Alcohol Use Disorders Identification Test (AUDIT)

1. Abstract

The Alcohol Use Disorders Identification Test (AUDIT) is a globally recognized, 10-item screening instrument developed under the auspices of the World Health Organization (WHO) to detect hazardous and harmful alcohol consumption as well as active alcohol dependence. Initially constructed through a multi-center collaborative initiative spanning six nations (Australia, Bulgaria, Kenya, Mexico, Norway, and the United States), the AUDIT was engineered to address a pervasive public health deficit: the under-identification of early-stage, sub-diagnostic alcohol-related problems in primary healthcare and general community settings. Unlike earlier diagnostic instruments that focused predominantly on entrenched chronic physiological alcoholism—such as the Michigan Alcoholism Screening Test (MAST) or the CAGE questionnaire—the AUDIT operationalizes a broad conceptual continuum extending from low-risk drinking to hazardous consumption, harmful use, and severe alcohol use disorder (AUD).

The instrument assesses three structurally distinct yet empirically correlated domains across 10 items: Hazardous Alcohol Use (Items 1–3, quantifying frequency, volume, and binge drinking patterns), Dependence Symptoms (Items 4–6, evaluating impaired behavioral control, salience of drinking, and morning eye-openers), and Harmful Alcohol Use (Items 7–10, evaluating guilt/remorse, memory blackouts, alcohol-related physical trauma, and collateral social or clinical concern). Responses are scored using an item-specific metric yielding a cumulative score between 0 and 40. Psychometric evaluations across diverse clinical, occupational, college, and epidemiological populations consistently demonstrate superior performance characteristics. Internal consistency reliability generally ranges from α = 0.80 to 0.94, with test-retest reliability intraclass correlation coefficients (ICC) ranging between 0.83 and 0.98. Receiver Operating Characteristic (ROC) analyses routinely establish area under the curve (AUC) trajectories exceeding 0.90 for detecting DSM-IV and DSM-5 alcohol use disorders, supporting the standard cut-off score of 8 for adult males and 7 for adult females. This comprehensive review synthesizes the theoretical architecture, structural validity, psychometric properties, and administrative nuances of the AUDIT.

2. Keywords

Alcohol Use Disorders Identification Test, AUDIT, World Health Organization, alcohol screening, hazardous drinking, harmful drinking, alcohol dependence, psychometrics, screening brief intervention and referral to treatment, SBIRT

3. Authors

The AUDIT was developed under a major cross-national initiative commissioned by the World Health Organization (WHO). The primary investigative team and collaborating authors who spearheaded the design, international field trials, and psychometric validation include:

• John B. Saunders, M.D., FRACP — Department of Psychiatry, University of Queensland, Brisbane, Australia; previously at the Royal Prince Alfred Hospital and the University of Sydney, Australia.
• Olaf G. Aasland, M.D., Ph.D. — Institute for Health and Society, University of Oslo; previously at the National Institute for Alcohol and Drug Research (SIFA), Oslo, Norway.
• Thomas F. Babor, Ph.D., M.P.H. — Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, Connecticut, United States.
• Juan Ramón de la Fuente, M.D. — National Autonomous University of Mexico (UNAM) and the Mexican Institute of Psychiatry (Instituto Mexicano de Psiquiatría), Mexico City, Mexico.
• Marcus Grant, M.A. — Former Director of the Programme on Substance Abuse, World Health Organization, Geneva, Switzerland.

Inquiries regarding official WHO documentation, public health guidelines, and clinical translation manuals are maintained through the Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland.

4. Purpose

The development of the Alcohol Use Disorders Identification Test was explicitly commissioned to resolve a major epidemiologic and clinical bottleneck: the pervasive failure of healthcare delivery systems to identify individuals with alcohol problems prior to the onset of severe physical morbidity or psychosocial disintegration. Historically, screening methodologies deployed within general clinical environments—most notably the CAGE questionnaire (Ewing, 1984) and the MAST (Selzer, 1971)—were optimized to detect end-stage physiological dependence, social collapse, or severe secondary consequences (e.g., delirium tremens, alcoholic cirrhosis, marital dissolution, or legal sanctions). Consequently, these legacy measures exhibited pronounced insensitivity toward earlier stages of hazardous drinking, wherein individuals routinely consume alcohol at levels placing them at heightened statistical risk of harm, but without yet manifesting formal diagnostic dependence criteria.

