| Course | PAC 302 Assessment Procedures in Addiction Studies |
|---|---|
| Module | Module 5 |
| Paper type | Instrument selection paper |
| Length | About 1,086 words, 6 pages |
| Format | APA 7 student paper |
| School | Aspen University |
| Program | Psychology and Addiction Studies |
| Updated | October 2026 |
Free sample paper for PAC 302 Module 5
Two Clinics, Three Screens: Choosing Substance Use Screening Instruments by Population, Evidence and Predictive Value
Student Name
Psychology and Addiction Studies Program, Aspen University
PAC 302: Assessment Procedures in Addiction Studies
Instructor Name
Month Day, Year
Two Clinics, Three Screens: Choosing Substance Use Screening Instruments by Population, Evidence and Predictive Value
Lakeview Counseling and Recovery, the Grand Rapids agency invented for these papers, has agreed to provide substance use screening in two new settings. The first is a health clinic inside a public high school that sees about six hundred students aged fourteen to eighteen each year. The second is a partner primary care practice that sees about four thousand adults. In both, screening will be done by nurses or medical assistants in a few minutes during routine visits, and positive screens will be followed by a conversation with a Lakeview counselor. The clinics asked which instruments to use. This paper reviews the evidence and recommends a choice. The clinics and their numbers are invented, though the validation studies are real.
Sensitivity, Specificity and Predictive Values
A screening instrument is judged by how well it separates people who have a problem from people who do not. Sensitivity asks what share of the people who truly have the problem the screen catches. Specificity asks what share of the people without it the screen correctly clears. Both depend on the cutoff: lowering the cutoff catches more true cases but also more false positives. Predictive values answer the questions clinicians actually face. Positive predictive value is the probability that a person who screens positive has the problem, and negative predictive value is the probability that a person who screens negative does not. Unlike sensitivity and specificity, predictive values depend on how common the problem is in the population being screened.
The CRAFFT for Adolescents
Knight et al. (2002) tested the CRAFFT, a six-item screen designed for adolescents, among patients aged fourteen to eighteen at a hospital-based adolescent clinic. The items ask about riding in a car driven by someone who had been using, using to relax, using alone, forgetting things while using, family or friends saying to cut down and getting into trouble while using. Each yes counts one point. Measured against a full diagnostic interview as the standard, a total of two or more picked out adolescents with any substance-related problem with a sensitivity of 0.80 and a specificity of 0.86, and performed even better for identifying a substance use disorder. The CRAFFT was brief, easy to administer and developed for adolescents' patterns of use.
The AUDIT-C for Adults
Bush et al. (1998) evaluated the AUDIT-C, the three consumption questions from the ten-item AUDIT, which cover frequency, usual quantity and how often a person has six or more drinks at a sitting. Among men attending veterans' general medical clinics, those three items detected heavy drinking and alcohol use disorders nearly as accurately as all ten items together. The AUDIT-C takes under a minute and fits easily into a primary care visit, though later studies have recommended lower cutoffs for women than for men.
The DAST for Drug Use
Skinner (1982) developed the Drug Abuse Screening Test, a twenty-eight-item yes or no questionnaire about consequences of drug use other than alcohol, modeled on an earlier alcohol screen. In a sample of people seeking treatment for alcohol and drug problems, it showed high internal consistency and related well to measures of drug use severity. Shorter versions, including a ten-item form, were later developed for use in general medical settings.
Comparing the Instruments
| Instrument | Population validated | Items and time | Cutoff | Fit for Lakeview's clinics |
|---|---|---|---|---|
| CRAFFT | Adolescents 14 to 18 in clinic settings | 6 items; about 2 minutes | 2 or more | School clinic: first choice |
| AUDIT-C | Adults in general medical clinics | 3 items; under 1 minute | Varies by sex; lower for women | Primary care: first choice for alcohol |
| Full AUDIT | Adults in many settings | 10 items; about 3 minutes | 8 or more | Follow-up after a positive AUDIT-C |
| DAST, 10-item form | Adults in medical and treatment settings | 10 items; about 3 minutes | 3 or more suggests further assessment | Primary care: drug use when indicated |
| DAST, 28-item form | Adults seeking treatment | 28 items; about 8 minutes | Longer form for assessment | Too long for routine screening |
How Prevalence Changes a Positive Screen
Suppose ten percent of the school clinic's students have a substance-related problem. Of one hundred students, ten have a problem and ninety do not. With a sensitivity of 0.80, eight of the ten screen positive. With a specificity of 0.86, about seventy-seven of the ninety screen negative, and about thirteen screen positive falsely. Of the roughly twenty-one students who screen positive, only eight have a problem, a positive predictive value of about thirty-eight percent. Of the roughly seventy-nine who screen negative, seventy-seven do not have a problem, a negative predictive value of about ninety-seven percent.
The lesson is central to screening. A negative CRAFFT is highly reassuring, but a positive CRAFFT means that further conversation is needed, not that the student has a disorder. Staff must be trained to say so.
Why Not Screen Everyone With Longer Tools?
Longer instruments, such as the full AUDIT or the twenty-eight-item DAST, give more information, and some staff suggested using them for everyone. The research and the setting argue against it. In a school clinic visit or a primary care appointment, a screen that takes eight minutes will often be skipped, and an unused screen has a sensitivity of zero. Brief screens are designed for this trade-off: they catch most problems quickly and send positive cases on to fuller assessment. The two-step approach, a brief screen for everyone and a longer instrument for those who screen positive, gives the clinics both reach and depth.
