Validation of CRAFFT for Use in Youth Correctional Institutions in Lagos, Nigeria

J Am Acad Psychiatry Law. 2017 Dec;45(4):439-446.


Substance-related disorders (SRD) are common psychiatric morbidities among adolescents within youth correctional systems. Identification and treatment of SRDs is critical for successful reformation and reintegration. Lack of simple, structured, valid, brief screening instruments that can be easily administered and scored by lay workers militates against screening for SRDs. We present the results of the reliability and concurrent validity of the CRAFFT (acronym for Car, Relax, Alone, Forget, Friends, and Trouble) substance abuse screening instrument among residents of youth correctional facilities in Lagos, Nigeria. Adolescents who screened positive on CRAFFT were further assessed with the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) to determine whether they met diagnostic criteria for SRDs. The mean CRAFFT scores for all the adolescents (n = 178) was 0.66 (SD ± 1.45). A total of 23 (12.9%) had CRAFFT scores of >1.00. The CRAFFT instrument has good internal consistency (Cronbach's α = 0.85) and 2-week test reliability (Spearman correlation = 0.979; p < .001). At a cutoff point of >1.00, CRAFFT had the best sensitivity and specificity (area under the curve = 0.889; 95% confidence interval 0.765-1.000) among the participants. As validated, the CRAFFT is a reliable instrument for screening for SRDs in incarcerated youth.

Publication types

  • Validation Study

MeSH terms

  • Adolescent
  • Alcoholism / diagnosis
  • Female
  • Humans
  • Juvenile Delinquency*
  • Male
  • Nigeria
  • Prisoners
  • Reproducibility of Results
  • Substance Abuse Detection / standards*
  • Substance-Related Disorders / diagnosis*
  • Surveys and Questionnaires / standards*