Sensitivity and specificity of the gain short-screener for predicting substance use disorders in a large national sample of emerging adults

- Uses a large (n = 9808) clinical sample of emerging adults (EAs)
- Uses the Substance Disorder Screener (SDScrY) subscale of the GAIN-Short Screener
- Demonstrates sensitivity and specificity in predicting EA substance use disorders
- Finds equivalent screening cutoffs for emerging adults and other age groups

Background and objectivesEmerging Adults (ages 18-25) have the highest prevalence of substance use disorders and rarely receive treatment from the specialty care system. Thus, it is important to have screening instruments specifically developed for emerging adults for use in Screening, Brief Intervention and Referral to Treatment (SBIRT) models. Optimal cutoffs for the widely-used GAIN Short-Screener's (GAIN-SS) Substance Disorder Screener (SDScrY) are not established specifically for emerging adults. Therefore, this study examined the sensitivity and specificity of the SDScrY in predicting emerging adult (ages 18-25) substance use disorders.MethodsWe analyzed data from emerging adults in a large clinical sample (n = 9,808) who completed both the five-item SDScrY (α = 0.85) and the full criteria set for DSM-IV Substance Use Disorders. We estimated the sensitivity, specificity and area under the curve to determine optimal cutoffs.ResultsAnalyses revealed a high correlation between the SDScrY screener and its longer parent scale (r = 0.95, p < 0.001). Sensitivity (83%) and specificity (95%) were highest at a cutoff score of two (AUC = 94%) on the SDScrY for any past year substance use disorder. Sensitivity (85%) was also high at a cutoff score of two on the SDScrY for any past year alcohol disorder.ConclusionsThe five-item Substance Use Disorder Screener is a sensitive and specific screener for emerging adults, and could be used to identify emerging adults who may benefit from SBIRT interventions.