The Rutgers Alcohol Problem Index (RAPI)

Abstract

The Rutgers Alcohol Problem Index (RAPI) is a widely utilized, clinically validated, self-administered psychometric screening instrument developed by Helene Raskin White and Erich W. Labouvie in 1989 to assess adolescent and young adult problem drinking. Designed specifically to circumvent the developmental limitations inherent in adult-focused alcoholism inventories, the RAPI assesses the frequency with which individuals have experienced negative social, psychological, academic, physiological, and behavioral consequences of alcohol consumption over a specified reference period (traditionally the preceding year). The standard version consists of 23 items scored along an authentic 5-point ordinal frequency metric: 1 = NEVER, 2 = ONE TO TWO TIMES, 3 = THREE TO FIVE TIMES, 4 = SIX TO TEN TIMES, and 5 = MORE THAN TEN TIMES (conventionally recoded to 0–4 for summative scoring, yielding an aggregate score ranging from 0 to 69). Psychometrically, the instrument exhibits strong internal consistency, with Cronbach’s alpha coefficients routinely exceeding α = .85 in non-clinical community cohorts and α = .90 in clinical or heavily drinking college populations. While originally operationalized as a unidimensional composite index representing generalized adolescent alcohol-related impairment, extensive exploratory and confirmatory factor analyses, as well as item response theory (IRT) investigations, have demonstrated its robust construct, convergent, predictive, and discriminant validity. This comprehensive article provides an exhaustive psychometric examination of the RAPI, detailing its conceptual origins, developmental necessity, theoretical architecture, structural validity, score interpretation guidelines, normative metrics, and diagnostic applications across research and clinical settings.

Keywords

Rutgers Alcohol Problem Index, RAPI, adolescent problem drinking, alcohol-related consequences, psychometrics, alcohol use disorder screening, substance misuse, college student drinking, developmental psychopathology, behavioral assessment, addiction assessment, youth risk behavior, psychometric evaluation, factor structure, test reliability.

Authors

The Rutgers Alcohol Problem Index was conceived, empirically operationalized, and psychometrically validated by Helene Raskin White, Ph.D., and Erich W. Labouvie, Ph.D., at the Center of Alcohol and Substance Use Studies at Rutgers, The State University of New Jersey, Piscataway, New Jersey, United States.

• Helene Raskin White, Ph.D. — Professor Emerita of Sociology and former Distinguished Professor of Alcohol Studies at Rutgers University. Dr. White has dedicated more than four decades to longitudinal research examining the etiology, developmental trajectories, and comorbid psychiatric sequelae of substance abuse, delinquency, and violence from adolescence into mid-adulthood. Her pioneering work has profoundly influenced developmental criminology and addictive behavior epidemiology.
• Erich W. Labouvie, Ph.D. — Professor Emeritus of Psychology at the Center of Alcohol and Substance Use Studies, Rutgers University. Dr. Labouvie is a prominent quantitative methodologist and developmental psychologist whose research focused extensively on the longitudinal modeling of adolescent drug and alcohol misuse, structural equation modeling (SEM), multivariate psychometrics, and cognitive-affective factors in substance dependence.

The instrument was initially introduced to the scientific community in their foundational 1989 article, “Towards the assessment of adolescent problem drinking,” published in the Journal of Studies on Alcohol (now the Journal of Studies on Alcohol and Drugs).

Purpose

The primary purpose of the Rutgers Alcohol Problem Index (RAPI) is to provide an empirically grounded, developmentally sensitive, and standardized measurement tool capable of identifying, quantifying, and monitoring problem drinking and alcohol-induced adverse consequences among adolescents (ages 12–18) and emerging adults (ages 18–25, particularly undergraduate college populations). Prior to the construction of the RAPI, clinical researchers and substance misuse practitioners predominantly relied on adult-oriented alcoholism assessment instruments, such as the Michigan Alcoholism Screening Test (MAST), the CAGE questionnaire, and traditional diagnostic criteria derived from early iterations of the Diagnostic and Statistical Manual of Mental Disorders (such as the DSM-III and DSM-III-R).

