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The CAST-6: Development of a short-form of the Children of Alcoholics Screening Test

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The 30-item Children of Alcoholics Screening Test (CAST) is shortened to a 6-item scale (CAST-6) using Principal Components Analysis of CAST responses for three distinct samples: outpatient substance abusers, outpatient psychiatric patients, and medical students. The face validity, internal consistency, and discriminatory ability of the CAST-6 are examined. The CAST-6 is judged to compare favorably with the full CAST and to provide a more efficient way to identify adult children of alcoholics.
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Ad d i c t i v e Be h a u i o r s , Vol. 18, pp. 337- 345, 1993
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0306- 4603193 $6. 00 + .OO
Copyright C 1993 Pergamon Press Ltd.
THE CAST-6: DEVELOPMENT OF A SHORT-FORM OF THE
CHILDREN OF ALCOHOLICS SCREENING TEST
DAVID C. HODGINS, ELEANOR MATICKA-TYNDALE,
NADY EL-GUEBALY, and MALCOLM WEST
University of Calgary
Abstract - The 30.item Children of Alcoholics Screening Test (CAST) is shortened to a 6-
item scale (CAST-6) using Principal Components Analysis of CAST responses for three
distinct samples: outpatient substance abusers, outpatient psychiatric patients, and medical
students. The face validity, internal consistency, and discriminatory ability of the CAST-6
are examined. The CAST-6 is judged to compare favorably with the full CAST and to
provide a more efficient way to identify adult children of alcoholics.
Researchers are increasingly interested in the emotional and behavioral problems
faced by the offspring of alcoholic parents. A number of approaches to screening
populations for adult children of alcoholics have been used, including the use of a
single screening question (e.g., Biek, 1981), the modification from self- to parent-
report of alcoholism screening tests such as the Michigan Alcoholism Screening Test
(MAST; Benson & Heller, 1987) and interview schedules in which subjects report on
their personal observations of their parents to determine whether diagnostic criteria
for alcoholism are reached (Endicott, Andreasen, & Spitzer, 1975).
The Children of Alcoholics Screening Test (CAST; Jones, 1981) is one widely used
method of screening. The CAST is a 30 true or false-item scale designed to identify
individuals who have lived with an alcoholic parent. It was initially designed for both
clinical and research purposes and, therefore, an attempt was made to include items
sampling a wide range of the experiences of children living in an alcoholic home
(Pilat & Jones, 1984/85). Questions concern not only perceptions of parental alcohol
problems but also attempts to control parents’ use, perceptions of marital discord,
efforts to escape the situation, and so on. While clinically useful, such a large
number of items is unnecessary for mere identification of children of alcoholics, and
it is often too unwieldy to use as a research screening tool. The goal of the present
investigation was to develop a short-form of the CAST by identifying a subset of the
30 CAST items that discriminate between adult children of alcoholics (ACOA’s) and
nonalcoholics (ACONA’s) across a range of samples of interest to researchers.
METHOD
Sumple
This analysis used three separate samples. Sample 1 consisted of 131 individuals
between the ages of 21-65 seeking short-term therapeutic services at a hospital-
based outpatient psychiatric service. Sample 2 was comprised of 90 individuals
between the ages of 21-65 seeking short-term therapeutic services at a community-
based substance abuse treatment program. Both of these samples were part of a
larger study on attachment patterns of adult children of alcoholics (el-Guebaly,
Requests for reprints should be sent to Dr. D. Hodgins. Division of Psychology, Foothills Hospital,
1403-29 Street NW. Calgary, AB T2N 2T9 Canada.
337
33x I). c‘. HODGINS et al.
Table I. Profiles of the three wmple\
oulpaticnl\
:L’= I31
Y female\ flu/:
4ge
Mean 37 year\
SD 10.7
Irange 21-65
Les\ than high xhool (7;) I?
High xhool completed Cc/;) I4
I’o~tsecondary (%I 63
Married. common-Ial+ (c/r) 47
Never married 3X
C.4ST mean score 6.5
SD 9. I
r; CAST 2 6 (% ) 37”r
Note: NA = Not available; SD = Standard deviation.
Student\
I IO
-WI ;
27 ~t’;ir-\
‘!.I
21-37
0
0
IO0
NA
NA
3.0
5.7
IY;
West, Maticka-Tyndale, & Pool, 1991). Individuals who had a significant physical
illness in an acute state, who were psychotic, or who were mentally retarded were
excluded from these samples. All subjects were individually administered the CAST
together with three other instruments.
Sample 3 consisted of 1 IO medical students (36%, first year. 40% second year, 23%’
third year) who completed the CAST as part of a study on the attitudes of medical
students toward substance abuse (el-Guebaly, Hodgins, & Dudar, 1992). The sub-
jects were administered the CAST and two other instruments via the university mail
system. The overall response rate was 53%‘.
As summarized in Table I, the samples consisted of 39-66s’ females. The two
help-seeking samples each had a mean age in the mid-30’s, while the medical student
sample had a mean age of 27 years. In terms of education, the majority of the two
help-seeking samples had at least some postsecondary education (63 and 59%).
Thirty-six percent of the substance abuse treatment seeking sample and 47% of the
outpatients were presently married or living common-law.
The CAST categorized 60% of the substance abuse sample and 37% of the outpa-
tient sample as ACOA’s compared with 19% of the medical students. Eighty-one
percent of the substance abuse sample and 24% of the outpatients meet the DSM-
IIIR criteria for alcohol dependence according to a scale derived from the Millon
Clinical Multiaxial Inventory (Millon, 1987). Of the medical students, 22% showed
evidence of alcohol problems by scoring at least 2 on the CAGE screening test
(Mayfield, McLeod, & Hall, 1974).
The 30-item CAST is a self-report instrument designed to identify ACOA’s (Jones,
1981). A cut-point of 6 is commonly used to distinguish ACOA’s from ACONA’s.
Reliability and validity of the CAST has been demonstrated in several studies (Pilat
& Jones. 1984/85; Staley & el-Guebaly, 1991).