The fundamental purpose of the AUDIT is four-fold:

1. Early Identification of At-Risk and Hazardous Drinkers: By capturing both quantity-frequency metrics and episodic high-intensity intoxication (binge drinking), the AUDIT flags patterns of consumption that elevate the absolute risk of adverse health outcomes (e.g., cardiovascular disease, metabolic syndrome, traumatic injury, cancer) before pathological biological dependence develops.
2. Detection of Harmful Use: The scale identifies individuals who are already experiencing tangible alcohol-induced somatic or psychological injury (e.g., post-drinking guilt, blackouts, trauma) but who may not recognize alcohol as the primary etiological factor.
3. Identification of Severe Alcohol Dependence: The AUDIT incorporates behavioral indicators of the alcohol dependence syndrome (e.g., loss of control, morning withdrawal drinking), enabling clinicians to identify candidates who require intensive psychiatric, pharmacological, or specialized addiction treatment.
4. Facilitating Evidence-Based Stepped Care (SBIRT): The AUDIT operates as the foundational screening engine within the Screening, Brief Intervention, and Referral to Treatment (SBIRT) framework. By categorizing respondents into four distinct risk strata (Zones I through IV), it prescribes specific, empirically supported clinical interventions ranging from simple primary care feedback and lifestyle advice to structured brief motivational interviewing and direct referral to tertiary addiction services.

In empirical research, the AUDIT serves as a standardized phenotypic metric for epidemiological surveillance, clinical trials evaluating pharmacotherapies for alcohol use disorder (e.g., naltrexone, acamprosate), health services research, and behavioral health outcome assessments across diverse global health systems.

5. Psychological Construct

The AUDIT conceptualizes alcohol pathology not as a binary, all-or-nothing medical entity, but as a multi-dimensional behavioral spectrum characterized by three interconnected domains: Hazardous Alcohol Use, Dependence Symptoms, and Harmful Alcohol Use. These dimensions correspond directly to public health classifications endorsed by the WHO and mirror structural criteria articulated within the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM).

Subscale 1: Hazardous Alcohol Use (Items 1–3)

Hazardous alcohol consumption is defined by the WHO as a pattern of alcohol intake that increases the consumer's risk of adverse physical, psychological, or social events, without necessarily implying existing pathology. This construct is quantified via consumption phenomenology across three facets:

• Drinking Frequency (Item 1): Assesses the baseline chronological pattern of alcohol intake, capturing regular daily or weekly engagement.
• Typical Consumption Volume (Item 2): Quantifies the typical daily dose of pure ethanol on drinking days, allowing calculation of standard drink units.
• Heavy Episodic Drinking (Item 3): Captures episodic acute intoxication (≥6 standard drinks in a single sitting). This behavioral pattern induces rapid spikes in blood alcohol concentration (BAC), leading to executive dysfunction, impaired psychomotor coordination, risk-taking behaviors, and acute toxicological stress.

Subscale 2: Dependence Symptoms (Items 4–6)

This subscale operationalizes the cognitive, behavioral, and physiological features of the Alcohol Dependence Syndrome, a construct originally formulated by Edwards and Gross (1976). Rather than emphasizing late-stage physiological sequelae alone, this construct captures the progressive behavioral reorganization around ethanol consumption:

• Impaired Control over Drinking (Item 4): Reflects the cognitive inability to arrest or regulate alcohol intake once initiated, reflecting frontostriatal dysregulation in executive control circuits.
• Increased Salience and Failure of Obligation (Item 5): Measures the behavioral prioritization of alcohol consumption over standard social, familial, or occupational roles, signaling motivational narrowing.
• Physiological Reliance / Morning Eye-Opener (Item 6): Assesses the need to consume alcohol upon awakening to terminate or prevent tremors, autonomic hyperactivity, or acute withdrawal dysphoria, reflecting neuroadaptive homeostatic dysregulation (allostasis).

Subscale 3: Harmful Alcohol Use (Items 7–10)

Harmful alcohol use describes consumption that has already resulted in demonstrable adverse somatic, psychological, or interpersonal consequences, fulfilling ICD definitions of alcohol-related damage:

• Psychological Repercussions / Post-Drinking Guilt (Item 7): Evaluates emotional distress, moral remorse, and cognitive dissonance occurring subsequent to drinking episodes.
• Neurocognitive Impairment / Alcohol-Induced Amnesia (Item 8): Quantifies anterograde blackout phenomena, where acute alcohol-induced inhibition of hippocampal NMDA receptor function impairs long-term memory consolidation while leaving short-term consciousness intact.
• Physical Trauma and Adverse Somatic Events (Item 9): Assesses alcohol-involved physical injuries sustained by the respondent or collateral individuals (e.g., motor vehicle collisions, falls, interpersonal violence).
• Interpersonal Concern and Social Pressure (Item 10): Captures collateral awareness of the individual's dysregulated intake, indicated by concern, confrontation, or advice from family members, peers, physicians, or allied healthcare professionals.