Adult diagnostic paradigms fundamentally emphasize long-term, chronic physiological and biological sequelae of severe alcohol dependence, including advanced liver disease, delirium tremens, sustained occupational disenfranchisement, marital dissolution, and severe physical withdrawal. White and Labouvie recognized that such criteria possess extraordinarily low base rates and minimal ecological validity among adolescents and secondary school students. Due to their relatively brief chronological exposure to ethanol, adolescents rarely display end-stage physical dependence, severe biological complications, or adult-pattern structural life impairment. Nonetheless, adolescents frequently engage in heavy episodic drinking (“binge drinking”), which catalyzes immediate, severe, and acute biopsychosocial disruptions.

Consequently, the RAPI was designed to systematically assess consequences that align with the developmental tasks, social roles, and ecological contexts of youth. These domains encompass:

• Academic and Occupational Disruptions: Inability to study, missing class or shifts, failing examinations, and attending school or employment while intoxicated or impaired.
• Interpersonal and Familial Conflict: Altercations with peers, verbal or physical fights with relatives, avoidance behaviors by family members, and shame or embarrassment inflicted on loved ones.
• Impaired Self-Regulation and Cognitive Control: Preoccupation with alcohol, unsuccessful attempts to restrict drinking to specific hours or geographic environments, broken promises regarding consumption limits, and subjective realization of loss of control.
• Neurocognitive and Acute Somatic Indicators: Memory blackouts (waking up in unfamiliar environments without recollection), syncope or fainting episodes, neurovegetative withdrawal distress, and somatic illness following cessation.
• Behavioral Dysregulation and High-Risk Conduct: Physical violence, behavioral misconduct, social alienation, and substantial financial expenditures disproportionate to adolescent economic resources.

In both clinical and research contexts, the RAPI fulfills multiple clinical objectives. In secondary schools, pediatric clinics, and university counseling centers, it functions as an efficient triage and secondary prevention screening tool to identify youths experiencing functional impairment who require brief motivational interviewing, psychoeducation, or intensive outpatient addiction treatment. In longitudinal, epidemiological, and pharmacological intervention studies, the RAPI serves as a continuous, highly sensitive outcome measure to gauge behavioral change, evaluate the efficacy of alcohol harm-reduction programs, and model developmental trajectories of substance use disorders across the life course.

Psychological Construct

The psychological construct evaluated by the RAPI is adolescent problem drinking, conceptualized as a multi-determined continuum of negative biopsychosocial consequences and behavioral manifestations stemming directly from acute and subacute alcohol intoxication. Rather than framing alcohol misuse as an all-or-nothing categorical medical disease, the construct treats alcohol-induced dysfunction as a continuous dimension ranging from complete absence of adverse events to severe, recurrent life impairment.

Although White and Labouvie deliberately structured the scale to yield a single, omnibus global problem score for clinical utility, thorough psychometric analysis indicates that the construct reflects several intertwined functional dimensions:

1. Role and Academic Impairment

Adolescence and emerging adulthood are defined by critical developmental transitions centered on educational attainment, skill acquisition, and preliminary workplace entry. The construct of problem drinking heavily weights the erosion of these role obligations. Items evaluating inability to complete homework or study for examinations (Item 1), missing entire or partial days of school or work (Item 13), attending work or school intoxicated or high (Item 4), and general neglect of primary responsibilities (Item 6) tap into functional role failure. In developmental psychopathology, early role failure often sets off cumulative developmental cascades, precipitating academic failure, institutional reprimands, and compromised vocational trajectories.

