• EN

Problem Oriented Screening Instrument for Teenagers (POSIT)

User Information



Author/Developer / Address:

National Institute on Drug Abuse (NIDA),
National Institutes of Health.
Elizabeth Rahdert, Ph.D.
Division of Clinical and Services Research.
National Institute on Drug Abuse.
National Institutes of Health Room 4229.
6001 Executive Boulevard.
Maryland, 20892-9563
(301) 443-0107.

Publication dates:


Description / Type of Assessment:

 Self-administered 139-item "yes/no" screening questionnaire.

Primary use / Purpose:

 Designed to identify potential problem areas that require further in-depth assessment. POSIT was designed to identify problems and potential treatment or service needs in 10 areas, including substance abuse, mental and physical health, and social relations. Related is the POSIT follow-up questionnaire that was derived from items on POSIT to screen for potential change in 7 out of the 10 problem areas represented on POSIT.

Domains measured / Life Areas / Problems Assessed:

  • Substance use and abuse
  • Physical health
  • Mental health
  • Family relations
  • Peer relations
  • Educational status (i.e., learning disabilities/disorders)
  • Vocational status
  • Social skills
  • Leisure/recreation
  • Aggressive behavior/delinquency


 Adolescents with 5th grade reading level.

Administration / Completion Time:

 20-30 minutes.

Scoring Procedures:

Two scoring systems are available, the original system presented in the Adolescent Assessment-Referral System (AARS) manual and the newer scoring system available from NIDA. The original scoring system includes "red flag" items and one expert-based cut-off score that indicates either a high or low risk for each of the 10 problem areas. In contrast, the newer scoring system does not consider red flag items but includes two empirically based cut-off scores that indicate low, medium, or high risk for each of the 10 problem areas. In the newer system, the total raw score for each problem determines the level of risk for that area.

Scoring Time:

 Two seconds for computerized scoring; 2-5 minutes when using the scoring templates placed over the paper and pencil versions of the POSIT and POSIT follow-up questionnaires.


No special qualifications are necessary to administer POSIT and POSIT follow-up questionnaires as their formats are very clear and straightforward.

Source of Psychometrics:

Dr. Rahdert (see addresses above).
To obtain the computerized POSIT and POSIT followup, contact the following for pricing information on the currently available computer software:
PowerTrain, Inc.
8201 Corporate Drive
Suite 1080. Landover, MD 20785
(301) 731-0900


 English and Spanish versions available.

Availability / Inquiries:

Dr. Rahdert (see addresses above).


POSIT is not copyrighted and is free-of-charge. Persons wanting to use the POSIT can use it. The only request in that Elizabeth Rahdert, Editor, National Institute on Drug Abuse, are acknowledged in written materials.

Practicability / usefulness:

POSIT can be utilized by school personnel, juvenile and family court personnel, medical and mental health care providers, and staff in substance use disorder treatment programs. When used in conjunction with POSIT, the POSIT follow-up questionnaire can be used as a measure of change or an outcome measure.


POSIT and POSIT follow-up questionnaires are not diagnostic instruments and require additional tests for full assessment. Some literacy is required.

Relevant Studies
Screening for Drug Abuse Among Adolescents in Clinical and Correctional Settings
Latimer, W.W., Winters, K.C., Stinchfield, R.D. Screening for Drug Abuse Among Adolescents in Clinical and Correctional Settings Using the Problem-Oriented Screening Instrument for Teenagers. American Journal of Drug and Alcohol Abuse, 23(1), 79-98, (1997).

 The present study examines the ability of the Problem-Oriented Screening Instrument for Teenagers (POSIT) to identify DSM-III-R-defined psychoactive substance use disorders among 342 adolescents aged 12-19 years. Participants were sampled from school, clinical, and correctional settings. Optimal-scale cut scores for drug abuse diagnosis classifications were derived with a minimum loss function method that minimise false classifications. When using the optimal cut score of two for the total sample, the standard POSIT substance use/abuse scale obtained a drug abuse diagnosis classification accuracy of 84% with sensitivity and specificity ratios of 95% and 79%, respectively. The internal validity of the specific substance use / abuse scale was analysed using principal components factor analysis, item analysis and the coefficient alpha, to determine if a shortened scale could retain acceptable classification accuracy. When using the same method mentioned to determine the diagnosis classification accuracy of the 11-item scale for the total sample, this shortened scale obtained similar and positive results. The findings suggest that the POSIT can be used as a useful screening instrument to identify adolescents in need of further drug abuse assessment.