6. Theoretical Framework

The AUDIT is theoretically grounded in the convergence of two major paradigm shifts within addiction medicine and public health epidemiology during the late 20th century: the Alcohol Dependence Syndrome concept (Edwards & Gross, 1976) and Rose's Prevention Paradox in population-level epidemiology (Rose, 1981).

The Alcohol Dependence Syndrome

Prior to the work of Griffith Edwards and Milton M. Gross, psychiatric medicine conceptualized alcoholism primarily through a moralistic or rigid categorical disease model. In their seminal 1976 formulation, Edwards and Gross postulated that alcohol dependence comprises a discrete cluster of physiological, cognitive, and behavioral phenomena that exist along an underlying psychometric continuum of severity. Key components of this syndrome include:

• Narrowing of the drinking repertoire;
• Salience of drink-seeking behavior over competing reinforcers;
• Subjective awareness of a compulsion to drink;
• Tolerance to the psychoactive effects of ethanol;
• Repeated physiological withdrawal phenomena;
• Relief or avoidance of withdrawal symptoms by further drinking;
• Reinstatement of the syndrome following periods of abstinence.

The AUDIT explicitly incorporates this dimensional continuum within Items 4, 5, and 6, conceptualizing dependence not as a qualitative break from normal behavior, but as a progressive neurobiological and behavioral process.

The Prevention Paradox and Population Health Theory

Geoffrey Rose's pioneering epidemiological work, encapsulated in the Prevention Paradox (Rose, 1981), demonstrated that the majority of alcohol-related societal harms (such as workplace accidents, domestic disputes, emergency department visits, and acute trauma) do not emanate from the relatively small demographic of severely dependent, chronic individuals. Instead, the bulk of societal morbidity originates within the far larger population of non-dependent, moderate-to-heavy "hazardous" drinkers who periodically engage in heavy episodic intoxication.

Consequently, the WHO commissioned the development of the AUDIT to operationalize Rose's thesis within clinical practice. By identifying the massive, hidden iceberg of hazardous and harmful drinkers who pass undetected through routine clinical encounters, healthcare providers can deploy secondary prevention techniques to avert progression to chronic dependence.

Cognitive-Behavioral and Allostatic Formulations

Modern psychometric theory also links the AUDIT's structure to allostatic models of addiction (Koob & Le Moal, 2001) and cognitive-behavioral relapse prevention theory (Marlatt & Gordon, 1985). As alcohol consumption transitions from impulsive reward-driven behavior (Items 1–3) to compulsive relief-seeking and neuroadaptation (Items 4–6), hedonic set points shift, resulting in negative reinforcement mechanisms (Item 6) and executive failure (Items 4, 5, 8). The AUDIT captures this progressive biological transition across its three psychometric domains.

7. Validity

The psychometric validity of the AUDIT has been subjected to rigorous empirical evaluation across hundreds of peer-reviewed clinical trials, epidemiological surveys, and primary care validation studies in more than 40 nations.

Construct and Criterion Validity

Criterion-related validity has been demonstrated by benchmarking AUDIT performance against structured clinical diagnostic interviews, including the Structured Clinical Interview for DSM Disorders (SCID), the Composite International Diagnostic Interview (CIDI), and the Diagnostic Interview Schedule (DIS). In the foundational WHO validation trial across 1,888 primary healthcare patients (Saunders et al., 1993b), the AUDIT demonstrated superior sensitivity (92%) and specificity (94%) at a cut-off score of 8 for distinguishing hazardous or harmful drinkers from non-problem drinkers.

Subsequent meta-analyses (e.g., Reinert & Allen, 2002, 2007) synthesizing results across dozens of independent international investigations confirmed that an AUDIT cut-off score of 8 exhibits a median sensitivity of 0.86 (range: 0.70 to 0.98) and a median specificity of 0.89 (range: 0.80 to 0.98) for detecting current alcohol abuse or dependence. When calibrated specifically for women, clinical investigators widely recommend lowering the cut-off threshold to 7 (or in some community settings, 5 or 6) to accommodate sex-specific biological differences in alcohol distribution volume and hepatic ethanol metabolism, which yields sensitivity and specificity metrics consistently above 0.85.