2. Interpersonal and Social Dysregulation

Youth alcohol consumption frequently transpires within peer networks, rendering the social arena highly vulnerable to alcohol-related disruption. The RAPI captures interpersonal friction across multiple dyadic contexts, differentiating between peer conflict (Item 17: “Had a fight, argument or bad feelings with a friend?”) and familial alienation (Item 18: “Had a fight, argument or bad feelings with a family member”; Item 7: “Relative avoided you?”). Furthermore, the construct encompasses interpersonal shame and external social sanctions (Item 5: “Caused shame or embarrassment to someone?”; Item 23: “Was told by a friend or neighbor to stop or cut down drinking?”). These manifestations reflect the interpersonal strain and breakdown of trust that accompany loss of emotional control under the pharmacological influence of alcohol.

3. Impaired Control and Compulsive Consumption

Central to modern conceptualizations of substance use disorders is the construct of impaired control over consumption. The RAPI samples internal struggles with behavioral moderation through behavioral indicators such as attempting to restrict drinking to specific times or venues (Item 9), drinking despite explicit personal resolutions to abstain or moderate (Item 19), attempting to quit or curtail consumption altogether (Item 14), and subjective awareness of dependency (Item 22: “Felt physically or psychologically dependent on alcohol?”; Item 12: “Felt you had a problem with alcohol?”). In youth cohorts, conscious recognition of problem drinking and futile attempts at restriction indicate that consumption has advanced beyond exploratory social recreation into maladaptive, compulsive patterns.

4. Neurocognitive and Acute Somatic Manifestations

Adolescent brain development is marked by ongoing maturation of frontostriatal circuits, rendering the adolescent central nervous system uniquely vulnerable to neurotoxic and disruptive effects of high blood alcohol concentrations (BAC). The RAPI incorporates pathognomonic somatic and neurological markers, notably anterograde alcohol-induced amnesia or blackouts (Item 15: “Suddenly found yourself in a place that you could not remember getting to?”), loss of consciousness (Item 16: “Passed out or fainted suddenly?”), neurochemical tolerance (Item 8: “Felt that you needed more alcohol than you used to use in order to get the same effect?”), and acute physical withdrawal distress (Item 10: “Had withdrawal symptoms, that is, felt sick because you stopped or cut down on drinking?”). These items denote biological adaptation and significant pharmacological toxicity.

5. Behavioral Delinquency, Emotional Distress, and Aggression

Finally, the construct encapsulates behavioral disinhibition, externalizing behaviors, and profound affective distress. Item 2 (“Got into fights, acted bad, or did mean things?”) taps into alcohol-induced aggression and antisocial behavioral manifestations. Item 3 (“Missed out on other things because you spent too much money on alcohol?”) measures financial trade-offs and misallocation of resources. Concurrently, affective dysphoria and existential alarm are tapped by Item 20 (“Felt you were going crazy?”) and Item 21 (“Had a bad time?”), demonstrating that problem drinking among adolescents is frequently accompanied by subjective psychological turmoil and emotional dysregulation.

Theoretical Framework

The development of the Rutgers Alcohol Problem Index is anchored at the intersection of several prominent theoretical paradigms within clinical psychology, developmental psychopathology, and behavioral pharmacology.

1. Problem Behavior Theory (Jessor & Jessor)

The foremost foundational architecture supporting the RAPI is Richard and Shirley Jessor’s Problem Behavior Theory (PBT). PBT conceptualizes adolescent risk-taking not as isolated, psychopathological aberrations, but as part of a coherent syndrome of transition-marking behaviors governed by three interrelated systems: the Personality System (e.g., values, expectations, alienation), the Perceived Environment System (e.g., peer models, parental controls), and the Behavior System (e.g., delinquency, sexual precocity, alcohol use). Within PBT, alcohol misuse is viewed as a purposive, functional behavior aimed at asserting developmental autonomy, gaining peer acceptance, coping with psychological distress, or testing adult boundaries. White and Labouvie operationalized the RAPI to measure the negative feedback and functional friction generated within the Behavior and Environment systems when alcohol consumption exceeds normative thresholds and actively obstructs conventional developmental milestones.

