Problem Oriented Screening Instrument For Teenagers Research Articles

Profilisanje osujećene omladine (POSIT) u Republici Srpskoj - deset godina poslije

Civil wars in former Yugoslavia have resulted in divided societies especially in those cultures where ethnic divisions exist. Problems become intergenerational when there are not sufficient resolutions leading to viable reconciliation. There often exists a collective malaise in these situations that manifests itself as primary and secondary post-traumatic disorders (PTSD). Secondary PTSD often afflicts the children and adolescent off springs of their parents or grandparents impacted by the conflict per se. Given that, group profiles of students from Republika Srpska (2010. versus 2020.) measured with the Problem-Oriented Screening Instrument for Teenagers, POSIT (Rahdert 1991) which covers 10 functional adolescent problem areas including substance use, mental health, family relations, and aggressive behavior/delinquency. Ten years later, it is important to maintain focus on the unmet psychological and social/cultural needs of traumatized children and youth, second-generation war victims because neglecting these problems could be costly for society in terms of later disorganization of this population, as it matures.

Validación psicométrica del POSIT para el cribado del consumo de riesgo de alcohol y otras drogas entre adolescentes

Early detection of alcohol and drug abuse among adolescents is decisive not only for rapid referral and intervention in cases of risk, but also as an indicator for use in the evaluation of prevention programs and public policies to reduce consumption. One of the most widely-used screening instruments in the world is the Problem Oriented Screening Instrument for Teenagers (POSIT) (Rahdert, 1991), whose substance use and abuse subscale (POSITUAS) is a brief tool of enormous applied potential. However, there is still no empirical validation study that would ensure its good psychometric performance in Spain. The aim of this paper is to analyse the psychometric properties of POSITUAS among Spanish adolescents. For this purpose, 569 students aged between 12 and 18 years (M = 14.71; SD = 1.79) were personally interviewed. The study sample was selected through two-stage sampling. The results obtained, using the Adolescent Diagnostic Interview (Winters & Henly, 1993) as the gold criterion, allow us to inform that the Spanish version of the POSITUAS has excellent psychometric behaviour, both at the level of internal consistency (a = .82) as well as regards sensitivity (94.3%) and specificity (83.9%), with an area under the ROC curve of .953. Also, the realisation of a Confirmatory Factor Analysis allows for verifying the one-dimensional character of the scale. As a result, POSITUAS is made available to researchers and professionals in the field of addictive behaviours for use with a minimum of psychometric guarantees.

Empirical validation of the CRAFFT Abuse Screening Test in a Spanish sample.

The CRAFFT Substance Abuse Screening Instrument, developed by the Center for Adolescents Substance Abuse Research (CeASAR) (Knight et al., 1999), is a screening tool for high-risk alcohol and drug risk consumption designed for use with adolescents. Since its publication it has been the subject of translations and validations in different countries, populations and contexts that have demonstrated its enormous potential. However, there is still no empirical validation study that would ensure its good psychometric performance in Spain. The aim of this paper is to develop an adapted version of the CRAFFT in Spanish and to analyze its psychometric properties in a sample of Spanish adolescents. For this purpose an individual interview was conducted on 312 adolescents aged between 12 and 18 years of age (M = 15.01; SD = 1.83) from the Galician community. The interview included a part of the Adolescent Diagnostic Interview (ADI) and the Problem Oriented Screening Instrument for Teenagers (POSIT). The results obtained, similar to those found in other countries, allow us to report that the Spanish version of the CRAFFT has a good psychometric behaviorproperties. It was found to have a satisfactory internal consistency with a Cronbach’s alpha value of .74. In terms of sensitivity and specificity, values of 74.4% and 96.4% respectively, were obtained and the area under the ROC curve was .946. The Spanish version of the CRAFFT is made available to researchers and professionals in the field of addictive behaviors, so that it can be used with the necessary psychometric guarantees.

