Abstract

Background/Purpose: A growing body of evidence suggests that people who are arrested for driving under the influence (DUI) of alcohol are more likely to screen positive for psychiatric disorders than the general population. Additionally, psychiatric comorbidity has been shown to increase vulnerability to criminal re-offense. However, DUI programs face many barriers to screening for psychiatric disorders. This paper evaluates the sensitivity and specificity of a screening tool developed for these programs, the Computerized Assessment and Referral System (CARS) Screener. Methods: We used data from 381 DUI offenders in Massachusetts, as well as a secondary data source, the National Comorbidity Survey-Replication (NCS-R: N = 9,282) to examine the accuracy of the CARS Screener when compared to full assessment. Results: Based on both sets of analyses, we found that the CARS Screener offers a sensitive and specific method to screen for many psychiatric disorders. Specifically, the CARS Screener has a high sensitivity and specificity for bipolar disorder, intermittent explosive disorder, depressive disorders, generalized anxiety disorder, alcohol and drug use disorders, gambling disorder, post-traumatic stress disorder, panic attacks, and social phobia. Conclusion: The CARS Screener appears to be an effective tool that will help DUI programs better understand and address the mental health issues facing their clients.

摘要

背景/目的：越来越多的证据表明，因酒驾 (DUI) 被捕的人比一般人群更有可能筛查出精神疾病阳性。此外，精神疾病的合并症已被证明会增加再次犯罪的风险。然而，酒后驾车计划在筛查精神疾病方面面临许多障碍。本文评估了为这些程序开发的筛查工具——计算机评估和转诊系统 (CARS) 筛查工具的敏感性和特异性。方法：我们使用了马萨诸塞州 381 名酒后驾车犯罪者的数据，以及二级数据来源，全国合并症调查 - 复制（NCS-R：N = 9,282) 以检查 CARS Screener 与完整评估相比的准确性。结果：基于两组分析，我们发现 CARS Screener 提供了一种敏感且特异的方法来筛查许多精神疾病。具体来说，CARS Screener 对双相情感障碍、间歇性爆发性障碍、抑郁障碍、广泛性焦虑障碍、酒精和药物使用障碍、赌博障碍、创伤后应激障碍、惊恐发作和社交恐惧症具有很高的敏感性和特异性。结论： CARS Screener 似乎是一种有效的工具，可以帮助 DUI 计划更好地了解和解决客户面临的心理健康问题。