2. Developmental Psychopathology and the Cascade Model

The RAPI draws heavily on developmental psychopathology frameworks, which emphasize the dynamic interplay between normative developmental transitions and emerging psychopathological deviations. As posited by Dante Cicchetti and colleagues, developmental cascades occur when deficits in one domain (e.g., self-regulation during social drinking) spill over into and compromise other domains (e.g., school performance, family relationships, emotional stability). The RAPI explicitly captures these multi-systemic cascade failures across social, academic, and physical ecologies. Rather than imposing adult criteria of institutional decline, it identifies the developmental arrest and social costs specific to youth navigating the transition from secondary education to young adulthood.

3. Bandura’s Social Cognitive Theory and Self-Regulation

From the perspective of Social Cognitive Theory formulated by Albert Bandura, substance dependence involves failures in self-regulatory mechanisms, including self-monitoring, self-judgment, and affective self-reaction. RAPI items assessing deliberate attempts to regulate drinking environments (Item 9), persistent drinking despite broken self-promises (Item 19), and efforts to moderate or terminate consumption (Item 14) represent conscious, albeit failing, self-regulatory control loops. The scale models the psychological strain that arises when an individual’s cognitive appraisal of their own behavior conflicts with their inability to manage consumption.

4. Continuum vs. Disease Models of Addiction

Historically, the classical disease model of addiction (E. M. Jellinek) posited that alcoholism is a discrete, progressive, irreversible physiological disease entity. Under this framework, diagnostic instruments utilized rigid binary thresholds (alcoholic vs. non-alcoholic). In stark contrast, modern dimensional psychiatry and behavioral pharmacology view alcohol-related harm along a continuous gradient of severity. The theoretical underpinning of the RAPI rejects binary typologies, positing instead that problem drinking encompasses a continuously distributed spectrum of acute and cumulative dysfunctions. This continuum approach directly mirrors modern diagnostic structures, such as the dimensional spectrum of Alcohol Use Disorder (AUD) in the DSM-5.

Validity

The Rutgers Alcohol Problem Index has undergone extensive empirical validation across thousands of adolescents, high school students, college undergraduates, and clinical populations in North America, Europe, and Asia. Its psychometric validity is substantiated across multiple domains:

1. Construct and Structural Validity

In their seminal validation study, White and Labouvie (1989) administered the RAPI to a non-clinical longitudinal sample of 1,308 adolescents aged 12, 15, and 18, alongside a clinical validation cohort of 71 adolescents undergoing residential or outpatient treatment for substance use disorders. Construct validity was affirmed by dramatic, statistically significant mean differences between non-clinical and clinical cohorts. Clinical adolescents scored markedly higher across every individual item and demonstrated overall mean RAPI scores between 21.0 and 25.4, compared to community samples whose mean scores ranged from 4.2 to 8.5 (p < .001). This large effect size confirms the instrument’s ability to differentiate normative experimental drinking from clinically significant alcohol pathology.

2. Convergent Validity

Convergent validity has been consistently documented through robust bivariate correlations with established substance use inventories and drinking parameters:

• Drinking Frequency and Heavy Episodic Drinking: RAPI total scores correlate moderately to strongly with self-reported drinking frequency (r = .45 to .60), volume of alcohol consumed per occasion (r = .50 to .65), and frequency of heavy episodic drinking / binge drinking episodes (r = .55 to .70) as measured by the Timeline Followback (TLFB) method.
• Alternative Alcohol Screening Instruments: The RAPI exhibits strong convergent associations with other validated problem drinking scales, including the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT-C (r = .65 to .78), the Brief Young Adult Alcohol Consequences Questionnaire (BYAACQ; r = .70 to .82), and the Young Adult Alcohol Problems Screening Test (YAAPST; r = .72 to .85).
• Formal Diagnostic Criteria: RAPI scores correlate strongly with symptom counts for DSM-IV Alcohol Abuse and Dependence, as well as DSM-5 Alcohol Use Disorder criteria (r = .60 to .75), demonstrating that higher scores align directly with standardized psychiatric diagnoses.

