Screening for Alcohol and Other Drug Problems

using the
Adolescent Alcohol and Drug Involvement Scale (AADIS)
D. Paul Moberg
Center for Health Policy and Program Evaluation
University of Wisconsin--Madison
May 2003 (Revised November 2005)
1. Background:
The AADIS is a revised tool based on Mayer and Filsteads (1979; see also Moberg, 1983)
Adolescent Alcohol Involvement Scale (AAIS) and Mobergs drug-specific adaptation of the
AAIS, the ADIS (Moberg and Hahn, 1991). The tool has recently been validated with juveniles
in state juvenile correctional institutions (JCIs) in Wisconsin. The validation project used the
Adolescent Diagnostic Interview-Light (ADI-L) which operationalizes DSM IV substance
disorder criteria as the gold standard (Winters, Latimer and Stinchfield, 1999; Winters and
Henly, 1993), and was conducted under the direction of Dr. Winters.
The information below covers the interview version of the tool tested in juvenile correctional
settings where reading level, attention span and compliance rule out using the paper and pencil
version of the tool. A self-administered paper and pencil version has also been developed for use
where appropriate, such as in group survey situations or with compliant adolescents. The survey
version has not been validated.
The original AAIS was developed and validated as an operational definition of adolescent
alcohol involvement in the mid-1970's in the Chicago area (Mayer and Filstead, 1979). The
tool reflected expert opinion on symptoms, problems and consequences of alcohol use, and on
the appropriate weighting of the items. While it incorporated many of the DSM symptoms
recognized at the time, the tool was not intended to be an operationalization of the diagnostic
criteria. There are several problems with the tool, in particular the lack of age-specific norms,
limited socio-economic and racial distributions in normative samples, and lack of a clear gold
standard for validity assessment and cut-points.
In 1979-80, the AAIS was used in a large telephone screening study of youth in Dane County,
WI and further validated as a useful screening tool for research applications (Moberg, 1983).
During the mid-1980's, the ADIS (Adolescent Drug Involvement Scale) was developed for use in
a two-county study of adolescents in substance abuse intervention and treatment programs in
Wisconsin (Moberg and Hahn, 1991, Moberg, 1985). Independently, another research group
developed a similar tool at about the same time (Wisniewski, Glenwick and Graham, 1985).
The ADIS was promulgated as a brief measure of the level of drug involvement in adolescents

for use as a research and evaluation tool. There is limited but promising data on validity, based
on samples of midwestern white adolescents already referred to intervention and treatment
programs; the gold standard in these studies was inadequate.
Since then, there has been little further development or testing of either tool, but both have been
listed in a number of manuals and reviews of adolescent screening and assessment tools, and
have been found useful in a number of settings. There has been widespread interest in both
tools; the ADIS continues to be requested around the country.
During the 1980s, both tools (AAIS, ADIS) were implemented as the standard AODA screening
tools in Wisconsin Juvenile Correctional Institutions (JCIs), and were used until they were
replaced by the AADIS in 2001. The screening is done during intake assessment, implemented
in an interview format. The original tools were structured as paper and pencil surveys.
The AADIS, the next iteration of these tools, was tested in a 2001 study (Winters et al., 2001). It
has several advantages over the existing tools:
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It combines alcohol and drug questions to simplify administration and reduce repetition
of item content.
Combining alcohol and drug items (conjoint screening) also overcomes the
differential social and legal stigmatization of drugs relative to alcohol, potentially
reducing the false negative rate of a drug only screen.
It incorporates an initial drug use grid to establish alcohol or drug use prior to the
questions related to consequences of use. (The grid had been included as optional
at the end of the old ADIS.) This grid is not scored.
It corrects and updates terminology (e.g., rock, weed) from prior versions.
It preserves the scoring structure of the original scales.

2. Purpose of AADIS
The Adolescent Alcohol and Drug Involvement Scale was designed to provide a short screen
which determines the need for a full assessment of an adolescents use of alcohol and other
drugs. Higher scale scores represent higher levels of alcohol and/or drug involvement. The
AADIS is intended as a research instrument and/or a screening tool; it has not been validated as a
diagnostic clinical measure. Positive results when used for screening should be followed with an
independent clinical assessment process.
3. Administration of the AADIS as an Interview
Since the tool is being used as a screening interview, it should be introduced as a way to learn
more about the youths history and concerns in order to assure that appropriate help and services
are provided.
For Part A (Drug Use History), I have found the best data occurs when you first ask the youth if
he or she has ever tried the substance in question, then probe about frequency for each substance
ever used. This should be done in a matter of fact manner, without surprise based on positive