Short-form Children of Alcoholics Screening Test 339
Data unalysis
Three statistical procedures were used to identify a subset of items on the CAST
which had an ability to discriminate between ACOA’s and ACONA’s comparable to
that of the full CAST. First, a principal components factor analysis was conducted
on the item intercorrelation matrices of the CAST (see Appendix for correlation
matrices) for each of the three samples. Since CAST items are dichotomous, the
numerical values of factor loadings were used as indications of the relative strength
of associations and not as exact numerical indicators. Simple structure was maxi-
mized using varimax rotation. This facilitated the identification of a subset of items
which retained high factor loadings (>.3) exclusively on the first factor. These analy-
ses permitted a comparison of the factor structure and relative item weights across
the three samples, and identification of a subset of items for further assessment as a
possible “short-form” of the CAST. Given the small sample sizes in each of the
three groups and the small number of individuals in the student sample with CAST
scores above the ACOA cut-point, congruence in results was necessary for a conclu-
sion that the identified items represented a measure of ACOA status which was not
sample specific.
Following the identification of the potential short-form subset of items, the se-
lected items were examined for face validity and for internal consistency using
interitem correlations and Cronbach’s alpha (Cronbach, 1970). The discriminate abil-
ity of various cut-points on the short-form was examined using the full CAST catego-
rizations (cut-point of 6) as the standard for comparison.
RESULTS
Selection of items: Principal components analysis
Table 2 contains factor loadings following rotation of principal components
results. Loadings >.3 are reported for each sample. As is expected in principal
components analysis, prior to rotation, all items loaded strongly on the first factor.
This factor accounted for 48-60s of the variance in the items across the three
samples, suggesting that all 30 items were, in fact, involved in parental alcoholism.
Varimax rotation allowed the identification of a subset of items, (I, 3, 5, 8, 10, 12,
and 25) with both a complexity of 1 and strong loadings only on the first factor. The
seven items so identified were selected for further assessment as a potential short-
form of the CAST.
Face validity
Six of the selected items addressed perception of a parental drinking problem or
interactions associated with alcohol consumption (e.g., arguments). Since one item,
No. 25, asked specifically about a mother’s drinking, it was decided to exclude this
item from the summed scale but to consider both this item and item 22 (father’s
drinking) as potential qualifiers identifying which parent(s) abused alcohol. Of note is
that item 22 has a factorial complexity of 2 for two of the samples and a relatively low
(.43) loading on the second factor for the third sample. Six items: I, 3, 5, 8, 10, and 12
are considered in further analyses and are displayed in Table 3.
Internal consistency
The internal consistency of a shortened CAST containing the six selected items
(CAST-6) was assessed by comparing item- total correlations for this and the full
340 11. C. HODGINS et al.
Table 2. Factor loading\ of 30 CAST item\ following varimax rotation of
principal component\ analyze\ for three separate sample\
Item\
I
,
5
4
5
6
7
x
Y
IO
I I
I?
I3
I-1
IS
Ih
I7
IX
IY
20
21
22
23
2-l
25
‘6
17
3x
29
30
Outpatients
Substance
abuse
treatment Student\
FI F? FI F? FI
.x5
.FO
.76
.6X
.72
.45
.55
.73
.43
.X6
.47
.5-l
.%I
.6Y
.X2
.67
.62
.6J
60
.62
.41
.67
.40
Eigenvalues 16.90
.75
.3l .6X
.5Y
.67 .4X
.75
.45 .6h
.-lo .4Y
.hS
.4Y
.h3
.X2
.75
.46 .65
.50 .55
.‘I6
,75
.64
.75
.7Y ,75
.72
.Jl .4h
.64
.33
.54 .70
.67
.5Y
.7l
.64
1.71 I4.04
I-2
.47
36
.X4
.7Y
.5X
.x3
.37
.6X
.52
.hJ
.Y)2
.47
.7?
.s4
.YS
2.04
M-item scale and with Cronbach’s alpha. Item-total correlations for the CAST-6
ranged from .62-.89 across the three samples. Each item correlated more strongly
with the short- than with the full-scale score. Correlations between CAST-6 and full
CAST scores ranged from .92-.94 for the three samples. Cronbach’s alphas were
.86. .91, and .92 for the student. substance abuse treatment, and outpatient samples.
Table 3. The item\ of the CAST-6
Original CAST
number Item
I
3
5
8
IO
I7
Have you ever thought that one of your parent\ had a drinking problem?
Did you ever encourage one of your parents to quit drinking?
Did you ever argue or fight with a parent when he or \he was drinking?
Have you ever heard your parents fight when one of them was drunk’!
Did you ever feel like hiding or emptying a parent’s bottle of liquor?
Did you ever wish that a parent would stop drinking’!
Short-form Children of Alcoholics Screening Test 341
Table 4. Percent of false positives and false negatives at
each score of shortened CAST using full CAST as a
standard, all samples combined
Shortened CAST:
cut-point
Percent
False negative False positive
I 0 21
2 2 II
3 4 2
4 II 0
5 20 0
6 31 0
Note: N = 331 (all three samples combined).
respectively. In all cases, these results support the conclusion that the CAST-6 is at
least as internally consistent as the full 30-item scale.
Discriminute ubility and cut-points
Given the low number of respondents in the student sample who are ACOA’s
(using the full CAST) and the similarity in internal consistency of the CAST-6 across
all three samples, the three samples were combined to establish a cut-point for the
CAST-6.
Table 4 presents the percentage of false positives and false negatives at various
scores on the 6-item scale, using the full 30-item scale and a cut-point of 6 as the
standard of comparison. Using a cut-point of 3 for the CAST-6 (i.e., scores of 3 or
higher categorize a respondent as an ACOA) results in 2% false positives and 4%
false negatives relative to full scale categorization. When the full CAST scores of the
false positives were examined, they were found to be either 6 or 7. Similarly, false
negative full CAST scores were found to be 4 or 5. The clustering of these scores
near the full scale cut-point supports the conclusion that the CAST-6 discriminates
between ACOA’s and ACONA’s as well as the full 30-item scale does.
DISCUSSION
Comparison of the factor structure of the 30-item CAST across 3 samples revealed
that a face-valid 6-item short-form can be used for the identification of children of
alcoholics. The CAST-6 was shown to be internally consistent and to discriminate
between ACOA’s and ACONA’s as well as the long-form. Two additional items:
“Did you ever think your father (your mother) was an alcoholic?“, although not
included in the summed score, provide qualifying information which may be helpful
in some applications. A cut of 3 true answers on the CAST-6 resulted in a 2% false
positive and 4% false negative rate compared with the recommended cut off of 6 on
the CAST.
One limitation of the present study is the absence of validation of ACOA status
separate from the CAST. This limitation restricted the type of data analysis which
could be conducted. In particular, it was neither possible to perform a discriminate
analysis, nor to assess fully the validity of the CAST-6 in identifying ACOA’s.
