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Instrument: AUDIT Self-Report version

Description:

The Alcohol Use Disorders Identification Test (AUDIT) is an alcohol screening instrument, this version of which is prepared for patient self-reporting. The AUDIT questionnaire is a 10-item alcohol screen that helps identify persons who are hazardous drinkers or have active alcohol use disorders (including alcohol abuse or dependence).

The Alcohol Use Disorders Identification Test was developed by the World Health Organization in 1989; the 2nd edition manual published in 2001 is available electronically (http://www.who.int/substance_abuse/publications/en/). All rights are reserved by the World Health Organization, but the document may be freely reviewed, abstracted, reproduced, and translated.

Instrument Usage:

Clinical Research

References:

Bradley KA, Bush KR, Epler AJ, et al (2003). Two brief alcohol-screening tests From the Alcohol Use Disorders Identification Test (AUDIT): Validation in a female Veterans Affairs patient population. Arch Intern Med. 163:821-9.

Sample Form:

Attachment	Size
AUDIT-SelfReport_v1.0_2014May20.pdf	22.92 KB

Module	Module ID
AUDIT	4178727

Associated Module

1. AUDIT

Module #1 - AUDIT

1. How often do you have a drink containing alcohol?

Never (Never)

Monthly or less (Monthly or less)

2 to 4 times a month (Two To Four Instance Per Month)

2 to 3 times a week (Two To Three Instance Per Week)

4 or more times a week (Four Or Greater Than Integer::4 Instance Per Week)

2. How many drinks containing alcohol do you have on a typical day when you are drinking?

1 or 2 (1 or 2)

3 to 4 (3 to 4)

5 to 6 (5 to 6)

7 to 9 (7 to 9)

10 or more (10 or more)

3. How often do you have six or more drinks on one occasion?

Never (Never)

Less than monthly (Less Than Monthly)

Monthly (Monthly)

Weekly (Weekly)

Daily or almost daily (Daily)

4. How often during the last year have you found that you were not able to stop drinking once you had started?

Never (Never)

Less than monthly (Less Than Monthly)

Monthly (Monthly)

Weekly (Weekly)

Daily or almost daily (Daily)

5. How often during the last year have you failed to do what was normally expected of you because of drinking?

Never (Never)

Less than monthly (Less Than Monthly)

Monthly (Monthly)

Weekly (Weekly)

Daily or almost daily (Daily)

6. How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session?

Never (Never)

Less than monthly (Less Than Monthly)

Monthly (Monthly)

Weekly (Weekly)

Daily or almost daily (Daily)

7. How often during the last year have you had a feeling of guilt or remorse after drinking?

Never (Never)

Less than monthly (Less Than Monthly)

Monthly (Monthly)

Weekly (Weekly)

Daily or almost daily (Daily)

8. How often during the last year have you been unable to remember what happened the night before because of your drinking?

Never (Never)

Less than monthly (Less Than Monthly)

Monthly (Monthly)

Weekly (Weekly)

Daily or almost daily (Daily)

9. Have you or someone else been injured because of your drinking?

No (No)

Yes, but not in the last year (Yes, but not in the last year)

Yes, during the last year (Yes, during the last year)

10. Has a relative, friend, doctor or other health care worker been concerned about your drinking or suggested you cut down?

No (No)

Yes, but not in the last year (Yes, but not in the last year)

Yes, during the last year (Yes, during the last year)