A Protocol After the Screen
For a negative screen, the clinician gives brief positive feedback and, for adolescents, encouragement to continue not using. For a positive screen, a Lakeview counselor holds a brief conversation that explores use, gives feedback and, where indicated, offers further assessment or referral. Adults with a positive AUDIT-C complete the full AUDIT, and those reporting drug use complete the ten-item DAST. For adolescents, the protocol explains confidentiality limits at the start of the visit, consistent with state law and clinic policy, so that students know what will and will not be shared with parents.
Conclusion
Lakeview's two clinics need different instruments. Knight and colleagues' validation supports the CRAFFT for adolescents, Bush and colleagues support the AUDIT-C for adults and Skinner's DAST offers a drug screen with a brief form for medical settings. The predictive value example shows that even good screens produce many false positives where problems are uncommon, which is why every positive screen should lead to a conversation and not a label.
References
Bush, K., Kivlahan, D. R., McDonell, M. B., Fihn, S. D., & Bradley, K. A. (1998). The AUDIT alcohol consumption questions (AUDIT-C): An effective brief screening test for problem drinking. Archives of Internal Medicine, 158(16), 1789-1795. https://doi.org/10.1001/archinte.158.16.1789
Knight, J. R., Sherritt, L., Shrier, L. A., Harris, S. K., & Chang, G. (2002). Validity of the CRAFFT substance abuse screening test among adolescent clinic patients. Archives of Pediatrics & Adolescent Medicine, 156(6), 607-614. https://doi.org/10.1001/archpedi.156.6.607
Skinner, H. A. (1982). The drug abuse screening test. Addictive Behaviors, 7(4), 363-371. https://doi.org/10.1016/0306-4603(82)90005-3
Reading the PAC 302 Module 5 assignment instructions
Screening instruments are the fifth module's subject in PAC 302, and assignments typically ask you to select tools for a setting and justify the choice with validation evidence for that population. The governing Module 5 instructions are in your Aspen course; the clinics here are invented. Describe each setting and its population. Define sensitivity, specificity and predictive values, and show how prevalence affects predictive values. Review the evidence for each candidate instrument, including the population it was validated in. Compare instruments on the same criteria. Plan what happens after a positive screen. Cite every validation study in APA 7, and note the cutoff each recommendation depends on. Plan the confidentiality explanation for minors before the first screen is given.
Inside the PAC 302 Module 5 example
The school clinic sees about six hundred students aged fourteen to eighteen a year, and the primary care partner sees four thousand adults. Knight and colleagues' Archives of Pediatrics and Adolescent Medicine study supports the CRAFFT for adolescents. Bush and colleagues' Archives of Internal Medicine study supports the AUDIT-C for adults. Skinner's Addictive Behaviors article introduces the DAST for drug use. A five-row table compares items, time, cutoffs and validation populations. A worked example shows that at ten percent prevalence, a positive CRAFFT is right about four times in ten while a negative is right about ninety-seven times in a hundred. A protocol covers brief intervention, follow-up instruments after a positive screen and how adolescents are told about confidentiality.
Where the marks sit in the PAC 302 Module 5 rubric
Instrument selection papers earn credit for matching instruments to populations, reporting validation evidence accurately and understanding predictive values. This example chooses different screens for adolescents and adults because each was validated in that population. The predictive value calculation shows why a positive screen is a reason for a conversation, not a diagnosis, which is the most practical lesson in screening. The table compares instruments on consistent criteria. The protocol for positive results shows that screening is only useful if something follows, and the paper notes confidentiality rules for adolescents, which a school setting makes essential to plan for in advance. Cutoffs are given for each instrument.
PAC 302 Module 5 help from the desk
Students often choose a well-known instrument without checking whether it was validated for the population in question. Match instruments to age, setting and substances. A second common slip is reading sensitivity as the odds that a positive result is right; that figure is the positive predictive value, and it moves with prevalence. Show the calculation. Report cutoffs and the populations in which they were tested. Compare instruments on the same criteria. Plan what happens after a positive and a negative screen. Address confidentiality, especially with adolescents. Avoid presenting a screen as a diagnosis, and state what follow-up assessment a positive result triggers. Train staff to explain a positive result without alarm.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Aspen University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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- PAC 302 Module 6: Selecting and Administering Tests
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- PAC 302 Module 8: Interpreting and Reporting Results
- PAC 115 Module 4: Digestive and Endocrine Terms
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PAC 302 Module 5 questions, answered
What does PAC 302 Module 5 usually ask for?
Aspen's PAC 302 covers substance use screening instruments here, so selecting tools for a setting and justifying them with validation evidence is typical. Check your Module 5 prompt.
What is the CRAFFT?
A six-item adolescent substance use screen; Knight and colleagues found a score of two or more had good sensitivity and specificity among adolescent clinic patients.
What is the AUDIT-C?
The three consumption questions of the AUDIT; Bush and colleagues found they performed about as well as the full AUDIT in identifying problem drinking.
Where can I find a free PAC 302 Module 5 sample paper?
Find the whole paper above: screening tools chosen for a school clinic and adult primary care, with an instrument table and a predictive value example.
Why does a positive screen not mean a person has a disorder?
Because predictive value depends on prevalence; where a problem is uncommon, many positive screens are false positives even with a good test.