ROC Curve Analyses

Receiver Operating Characteristic (ROC) curves across adolescent, adult, and geriatric cohorts consistently yield Area Under the Curve (AUC) values ranging from 0.87 to 0.98. In emergency department trauma evaluations, Cherpitel (1998) found that the AUDIT achieved an AUC of 0.93 for detecting ICD-10 alcohol dependence, significantly outperforming legacy scales such as the CAGE (AUC = 0.82) and the Brief MAST (AUC = 0.84).

Convergent and Discriminant Validity

Convergent validity is robustly supported by strong positive correlations with biological markers of heavy alcohol ingestion, including:

• Serum Gamma-Glutamyltransferase (γ-GT): Typical Pearson correlation coefficients range from r = 0.35 to 0.52 (Saunders et al., 1993b).
• Carbohydrate-Deficient Transferrin (%CDT): Correlations range between r = 0.40 and 0.60 in actively consuming medical inpatients.
• Mean Corpuscular Volume (MCV): Modest but statistically significant correlations (r = 0.28 to 0.42).

Furthermore, convergent validity is substantiated through high correlations with collateral psychometric indices, including the Alcohol Use Inventory (AUI; r = 0.78) and the Severity of Alcohol Dependence Questionnaire (SADQ; r = 0.74). Discriminant validity has been established through low-to-negligible correlations with unrelated psychiatric screening constructs, such as generalized anxiety (GAD-7; r = 0.15–0.22) and non-substance-induced depressive symptomatology (PHQ-9; r = 0.18–0.25), demonstrating that the AUDIT does not confound generalized affective distress with alcohol-specific pathology.

8. Reliability

The AUDIT demonstrates exceptional reliability across diverse languages, demographic strata, and administrative modalities.

Internal Consistency

Extensive international literature documents robust internal consistency across general populations, psychiatric samples, and primary care cohorts:

• Full Scale: Cronbach's alpha (α) coefficients routinely fall between 0.80 and 0.94 across published studies. In their benchmark systematic review, Reinert and Allen (2007) analyzed over 60 validation studies and reported a median Cronbach's alpha of 0.83.
• Subscale Consistency: Individual subscales demonstrate varied but acceptable internal consistency: the Hazardous Alcohol Use subscale (Items 1–3) yields alpha coefficients between 0.72 and 0.86; the Dependence Symptoms subscale (Items 4–6) demonstrates alphas between 0.70 and 0.82; and the Harmful Alcohol Use subscale (Items 7–10) yields alphas between 0.65 and 0.78, reflecting the broader conceptual diversity of secondary harm indicators.
• McDonald's Omega: Recent psychometric investigations employing modern latent variable modeling report McDonald's total omega (ω_t) exceeding 0.88, confirming high composite reliability that does not depend on the assumption of tau-equivalence.

Test-Retest Reliability

Temporal stability evaluations demonstrate that the AUDIT exhibits high test-retest reliability across diverse test intervals:

• Short-Term Intervals (1 to 2 Weeks): Test-retest reliability coefficients (Pearson's r and Intraclass Correlation Coefficients, ICC) range from 0.84 to 0.98 in non-clinical and primary care populations (e.g., Dybek et al., 2006).
• Extended Intervals (4 to 12 Weeks): Dybek et al. (2006) observed an ICC of 0.86 over a six-week interval among medical outpatients, indicating that the instrument captures stable behavioral patterns while remaining sensitive to genuine clinical changes resulting from therapeutic interventions.

Inter-Rater and Administration Mode Concordance

Comparative studies assessing self-report questionnaires, clinician-administered structured interviews, telephonic evaluations, and digital/computerized survey interfaces demonstrate high concordance rates (kappa coefficients > 0.80), confirming that the AUDIT preserves psychometric fidelity across disparate administrative formats.

9. Factor Analysis

The latent structural architecture of the AUDIT has been extensively evaluated using both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). Although the scale was theoretically conceived as a tri-dimensional instrument, psychometric findings have revealed a more nuanced debate regarding its dimensionality.

The Theoretical Three-Factor Model

The original conceptual architecture proposed by Saunders et al. (1993) delineates three distinct first-order factors:

1. Factor 1: Hazardous Alcohol Use — Defined by Items 1, 2, and 3.
2. Factor 2: Alcohol Dependence Symptoms — Defined by Items 4, 5, and 6.
3. Factor 3: Harmful Alcohol Consequences — Defined by Items 7, 8, 9, and 10.

