Screening for Disinhibited Disorder Cases in a College Population: Performance of the SMAST, DAST, SCID-II-Q, and PDQ-4

Psychiatric disorders characterized by disinhibition--substance use disorders, antisocial personality disorder (PD), and borderline PD--represent a serious risk to the safety and health of college students. The ability of researchers and clinicians to identify students most at risk for disinhibited disorders associated with campus crime, violence, and self-harm depends on measures with strong evidence of diagnostic efficiency, yet data on the diagnostic efficiency of screening measures in college populations are lacking. The authors addressed this need by examining the diagnostic efficiency of commonly used screening measures for disinhibited disorders in a sample of 2,085 students, 79 of whom also completed diagnostic interviews. Results suggest that the diagnostic efficiency (e.g., sensitivity, specificity) of screening measures for substance use disorders and antisocial PD in college samples can be increased by making simple adjustments in screening cutoff criteria. Similar adjustments did not increase the diagnostic efficiency of the screening measure for borderline PD, and this suggested that certain screeners may best be aimed at ruling out disorders. This type of information offers users flexibility with which to tailor the screening threshold to serve different objectives. (Contains 3 tables and 3 footnotes.)