3. Predictive and Longitudinal Validity

Longitudinal studies tracking adolescents into young adulthood demonstrate that baseline RAPI scores predict sustained alcohol misuse, university academic probation, collegiate attrition, alcohol-involved motor vehicle collisions, emergency department admissions, and legal interventions up to seven years post-assessment. Furthermore, early adolescent RAPI scores predict adult AUD diagnosis at age 25 and age 30, even after controlling for baseline quantity-frequency metrics, illustrating that experiencing adverse consequences in youth has independent prognostic significance beyond consumption volume alone.

4. Discriminant and Incremental Validity

Discriminant validity has been demonstrated by showing that RAPI scores correlate significantly higher with alcohol-specific behaviors than with general, non-alcohol-involved delinquent acts, non-substance psychiatric morbidity, or generalized negative affectivity. In multiple hierarchical regression models, the RAPI demonstrates incremental validity by accounting for significant unique variance in psychological distress, academic drop-out, and physical injuries after controlling for age, gender, socioeconomic status, and total alcohol volume consumed.

Reliability

The RAPI exhibits robust internal consistency and temporal stability across diverse cultural, demographic, and clinical strata.

1. Internal Consistency

In the original validation studies conducted by White and Labouvie (1989), the 23-item instrument exhibited high internal reliability across developmental cohorts:

• General Adolescent Community Samples: Cronbach’s alpha coefficients ranged from α = .88 to .92 across age cohorts (ages 15, 18, and 21).
• Clinical Inpatient and Outpatient Samples: Internal consistency was similarly strong, yielding an alpha coefficient of α = .92.
• Subsequent Replications in College Cohorts: Subsequent studies involving large university cohorts (e.g., Martens et al., 2007; Neal et al., 2006) reported Cronbach’s alpha values consistently ranging between α = .86 and .92, and McDonald’s omega hierarchical (ωh) values around .82, confirming that the scale is dominated by a strong, reliable common core variance.

2. Test-Retest Reliability

The temporal stability of the RAPI has been evaluated across varying retest intervals:

• Short-Term Stability (2 to 4 Weeks): In non-intervention control conditions among high school and college students, test-retest reliability coefficients range from r = .78 to .88, demonstrating high stability in the absence of clinical intervention or life transitions.
• Medium-Term Stability (3 to 6 Months): Across multi-month intervals in non-clinical cohorts, stability coefficients remain moderate to high (r = .65 to .75), reflecting both consistent individual trait-level differences and expected developmental fluctuations in drinking patterns.

3. Measurement Invariance

Extensive psychometric investigations have examined the measurement invariance of the RAPI across demographic groups. Multi-group confirmatory factor analyses demonstrate configural, metric, and scalar invariance across gender (male vs. female) and educational context (high school students vs. college students). Although males frequently endorse higher absolute frequencies of physical altercations and reckless conduct (Items 2 and 4), the underlying factor structure and factor loadings operate equivalently across biological sexes, confirming that score comparisons between male and female youths are psychometrically valid.

Factor Analysis

The latent structure of the RAPI has been a focal point of psychometric debate, leading to evaluations using Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and Item Response Theory (IRT).

1. The Unidimensional Model

White and Labouvie (1989) originally conceptualized the RAPI as a unidimensional scale representing general adolescent problem drinking. Principal component and principal axis factoring in their original sample revealed a dominant first factor accounting for the vast majority of common variance (eigenvalues typically > 8.0, with all 23 items loading > .40 on the primary unrotated factor). This unidimensional conceptualization supports the primary clinical and empirical practice of summing all items to calculate a single omnibus composite score.