Additional analyses in which status is confirmed by collateral report are needed to
342 D. C. HODGINS et al
verify the validity of the CAST-b. The USC of the methods reported in this paper,
however. are superior to the more common technique of shortening the CAST by
selecting items which are face-valid for identification of ACOA status (e.g.. Tweed &
Ryff, 1991).
c‘ 0 N (‘ I. 1J S I 0 N
The CAST-6 is an efficient method of identifying adult children of alcoholics which
compares favorably with the full XI-item CAST. This shortened form allows clini-
cians and researchers to concentrate assessment and mcasurcment efforts on other
areas of interest while quickly identifying ACOA’s.
R E F- E R E N c E s
Endicott. J.. .4ndreasen. N.. & Spitter. R. L. (1975). I;o~?i/v Iri\ro,.x w~c~r( Ir ditro,r~\tic c~~icc,ric~. Nev,
YOI-k: Biometrics Rewarch.
Jane\. J. W. (IYXI ). 771~ Chi/drc,~r c!f A/( oholic~t .yc,rc,c>~iqq 7c\z (c‘r1S7 ). C‘hlcago: I-amill Recovery Press.
Mayfield. D. C.. Mclxod. G.. & Hall. I’. (lY731. The C4GE questionnaire: Validation ofa new alcoholivn
xreening instrument. Atuc~ric cl)! .forru~rr/ r!f’Ptyc,/iitrfr~,, 131. I 131-l 13.
Millon, T. (19X7). :tltr~zrrtr/,fi~~ thc~ AIC:CIf-If (2nd cd.). Minneapolis. MN: National Computer- Systems.
I’ilat. J. M., & Jones. J. W. (19X4%5). Identification of children of alcoholic\: TMO empirical \tudie\.
/I/< o1101 Hccilih trrrd Rc.\c,trrc /I Wiwld. 77-36.
Staley. I).. & el-Guebaly. N. (IYY I). bychometric rvaluatlon of the Children of .4lcoholic\ Screening
Test (CAST) in a psychiatric wmple. 7’11~ ftr/rrutr/ic~trtr/ Jor~r/rt~/ c!f tlrc, Addic~tiou\, 26. 657-66X.
Tweed, S. H.. & Ryff, C. D. (IVYI). .4dult children of alcoholica: Profiles of \bellne\\ amidst di\tre\\.
.Io~,./~trl of .S/r/dir.\ O,I Alu~hol. 52. I ii- I3 I
Cl
c2
c3
c4
c5
C6
Cl
CB
c9
Cl 0
Cl 1
Cl 2
'W Cl 3
L? J Cl 4
Cl 5
Cl 6
Cl 7
Cl 8
Cl 9
c20
c21
c22
C2 3
C2 4
C2 5
C2 6
c2-l
c20
c29
c30
APPENDIX
Pearson product moment correlation coefficients psychiatric outpatients (N = 131)
Cl C2 C3 C4 C5 C6 C7 C8
1. 0 .64 .75 .7f3 .73 .48 .56 .60
1. 0 .61 .71 69 .60 .61 46
1. 0 .70 :67 53 .53 '49
1. 0 .64 :59 .67 :53
1. 0 . 55 .I3 .62
1. 0 .60 .50
1. 0 .62
1. 0
C9 Cl 0 Cl 1 Cl 2 Cl 3 Cl 4 Cl 5 Cl 6 Cl 7 Cl 0 Cl 9 C2 0 C2 1 C2 2 C2 3 C2 4 C2 5 C2 6 C2 7 C2 8 C2 9 C3 0
.46 .65 .53 .95 .45 .50 .59 .59 .41 50 .84 .04 .36 .74 .I2 .61 43 .66 .45 .58 .68 .46
141 50 .55 .69 .68 .51 .64 .75 .54 .37 .65 .40 .63 .56 .62 .67 .36 .26 '54 :60 :67 70 :67 53 134 32 67
:50
:60 60 55
:65
'21
134
.62 37 68 61 40
.63 137 :65 :70 :SO
:52 59 .72 .61 .65 57 .02 .73 .55 .40 .50 .50 .68 .61 .65 .71 .39 29 .63 .56 .02 .69 .67 .61 .44 30 .71 .61 .85 .71 .72 .31 .74 .44 .72 .71 .57
.69 .43 .63 .45 .65 .71 .40
:68 50 .63 .51 :59 42
:33
.50 .56 .43 .43 .51 .55 :50 50 .53 .75 :32 .36 .43 .50 .55 .70 .37 .41 :49 .39 :54 60 164 56 62
:64
23
120
61
:49
50
137
.66 .60 .41
.73 .61 46
.63 .50 .61 25
145
.44 .46 .56 .20 .46 .50 .46 .20 .51 52 .46 .20 .44 .40 .54 .50 '30
1. 0 .42 .45 .45 .60 .54 .60 .31 .50 .59 .35 .46 .52 :50 .47 .02 .50 .30 .65 .50 140
1. 0 .55 .60 .45 .32 .62 .60 .32 .53 .62 .65 .41 62
:52
.64 .72 .48 .71 .33 .62 .73 .60
1. 0 .55 .50 .51 .62 .46 .50 .53 .60 .44 .35 .63 .60 .40 .64 .24 .64 .57 .49
1. 0 . 47 .40 .62 .59 .43 .51 .01 .05 .37 .70 .76 .64 -45 .70 .47 .51 .I1 49
1. 0 .62 .57 .41 .76 .42 .51 . 42 .44 .30 .56 .51 .10 .56 .39 .60 .40 :52
1. 0 .54 .54 .41 .61 . 50 .42 .42 .54 .65 .43 .ll .56 .30 .61 55 .34
1. 0 .50 .37 .55 .67 .44 .30 .52 .72 .52 '.20 .70 .32 .65 :63 .66
1. 0 .27 .69 .60 .46 .56 .55 .70 .79 .25 .60 .41 .69 .00 .61
1. 0 .20 .47 .30 .30 .26 .39 .32 .21 .>7 .36 .47 .36 .34
1. 0 .63 .52 .50 .53 .63 .67 .32 .65 .30 .56 .60 .45
1. 0 .68 .41 .69 .75 .70 .33 .64 -36 .67 .66 -53
1. 0 .42 .53 .63 .57 .46 .59 .32 .40 .64 .45
1. 0 .20 .49 -55 .27 .47 .44 .43 .52 .59
1. 0 .65 .50 .12 .64 .33 .49 .54 .36
1. 0 .60 .36 .79 .51 .60 .77 .59
1. 0 .42 .71 .45 .62 .70 .60
1. 0 .41 . 10 .38 .34 .40
1. 0 . 44 .61 76 50
1. 0 .40 154 :30
1. 0 .68 .57
1. 0 .57
1. 0
No t e : All coefficients significant. p i ,001.
