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Article Excerpt
A commonly used instrument to assess negative consequences of substance use among college students is the Core Alcohol and Drug Survey (CADS; C. A. Presley, P. W. Meilman, & J. S. Leichliter, 1998; C. A. Presley, P. W. Meilman, & R. Lyerla, 1993). Results from 2 studies suggest that a subset of CADS negative consequences items can be explained by 2 factors, which the authors named "Personal Consequences" and "Consequences With Others."
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Alcohol and other drug abuse among college students on university campuses across the United States has become a major public health concern (Ham & Hope, 2003). According to recent national large-scale studies, approximately 80% of college students reported using alcohol within the past year (The Core Institute, 1998; Wechsler et al., 2002), a considerable portion of which may be considered "at-risk" drinkers (i.e., likely to experience negative consequences as a result of alcohol use). Several national studies have found that more than 40% of college students reported "heavy episodic" drinking (typically defined as at least 4 or 5 drinks in one sitting) within the past 2 weeks (O'Malley & Johnston, 2002; Wechsler et al., 2002), that more than 20% of students reported three or more heavy episodic drinking episodes in the past 2 weeks (Wechsler et al., 2002), and that approximately one third of all college students reported meeting Diagnostic and Statistical Manual of Mental Disorders, text revision (DSM-IV-TR; American Psychiatric Association, 2000), criteria for alcohol abuse or dependence in the past 12 months (Knight et al., 2002). National studies have also found that approximately 16% of college students reported using marijuana and approximately 5% reported using another illicit drug (e.g., heroin, cocaine) at least once in the past 30 days and that drug-use rates among college students rose between 1993 and 1999 (Gledhill-Hoyt, Lee, Strote, & Wechsler, 2000).
The findings regarding alcohol and other drug use are particularly important when one considers the negative consequences college students may experience as a result of such use. Most of the research in this area has focused on negative consequences of alcohol consumption, but we are assuming that similar findings exist regarding use of other drugs. Although research indicates that most college students who are heavy drinkers transition out of such consumption patterns after graduation (Bartholow, Sher, & Krull, 2003), those who engage in heavy episodic drinking are more likely than those who do not to experience a host of negative alcohol-related consequences during the college years. Studies have consistently linked heavy episodic drinking with a host of personal and interpersonal problems, such as doing something that is later regretted, missing a class, and engaging in unplanned sexual activity (Wechsler, Davenport, Dowdall, Moeykens, & Castillo, 1994; Wechsler, Lee, Kuo, & Lee, 2000). Most dramatically, research from the Task Force on College Drinking, which was commissioned by the National Institute on Alcohol Abuse and Alcoholism (2002), found that approximately 1,400 college students are killed and an additional 500,000 students are injured each year from unintentional alcohol-related injuries, 70,000 students are victims of alcohol-related sexual assaults, 600,000 students are assaulted by another student who has been using alcohol, and 2.1 million students report driving under the influence of alcohol (Hingson, Heeren, Zakocs, Kopstein, & Wechsler, 2002). Clearly, heavy drinking among college students represents a health problem to both the individuals themselves and others with whom they interact.
Given these concerns regarding negative alcohol and drug-related consequences, it is important that counselors, prevention specialists, and researchers have reliable and valid means to conceptualize and organize such consequences. Accurately measuring alcohol-related consequences allows researchers to evaluate the effectiveness of various intervention and education programs, which can then guide the applied work of prevention and treatment specialists. If, for example, a set of negative consequences could be organized into relatively homogenous subscales that represent theoretically meaningful domains, then researchers could determine if interventions were more effective for reducing certain types of consequences, while counselors could better assess the types of alcohol-related problems experienced by their clients.
A commonly used measure to assess both alcohol and drug consumption and related negative consequences is the Core Alcohol and Drug Survey (CADS; Presley, Meilman, & Leichliter, 1998; Presley, Meilman, & Lyerla, 1993). The CADS is designed to assess the nature, scope, and consequences of college students' alcohol and drug use, as well as students' awareness of relevant alcohol and drug-related policies. Because, for the purposes of this study, we are most interested in the negative consequences items, we limit our review to that area of the CADS. The test developers (Presley et al., 1993) reported satisfactory reliability and content validity regarding scores from most of the CADS negative consequences items, but the nature of the relationship among the items themselves was unclear. That is, the construct validity of the scores from these items was not sufficiently established. We do not know, for example, if the items measure a single construct, if they measure multiple constructs, if certain items do or do not relate to each other, and so forth. Although the authors do report results from an exploratory factor analysis, (a) they included all of the CADS items in the analyses (not just the negative consequences items), which makes determining the relationships specifically among the negative consequences items somewhat difficult; (b) the procedures for conducting the analyses were unclear (e.g., method of extraction, type of rotation); and (c) only a portion of the consequences items demonstrated strong structure coefficients with any factor.
Since the development of the CADS, the instrument has been used extensively to assess prevalence rates of alcohol use, drug use, and negative consequences of such use (Presley, Meilman, & Leichliter, 2002). In addition, a number of researchers have used the CADS for purposes such as assessing prevalence rates among diverse populations (Madison-Colmore, 2003), examining the relationship between a variety of potential correlates and substance use/negative consequences (Lanier, Nicholson, & Duncan, 2001; Plucker & Dana, 1998), and evaluating program/intervention effectiveness (Glider, Midyett, Mills-Novoa, Johannessen, & Collins, 2001; Licciardone, 2003). Although some of these studies commented on the overall psychometric properties of scores obtained from the CADS, none conducted any rigorous examinations of the negative consequences items. Therefore, even though the negative consequences of the CADS have been used extensively for a variety of purposes, the psychometric properties of the scores obtained from the items themselves remain largely unknown.
Considering (a) the number of college students who are harmed every year from excessive alcohol consumption, (b) the popularity of the CADS in assessing negative alcohol-related consequences among college students, and (c) the lack of psychometric information on CADS negative consequences scores, the purpose of this study was to conduct an examination of the reliability and validity of the scores obtained from the CADS's negative consequences items. Although we have no...
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