Adolescent substance-use assessment: methodological issues in the use of the ADAD (Adolescent Drug Abuse Diagnosis)

Reliability and construct validity of five life domains in the adolescent drug abuse diagnosis instrument in a sample of Swedish adolescent girls in special residential care

Aim:

This cross-sectional study investigates the psychometric properties of the Swedish edition of the Adolescent Drug Abuse Diagnosis (ADAD), and specifically examines the internal consistency and construct validity of five life domains reported by female adolescents in special residential care in Sweden (N = 780; M_age = 16 years old).

Methods:

Principal component analysis and entropy-based analysis were used to test construct validity.

Conclusion:

Results indicate that ADAD may be able to reliably distinguish between areas that are important targets for intervention.

Risky alcohol use, peer and family relationships and legal involvement in adolescents with antisocial problems

The aim of the study was to examine risk and vulnerability factors contributing to problems with alcohol use in adolescence. Data relating to seven life areas (medical status, school status, social relationships, family background and relationships, psychological functioning, legal involvement, and alcohol use) was gathered using the ADAD (Adolescent Drug Abuse Diagnosis) interview. A total of 1163 Swedish adolescents (809 boys and 354 girls) between the ages of 12 and 20 years old were interviewed. All had antisocial problems and were detained at special youth homes. It was found that for those aged between 12 and 18 years, the general risk factors for alcohol use were leisure and peer problems, problems associated with family background and relationships, and criminal behavior. These results suggest that drug abuse treatment planning should focus on altering the predisposing factors that exist in these domains. It was also found that the ADAD problem areas seem to be most useful as prognostic indicators of treatment outcome for adolescents with antisocial problems who are under 18 years of age.

The adolescent drug abuse diagnosis composite scores in Swedish normal and antisocial adolescents

The present study evaluates the utility and issues around the composite scores in Adolescent Drug Abuse Diagnosis (ADAD). Participants were Swedish normal adolescents (121) and adolescents manifesting antisocial problems (1,168), ages 10 to 21. The results show that the interviewer severity ratings seem to be the most appropriate outcome when the objective is to differentiate between normal and antisocial adolescents. The composite scores appear to function as an indicator of current problems in all areas except for Medical and Alcohol sections. The critical items within the Medical and Alcohol composite scores are explored and discussed.

The psychometric properties of the Swedish version of the Adolescent Drug Abuse Diagnosis (ADAD)

The psychometric properties of the Swedish version of the Adolescent Drug Abuse Diagnosis (ADAD) instrument were evaluated in two adolescent groups. The participants in the Normal group comprised 121 adolescents aged 15-17 years and the participants in the group of adolescents with antisocial problems comprised 1168 youths aged 10-21 years detained under the Swedish Care of Young Persons Act in special youth homes. The ADAD instrument produced good interrater reliability; the subscales showed moderate internal consistency and concept validity was satisfactory and comparable with American and Swiss versions. Finally, the ADAD subscales produced meaningful correlations. The interviewer rating, the adolescent's rating and the composite scores are compared and discussed. The Swedish version of ADAD appears to be a psychometrically good instrument for assessing the severity of adolescent problems and their need for treatment. However, the composite scores need to be reconstructed to be useful in future research.

Adolescent Drug Abuse Diagnosis (ADAD) vs. Health of Nation Outcome Scale for Children and Adolescents (HoNOSCA) in clinical outcome measurement

BACKGROUND

The Adolescent Drug Abuse Diagnosis (ADAD) and Health of Nation Outcome Scales for Children and Adolescents (HoNOSCA) are both measures of outcome for adolescent mental health services.

AIMS

To compare the ADAD with HoNOSCA; to examine their clinical usefulness.

METHODS

Comparison of the ADAD and HoNOSCA outcome measures of 20 adolescents attending a psychiatric day care unit.

RESULTS

ADAD change was positively correlated with HoNOSCA change. HoNOSCA assesses the clinic's day-care programme more positively than the ADAD. The ADAD detects a group for which the mean score remains unchanged whereas HoNOSCA does not.

CONCLUSIONS

A good convergent validity emerges between the two assessment tools. The ADAD allows an evidence-based assessment and generally enables a better subject discrimination than HoNOSCA. HoNOSCA gives a less refined evaluation but is more economic in time and possibly more sensitive to change. Both assessment tools give useful information and enabled the Day-care Unit for Adolescents to rethink the process of care and of outcome, which benefited both the institution and the patients.