cl c2 c3 C4 CS C6 ~7 ci 3 C9 Cl 0 Cl 1 Cl 2 Cl 3 Cl 4 Cl 5 Cl 6 Cl 7 Cl 8 Cl 9 C2 0 C2 1 C2 2 C2 3 C2 4 C2 5 C2 6 C2 7 C2 8 C2 9 ~30
1. 0 .71 49
:55
.79 .66 .55 .68 .77 49
:64
.60 .50 .85 .53 .63 .76 .66 .41 .65 .85 .76 .43 .89 .70 .68 .44 .68 .42 .66 .74 .59
1. 0 .80 .50 .63 .69 .68 .57 .58 79
:58
56
:40
.66 .71 13
:50
-42 .64 .74 .71 44
:34
.I5 .67 .73 .46 .64 .30 .66 .73 .64
1. 0 .52 .45 .30 .49 .57 .57 .51 . 55 .52 .50 .19 .36 .53 .60 .45 .49 .38 .55 .43 .32 .34 .52 .33
1. 0 .67 .64 .75 .73 .64 .67 .63 .75 .53 .61 .78 .71 . 31 .68 .84 .69 .43 .85 .73 .67 .50 .72 .37 .65 .80 .6o
1. 0 .53 .73 . 63 .50 .62 .43 .65 .42 .56 .66 .59 -37 .59 .61 . 62 .55 .62 .63 .59 .46 .55 .38 .57 .60 .50
Cl
c2
c3
c4
c5
C6
c7
C0
c9
Cl 0
Cl 1
Cl 2
Cl 3
Cl 4
'LJ Cl 5
:: Cl 6
Cl 7
Cl 8
Cl 9
c20
c21
c22
C2 3
C2 4
C2 5
C2 6
C2 7
C2 8
c29
c30
No t e :
1. 0 .56 .53 .52 .61 .46 .60 .72 .57 .63 .68 .47 .56 .60 .44 .56 .57 .56 .57 .42 .62 .43 .68 .55 .63
1. 0 .76 .61 . 59 .46 .73 .45 .63 .75 .69 .42 .65 .69 .66 .55 .69 .I5 .60 .41 .60 .38 .63 .60 .53
1. 0 .63 .60 . 47 .80 .47 .63 .69 .68 .31 .61 .66 .69
1. 0 .49 . 48 .50 .40 .58 .54 .69 .27 .46 .50 .54
1. 0 .57 . 66 .49 .62 .70 .62 .30 .56 .66 .61
1. 0 .63 .48 .52 .62 .56 .21 .60 .68 .57
1. 0 .58 .70 .76 .70 .43 .67 .82 .85
1. 0 . 57 .56 .56 .60 .62 .58 .42
1. 0 . 65 .70 .39 .58 .65 .65
1. 0 .62 .44 .72 .76 .69
1. 0 .31 .64 .74 .57
1. 0 .42 .38 .38
1. 0 .72 .53
1. 0 .71
1. 0
.44 .70
41 56
:38 :58
.36 .60
45 .77
:63 .55
.47 .66
.51 76
.55 :66
:66 52 .41 .64
.45 .86
i.0 40 .71 .43
1. 0
.68 .64 .51 .60 .37 .53 .63 .58
.56 .51 . 49 .49 .32 .50 .55 .63
.73 .51 . 46 .66 .48 .58 .63 .59
175 60 .57 .71 .49 . 52 .66 .62 .45 .44 .63 .69 .63 .70 .ii .60
.50 .59 .44 .55 .44 .56 .58 .61
62 .60 .42 .65 .43 .67 .57 .64
187 .67 .42 .80 .50 .74 .62 .64
.72 .64 . 46 .68 .38 .62 .64 .64
164 39 .45 .f36' .19 .47 .39 .73 .48 .42 .41 .65 ::: '2:
.80 .71 . 47 .75 .39 .73 .78 155
.69 .62 .48 .53 .45 .55 .66 .50
.46 .63 .36 .47 .52 .54 .36 .50
.80 .67 .39 .67 .36 .70 .74 .57
1. 0 .59 .37 .73 .45 .71 .62 .62
1. 0 .44 .68 .50 .66 .55 .68
1. 0 .39 .12 .35 .49 .48
1. 0 .51 .61 .55 .59
1. 0 .47 .40 .53
1. 0 .67 .70
1. 0 .56
1. 0
Medical students (N = I IO)
Cl c2 c3 c4 cs c7 CB c9 Cl 0 Cl 1 Cl 2 Cl 3 Cl 4 Cl 5 Cl 6 Cl 7 Cl 8
1. 0 .52 .57 .65 .57 .50 .44 .37 -42 .33 .73 .26 .39 .41 .43 .06 .32
1. 0 .62 .67 .69 .54 .51 .63 .54 .44 .52 .44 .61 .68 .63 .15 .35
1. 0 .54 .56 .41 32
:56
.47 .52 .40 .53 .41 44 .44 .40 .I4 .32
1. 0 .68 .70 .56 .50 .27 .57 .39 :53 .53 .56 .13 .40
1. 0 .57 .59 .47 .50 .41 53
:38
.41 .53 .53 .58 .14 .32
1. 0 .61 . 53 .27 .19 .46 .51 .48 .55 .16 .37
1. 0 .39 .41 .34 .45 .34 .61 44
1. 0 .40 .33 .28 .70 .57 :76
.49 .lO .25
.55 .27 .43
Cl
c2
c3
c4
c5
c7
ca
c9
Cl 0
Cl 1
Cl 2
Cl 3
Cl 4
'K
Cl 5
m Cl 6
Cl 7
Cl 8
Cl 9
c20
c21
c22
C2 3
C2 4
C2 5
C2 6
C2 7
c2a
c29
c30
1. 0 .23 .41 53 .52 .57 .40 .19 .18
1. 0 .44 :23 .41 .48 .28-.02 .12
1. 0 .19 .53 .44 .24 .lO .18
1. 0 . 56 .64 .60 .40 .41
1. 0 .80 .55 .21 19
1. 0 . 64 .24 124
1. 0 .22 .50
1. 0 .24
1. 0
Cl 9 c20 c21 c22
.67 .66 .14 .67
154 67 .49 .44 .25 .23 .42 .51
.71 .60 .22 .49
.67 .63 .23 .51
:55 56 .45 .51 .26 20 .45 .41
:52 51 :33-.03 38 :40 :29 33
:61 35 .33-.02 .68-.04 .38 .48
:48 36 .33-.Ol .61-.02 .38 .41
.47 .54 .02 .39
:11 41 . 39 lo-.Ol .34
i.0 46 124 .59 :20 37
.44 .12
:56 39
l.O-.04 .58
l.O-.04
1. 0
C2 3 C2 4 C2 5 C2 6 C2 7 C2 8 C2 9 C3 0
163 53 .37 .53 .26 .27 .49 .73 .25 .27 .40 .57 .51 .07 .33 .57
:75 40 .47 .58 .41 .39 :59 50 .41 .39 .42 .61 .55 .70 .53 .51
:60 57 .47 .66 .25 .ll .59 .40 .25 .28 -53 .48 .72 .54 .53 .60
.49 .39 .20 .42 .20 .44 .61 45
:45 59 .72 .51 .04 43 .62 .45 .21 .43 .76 .57 .72 .63 172 .54
:41 07 .14 19 :23 .33 .39 .51 .23 .33
.50 :70-.03 .53 .31
.30 .33 .51 .51 '21 16
.64 .50 :77
145 40 .51 .65 124 15 .64 .69 .36 .52 .37 .54 .71 .70 .66 .57
:lS 59 .70 .27-.02 .17 .56 19- . 02 .38
.59 .04 ,:30 .19
.50 .24 .61 .18 :30 78
.66 .39 .29 .48
:53 71 :29 42 .21 .20 :55 59 .21
.33 .55 .33 .63 .52 .35 -33
:61 29 .40-.Ol-.03-.Ol 33- . 07 .65 .08 .37 .29 .29 .43 .26 .44
1. 0 :69-. 04 .63 .18 .66 .63 .5&3
1. 0 .21 . 37 .45 .65 .62 .91
l.O-.05 .66 .18 .32 .23
1. 0 .14 .43 .74 .39
1. 0 .18 .32 .50
1. 0 .66 .66
1. 0 .65
1. 0
Note: Coefficients > .22, p < .05.
Item 6 is excluded from the matrix as no student responded affirmatively.
