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Alcohol Dependence Scale

User Information

Acronym:

ADS

Author/Developer / Address:

Harvey A. Skinner, Ph.D.
Professor and Chair
Department of Public Health Sciences
Faculty of Medicine.
University of Toronto.
12 Queen's Park Cres.
West, Toronto.
Ontario. Canada, M5S, 1A8.
Phone: (416) 978-8989.Fax: (416) 978-2087.
E-mail: harvey.skinner@utoronto.ca

For questions regarding the Czech version of the Alcohol Dependence Scale please contact Alena Trojackova

Publication dates:

1982

Description / Type of Assessment:

ADS is a 25-item pencil and paper questionnaire, or computer self-administered or interview.

Primary use / Purpose:

ADS provides a quantitative measure of the severity of alcohol dependence symptoms.

Domains measured / Life Areas / Problems Assessed:

The 25 items cover alcohol withdrawal symptoms, impaired control over drinking, awareness of a compulsion to drink, increased tolerance to alcohol, and salience of drink-seeking behavior.

Population:

Adults

Administration / Completion Time:

The 25-item ADS takes approximately 10 minutes to complete.

Scoring Procedures:

Scored by administrator or by computer. Computerized scoring or interpretation is available as part of the Computerized Lifestyle Assessment.

Scoring Time:

5 minutes.

Credentials/Training:

Only basic training is required for administration.

Source of Psychometrics:

Norms available: ADS is Normed on various treatment samples
Reliability studies done: Test-retest Internal consistency.
Measures of validity derived: Content Criterion (predictive, concurrent, "postdictive") Construct.
Factor analysis has been done
ADS showed excellent reliability and validity
Harvey A. Skinner, Ph.D. (See address above).

Languages:

English and French

Availability / Inquiries:

Marketing Services, Department 417.Addiction Research Foundation, 33 Russell Street, Toronto, Canada M5S 2S1.Tel: (416) 595-6057

Price:

© 1984, J.L.. Horn, HA Skinner, K Wanberg, and F.M. Foster and the Alcoholism and Drug Addiction Research Foundation, Toronto. Reproduced with the permission of Harvey Skinner, Ph.D. ADS cannot be copied. ADS User's Guide:$14.25 Package of 25 ADS Questionnaires $ 6.25 each. Specimen set of 25 questionnaires and 1 User's Guide: :$15.00

Practicability / usefulness:

The ADS provides a quantitative measure of the severity of alcohol dependence consistent with the concept of the alcohol dependence syndrome. The ADS is widely used as a research and clinical tool, and studies have found the instrument to be reliable and valid. The printed instructions for the ADS refer to the past 12-month period. However, instructions can be altered for use as a outcome measure at selected intervals (e.g., 6, 12, or 24 months) following treatment. Use of the ADS has been reported mostly for clinical adult samples; however, studies have used the instrument in general population and correctional settings. ADS scores have proven to be highly diagnostic with respect to a DSM diagnosis of alcohol dependence, and has been found to have excellent predictive value with respect to a DSM diagnosis. The ADS yields a measure of the severity of dependence that is important for treatment planning, especially with respect to the intensity of treatment. The ADS can be used in wide variety of settings for screening and assessment of alcohol dependence. Several studies have used the ADS with adolescents. The ADS can be used for screening and case finding in a variety of settings including health care, corrections, general population surveys, workplace, and education. A score of 9 or more is highly predictive of DSM diagnosis of alcohol dependence. Guidelines are given for using the ADS with respect to treatment planning, particularly with respect to the level of intervention (e.g., American Society of Addiction Medicine Placement Criteria). The ADS can be used for basic research studies where a quantitative index is required regarding the severity of alcohol dependence. For clinical research, the ADS is a useful screening and case-finding tool. It is also of value with respect to matching clients with the appropriate intensity of treatment and for treatment outcome evaluations.

Comments:

In addition to the questionnaire version, a computer-administered version is available as part of the Computerized Lifestyle Assessment (Alcohol Module). Among relevant studies on ADS, you can found abstracts from two original studies and a summary of a meta-evaluation from the Addiction Research Foundation. In this last report, the ARF reviewed 20 additional studies on the ADS.

Instrument
Relevant Studies
Detailed Review of the Alcohol Dependence Scale (ADS)
Addiction Research Foundation. Detailed Review of the Alcohol Dependence Scale (ADS). In: Addiction Research Foundation (1993). Directory of client outcome measures for addiction treatment programs. (Ontario. Addiction Research Foundation).

