Clinical versus psychometrically-based judgments of adolescent alcohol use

Abstract

This study compares clinical versus psychometric judgments of problematic alcohol use by minors and, if present, its degree of use.;The purposes are to determine what factors are related to agreements and disagreements between the two judgments, and, when a minor's alcohol use is judged to be present, what factors relate to a more or less severe clinical judgment.;One hundred and sixty-eight adolescent clients, referred to a central diagnostic and referral service, were administered the Michigan Alcoholism Screening Test (MAST) which provided the psychometrically-based judgment. The score was compared to clinical judgments made by all seven clinicians employed by the diagnostic and referral program.;Factors related to modification of clinical judgment were tested. These factors included characteristics of the client, characteristics of the judge, economic similarity of client and judge, and situational characteristics.;A significant difference between the MAST range-scores and the clinical judgment categories was demonstrated. It was found that the agency priorities were significantly related to number of adolescents diagnosed as problematic alcohol users, and that the status of the clinician in the organization was positively correlated with severity of diagnosis. MAST tended toward extreme diagnoses, non-user or abuser, while the clinicians tended to use the middle range diagnosis. Agreement occurred most often at the extremes, and least often in the middle range.