In CFA investigations within clinical populations exhibiting elevated alcohol intake, this three-factor model demonstrates excellent goodness-of-fit indices (e.g., Comparative Fit Index [CFI] > 0.96; Tucker-Lewis Index [TLI] > 0.95; Root Mean Square Error of Approximation [RMSEA] ≤ 0.05). Factor correlations between Dependence and Harmful Use in these samples are typically high (r > 0.70), reflecting their common clinical association.

The Two-Factor Model

Numerous large-scale empirical studies, particularly in general population, university, and community-dwelling samples, have demonstrated superior parsimony for a two-factor model (e.g., Shields et al., 2004; Doyle et al., 2007):

• Factor 1: Alcohol Consumption (Items 1–3): Representing quantity, frequency, and episodic binge drinking. This factor is identical to the AUDIT-C abbreviated subscale. Factor loadings for Items 1, 2, and 3 routinely load onto this latent construct with high standardized coefficients ranging from 0.72 to 0.88.
• Factor 2: Alcohol-Related Consequences and Dependence (Items 4–10): Collapsing the dependence and harm items into a single overarching dimension representing secondary negative manifestations. Factor loadings for Items 4 through 10 on this combined factor typically range from 0.58 to 0.82.

Comparative CFA studies frequently observe that the two-factor model yields fit indices virtually identical or superior to the three-factor model, while avoiding collinearity between the latent dependence and harm constructs in populations where severe dependence is rare.

Bifactor and Unidimensional Models

In recent structural equation modeling evaluations, researchers have evaluated a bifactor model comprising one general "Alcohol Use Disorder" latent factor and two or three group-specific factors. These analyses frequently demonstrate that the general AUD factor accounts for greater than 70% to 80% of the common variance (Omega Hierarchical ω_h > 0.80), providing empirical justification for the routine clinical practice of summing all 10 items into a single composite score.

10. Instrument / Measurement Tool

The AUDIT is an administratively efficient instrument designed to be deployed across a wide spectrum of clinical, workplace, forensic, and academic environments. The structural specifications and scoring rules are detailed below:

• Test Type: Screening inventory; standardized self-report questionnaire or clinician-administered structured interview.
• Administration Format: Paper-and-pencil questionnaire, digital/tablet interface, computerized web survey, or clinician-conducted clinical interview.
• Number of Items: 10 questions.
• Target Population: Adolescents (ages 14–17 with calibrated thresholds) and adults across all age cohorts.
• Completion Time: Approximately 2 to 4 minutes for self-administration; 3 to 5 minutes for clinician interview.
• Response Scale: Item-specific scoring (0 to 4 points per item): Questions 1-3 use frequency/quantity scales; Questions 4-8 use a 5-point frequency scale (0=Never, 1=Less than monthly, 2=Monthly, 3=Weekly, 4=Daily or almost daily); Questions 9-10 use a 3-point scale (0=No, 2=Yes, but not in the last year, 4=Yes, during the last year).
• Reverse-Scored Items: None. All items are positively keyed toward alcohol pathology.
• Scoring Range: Total raw scores range from 0 to 40 points:
• Questions 1 through 8 are each scored 0, 1, 2, 3, or 4.
• Questions 9 and 10 are scored 0, 2, or 4.
• Clinical Cut-Off Scores and Interpretation Risk Strata (WHO Guidelines):
  • Zone I (Score 0–7 for men, 0–6 for women): Low-risk drinking or total abstinence. Recommended action: Primary prevention and positive reinforcement of current habits.
  • Zone II (Score 8–15 for men, 7–15 for women): Hazardous alcohol consumption. Score of 8 or more in men (7 in women) indicates hazardous or harmful alcohol use. Recommended action: Simple brief intervention, education on safe drinking limits, and lifestyle feedback.
  • Zone III (Score 16–19): Harmful alcohol consumption with emerging dependence features. Recommended action: Extended brief intervention, motivational interviewing sessions, and scheduled follow-up monitoring.
  • Zone IV (Score 20–40): Scores of 20 or more suggest alcohol dependence. Recommended action: Comprehensive medical diagnostic workup, structured addiction consultation, and specialized pharmacotherapy or psychosocial referral.
• Abbreviated Clinical Sub-Variants:
  • AUDIT-C: Comprising Items 1–3 only (Scored 0–12). Serves as an ultra-rapid screening tool for consumption volume. Cut-offs of ≥4 for men and ≥3 for women are widely validated to prompt full 10-item AUDIT administration.
  • AUDIT-3: Item 3 alone (binge drinking frequency), serving as a single-item ultra-rapid screen in busy emergency or trauma settings.