2. Multidimensional and Correlated Factor Models

Subsequent psychometric evaluations involving college students suggested that multidimensional structures could also account for the data. Several investigators (e.g., Neal et al., 2006; Martens et al., 2007) proposed multi-factor solutions, typically identifying between two and five correlated factors:

• Factor 1: Personal/Social Consequences (e.g., fights, family arguments, personality changes, bad times).
• Factor 2: Academic/Role Deviance (e.g., missed homework, missing work/school, going to class drunk).
• Factor 3: Impaired Control / Dependence Symptoms (e.g., withdrawal, tolerance, inability to quit, physical dependence).
• Factor 4: Blackouts / Somatic Syncope (e.g., passing out, sudden amnesia).

While these correlated multi-factor models frequently display acceptable fit indices in CFA (e.g., CFI > .92, RMSEA < .06), the inter-factor correlations are typically very high (r > .70 to .85), pointing toward substantial structural collinearity.

3. Bifactor Solutions and Item Response Theory (IRT)

Recent advances in psychometrics have clarified this structural debate using bifactor modeling and IRT analysis. A bifactor model positing one general “Alcohol Consequences” factor alongside several specific orthogonal sub-factors (Academic, Interpersonal, Somatic/Control) consistently demonstrates superior model fit (CFI > .96, TLI > .95, RMSEA < .045). Importantly, the Explained Common Variance (ECV) for the general factor typically exceeds 70% to 80%, indicating that despite multidimensional nuances, the RAPI is functionally essential unidimensional.

Item Response Theory analyses (utilizing Samejima’s Graded Response Model) demonstrate that RAPI items vary substantially in their item difficulty (severity) and discrimination parameters (α parameters ranging from 1.2 to 2.8):

• Low-Severity / High-Endorsement Items: Items like Item 21 (“Had a bad time?”) and Item 1 (“Not able to do your homework or study for a test?”) provide maximum measurement precision at lower latent severity levels (θ between 0.0 and +1.0).
• High-Severity / Diagnostic Items: Items tapping physiological dependence (Item 22), physical withdrawal (Item 10), and severe cognitive blackouts (Item 15) exhibit very high threshold parameters (θ > +2.0 to +3.0), providing critical measurement precision at the extreme clinical end of the problem drinking continuum.

Instrument / Measurement Tool

• Formal Tool Name: The Rutgers Alcohol Problem Index (RAPI)
• Original Authors: Helene Raskin White, Ph.D., and Erich W. Labouvie, Ph.D. (1989)
• Test Format: Standardized self-report questionnaire; paper-and-pencil or computerized/digital administration
• Target Population: Adolescents (ages 12–18) and emerging adults / college students (ages 18–25)
• Administration Time: Approximately 5 to 10 minutes
• Item Count: 23 authentic items
• Recall Reference Window: Typically the preceding 12 months (in clinical and epidemiological trials), though adaptable to preceding 30 days, 60 days, or 3 years depending on longitudinal study design
• Authentic Response Scale: 5-point ordinal frequency metric:
  • 1 = NEVER
  • 2 = ONE TO TWO TIMES
  • 3 = THREE TO FIVE TIMES
  • 4 = SIX TO TEN TIMES
  • 5 = MORE THAN TEN TIMES
• Scoring and Coding Rules:
  • In conventional empirical scoring, responses are recoded to a 0–4 scale: Never = 0; 1–2 times = 1; 3–5 times = 2; 6–10 times = 3; More than 10 times = 4.
  • Items are summed across all 23 questions to compute an aggregate composite score ranging from 0 to 69.
  • Alternatively, when scored directly using the raw 1–5 values, the aggregate score spans from 23 to 115. Researchers must explicitly declare their coding scheme in psychometric reporting.
• Normative Thresholds and Clinical Benchmarks (0–69 Coding Metric):
  • Non-Clinical Community Adolescents (Ages 15–18): Typical normative mean scores range from 4.0 to 8.5 (with standard deviations between 5.0 and 8.0).
  • Clinical / Substance-Referred Adolescents (Ages 14–18): Mean scores typically range from 21.0 to 25.4 (standard deviations between 12.0 and 15.0).
  • College Undergraduate Populations: Mean scores typically range from 8.0 to 14.0, with substantial inflation observed among fraternity/sorority members and competitive athletes.
  • Recommended Screening Cut-offs: A total score ≥ 15 (on the 0–69 scale) is widely utilized as an empirical cut-point denoting hazardous problem drinking warranting clinical secondary intervention. Scores ≥ 20 indicate severe alcohol-related impairment and a high probability of meeting DSM-5 Alcohol Use Disorder criteria.

