Computer adaptive testing of liability to addiction: identifying individuals at risk

Abstract

Background: Employed as a quantitative measure of substance use disorder (SUD) risk, the transmissible liability index (TLI) can be useful for detecting youths requiring prevention intervention. This study was conducted to develop and evaluate a computer adaptive test (CAT) version of the TLI to identifying individuals at risk for SUD.

Methods: In the first sample (N=425) of male and female subjects were recruited under aegis of the Center for Education and Drug Abuse Research in Pittsburgh, PA, USA, having a mean age of 18.8 years. A provisional CAT version of the TLI was assessed using simulation procedures. In sample 2, twins were recruited at the 2010 Twinsburg Festival in Twinsburg, OH, USA. The CAT and paper and pencil (P&P) versions of the TLI were administered to 276 twin pairs having a mean age of 19.94 years.

Results: The simulated CAT version of the TLI predicted cannabis use disorder 2 years after initial study with 4% less accuracy (72% vs. 68%) than P&P version but with 78% reduction of items. In the twin sample, the CAT version predicted alcohol and drug use (OR=1.7 [2.1], p<.001) with 64% and 65% accuracy (sensitivity=75% [75%] and specificity=64% [65%]).

Conclusions: This study demonstrated that the CAT version of the TLI is an accurate and efficient measure of risk for SUD. The CAT version of the TLI potentially affords the opportunity for efficient screening of risk so that timely interventions can be implemented to prevent occurrence of SUDs having frequently lifelong consequences.