 Initial analyses of the reliability and validity of the ADS have been based on studies that used the early 29-item version of the ADS. As the 29-item and 25-item version of the ADS are very highly correlated          (r = .96 to .99), these findings would also likely apply to the current revised version.

 The ADS has high internal consistency, reporting alpha coefficients of .90 and .91 for two samples who completed the revised ADS. A estimated test-retest reliability of .92 after one week of therapy supported the temporal stability of the scale. Other studies reported internal consistency coefficients of .92, .85, and .94.

The ADS was derived from a larger scale, it was not developed specifically to measure alcohol dependence, and it has been criticized for being weighted towards physiological aspects of dependence and for not being consistently reflective of all aspects that have been formally defined by Edwards and Gross as the alcohol dependence syndrome. Nevertheless, the ADS appears to cover most of the domains generally associated with alcohol dependence.

Some studies also showed evidence of response bias on the ADS, with a correlation with Denial response style and with Social Desirability. However, all approaches to assessing substance abuse are vulnerable to the effects of social desirability, but thus far social desirability has only been assessed in relation to the ADS.

Some studies demonstrated that the ADS is positively associated with measures of similar and related constructs. Ross et al.'s (1990) study provided evidence for the diagnostic accuracy of the ADS.

Other validation data for the ADS are based on confirming expected relationships between alcohol dependence and other variables. As expected, those who received higher scores on the ADS tended to have more psychological problems, more medical problems, and more legal problems. On the other hand, no consistent relationship has been found between scores on the ADS and neuropsychological functioning, as predictable.

Studies using the ADS have also looked at the ability of the ADS to predict treatment compliance and treatment outcome, although the findings using the ADS are difficult to interpret in terms of support or lack of support for the validity of the scale.

Diagnostic Validity of the MAST and the Alcohol Dependence Scale in the Assessment of DSM-III Alcohol Disorders.
Ross, H.E., Gavin, D.R., Skinner, H.A. Diagnostic Validity of the MAST and the Alcohol Dependence Scale in the Assessment of DSM-III Alcohol Disorders. Journal of Studies on Alcohol, 51, 6, 506-513, 1990. 

The comparative validity of the Michigan Alcoholism Screening Test (MAST) and the Alcohol Dependence Scale (ADS) in screening for current DSM-III alcohol abuse/dependence disorders is evaluated. These scales were administered to 501 patients presenting for treatment of alcohol or drug problems. DSM-III alcohol disorders are diagnosed using the Diagnostic Interview Schedule. Receiver Operating Characteristic (ROC) analysis is used to determine optimum threshold scores for the MAST and ADS and to compare the screening ability of the two instruments. Optimum cut points for the MAST and the ADS are 12/13 and 8/9, respectively. The overall accuracy of classification for both instruments using these threshold scores is 88%. The areas under the ROC curves am .91 and .90 (SD = .02) and there are no significant differences between the MAST and the ADS in their ability to screen for alcohol abuse or dependence in this population. The MAST and the ADS correlate highly with each other (.79). The results reported in our study should be applicable to the revised DSM-III since a field trial found a high level of agreement on alcohol disorders between the diagnostic systems. Categorical versus dimensional approaches to the assessment of alcoholism am discussed.

Reliability of Alcohol Use Indices
Skinner, H.A., Wen-Jenn Sheu. Reliability of Alcohol Use Indices. The Lifetime Drinking History and the MAST. Journal of Studies on Alcohol, 43, 11, 1157-1170, 1982.

Reliability estimates for internal consistency and for test-retest values are presented for various indices of the Lifetime Drinking History. Reliability estimates were obtained under conditions that closely resemble a typical clinical setting, not in optimal conditions to obtain the highest estimates.

In the LDH, aggregate indices for total lifetime drinking can be assessed with moderate to fairly high reliability. For epidemiological research into relationships between alcohol consumption and morbidity patterns, lifetime duration of drinking (.94), total volume (.80) corrected for body weight, and daily average (.68) should prove to be valuable tools. Furthermore, this structured interview typically provides important clinical background information about factors associated with major shifts in drinking patterns and, so, could be helpful in treatment.

Reliability estimates for the drinking phase just prior to entering treatment, on the other hand, are only moderate for the LDH. One reason is that subjects were required at the retest session to reconstruct their drinking patterns at the pretreatment phase an average of 4.8 months previous. Moreover, many subjects in this study had a long history of excessive alcohol consumption which could have resulted in memory deficits. Another factor might be the atypical nature of drinking patterns just prior to an individual's seeking treatment for alcohol misuse.

Page last updated: Wednesday, 23 May 2007