Permissions & Fee and Test Year

• Year of Initial Publication: 1989.
• Intellectual Property & Copyright: The Rutgers Alcohol Problem Index was created by Drs. Helene R. White and Erich W. Labouvie at Rutgers University and published in the Journal of Studies on Alcohol (1989).
• Usage Permissions and Royalties: The RAPI is generally accessible within the public domain for non-profit academic research, scientific inquiry, educational training, and clinical evaluation without payment of licensing royalties. Commercial applications, integration into proprietary clinical diagnostic platforms, or fee-for-service digital implementations may require formal permission from the original authors or the Rutgers Center of Alcohol and Substance Use Studies.
• Repository Access: Official instrument documentation, historical background, and administration guidelines are maintained through academic substance research archives and international repositories, including the European Union Drugs Agency (EUDA, formerly EMCDDA) evaluation instrument databank.
• Citation Obligation: Users of the scale are required to maintain the integrity of the original item wording and cite the foundational peer-reviewed publication: White, H. R., & Labouvie, E. W. (1989). Towards the assessment of adolescent problem drinking. Journal of Studies on Alcohol, 50(1), 30–37.

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://iris.who.int/handle/10665/67205
• Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Prentice-Hall, Inc.
• Cicchetti, D. (1993). Developmental psychopathology: Reactions, reflections, projections. Development and Psychopathology, 5(4), 471–502. https://doi.org/10.1017/S0954579400006129
• Devos-Commelin, P., Miranda, R., Jr., & Monti, P. M. (2010). Psychometric evaluation of the Rutgers Alcohol Problem Index among young adults: A comparison between clinical and non-clinical samples. Addictive Behaviors, 35(10), 918–924. https://doi.org/10.1016/j.addbeh.2010.06.007
• Earleywine, M., Cherpitel, C. J., & Borges, G. (2008). Item response theory analysis of the Rutgers Alcohol Problem Index. Addictive Behaviors, 33(8), 1054–1058. https://doi.org/10.1016/j.addbeh.2008.03.011
• Jessor, R., & Jessor, S. L. (1977). Problem behavior and psychosocial development: A longitudinal study of youth. Academic Press.
• Martens, M. P., Neighbors, C., Lewis, M. A., Lee, C. M., Oster-Aaland, L., & Larimer, M. E. (2007). The factor structure of the Rutgers Alcohol Problem Index (RAPI) among college students: Evaluation of clinical utility and invariance. Journal of Studies on Alcohol and Drugs, 68(4), 572–581. https://doi.org/10.15288/jsad.2007.68.572
• Neal, D. J., Corbin, W. R., & Fromme, K. (2006). Measurement of alcohol-related problems among college students: An item response theory evaluation of the Rutgers Alcohol Problem Index. Psychological Assessment, 18(4), 402–414. https://doi.org/10.1037/1040-3590.18.4.402
• White, H. R., & Labouvie, E. W. (1989). Towards the assessment of adolescent problem drinking. Journal of Studies on Alcohol, 50(1), 30–37. https://doi.org/10.15288/jsa.1989.50.30
• White, H. R., Labouvie, E. W., & Papadaratsakis, V. (2005). Changes in substance use and related problems during the transition to young adulthood. Journal of Studies on Alcohol, 66(5), 652–662. https://doi.org/10.15288/jsa.2005.66.652

Items of the Scale