2 (for each arrest) | 24. |
Have you ever been arrested, even for a few hours, because of drunken behavior? |
2 | 25. |
Have you ever been arrested for drunk driving? |
Scoring: For each "yes" for all questions except 1, 4, and 8, give yourself the points indicated. For questions 1, 4, and 8 (marked with an asterisk, "*") give yourself the points indicated if you give a "no" answer and zero points for a "yes" answer. A score of 12 or more indicates in most cases, that the client/patient has alcoholism. | ||
Traditionally the cutoff score for determining alcoholism was 5 but this seemed to result in a high false positive rate of 33% to 59%. By using a cutoff of 12, the false positive dropped to 5% to 8%. Scores between 5 and 10 are suggestive of an alcohol problem, not necessarily alcoholism. Each clinician giving the test determines the cutoff best for his or her clients or patients. A person self-administering the test also has to judge whether a score of between 5 and 12 is reason for concern. |
CONCLUSIONS
When surveys are done on the incidence of alcoholism and drinking problems, what is often lost is the idea that first, alcoholism is a progressive illness that will prove fatal if not treated. Second is that although the progression from experimentation to addiction can take 3 months or 30 years, if one continues to drink heavily and frequently, the biochemical and psychological changes become extremely difficult, if not impossible, to reverse. Finally, alcohol use is often involved in polydrug use, so any treatment has to include the other addictions as well.
Epidemiology of Alcohol Consumption