Younger and Female Adolescents at Highest Risk
Marques, P.R.; Rahdert, E.; Danseco, E.R. Younger and Female Adolescents at Highest Risk Among New Intakes at a Public Substance Abuse Services Clinic and Juvenile Justice System. National Institute on Drug Abuse. NIDA Research Monograph Series No. 179. NIH Publication No. 99-4395. (1999).

Can the use of quick screening tools by adolescent drug abuse counsellors facilitate risk identification?. This study identified variables associated with risk in two samples: primarily white, middle class, adolescent referred for intake at a public substance abuse services clinic in Charles County Maryland (N = 463, age=16.5 + - 1.3 years), and primarily white juvenile offenders in the state of Kansas (N = 1917, age 15.3, + - 1.4 years). Data obtained included: demographics, prior treatment information, and the problem Oriented Screening Instrument for Teenagers (POSIT), a validated ten life domain risk assessment instrument. To identify predictors, the POSIT domains were set as dependent in a MANOVA in the first sample. In the clinic sample, at the multivariate level there was no gender by age interaction, but both younger and age and female gender accounted for 10% of the POSIT risk variance independently. On the mental health scale young females had the highest mean relative risk. These and other gender and age findings were replicated in a second larger sample. At the end of a service episode among the clinic sample, neither gender nor age predicted unsatisfactory discharge, but the POSIT family scores was a good predictor. Among the second sample, family scale of POSIT was the second strongest predictor of felony convictions and more violent offences. The findings suggest that both the youngest and female referrals -specially those with family troubles- need special attention. The use of screening tools along with referrals to speciality professionals, when appropriate, may improve care.

The Problem Oriented Screening Instrument for Teenagers
Santisteban, D.A., Tejeda, M., Dominicis, C., Szapocznik, J. An Efficient Tool for Screening for Maladaptive Family Functioning in Adolescent Drug Abusers: The Problem Oriented Screening Instrument for Teenagers. American Journal of Drug and Alcohol Abuse, 25(2), 197-206, (1999).

The aim of this study was to study the degree to which the Problem Oriented Screening Instrument for Teenagers screen for the family domain provides useful information regarding family functioning when used with clinics-referred adolescents with behaviour problems. Participants in the study were 135 Hispanic and African-American youth referred for treatment of severe behaviour problems and drug use. The findings provide support for the usefulness of the POSIT family functioning scale. Data also supported the criterion validity of this 11-item Family screen scale, its ability to classify families in terms of their family functioning and its construct validity. Further analysis designed to determine the relationships between gender and race / ethnicity and the POSIT Family scale showed that differences in scores by gender, race and ethnicity are not unique to the POSIT, but rather reflect similar relationships with family functioning scores obtained with more extensive family measures.

Psychosocial stressors of drug-abusing disadvantaged adolescent mothers
Scafidi, F.A., Field, T., Prodromidis, M., Rahdert, E. Psychosocial stressors of drug-abusing disadvantaged adolescent mothers. Adolescence, 32(125), 93-100, (1997).

The Problem Oriented Screening Instrument for Teenagers (POSIT) and the Beck Depression Inventory (BDI) were administered to 55 disadvantaged adolescent mothers who abused drugs during pregnancy and 49 nondrug-abusing disadvantaged adolescent mothers. A multiple regression analysis of POSIT scales indicated that the best predictors of drug abuse during pregnancy were mental health status, leisure and recreational activities, and peer relationships. These results highlight the utility of administering the POSIT to identify the stressors that place the pregnant adolescents at risk for drug abuse.


Page last updated: Thursday, 20 November 2008