Validation of the AUDIT scale and factors associated with alcohol use disorder in adolescents: results of a national Lebanese study

Abstract

Background This study objective was to evaluate the prevalence as well as factors (smoking, internet addiction, social phobia, depression, child abuse and bullying) associated with alcohol use disorder among a representative sample of Lebanese young people, in addition to validating and confirming psychometric properties of the AUDIT scale. Methods A cross-sectional study, conducted between January and May 2019, enrolled 1810 adolescents aged between 14 and 17. Alcohol dependence was defined as a high AUDIT score. A principal component analysis technique to confirm the validity of the construct of the AUDIT scale score was done and a confirmatory analysis to assess the structure of the instrument was conducted. Results The mean AUDIT score was 6.46 ± 8.44 and high risk of hazardous alcohol drinking was found in 28% of adolescents. One factor solution of the AUDIT scale had been found after running the factor analysis and the confirmatory factor analysis demonstrated that the χ2/df=2.4, the Steiger-Lind RMSEA was 0.10 [0.084-0.155] and the Joreskog GFI equaled 0.91 and AGFI equaled 0.92. Higher cigarette (Beta=0.372) and waterpipe (Beta=0.319) dependence, higher child sexual (Beta=0.581) and neglect (Beta=0.106) abuse, higher internet addiction (Beta=0.088), separated parents compared to living together (Beta=3.202) and higher bullying victimization (Beta=0.143) were significantly associated with higher AUDIT scores. Conclusion Alcohol dependence seems to be influenced by several risk factors among the Lebanese adolescents such as cigarette and waterpipe dependence, higher internet addiction, bullying, and child sexual and neglect abuse. Parents and healthcare professionals could use this data to influence intervention efforts.

Drunkorexia behaviors and motives, eating attitudes and mental health in Lebanese alcohol drinkers: a path analysis model

“…While some countries have briefly studied the association between drunkorexia with disordered eating and problematic substance abuse [26], other countries, one of which is Lebanon-a middle-income country-have yet to approach investigating this association. Specifically, a previous study conducted in Lebanon concluded that around 28% of the adolescents are at risk of alcohol use disorder, and higher alcohol use disorder was significantly associated with higher cigarette and waterpipe smoking and bullying [27]. Furthermore, higher disordered eating attitudes and higher difficulties in emotion regulation are significantly associated with more drunkorexia motives among Lebanese adults [14].…”

Association between parental separation and addictions in adolescents: results of a National Lebanese Study

“…Out of 2000 questionnaires distributed, 1810 (90.5%) were completed and collected back. The methodology used in this study is similar to that of previous publications [32][33][34].…”

“…The 10-item self-reported version of the AUDIT, validated in Lebanon [33], was used in this study to assess alcohol use, drinking patterns, and alcohol-related issues [37]. Hazardous Alcohol Disorder (HAD) is considered when the patients score 8 or more (Cronbach's alpha = 0.960).…”

Portuguese Validated Versions of the Alcohol Use Disorders Identification Test: A Systematic Review Protocol

“…13 Several studies focusing on the validity and performance characteristics of the AUDIT for different populations have been published, showing acceptable validity and reliability across a wide range of settings. [16][17][18][19][20][21] To our knowledge, only one such study was conducted in Portugal, in which Roque da Cunha used translation and back-translation to obtain a valid Portuguese language version of the AUDIT questionnaire. 23 Based on this study, the AUDIT was included in the Portuguese national guidelines for 'Early Detection and Brief Intervention in Alcohol Consumption' as the recommended tool to screening for at-risk drinkers.…”

“…For instance, not determining the best cut-off points may increase the number of low-risk drinkers classified as high-risk drinkers (false positives); conversely, and potentially more problematic, it may also increase the number of high-risk drinkers that are classified as low-risk drinkers (false negatives) and to whom counselling is not, therefore, offered. A number of systematic reviews focused on the AUDIT's validity have been published, [19][20][21][22][23] but none included Portuguese data that could answer the above-mentioned limitations. 24 A systematic review focused on Portuguese versions of the AUDIT is, therefore, needed to strengthen the recommendation to use the AUDIT as a screening tool for at-risk drinkers in Portugal, which could contribute to its more widespread use in clinical practice.…”