The concurrent validity of the Problem Oriented Screening Instrument for Teenagers (POSIT) substance use/abuse subscale in adolescent patients in an urban federally qualified health center

ABSTRACTBackground: The Problem Oriented Screening Instrument for Teenagers (POSIT) substance use/abuse subscale has been validated with high school students, adolescents with criminal justice involvement, and adolescent substance use treatment samples using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-III-R and DSM-IV. This study examines the concurrent validity of the POSIT's standard 17-item substance use/abuse subscale and a revised, shorter 11-item version using DSM-5 substance use disorder diagnoses. Methods: Adolescents (N = 525; 93% African American, 55% female) 12–17 years of age awaiting primary care appointments at a Federally Qualified Health Center in Baltimore, Maryland completed the 17-item POSIT substance use/abuse subscale and items from a modified World Mental Health Composite International Diagnostic Interview corresponding to DSM-5 alcohol use disorder (AUD) and cannabis use disorder (CUD). Receiver operating characteristic curves, sensitivities, and specificities were examined with DSM-5 AUD, CUD, and a diagnosis of either or both disorders for the standard and revised subscales using risk cutoffs of either 1 or 2 POSIT “yes” responses. Results: For the 17-item subscale, sensitivities were generally high using either cutoff (range: 0.79–1.00), although a cutoff of 1 was superior (sensitivities were 1.00 for AUD, CUD, and for either disorder). Specificities were also high using either cutoff (range: 0.81–0.95) but were higher using a cutoff of 2. For the 11-item subscale, a cutoff of 1 yielded higher sensitivities than a cutoff of 2 (ranges for 1 and 2: 0.96–1.00 and 0.79–0.86, respectively). Specificities for this subscale were higher using a cutoff of 2 (ranges for 1 and 2: 0.82–0.89 and 0.89–0.96, respectively). Conclusions: Findings suggest that the POSIT's substance use/abuse subscale is a potentially useful tool for screening adolescents in primary care for AUD or CUD using a cutoff of 1 or 2. The briefer, revised subscale may be preferable to the standard subscale in busy pediatric practices.

Adaptación transcultural y validación del test CRAFFT como prueba de pesquisa para consumo problemático, abuso y dependencia de alcohol y otras sustancias en un grupo de adolescentes argentinos

Substance use and abuse and their consequences are a major problem among adolescents. The screening for problematic alcohol and substance use, abuse and dependence should be part of the case-taking process for adolescents. The Problem Oriented Screening Instrument for Teenagers (POSIT) and the Car, Relax, Alone, Forget, Family/Friends, Trouble questionnaire (CRAFFT) are used to this end. 17 items corresponding to substance use and abuse (POSITsua); it has been validated in Spanish. six questions; it has not been validated in Argentina. To assess the validity of a version of the CRAFFT screening test adapted to Spanish in a group of Argentine adolescents using the POSITsua test as reference. The CRAFFTa and the POSITsua tests were administered to 14-20 year-old adolescents. An affirmative answer was scored as 1, and a negative answer, as 0. An individual was considered to have an increased risk of problematic use, abuse and dependence if he/she scored >2 in the CRAFFTa and POSITsua tests. Two hundred and eighty-six adolescents were included; 52% were female; mean age: 16.6 years old. The CRAFFTa score was >2 for 29%, while the POSIT score was >2 for 37%. CRAFFTa sensitivity: 59%; specificity: 88%. CRAFFTa positive predictive value: 0.74; negative predictive value: 0.78. The area under the curve was 0.73. In the linear regression, the R for the six CRAFFT questions was 0.60. Gender and age did not modify results. Cronbach's alpha was 0.64. CRAFFTa sensitivity was 59%, and its specificity was 88%, compared to the POSITsua test as a screening tool for problematic alcohol and substance use, abuse and dependence among Argentine adolescents.

Screening Questionnaires for Problem Drinking in Adolescents: Performance of AUDIT, AUDIT-C, CRAFFT and POSIT

Background/Aims: Only rather few data on the validity of screening questionnaires to detect problem drinking in adolescents exist. The aim of this study was to compare the performance of the Alcohol Use Disorders Identification Test (AUDIT), its short form AUDIT-C, the Substance Module of the Problem Oriented Screening Instrument for Teenagers (POSIT), and CRAFFT (acronym for car, relax, alone, forget, family, and friends). Methods: The questionnaires were filled in by 9th and 10th graders from two comprehensive schools. All students received an interview using the alcohol section of the Composite International Diagnostic Interview. Alcohol abuse and alcohol dependence according to DSM-IV as well as episodic heavy drinking served as criteria to validate the screening instruments. Results: All 9th and 10th graders (n = 225) of both schools participated. No significant differences were found for areas under the receiver operating characteristic curves ranging from 0.810 to 0.872. Cronbach’s alpha was satisfactory (0.77–0.80) but poor for CRAFFT (0.64). Different cut-offs are discussed. Conclusions: Considering validity as well as reliability, AUDIT, AUDIT-C and POSIT performed well; however, the POSIT is quite lengthy. AUDIT-C showed good psychometric properties and has clear advantages because of its brevity.

