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An adolescent version of the Michigan Alcoholism Screening Test.

The binary-choice, 25-item Michigan Alcoholism Screening Test (MAST; Selzer, 1971) is probably the most widely used test of its type for adults (Parsons, Wallbrown, & Myers, 1994). Its popularity is related in part to speed of administration (approximately 5 minutes) and relative ease of scoring (see Radzid, Freeman, & Mackenzie, 1999). The MAST has been used sporadically as an assessment instrument with adolescents (e.g., Kadis, Malca-Vila, McNiel, & McClendon, 1990), but to our knowledge (based on a computer-assisted literature search) there have been no attempts to modify the item content of the adult test to render it more appropriate for adolescents. Certain MAST items refer to "wife" or "work," which may be foreign to the life experiences of younger test-takers. Moreover, there are items dealing with drug-related physical deterioration (e.g., liver problems) that may not be discriminating for young persons. Thus, the aim of the present study was to develop a modified version of the MAST with item conten t appropriate for adolescent respondents.

METHOD

The modification of the MAST basically involved making item content consistent with the life experiences of adolescents. Changes included substitution of "family member or significant other" for "wife" (item 3), "boyfriend/girlfriend" for "wife"' (item 11), and "school" for "work" (items 14 and 16). Data were then collected from 201 adolescents referred to an outpatient treatment center for evaluation of possible substance abuse: 145 males and 56 females, ranging in age from 12 to 19 years (M = 16). There were 171 Caucasians, 28 Hispanics, and 2 Native Americans in the sample. Administration of the adolescent MAST was part of a comprehensive series of assessments for chemical dependency problems. The psychometric goal of the current investigation was the same as in any initial approach to test construction: an internally consistent, homogeneous scale (see Nunnally, 1978). Accordingly, several itemetric indexes of homogeneity were computed, including coefficient alpha, the average interitem correlation, split- half reliability, and item-total correlations. Additionally, factor analytic procedures were used to ascertain the tenability of a single-factor solution.

RESULTS

The items comprising the adolescent version of the MAST are presented in Table 1, together with respective item means and item-total correlations. Item 7 is not included because the weighted scoring procedures inexplicably use a weight of zero for this item; hence, it is not scored (see Selzer, 1971). The average interitem correlation was .12, the split-half reliability was .65 and the alpha coefficient was .68. These values are adequate for basic research, but are below the standards for tests used for applied decision-making (Nunnally, 1978). Next, items with low endorsement or low item-total correlations were deleted (items 3, 5, 18, and 25). Additionally, item 24 had poor overall relationships with the other items and was also removed. These deletions increased alpha to .73, an acceptable value.

From a factor analytic perspective, item homogeneity is evinced by the emergence of a unitary factor with essentially equal paths from each observed variable (item) to the latent variable (see Hoyle & Smith, 1994). It is important to note that this approach should not supplant traditional techniques (above) for evaluating internal consistency. Maximum likelihood estimates (Amos; see Arbuckle, 1997) failed to confirm a unitary factor for the modified MAST. A subsequent exploratory principal components analysis suggested that both the 24- and 19-item scales are factorially complex. For the longer scale, nine components were extracted based on eigenvalue 1 and scree-test criteria, accounting for 63% of scale variance. Using the same criteria, seven components were extracted for the shorter scale, accounting for 64% of the variance.

DISCUSSION AND RECOMMENDATIONS

The adolescent MAST did not demonstrate homogeneity congruent with that of the adult version (e.g., Zung, 1980). However, expunging certain psychometrically "poor" items increased internal consistency to a still comparatively low but acceptable level. Nevertheless, the modified MAST, in its current binary form with weighted scoring procedures, appears to be multidimensional in nature.

Items involving drug-related arrests (items 24 and 25) ostensibly detract from scale homogeneity. It is noteworthy that these same items were likewise found to be disparate from other items in our earlier study with the adult MAST (Thurber, Snow, Lewis, & Hodgson, 2001). It may be that arrests involving drugs are fairly improbable events that do not necessarily covary with more pervasive and reliable symptoms of substance abuse.

The item related to liver dysfunction (item 18) is one that should obviously be eliminated in a scale designed for adolescents. Deleting items dealing with complaints from family members (item 3) and feelings of guilt (item 5) also improved internal consistency to some extent. These items may have been "poor" simply because of disproportionate responding in the dichotomized response format, unique to the current participants. It is also possible that adolescents in general may be guarded with respect to admitting feelings of guilt or acknowledging the private matter of complaints from important people in their lives.

