Short scales to assess cannabis-related problems: a review of psychometric properties

Aims: The purpose of this paper is to summarize the psychometric properties of four short screening scales to assess problematic forms of cannabis use: Severity of Dependence Scale (SDS), Cannabis Use Disorders Identification Test (CUDIT), Cannabis Abuse Screening Test (CAST) and Problematic Use of Marijuana (PUM). Methods: A systematic computer-based literature search was conducted within the databases of PubMed, PsychINFO and Addiction Abstracts. A total of 12 publications reporting measures of reliability or validity were identified: 8 concerning SDS, 2 concerning CUDIT and one concerning CAST and PUM. Studies spanned adult and adolescent samples from general and specific user populations in a number of countries worldwide. Results: All screening scales tended to have moderate to high internal consistency (Cronbach's alpha ranging from .72 to .92). Test-retest reliability and item total correlation have been reported for SDS with acceptable results. Results of validation studies varied depending on study population and standards used for validity assessment, but generally sensitivity, specificity and predictive power are satisfactory. Standard diagnostic cut-off points that can be generalized to different populations do not exist for any scale. Conclusion: Short screening scales to assess dependence and other problems related to the use of cannabis seem to be a time and cost saving opportunity to estimate overall prevalences of cannabis-related negative consequences and to identify at-risk persons prior to using more extensive diagnostic instruments. Nevertheless, further research is needed to assess the performance of the tests in different populations and in comparison to broader criteria of cannabis-related problems other than dependence.