Methamphetamine Use and Sexual Risk Behavior among High School Students in Cape Town, South Africa

Objective: To investigate whether methamphetamine use is associated with sexual risk behavior among adolescents. Method: A cross-sectional survey of 1,561 male and female high school students in Cape Town (mean age 14.9 years) was conducted using items from the Problem Oriented Screening Instrument for Teenagers (POSIT) HIV Risk Scale. Results: Nine percent of the students had tried methamphetamine and 30% of male and 17% of female students reported sexual debut. Multinomial logistic regression analyses showed that methamphetamine use in the past year was significantly associated with being in a higher HIV/STI risk category (RRR = 2.1, 95% CI: 1.10–4.03, p < 0.05). Conclusions: Methamphetamine use, coupled with a high HIV prevalence in South Africa, raises serious cause for concern about the potential for methamphetamine to further exacerbate the prevalence and spread of HIV in Cape Town.

Reducing Sensitive Survey Response Bias in Research on Adolescents: A Comparison of Web-Based and Paper-and-Pencil Administration

Using the Problem Oriented Screening Instrument for Teenagers (POSIT), the effect of mode of administration on (1) students' willingness to disclose sensitive information and (2) response rates was investigated. A 2 × 2 unequal N factorial analysis of variance (ANOVA) design was employed. Mode of administration (paper-and-pencil vs. Web-based) was crossed with grade level (middle vs. high school). The study was conducted in two middle and two high schools. A total of 628 middle and high school students completed the survey. The POSIT is a self-report measure with 139 yes/no items that identifies stressors in 10 functional areas (e.g., Substance Use). An unequal N 2 (mode) × 2 (grade level) factorial ANOVA was employed. No statistically significant differences were found for self-reported risk across modes of administration. Students completing the Web-based version of the survey were four times more likely to skip an item. Effect of Mode on Reporting of Sensitive Information-Students completed the Web-based surveys in computer labs with other students. The intent of the Web-based survey was to increase perceived privacy but the environment likely negated any effect. Effect of Mode on Response Rates-The higher response rate for the paper-and-pencil survey was the opposite of what was expected and revealed that students were more likely to skip sensitive items on the Web survey.

Methamphetamine use, aggressive behavior and other mental health issues among high-school students in Cape Town, South Africa

Objective Methamphetamine use has become a growing problem in a number of countries over the past two decades, but has only recently emerged in South Africa. This study investigated the prevalence of methamphetamine use among high-school students in Cape Town and whether students reporting methamphetamine use were more likely to be at risk for mental health and aggressive behavior problems. Methods A cross-sectional survey of 15 randomly selected high schools in Cape Town, of 1561 males and females grade 8–10 students (mean age 14.9), was conducted using the Problem Oriented Screening Instrument for Teenagers (POSIT) and the Beck Depression Inventory (BDI). Results Findings indicated that 9% of the students had tried methamphetamine at least once. Ordinal logistic regression analyses showed that methamphetamine use in the past year was significantly associated with higher aggressive behavior scores (OR = 1.81, 95% CI: 1.04–3.15, p < 0.05), mental health risk scores (OR = 2.04, 95% CI: 1.26–3.31, p < 0.01) and depression scores (OR = 2.65, 95% CI: 1.64–4.28, p < 0.001). Conclusions Methamphetamine use has become a serious problem in Cape Town, particularly among adolescents. Screening adolescents in school settings for methamphetamine use and behavior problems may be useful in identifying youth at risk for substance misuse, providing an opportunity for early intervention. These findings have implications for other parts of the world where methamphetamine use may be occurring at younger ages and highlight the importance of looking at co-morbid issues related to methamphetamine use.