... Exposure to PPAU. The questionnaire included the six item version of the Children of Alcoholics Screening Test (CAST-6), used to assess whether participants perceived their parents' alcohol consumption as problematic (e.g., whether respondents had ever thought one of their parents to have a drinking problem, encouraged one of their parents to quit drinking or argued with a drinking parent) (Hodgins et al., 1993). Response categories were yes/no. ...
... Responses are summed (scale 0-6) and a score of ≥3 was defined as having been exposed to PPAU. The reliability of the scale has been confirmed in previous studies; for example, in a validation study, Cronbach's alpha ranged from 0.86 to 0.92 for students and patients with substance use disorders (Hodgins et al., 1993). ...
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Objectives This study examined associations of three prevalent adverse childhood experiences (ACEs) – parents' problematic alcohol use (PPAU), parental separation/divorce, and lack of support from a trusted adult–with adult quality of life (QoL), and potential mediators of associations. Methods Data were from a representative survey (N = 28,047) in Norway that assessed ACEs, QoL, and potential mediators: enduring perceptions of childhood hardships (Difficult Childhood Questionnaire; DCQ), current mental distress, and current social isolation. Latent regression analyses examined potential mediators. Results Each ACE was positively associated with perceptions of childhood as difficult (higher DCQ scores). In turn, ACEs were negatively associated with adult QoL through indirect effects. Lack of support from a trusted adult had the strongest negative association with adult QoL, compared to PPAU and parental separation/divorce. The association between the ACEs and QoL was explained through the mediators of mental distress and social isolation. Conclusions Of the examined ACEs, lack of support from a trusted adult had the strongest negative impact on adult QoL. Adult support to vulnerable children could potentially ameliorate adult consequences of ACEs. In addition, adults reporting difficulties due to childhood adversities may benefit from therapeutic interventions that address both psychological distress and isolation.
... It may be that where mental health impacted caregiving, similar levels of associations to substance use would be found. A more robust measure of alcohol use could have been used, such as the Children of Alcoholics Screening Test (CAST-6) scale (Hodgins et al., 1993). Given that families with substance problems are heterogeneous, future studies could provide a more nuanced understanding of the impact of parental alcohol and drug use by exploring factors such as the severity, age of exposure, and chronicity of exposure (Panagou & MacBeth, 2022). ...
Abstract Several adverse childhood experiences, such as abuse and neglect, are established risk factors for early maladaptive schemas in adulthood. The aim of this study was to examine the associations between adults’ recollections of caregiver mental illness and substance use in childhood and current early maladaptive schemas. A total of 404 participants residing in Western countries (M age = 40.69 years, SD = 15.68; 45.8% female) completed the Young Schema Questionnaire – Short Form Version 3 and items from the Adverse Childhood Experiences International Questionnaire via an online survey. Regression analyses indicated that having a caregiver who was too drunk or high to take care of the family, showed small to moderate associations with all five schema domain scores, whilst controlling for covariates. Caregiver mental illness showed small associations with disconnection rejection and impaired autonomy and competence domain scores, but not when parental substance use was included in the models. The finding that parental substance use that impacted caregiving was more strongly associated with schemas is consistent with Young’s theory that thwarted emotional needs are fundamental to schema formation.
... We used the 6-item modified Children of Alcoholics Screening Test to assess exposure to parental alcoholism [35]. Participants were able to opt out of this question if it did not apply. ...
