the adolescent drinking index notes

Introduction:

            The ADI is a 24-item scale that measures the severity of adolescent drinking problem. The ADI measures severity by including both the number of different areas in which an adolescent has had alcohol-related problems and the intensity of the problem in these areas.

Why Adolescent?

            As in adolescent’s developmental stage, they involve dramatic changes related to physical maturation, shifting family and peer group relationship and sexual identity issues. So, they frequently use alcohol to help them to manage certain developmental issues.

Domains:

            ADI items were selected to represent four domains of problem drinking indicators identified as;

·         Loss of control of drinking.

·         Social indicators

·         Psychological indicators

·         Physical indicators

Factors:

There are some factors contributing to drinking problems.

§  Family drinking patterns as predictors of genetic risk and social learning opportunities.

§  Sociocultural variations in alcohol consumption and peer group drinking pattern.

§  Psychological variations in alcohol expectancies and reasons for drinking.

 

Sub Scales:

·         Self-Medicated drinking(MED)

·         Aggressive Rebellious behavior(REB)

Self-Medicated drinking(MED):

            It is an indicator of drinking to alter mood. This pattern is characterized by drinking to cope with negative feelings or to achieve positive mood states. In the first 10 items of ADI, the MED subscale consists of items 2, 3, 6 and 7. The response options of first 10 items include like me a lot, like me some and Not like me at all.

Aggressive Rebellious behavior(REB):

            It is an indicator of aggressive, rebellious behavior related to drinking. This pattern is characterized by fighting with others and exhibiting delinquent behavior while drinking. The next 14 items (items 11-24) of ADI, the REB subscale consists of items 12, 15, 16, 18, 19, 21 and 24. The response options of last 14 items are Never, Only once, 2-3 times, 4 or more times.

Summary of Scale Construction:

Initially, 40 item ADI scale was introduced. In the item pool, 16 items were deleted. Now 24 item scales with two subscales; a 4 item MED and 7 item REB subscales are used.

Advantages

·         ADI can be easily administered in a wide variety of settings.

·         Studies support the accuracy, reliability, and validity of ADI.

·         It requires a minimal investment of time on staff and client.

Disadvantages

·         It is also a self-report instrument so, there is a risk that adolescent may conceal their drinking problems and provide answers they deem to be socially acceptable.

·         The 24 items can’t represent all possible drinking problems and all the situations in which alcohol problems manifest.

 Mode of Administration

·         The ADI can be administered either in individual or group situations.

·         That administered should be accomplished in a relatively quite setting free from distractions.

·         Sufficient privacy should be provided so that the adolescent’s answers cannot seen by others.

·         The ADI can also be administered orally. For oral administration, a private location and more time are required.

   Instructions

                        Adolescents being tested should be told that the ADI is a short checklist that will help identify whether drinking is causing problem for them. The adolescent should be instructed to answer all items as accurately as possible, choosing the one that best describes them. If an item has been skipped, the adolescent should be told that it is necessary to answer all items.

Scoring

The ADI total score is obtained by summing the item scores for all 24 items. Item scores range from 0 to 2 for items 1-10 and from 0 to 3 for items 11-24. The range of possible ADI total scores is 0 to 62. Al least 22 of the 24 items must be completed in order to consider an ADI as valid. In case where one or two items are left blank, an estimated ADI total score can be obtained by prorating (ADI obtained score x 24/the number of items completed).

The MED and REB subscale scores are obtained by summing the items scores for item marked MED (items 2,3,6 and 7) and REB (items 12,15,16,18,19,21 and 24) respectively.

The ADI scores may be entered in the scoring grid on the second page of the booklet. The scoring grid provides optional space for entry of percentile scores based on comparisons with three normative samples adolescents in school (Appendix A), adolescent referred for psychological evaluation (Appendix B), and adolescents in treatment for substance abuse (Appendix C). Percentile score equivalents for ADI total, MED, and REB scores are provided for these three normative samples in Appendices A, B and C respectively according to age and sex.

Interpretation:

            The ADI is a screening instrument that is best served by using a cutoff score, against which the ADI total score is compared. The cutoff score is 15. If the adolescent’s score is above the cutoff score, should be considered for further evaluation and possible treatment.

Reliability:

            Internal consistency reliability across adolescent samples are uniformly high, exceeding .90. The test-retest reliability of ADI is .78.

Correlation:

 The cutoff score has an 82% accuracy rate, and the ADI correlates .60 to .63 with the Michigan Alcoholism Screening Test (MAST).