Korean Version of the Revised Problem-Oriented Screening Instrument for Teenagers Substance Use/Abuse Scale: A Validation Study

ABSTRACTThe objective of this study is to validate the Korean version of the revised Problem-Oriented Screening Instrument for Teenagers (POSIT) substance use/abuse scale for measuring adolescent substance abuse problems. The Korean version of the revised POSIT was validated with a sample of 1,051 students in grades 7–12 in Korea. Exploratory factor analysis identified that the Korean version of the revised POSIT is a unidimensional screening instrument similar to the English version. The Korean version of the revised POSIT showed high internal consistency reliability and good convergent validity and demonstrated optimal performance at a cut-off score of 1, which was the score recommended by its developer. The Korean version of the revised POSIT is a reliable and valid instrument for measuring Korean adolescent substance abuse. However, validation with clinical samples is needed to improve its ability to correctly capture substance-abusing adolescents.

Adolescent Suicide Risk Screening in the Emergency Department

Many adolescents who die by suicide have never obtained mental health services. In response to this, the National Strategy for Suicide Prevention recommends screening for elevated suicide risk in emergency departments (EDs). This cross-sectional study was designed to examine 1) the concurrent validity and utility of an adolescent suicide risk screen for use in general medical EDs and 2) the prevalence of positive screens for adolescent males and females using two different sets of screening criteria. Participants were 298 adolescents seeking pediatric or psychiatric emergency services (50% male; 83% white, 16% black or African American, 5.4% Hispanic). The inclusion criterion was age 13 to 17 years. Exclusion criteria were severe cognitive impairment, no parent or legal guardian present to provide consent, or abnormal vital signs. Parent or guardian consent and adolescent assent were obtained for 61% of consecutively eligible adolescents. Elevated risk was defined as 1) Suicidal Ideation Questionnaire-Junior [SIQ-JR] score of > or =31 or suicide attempt in the past 3 months or 2) alcohol abuse plus depression (Alcohol Use Disorders Identification Test-3 [AUDIT-3] score of > or =3, Reynolds Adolescent Depression Scale-2 [RADS-2] score of > or =76). The Beck Hopelessness Scale (BHS) and Problem Oriented Screening Instrument for Teenagers (POSIT) were used to ascertain concurrent validity. Sixteen percent (n = 48) of adolescents screened positive for elevated suicide risk. Within this group, 98% reported severe suicide ideation or a recent suicide attempt (46% attempt and ideation, 10% attempt only, 42% ideation only) and 27% reported alcohol abuse and depression. Nineteen percent of adolescents who screened positive presented for nonpsychiatric reasons. One-third of adolescents with positive screens were not receiving any mental health or substance use treatment. Demonstrating concurrent validity, the BHS scores of adolescents with positive screens and the POSIT scores of those with positive screens due to alcohol abuse and depression indicated substantial impairment. The addition of alcohol abuse with co-occurring depression as a positive screen criterion did not result in improved case identification. Among the subgroup screening positive due to depression plus alcohol abuse, all but one (>90%) also reported severe suicide ideation and/or a recent suicide attempt. This subgroup (approximately 17% of adolescents who screened positive) also reported significantly more impulsivity than other adolescents who screened positive. The suicide risk screen showed evidence of concurrent validity. It also demonstrated utility in identifying 1) adolescents at elevated risk for suicide who presented to the ED with unrelated medical concerns and 2) a subgroup of adolescents who may be at highly elevated risk for suicide due to the combination of depression, alcohol abuse, suicidality, and impulsivity.

CE FEATURE: The Effect of Positive Adolescent Life Skills Training on Long Term Outcomes for High-Risk Teens

This paper reports on long term follow-up data-12 months post intervention-from a clinical trial of an intervention designed to enhance teen resilience by supporting the development of social skills needed to make positive connections and overcome the influence of negative environmental influences. Sixteen adolescents aged 12 to 16 (10 boys and 6 girls) attending an inner city urban secondary school participated in a 32 week intervention study. Subjects were randomly assigned within sex to Teen Club plus Positive Adolescent Life Skills (PALS) or Teen Club intervention groups. The Problem Oriented Screening Instrument for Teenagers (POSIT) was used to measure the dependent variables (problems related to substance use, health, mental health, family relations, peer relations, education status, vocational status, social skills, leisure and recreation, and aggression). The small sample size limited the ability to determine statistical differences between the POSIT subscale scores for PALS plus Teen Club or Teen Club only interventions. Descriptive data suggest mixed results for both interventions and sex groups. Most important were reductions in mental health problems for all boys in both groups and only slightly increased numbers of problems in substance use for PALS boys and girls over time. Other trends by group and sex are reported.