self reports of use. Categories of drugs should be expressed in terms of your knowledge of the
youths subcultural vernacular--e.g., talk about rock, NOT crack, with African American
youth from the Midwest. Some of the terms are provided in parentheses, feel free to substitute
other names as appropriate. If the use pattern is unclear, work with the youth to circle the
category that is closest to his or her regular pattern. For drugs not listed that dont fit another
category, write them in under OTHER DRUG_______.
While tobacco is listed on the use grid, it is NOT to be considered as a drug of abuse when
asking the questions under part B. However, if the young person admits to regular tobacco use,
it is statistically highly likely that she or he also uses other drugs (at least alcohol, likely
marijuana). Thus the tobacco use pattern should give the screener a clue as to how hard to probe
if alcohol/other drug use is denied.
For Part B, ask each question as written and see what answers are volunteered before reading the
answers as written. After hearing the responses from the youth, circle the answers that are
closest to the response, and confirm that the answers meet the responses intended by the youth.
Probe and read the remaining answers to see if any of the other answers also apply. For
most of the items, circle ALL answers that are true for the youth. Items 1, 2, 6, and 9 can have
only one answer; all others may have several answers circled.
If the youth denies any use in questions 1 and 2, and this is consistent with Part A, the screening
is done. However, the screener should be satisfied that she/he has probed sufficiently and that
there really is no use, or that the youth is steadfastly in a denial mode which is unlikely to change
on this occasion. Screeners have indicated that they find it useful to ask all questions when there
is a suspicious denial.
If inconsistencies between answers are apparent, ask the youth to clarify. You can say
something like: On an earlier question you said you only tried alcohol once in your life, but
now you are saying you drink 10 or more drinks when you do drink. This doesnt seem
consistent.
These instructions should be modified to fit the circumstances if using the survey version of the
tool.
4. Scoring Procedures
After completing the screening interview, please score the AADIS by adding the weights on
items B.1-14. Complete the face page and add any comments on the youths responses. The
screener may decide to recommend a full assessment in spite of the AADIS score; if so, indicate
why in the comments section.
Add the weights to the highest positive answer to each item in section B.. Each item B.1 to
14 is given only one weight in the scoring. The interview version includes the weights
[numbers in square brackets] on the instrument itself. Use these same weights for the survey
(self completed) version. The drug use grid is not scored, but serves as an introductory section to
establish the pattern of use before determining the consequences and problems related to use.

One purpose of the research project was to assess the validity of the scoring process. The cut
point has been adjusted after early data analysis. We may also develop a weighting system for
the drug use grid, currently not included in the scoring.
The results from the validation study indicate the cutoff score of 37 on the AADIS is best in
terms of sensitivity and specificity for DSM-IV substance use disorders. Any youth scoring
37 or higher should be fully assessed for substance use disorders using a standard clinical
assessment.
AADIS Score Interpretation:
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0
= No alcohol or other drug use
1-36 = Alcohol and/or other drug use present, does not reach threshold for
substance use disorder based on DSM-IV criteria. (Screener may find clinical
cause to over-ride negative finding.)
37 or higher = Alcohol and/or other drug use present which may reach DSM IV
criteria; full assessment is indicated.

Contacts:
Feedback on the tool will be appreciated. Contact me by phone, letter or email:
D. Paul Moberg, Ph.D.
UW Population health Institute
University of Wisconsin--Madison
610 Walnut Street Suite 760
Madison, WI 53726-2397
(608) 263-1304
[email protected]
The original AAIS remains under copyright. Information is available from:
William J. Filstead
AAIS Project
819 W. Fairview Street
Arlington Heights, Illinois 60005
847.632.1926 fax 847.632.1927 e-mail [email protected]

References
Mayer, J.E. and Filstead, W.J. (1979). The Adolescent Alcohol Involvement Scale: An
instrument for measuring adolescents use and misuse of alcohol. Journal of Studies on
Alcohol 40:291-300.
Moberg, D. P. (1983). Identifying adolescents with alcohol problems: A field test of the
Adolescent Alcohol Involvement Scale. Journal of Studies on Alcohol 44:701-721.
Moberg, D.P. (1985). The Social Control of Deviance: Intervention with Adolescent Alcohol and
Other Drug Users. Unpublished Ph.D. Dissertation, University of Wisconsin-Madison.

Moberg, DP and Hahn, L. (1991). The adolescent drug involvement scale. Journal of Adolescent
Chemical Dependency 2(1):75-88.
Note: This journal has been renamed Journal of Child and Adolescent Substance
Abuse
Winters, K.C., Latimer, W., and Stinchfield, R. (1999). The DSM-IV criteria for adolescent
alcohol and cannabis use disorders. Journal of Studies on Alcohol 60:337-344.
Winters, K.C. and Henly, G.A. (1993). Adolescent Diagnostic Interview Schedule and Manual.
Los Angeles: Western Psychological Services.
Wisniewski, N.M., Glenwick, D.S., and Graham, J. R. (1985). MacAndrew scale and
sociodemographic correlates of adolescent alcohol and drug use. Addictive Behaviors
10: 55-67.
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