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Background: The COVID-19 pandemic has profoundly transformed substance use disorder (SUD) treatment in the United States, with many web-based treatment services being used for this purpose. However, little is known about the long-term treatment effectiveness of SUD interventions delivered through digital technologies compared with in-person treatment, and even less is known about how patients, clinicians, and clinical characteristics may predict treatment outcomes. Objective: This study aims to analyze baseline differences in patient demographics and clinical characteristics across traditional and telehealth settings in a sample of participants (N=3642) who received intensive outpatient program (IOP) substance use treatment from January 2020 to March 2021. Methods: The virtual IOP (VIOP) study is a prospective longitudinal cohort design that follows adult (aged ≥18 years) patients who were discharged from IOP care for alcohol and substance use-related treatment at a large national SUD treatment provider between January 2020 and March 2021. Data were collected at baseline and up to 1 year after discharge from both in-person and VIOP services through phone- and web-based surveys to assess recent substance use and general functioning across several domains. Results: Initial baseline descriptive data were collected on patient demographics and clinical inventories. No differences in IOP setting were detected by race (χ22=0.1; P=.96), ethnicity (χ22=0.8; P=.66), employment status (χ22=2.5; P=.29), education level (χ24=7.9; P=.10), or whether participants presented with multiple SUDs (χ28=11.4; P=.18). Significant differences emerged for biological sex (χ22=8.5; P=.05), age (χ26=26.8; P<.001), marital status (χ24=20.5; P<.001), length of stay (F2,3639=148.67; P<.001), and discharge against staff advice (χ22=10.6; P<.01). More differences emerged by developmental stage, with emerging adults more likely to be women (χ23=40.5; P<.001), non-White (χ23=15.8; P<.001), have multiple SUDs (χ23=453.6; P<.001), have longer lengths of stay (F3,3638=13.51; P<.001), and more likely to be discharged against staff advice (χ23=13.3; P<.01). Conclusions: The findings aim to deepen our understanding of SUD treatment efficacy across traditional and telehealth settings and its associated correlates and predictors of patient-centered outcomes. The results of this study will inform the effective development of data-driven benchmarks and protocols for routine outcome data practices in treatment settings.
... Early exposure to parental alcoholism-Children of Alcoholics Screening Test-short form (CAST 6;Hodgins et al., 1993). The questionnaire, consisting of six items of a true/ false format, identifies those who have lived a majority of their childhood and/or their adolescent life with alcohol-addicted parents or guardians. ...
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Owing to growing alcoholism and gambling, numerous variables have been the subject of study to better understand the causes of such addictions. This study aims to investigate personality factors, parental styles in upbringing and early exposure to alcoholism integratively to shed light on how such variables generally shape vulnerability for addictive behaviours and alcohol use disorder (AUD) as well as pathological gambling (PG), separately. The sample consisted of 150 for the inpatient groups (78 AUD and 72 PG) and 102 participants for the control group. The inpatient group comprised “pure” AUD (excluding gambling and other significant addictive disorders) and “pure” PG (excluding AUD and other significant addictive disorders). A random forest-trees analysis established a model accurately classifying 79% of participants from the addictive group and found low conscientiousness, an authoritarian father, a less-flexible mother and neuroticism to be predisposed factors for both addictions. Additionally, through structural equation modeling, a satisfying-index model shows higher extroversion and lower openness may be attributed to PG, as well as the father’s authoritarian parenting style. The mother’s authoritarian or permissive styles may be linked to AUD and the father’s alcoholism. The research concludes AUD and PG have similarities in personality as vulnerable factors for addictive behaviours as well as essential differences in personality and early experiences from boundaries set by mothers and fathers and alcoholism in childhood. The results are applicable in preventive programs as well as working with patients and their parents to create more individualized treatment in relation to addiction type.
... Finally, we used a Polish adaptation of the short form of the Children of Alcoholics Screening test (CAST-6; Hodgins et al., 1993). The CAST-6 is a brief six-item screening instrument used often in studies among ACOAs. ...
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Objective: The main aim of this study was to examine the heterogeneity of a sample of adult children of alcoholics (ACOAs) within the International Classification of Diseases (ICD)-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as well as DSM-5 PTSD diagnoses regarding the participants' subjective well-being (SWB). In addition, the construct validity of the ICD-11 CPTSD was assessed, and the ICD-11 and DSM-5 PTSD diagnoses among participants were compared. Method: The sample consisted of 609 ACOAs. Participants filled out the PTSD Checklist for the DSM-5 (PCL-5), International Trauma Questionnaire (ITQ), Satisfaction with Life Scale (SWLS), Positive and Negative Affect Schedule (PANAS-X), and the Children of Alcoholics Screening test (CAST-6). Results: We observed many fewer PTSD cases when we followed the ICD-11 criteria compared to cases of PTSD diagnosed based on DSM-5 criteria among participants. In addition, latent profile analysis (LPA) did not provide evidence of the construct validity of CPTSD. Finally, we found heterogeneity of ACOAs sample in terms of PTSD/CPTSD profiles, which were differently related to their SWB. Conclusions: Further research is needed to establish to what extent CPTSD and PTSD are separate and discrete disorders and why such discrepancy in PTSD level is observed when we follow either DSM-5 or ICD-11. In addition, the person-centered approach may provide more insight than variable-centered methods and thus, undermine the "uniformity myths" about ACOAs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... The current review included several studies where problem gambling was identified by spouses or children of gamblers, but none used standardised scales. It may be possible to meet this need by modifying tools currently employed to identify the severity of harm suffered by affected others related to alcohol (Alcohol's Harm to Others; [Kaplan, Nayak, Greenfield, & Karriker-Jaffe, 2017], CAST-6 [Hodgins, Maticka-Tyndale, El-Guebaly, & West, 1993]). This data can assist clinical researchers to better examine the extent of familial gambling harm across special populations and better understand where interventions are needed. ...
Article
Background Children living with a problem gambling parent are at risk of harm but no previous systematic reviews have specifically focused on the relationship of parental problem gambling and child wellbeing outcomes. The current review aimed to redress this gap by reviewing all available empirical evidence on parental problem gambling and child wellbeing. Method Articles were identified by searching PsychINFO, CINAHL, Medline and Scopus. The search included terminology pertaining to parents, problem gambling and children and we included all peer-reviewed articles that reported parental problem gambling and child wellbeing outcome(s). Results Overall, 35 studies reporting a relationship between parental problem gambling and child wellbeing were included. Child wellbeing outcomes were reported across six domains: (1) psychological (k=14); (2) family relationships (k=17); (3) violence (k=9); (4) behavioural (k=7); (5) financial (k=9); and (6) physical health (k=3). The included studies were mostly unequivocal about negative impacts of parental problem gambling across the six domains. Sixteen studies provided evidence of negative child outcomes that were directly attributed to parental problem gambling (e.g., as a result of your parent’s problematic gambling, you felt depressed). Nineteen studies reported evidence of the association of child negative outcomes and parental problem gambling but child outcomes were not directly attributed to parental problem gambling (e.g., parent is a problem gambler, child is depressed). Evidence was particularly robust on child distress and family dysfunction directly attributed to parental problem gambling. Conclusion This is the first systematic review focusing exclusively on specific intra- and interpersonal problems experienced by children whose parents have a gambling problem.