The Substances and Choices Scale (SACS) - the development and testing of a new alcohol and other drug screening and outcome measurement instrument for young people

To describe the development and evaluation of the Substances and Choices Scale (SACS), an adolescent alcohol and other drug (AOD) self-report instrument designed in a similar format to the Strengths and Difficulties Questionnaire (SDQ). A literature review, extensive consultation and discriminant analysis on a pilot sample (n = 61) of adolescents informed the development of the SACS. The psychometric properties of the SACS were then tested in a larger community and clinical sample. Three youth out-patient AOD treatment services and three secondary schools in Auckland, New Zealand. 13-18-year-old males and females attending the services (n = 120) or schools (n = 531). The SACS was administered with the CRAFFT, the Problem Oriented Screening Instrument for Teenagers (POSIT) and the Strengths and Difficulties Questionnaire (SDQ). Reliability of the SACS was sound, with coefficient alpha 0.91 and 3-week test-retest correlation 0.88. Congruent validity coefficients of the SACS versus the CRAFFT and the POSIT were 0.79 and 0.91, respectively. A ROC curve demonstrated the SACS as having a predictive value of 92%. Repeat SACS scores in a treatment sample indicated that the SACS had utility in measuring change. Feedback from participants indicated that the SACS was highly acceptable. The SACS is a simple AOD instrument that is reliable, valid and acceptable to young people. It has utility in screening and measuring outcome and should enhance the identification and treatment of AOD difficulties in adolescents across a range of health settings.

Validation of the CAST, a general population Cannabis Abuse Screening Test

Background: Although the use of cannabis among young people has become a major public health concern, there is no such test in France for general population surveys.Objective: This article aims to present a short screening test for cannabis abuse among adolescents and young adults in general population surveys, the CAST (Cannabis Abuse Screening Test) designed at the French Monitoring Center for Drug and Drug addictions (OFDT).Methods: The survey was conducted in France among 1728 scholars aged 14–22, in secondary schools, high schools, and university. After presenting internal consistency and factorial structure, the authors compared the CAST with the part of the POSIT (Problem‐Oriented Screening Instrument for Teenagers) dealing with alcohol and drug abuse among cannabis users in order to validate the optimal thresholds of the CAST for the high risk of abuse defined for the POSIT.Results: The CAST appears to be unidimensional and have high internal consistency (Cronbach's alpha equals 0.81). Among cannabis users whoa are low alcohol consumers, CAST presents very high sensitivity and specificity compared with the POSIT (respectively, 93 and 81%).Conclusions: The CAST seems to be an efficient tool in order to screen for cannabis use disorders among adolescents and young adults. Further research is needed to confirm this result.

Positive Adolescent Life Skills Training for High-Risk Teens: Results of a Group Intervention Study

This study tested the addition of a cognitive-behavioral skill-building component called Positive Adolescent Life Skills (PALS) training to an existing intervention for urban adolescents to enhance resiliency. In previous pilot work with the existing intervention, called "Teen Club," it was found that participants in group meetings and intensive case management reported an enhanced ability to connect with positive resources. Sixteen adolescents aged 12 to 16 years (10 boys and 6 girls) attending an urban secondary school were randomly assigned to Teen Club or Teen Club plus PALS. Boys and girls met separately in one of the two conditions for 30 weeks. The Problem-Oriented Screening Instrument for Teenagers (POSIT) subscale scores were measured at baseline and at the completion of the program. The sample consisted of 11 Black and five Hispanic teens. Between-group differences in the POSIT subscale scores were not significantly different in this small sample. Group interviews conducted at the conclusion of the intervention revealed that participants found the PALS intervention to be relevant and useful. Results suggest that the PALS component strengthened the existing intervention and lend preliminary support for the continuation of this combination of interventions. Future research with larger numbers is needed.

