The Michigan Alcoholism Screening Test (MAST): A Statistical Validation Analysis

Article excerpt

This study extends the Michigan Alcoholism Screening Test (MAST; M. L. Selzer, 1971) literature base by examining 4 issues related to the validity of the MAST scores. Specifically, the authors examine the validity of the MAST scores in light of the presence of impression management, participant demographic variables, and item endorsement infrequency.

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According to the National Mental Health Association (NMHA; 2001), of the more than 54 million Americans who have a diagnosable mental illness, approximately 8 million will seek counseling this year. Fifteen percent of these treatment seekers will experience a comorbid substance disorder (Beeder & Millman, 1992; NMHA, 2001). Given such percentages, it is likely that many counselors, regardless of their practice areas, will encounter clients who abuse or are dependent on alcohol. Thus, it is essential that counselors have the necessary assessment skills to screen clients to determine who is and who is not experiencing alcohol-use-related problems (McLellan & Dembo, 1992). Although not all counselors can be experts at diagnosing and treating alcohol abuse and dependence, Horrigan, Piazza, and Weinstein (1996) asserted that the failure to screen for the presence of alcohol dependence may lead counselors to misdiagnose their clients' presenting concerns and subsequently provide less than optimum care.

Counselors interested in using a brief, easy to administer and score screen for alcohol abuse and dependence are faced with a wide variety of choices. Some of the most well-known and well-researched instruments currently available include the CAGE (asks about respondents' needing to cut down, being annoyed by criticism, feeling guilty over drinking, and using drink as an eye-opener; Ewing, 1984), the Alcohol Use Disorders Identification Test (AUDIT; Saunders, Aasland, Babor, De La Fuente, & Grant, 1993), the TWEAK (similar to CAGE but asks about tolerance, worried, eye-openers, amnesia, and k for cut down; Russell et al., 1994), the T-ACE (tolerance, annoyance, cut down, and eye-opener; Sokol, Martier, & Ager, 1989), the Substance Abuse Subtle Screening Inventory-3 (SASSI-3; Miller & Lazowski, 1999), and the Michigan Alcoholism Screening Test (MAST; Selzer, 1971). Of these various choices, the MAST and the SASSI-3 are the most often and widely selected screening instruments (Brady, Foulks, Childress, & Pertschuk, 1982; Juhnke, Vacc, Curtis, Coll, & Paredes, 2003; Myerholtz & Rosenberg, 1997; Piazza, Martin, & Dildine, 2000; Thurber, Snow, Lewis, & Hodgson, 2001).

The MAST was designed to serve as a quantifiable measure of alcohol dependence (Selzer, 1971). The MAST contains 25 true/false questions about alcohol consumption and related behaviors. It is estimated that the MAST can be completed in 10 to 15 minutes (Hedlund & Vieweg, 1984). Selzer assigned item weights of 0, 1, 2, or 5 based on his perception of each item's contribution toward an overall indication of alcohol abuse severity. The MAST's total score, the sum of each individual item, ranges from 0 to 53. Selzer's original scoring system classified total scores of 0 through 3 as representative of social drinking, 4 as borderline or suggestive of alcohol abuse, and a score of 5 or more as a clear indication of alcohol abuse. Later, however, the MAST scoring system was adjusted such that the following range of scores is generally used by clinicians: 0-4, not alcohol dependent; 5-6, may be alcohol dependent; 7 or more, alcohol dependent (Hedlund & Vieweg, 1984; Selzer, Vinokur, & Rooijen, 1975).

Since its inception, the MAST has been studied extensively. Articles summarizing the populations in which the MAST has been studied appeared in 1982 (Brady et al., 1982) and 1984 (Hedlund & Vieweg, 1984). While representing exhaustive reviews of the literature at the time, none of the referenced studies compared the MAST's performance against other psychological measures of alcohol dependence. …