Article
Background: Parental drinking has a direct bearing on children. Behavioral problems such as anxiety and depression are common problems among children whose parents drink heavily. Psychosocial interventions have shown promising results for anxiety and depression among children; however, few studies have been conducted in the context of children of parents with alcohol dependence in India. Aim: To evaluate the efficacy of psychosocial intervention for internalizing behavioral problems among children of parents with alcohol dependence. Methods: A randomized controlled trial with a 2 × 4 factorial design was adopted with longitudinal measurement of outcomes for 6 mo. Two-hundred and eleven children who met the eligibility criteria (at least one parent with alcohol dependence) at government high schools in Bangalore, India, were randomized to the experimental (n = 97) or control group (n = 98). The psychosocial intervention was administered to the experimental group in eight sessions (biweekly) over 4 wk after baseline assessment. The intervention focused on identifying and modifying negative thoughts, replacing thinking errors with realistic alternatives, modification of maladaptive behavior, developing adaptive coping skills and building self-esteem. The data was collected pre-intervention and at 1, 3 and 6 mo after the intervention. Data were analyzed using SPSS 28.0 version. Results: Mean age of the children was 14.68 ± 0.58 years, 60.5% were male, 56% were studying in 9th standard, 70.75% were from nuclear families, and mean family monthly income was 9588.1 ± 3135.2 INR. Mean duration of parental alcohol dependence was 7.52 ± 2.94 years and the father was the alcohol-consuming parent. The findings showed that there were significant psychosocial intervention effects in terms of decreasing anxiety and depression scores, and increasing self-esteem level among experimental group subjects over the 6-mo interval, when compared with the control group (P < 0.001). Conclusion: The present study demonstrated that the psychosocial intervention was effective in reducing anxiety and depression, and increasing self-esteem among children of parents with alcohol dependence. The study recommends the need for ongoing psychosocial intervention for these children.
Article
BACKGROUND Parental drinking has a direct bearing on children. Behavioral problems such as anxiety and depression are common problems among children whose parents drink heavily. Psychosocial interventions have shown promising results for anxiety and depression among children; however, few studies have been conducted in the context of children of parents with alcohol dependence in India. AIM To evaluate the efficacy of psychosocial intervention for internalizing behavioral problems among children of parents with alcohol dependence. METHODS A randomized controlled trial with a 2 × 4 factorial design was adopted with longitudinal measurement of outcomes for 6 mo. Two-hundred and eleven children who met the eligibility criteria (at least one parent with alcohol dependence) at government high schools in Bangalore, India, were randomized to the experimental (n = 97) or control group (n = 98). The psychosocial intervention was administered to the experimental group in eight sessions (biweekly) over 4 wk after baseline assessment. The intervention focused on identifying and modifying negative thoughts, replacing thinking errors with realistic alternatives, modification of maladaptive behavior, developing adaptive coping skills and building self-esteem. The data was collected pre-intervention and at 1, 3 and 6 mo after the intervention. Data were analyzed using SPSS 28.0 version. RESULTS Mean age of the children was 14.68 ± 0.58 years, 60.5% were male, 56% were studying in 9th standard, 70.75% were from nuclear families, and mean family monthly income was 9588.1 ± 3135.2 INR. Mean duration of parental alcohol dependence was 7.52 ± 2.94 years and the father was the alcohol-consuming parent. The findings showed that there were significant psychosocial intervention effects in terms of decreasing anxiety and depression scores, and increasing self-esteem level among experimental group subjects over the 6-mo interval, when compared with the control group (P < 0.001). CONCLUSION The present study demonstrated that the psychosocial intervention was effective in reducing anxiety and depression, and increasing self-esteem among children of parents with alcohol dependence. The study recommends the need for ongoing psychosocial intervention for these children. Keywords: Anxiety, Depression, Self-esteem, Psycho-social intervention, Children of parents with alcohol dependence
Article
Slovenija predstavlja t. i. "mokro kulturo", kjer je alkohol splošno sprejet. Najpogosteje zaradi škodljivega pitja posameznika trpi njegova družina, predvsem otroci, ki predstavljajo ranljivo skupino s povečanim tveganjem za duševne in telesne težave. Namen pričujoče raziskave je bil preveriti, ali prihaja do razlik v težavah v duševnem zdravju, v različnih oblikah samomorilnega vedenja in v pogostosti pojavljanja travme v otroštvu med posamezniki, ki so odraščali ob staršu s škodljivo rabo alkohola, in posamezniki, ki niso odraščali ob staršu s škodljivo rabo alkohola. Hkrati je bil namen preveriti odnos med samomorilnim vedenjem odraslih otrok staršev s škodljivo rabo alkohola in pogostostjo pojavljanja travm iz otroštva ter proučiti morebitne napovednike samomorilnega vedenja tekom življenja pri odraslih otrocih staršev s škodljivo rabo alkohola. Vzorec je zajemal 216 udeležencev; 106 posameznikov je bilo uvrščenih v skupino odraslih otrok staršev s škodljivo rabo alkohola, preostalih 110 pa v primerjalno skupino. Odrasli otroci staršev s škodljivo rabo alkohola so v primerjavi s primerjalno skupino pogosteje poročali o poskusu samomora v preteklosti ter o pogostejšem doživljanju fizične in čustvene zlorabe ter zanemarjanja. Ugotovljena je bila pozitivna povezava med čustvenim zanemarjanjem in občutkom, da je oseba drugim v breme, in sicer pri odraslih otrocih staršev s škodljivo rabo alkohola. Doživljanje travme v otroštvu se je izkazalo kot najpomembnejši napovednik poskusa samomora v preteklosti pri odraslih otrocih staršev s škodljivo rabo alkohola, medtem ko je misli o smrti najmočneje napovedoval občutek, da oseba drugim predstavlja breme. Na splošno rezultati nakazujejo, da travma, doživeta v otroštvu, lahko pomembno prispeva k poskusu samomora pri odraslih otrocih staršev s škodljivo rabo alkohola.