Psychosocial profiles of older adolescent MDMA users

Purpose: Using a case-control design, patterns of drug use, psychological symptoms, and behavioral characteristics associated with 3,4-methylenedioxymethamphetamine (MDMA ) use were surveyed in a sample of older adolescents (median age 20). Methods: One hundred (42 MDMA users; 58 non-MDMA users) older adolescents were recruited using the “snowball” technique and interviewed regarding their use of MDMA and other drugs. The Brief Symptom Inventory (BSI), the Problem Oriented Screening Instrument for Teenagers (POSIT), the HIV/sexually transmitted diseases (STD) risk scale, and the Childhood Trauma Questionnaire (CTQ) were also administered. Results: MDMA users were more likely to use other substances, endorse more symptoms of psychological distress, and had more problems in functional lifestyle areas. They also reported more childhood experiences of physical abuse, emotional neglect, and physical neglect than non-MDMA users. MDMA users also reported more sexually risky behaviors. Conclusions: Occasional MDMA use among older adolescents was associated with polydrug use, multiple social difficulties, psychological symptoms, and health risk behaviors. Further research is warranted to understand the long term psychosocial consequences of chronic MDMA and polydrug usage.

The CRAFFT test was accurate for screening for substance abuse among adolescent clinic patients

(2002) Arch Pediatr Adolesc Med 156, 607. Knight JR, Sherritt L, Shrier LA, et al. . Validity of the CRAFFT substance abuse screening test among adolescent clinic patients. . ;...

Development and Validation of a POSIT-Short Form: Screening for Problem Behaviors Among Adolescents at Risk for Substance Use

ABSTRACT The Problem-Oriented Screening Instrument for Teenagers (POSIT) screens for multiple problems among adolescents at risk for substance use. To provide cost-efficient intake procedures, a shortened version of the POSIT was developed, using factor analysis, correlational and reliability analyses, based on full version POSITs of youth entering the Kansas juvenile justice system (n = 3,464). A short form with 64 items across eight scales showed good reliability, and scales were consistent with the full-length POSIT. Moderate correlations with criterion measures were obtained for the POSIT-Short Form scales except the Vocational Status scale, using the original POSIT validation sample (n = 346). The POSIT-SF shows potential for a reliable and cost-efficient screen for youth with substance abuse problems.

Use of the POSIT Among Arrested Youths Entering a Juvenile Assessment Center: A Replication and Update

ABSTRACT The Problem Oriented Screening Instrument for Teenagers (POSIT) is a key aspect of the preliminary screening activities at the Hillsborough County Juvenile Assessment Center. We report the results of the third in a series of studies examining the test-retest reliability of the POSIT, involving an examination of the relationships between the youths' initial and second admission POSIT results for different time intervals between administration of the instrument. Comparisons are also made in POSIT scores for youths with different sociodemographic characteristics. Further, logistic regression analyses involving various predictors of involvement in mental health or substance abuse treatment are reported. The results continue to document the usefulness of the POSIT as a preliminary screening tool.

Factors associated with aggressive and delinquent behaviors among patients attending an adolescent medicine clinic

The purpose of this study was to examine the associations among delinquency/aggressiveness and alcohol or drug use, sexual risk behaviors, and other scales from the Problem-Oriented Screening Instrument for Teenagers (POSIT). A total of 173 15- to 18-year-olds attending adolescent medicine clinic completed a 183-item questionnaire. The questionnaire contained the POSIT, the CAGE questions, a 22-item alcohol and drug screen (AOD), and a human immunodeficiency virus and sexual risk behavior screen. The dependent variable was the Aggressive Behavior/Delinquency (ABD) scale from the POSIT. There were no gender or racial differences in the ABD scale (p > 0.05). The ABD scale was significantly (p < or = 0.001) associated with the POSIT AOD scale (r = 0.46), the 22-item AOD drug screen (r = 0.57), the CAGE questions (r = 0.39), the sexual risk behavior scale (r = 0.39), and the POSIT physical health (r = 0.34), mental health (r = 0.51), family relations status (r = 0.37), peer relations (r = 0.57), educational status (r = 0.44), social skills (r = 0.31), and leisure/recreation (r = 0.16) scales. Multiple regression analysis indicated that the AOD screen and problems in the area of peer relations, family relations, and mental health accounted for 47.7% of the variation in the ABD scale (p < or = 0.00001). These findings suggest that adolescents who engage in more aggressive and delinquent behaviors are more likely to use alcohol and other drugs, engage in sexual risk behaviors, report problems with peer and family relationships, and report more mental health symptoms.