11. Permissions & Fee and Test Year

The Alcohol Use Disorders Identification Test was developed in 1989 and formally published in peer-reviewed scientific literature in 1993 under the authorization of the World Health Organization.

• Copyright Holder: World Health Organization (Geneva, Switzerland).
• Fee and Commercial Licensing: The AUDIT is in the public domain and is made available by the WHO completely free of charge for clinical, educational, research, and non-commercial public health screening initiatives.
• Commercial and Digital Redistribution: Commercial adaptation, digital software integration for profit, or modified print reproduction requires formal written permission or licensing requests submitted to WHO Publications (WHO Permissions).
• Standardized Documentation: Clinicians and researchers are encouraged to consult the official WHO intervention manual: Babor, T. F., Higgins-Biddle, J. C., Saunders, J. B., & Monteiro, M. G. (2001). AUDIT: The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care (2nd ed.). World Health Organization.

12. References

• Babor, T. F., Higgins-Biddle, J. C., Saunders, J. B., & Monteiro, M. G. (2001). AUDIT: The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care (2nd ed.). World Health Organization. https://apps.who.int/iris/handle/10665/67205
• Cherpitel, C. J. (1998). Differences in performance of screening instruments for problem drinking among blacks, whites and Hispanics in an emergency room population. Journal of Studies on Alcohol, 59(4), 420–426. https://doi.org/10.15288/jsa.1998.59.420
• Doyle, S. R., Donovan, D. M., & Kivlahan, D. R. (2007). The factor structure of the Alcohol Use Disorders Identification Test (AUDIT). Journal of Studies on Alcohol and Drugs, 68(3), 474–479. https://doi.org/10.15288/jsad.2007.68.474
• Dybek, I., Bischof, G., Grothues, J., Reinhardt, S., Meyer, C., Hapke, U., John, U., & Rumpf, H.-J. (2006). The reliability and validity of the Alcohol Use Disorders Identification Test (AUDIT) in a German general practice population sample. Journal of Studies on Alcohol, 67(3), 473–481. https://doi.org/10.15288/jsa.2006.67.473
• Edwards, G., & Gross, M. M. (1976). Alcohol dependence: Provisional description of a clinical syndrome. British Medical Journal, 1(6017), 1058–1061. https://doi.org/10.1136/bmj.1.6017.1058
• Ewing, J. A. (1984). Detecting alcoholism: The CAGE questionnaire. JAMA, 252(14), 1905–1907. https://doi.org/10.1001/jama.1984.03350140051025
• Koob, G. F., & Le Moal, M. (2001). Drug addiction, dysregulation of reward, and allostasis. Neuropsychopharmacology, 24(2), 97–129. https://doi.org/10.1016/S0893-133X(00)00195-0
• Marlatt, G. A., & Gordon, J. R. (Eds.). (1985). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. Guilford Press.
• Reinert, D. F., & Allen, J. P. (2002). The Alcohol Use Disorders Identification Test (AUDIT): A review of recent research. Alcoholism: Clinical and Experimental Research, 26(2), 272–279. https://doi.org/10.1111/j.1530-0277.2002.tb02534.x
• Reinert, D. F., & Allen, J. P. (2007). The Alcohol Use Disorders Identification Test: An update of research findings. Alcoholism: Clinical and Experimental Research, 31(2), 185–199. https://doi.org/10.1111/j.1530-0277.2006.00295.x
• Rose, G. (1981). Strategy of prevention: Lessons from cardiovascular disease. British Medical Journal (Clinical Research Ed.), 282(6279), 1847–1851. https://doi.org/10.1136/bmj.282.6279.1847
• Saunders, J. B., Aasland, O. G., Babor, T. F., de la Fuente, J. R., & Grant, M. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption–II. Addiction, 88(6), 791–804. https://doi.org/10.1111/j.1360-0443.1993.tb02093.x
• Selzer, M. L. (1971). The Michigan Alcoholism Screening Test: The quest for a new diagnostic instrument. American Journal of Psychiatry, 127(12), 1653–1658. https://doi.org/10.1176/ajp.127.12.1653
• Shields, A. L., Guttmannova, K., & Caruso, J. C. (2004). An examination of the factor structure of the Alcohol Use Disorders Identification Test in two high-risk samples. Journal of Studies on Alcohol, 65(2), 274–282. https://doi.org/10.15288/jsa.2004.65.274

13. Items of the Scale (Questionnaire)