Article
Objective: Alcohol cue salience is considered core to the broader understanding of drinking behaviors. In the present research, we sought to build the knowledge of alcohol cue salience by exploring P3 responses to alcohol images among social drinkers within a large-scale alcohol-administration study. Method: Participants (N = 246) were randomly assigned to receive either a moderate dose of alcohol (target BAC = .08%) or a nonalcoholic control beverage. Following beverage administration, participants engaged in image-viewing tasks while EEG was recorded. We examined the impact of alcohol on the amplitude of P3 responses to pictures of alcoholic versus nonalcoholic beverages, exploring both beverage-manipulation and individual-difference moderators of these effects. Results: Results revealed a significant effect of acute alcohol intoxication on P3 responses across stimulus types, with the overall amplitude of P3 being significantly smaller among participants consuming alcohol versus a nonalcoholic beverage. In addition, results revealed a significant main effect of image type, such that P3 amplitude was larger for alcohol images compared to nonalcohol images. No interactions emerged between stimulus type and beverage condition or stimulus type and AUD risk level. Conclusions: With the aim of better understanding the potential influence of the broader context on responses to individual cues, the present study examined the perceived salience of alcohol cues within a drinking setting. Findings provide evidence for alcohol cue salience that is both robust and also widespread across drinkers. More generally, the present study's findings may offer new directions for understanding neurocognitive processes of alcohol cue salience across contexts. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Describes a children of alcoholics screening test (CAST) and its validity and reliability studies with 82 clinically diagnosed and 15 self-reported children of alcoholics, 118 randomly selected control group children, and with 81 adults. Also presented are 2 research studies using the CAST. The 1st research project was conducted in a Chicago-area high school in a predominantly blue-collar, White neighborhood. The CAST was administered to 174 10th–12th graders. More than one-fourth of Ss tested as being children of alcoholics. 17% of Ss tested as children of problem drinkers. The 47 identified children of alcoholics were shown to be working at approximately grade level or above. However, almost 1 out of 5 had failed 1 or more classes the past semester. The 2nd research project was an examination of the incidence of parental alcoholism in a group of 81 experienced therapists, 47 social work and family therapy students, and 26 miscellaneous health professionals. Results indicate a high incidence of alcoholism and parental drinking problems and support the hypothesis that many therapists' interests in the field of alcoholism may be related to early exposure to parental alcoholism. (38 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The Children of Alcoholics Screening Test (CAST) is a 30-item screening instrument developed to identify children who are either living with or have lived with alcoholic parents. In a sample of 250 psychiatric patients, the CAST exhibited substantial item-total scale correlations and a high level of internal consistency reliability. Total CAST scores discriminated self-identified children of problem drinkers from control subjects and were significantly correlated with the severity of parental psychological and social complications due to alcohol misuse. Factor analysis indicated a unidimensional scale structure. CAST cut-off scores produced a low false positive and false negative rate. The psychometric properties of the CAST suggest that it is a useful screening instrument for identifying the offspring of problem drinkers and alcoholics.
Article
This research investigated the psychological adjustment of adult children of alcoholics. Few studies have explored the long-term effects of this childhood experience. The total sample (N = 239) included 114 adult children of alcoholics and 125 sociodemographically comparable adults from nonalcoholic family environments. The sample was further divided into young- and middle-adult age groups and men and women. All respondents completed a self-report instrument that included standardized measures of psychological well-being, emotional distress, personality characteristics and psychological development. Results indicated that adult children of alcoholics did not differ from the comparison group on the majority of measures that assessed multiple aspects of psychological well-being and personality development. However, adult children of alcoholics scored significantly higher on the measures of anxiety and depression than did adults from nonalcoholic families. Few gender differences were obtained in the overall pattern of results. The findings are discussed in light of the generally negative clinical descriptions of adult children of alcoholics and the need to implement future research that will explain the apparent variability in the psychological functioning of adult children of alcoholics.
Article
The adjustment status of women whose fathers were alcoholic, psychiatrically disturbed, or normal was compared to determine the extent of daughters' vulnerability and whether family climate and social support variables moderated the development of symptomatology. The 240 respondents, who were either university staff members or students, comprised four groups: women with normal fathers (n = 81), women with alcoholic and problem drinking fathers (n = 114), women with psychiatrically disturbed fathers (n = 30), and women with both parents who were alcoholic or problem drinkers (n = 15). Daughters of alcoholic and problem drinking fathers reported more neurotic and acting-out symptoms than did daughters of normal fathers. However, a similar elevation of neurotic and acting-out symptoms was found among the daughters of psychiatrically disturbed fathers, who in addition had significantly higher depression scores than did the daughters of alcoholic and problem drinking fathers. Daughters' rates of alcohol use did not distinguish the groups. Family climate and social support variables were found to be related to daughters' current adjustment.
Article
The CAGE questionnaire, a new brief alcoholism screening test, was administered to all patients (N = 366; 39% alcoholic) admitted to psychiatric service over a one year period. The authors indicate that the CAGE questionnaire is not a sensitive alcoholism detector if a four item positive response is the criterion; however, if a two or three item criterion is used, it becomes a viable rapid alcoholism screening technique for large groups.
Article
It is believed that 28 million children nationally are affected adversely by parental alcoholism. To help them, we must identify them. A screening tool was developed and tested to identify adolescents experiencing difficulties because of a parents's drinking problem. The single question, "Has the drinking of either parent created any problem for you?", was given in a medical screening inventory at a teenage clinic. This was followed by an eight-question semistructured interview. Of the 37 patients screened, 57% had high interview scores, suggesting that a parent's drinking had created a problem for them. Their substantiating information was consistent with the literature describing the effects of alcoholics on their children. In contrast, those with low or medium scores consistently reported no problem because of a parent's drinking. High scorers had nearly twice as many somatic symptoms and health concerns as those not reporting a problem with parental drinking. Based on the high percentage of adolescents adversely affected by a parental drinking problem and the patients' responsiveness to specific direct questions, this type of semistructured interview may be useful as a teenage intake interview in a variety of settings. Such screening could allow early referral and interventions to treat the family in which there is alcohol abuse, this promoting healthier psychosocial development. This might also decrease the adolescent's risk of abusing alcohol. Such screening may help the physician to place vague, somatic complaints in a more meaningful perspective. Our method is a quick, brief screen for a common but easily overlooked, potentially serious family problem.
Article
Disturbed or impoverished relationships have been identified as a predominant feature of adult children of alcoholics (ACOAs). Recently, the concept of co-dependency has been advanced to depict the interpersonal difficulties of these individuals, but lacks definitional rigor. The notion that childhood experiences with parents are 'carried forward' to affect attitudes and behaviors relevant to later intimate relationships is also consistent with attachment theory. This study examined the patterns of attachment of ACOAs as compared to adult children of non alcoholics (ACONAs). A cross-sectional sample of 203 individuals attending either a short term hospital based outpatient psychiatric program or a community based alcoholism treatment program was included in this study. Results supported the hypothesis that female ACOAs had a distinctive dysfunctional attachment profile. There were no significant differences in the attachment styles of male ACOAs as compared to ACONAs, or male substance abusers as compared to non-abusers.
The CAGE questionnaire: Validation of a new alcoholism screening instrument
  • Mayfield