In our view, it is worthwhile to attempt a modified extension of the MAST to young people. There appears to be a core of items from the modified MAST that may reliably differentiate adolescents in need of further assessment for substance abuse. Further improvements in the psychometric properties of the adolescent MAST might result by changing the response format from binary to multipoint (Comrey, 1978, cogently discusses the itemetric problems associated with dichotomized forced-choice approaches). Further, the weighted scoring procedures have never been justified empirically and include the incomprehensible zero weighting for one item (related to personal attempts to limit drinking behavior) and its de facto elimination from the total score. Future investigators might consider the psychometric characteristics of the adolescent MAST following a change in the response format and a modification of the scoring system.
Table 1

Adolescent MAST Items, Means, and Item-Total Correlations

Item M r

1. Do you feel you are a normal .59 .26
drinker/user?

2. Have you ever awakened the .47 .29
morning after some drinking/using
the night before and found that
you could not remember a part of
the evening?

3. Does any family member or .83 .09
significant other ever worry or
complain about your drinking/
using?

4. Can you stop drinking/using .23 .27
without a struggle after one or
two drinks or one or two uses?

5. Do you ever feel bad about your .62 .09
drinking/using?

6. Do friends or relatives think .70 .27
you are a normal drinker/user?

8. Are you always able to stop .42 .40
drinking/using when you want to?

9. Have you ever attended a .70 .48
meeting of Alcoholics/Narcotics
Anonymous?

10. Have you gotten into fights .20 .45
when drinking/using?

11. Has drinking/using ever .55 .37
created problems with you and your
girlfriend/boyfriend?

12. Has any family member or .71 .37
significant other ever gone to
anyone for help about your
drinking/using?

13. Have you ever lost friends or .26 .44
girlfriends/boyfriends because of
drinking/using?

14. Have you ever gotten into .57 .17
trouble at school because of
drinking/using?

15. Have you ever lost a job .12 .40
because drinking/using?

16. Have you ever neglected your
obligations, your family or school
for two or more days in a row
because you were drinking/using? .31 .31

17. Do you ever drink/use before
noon? .34 .26

18. Have you ever been told you
have liver trouble Cirrhosis? .01 -.05

19. Have you ever had delirium .13 .29
tremens (DTs), severe shaking,
heard voices, or seen things that
were not there after heavy
drinking/using?

20. Have you ever gone to anyone
for help about your drinking/
using? .58 .27

21. Have you ever been in a
hospital because of drinking/
using? .49 .34

22. Have you ever been a patient in
a psychiatric hospital or on a
psychiatric ward of a general
hospital where drinking/using was
part of the problem? .11 .34

23. Have you ever been seen at a
psychiatric or mental health
clinic, or gone to a doctor,
social worker or clergyman for
help with an emotional problem
in which drinking/using had
played a part? .19 .34

24. Have you ever been arrested or
gotten a ticket when you have been
drinking/using? (For anything
other than a DUI.) 2.77 .27

25. Have you ever been arrested for
drunk driving, driving after
drinking or drinking under the
influence? .17 -.01

Note. Item 7 was deleted. Items 24 and 25 are scored by weighting the
number of reported arrests by 2.


REFERENCES

Arbuckle, J. L. (1997). Amos users' guide. Chicago: Smallwaters.

Comrey, A. L. (1978). Common methodological problems in factor analytic studies. Journal of Consulting and Clinical Psychology, 46, 648-659.

Hoyle, R. H., & Smith, G. T. (1994). Formulating clinical research hypotheses as structural equation models: A conceptual overview. Journal of Consulting and Clinical Psychology, 62, 429-440.

Kadis, L. B., Malca-Villa, M., McNiel, D. E., & McClendon, R. A. (1990). Alcoholism and the family in Peru: The impact of an alcoholic on teenagers' perceptions of the family. American Journal of Family Therapy, 18, 345-354.

Nunnally, J. C. (1978). Psychometric theory. New York: McGraw-Hill.

Parsons, K. J., Wallbrown, F. H., & Myers, R. W. (1994). Michigan Alcoholism Screening Test: Evidence supporting general as well as specific factors. Educational and Psychological Measurement, 54, 530-536.

Radzid, M., Freeman, B. J., & Mackenzie, R. G. (1999). Substance-related disorders. In S. D. Netherton, D. Homes, & C. E. Walker (Eds.), Child and adolescent psychological disorders (pp. 241-263). New York: Oxford University Press.

Selzer, M. L. (1971). The Michigan Alcoholism Screening Test: The quest for a new diagnostic instrument. American Journal of Psychiatry, 127, 89-94.

Thurber, S., Snow, M., Lewis, D., & Hodgson, J. M. (2001). Item characteristics of the Michigan Alcoholism Screening Test. Journal of Clinical Psychology, 57, 139-144.

Zung, B. J. (1980). Factor structure of the Michigan Alcoholism Screening Test (MAST) in a psychiatric outpatient population. Journal of Clinical Psychology, 36, 1024-1030.

Mark Snow, Steven Thurber, and Joele M. Hodgson, Department of Psychology, Boise State University.

Reprint requests to Steven Thurber, Woodland Centers, 1125 S.E. Sixth Street, Willmar, Minnesota 56201.
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Author:Snow, Mark; Thurber, Steven; Hodgson, Joele M.
Publication:Adolescence
Geographic Code:1USA
Date:Dec 22, 2002
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