Criminal Justice Drug Abuse Treatment Studies (CJ-DATS): The Criminal Justice Co-Occurring Disorder Screening Instrument (CJ-CODSI), 2002-2008 [United States]

Currently, there exists an inadequacy in mental and substance use disorder screening instruments. This inadequacy stems from two reasons. First, the instruments are untested for widespread use with criminal justice populations. Second, most test for only one disorder at a time. The Criminal Justice Co-Occurring Disorder Screening Instrument (CODSI) study addresses this issue, investigating new methods by which to quickly, accurately, and easily evaluate individuals in the criminal justice population for COD (Co-Occurring Disorders). After determining that the Texas Christian University Drug Screen (TCUDS) would be the appropriate substance abuse screening component for a COD screen, researchers tested three possible mental disorder screening components: the Global Appraisal of Individual Needs (GSS, version 1.0); the Mental Health Screening Form (MHSF); and the Modified MINI Screen (MMS). The Structured Clinical Interview for DSM-IV (SCID), generally accepted as an accurate measure of mental disorder, was used as a reference by which to evaluate the three different screeners. Researchers also used items from the three different screeners to create two additional instruments: the CODSI-MD for any mental disorder and the CODSI-SMD for severe mental disorder. Actual testing was conducted at four different sites, taking a total of 280 new admissions to prison-based substance abuse treatment programs. Instruments were evaluated based on their sensitivity (ability to correctly identify those with COD), specificity (ability to correctly identify those without COD), and overall accuracy (percentage of correct identification across all people). Researchers also conducted a study using a sample comprised of a greater proportion of Latinos and African Americans, in order to evaluate the effect of race on the results of the instruments.

当前，精神和物质使用障碍筛查工具（mental and substance use disorder screening instruments）存在不足，该不足源于两方面原因：其一，现有筛查工具未针对刑事司法人群（criminal justice populations）开展广泛应用的验证研究；其二，多数工具仅能单次筛查单一障碍类型。刑事司法共病障碍筛查工具（Criminal Justice Co-Occurring Disorder Screening Instrument, CODSI）研究旨在解决这一问题，探索可快速、准确且便捷地对刑事司法人群开展共病障碍（Co-Occurring Disorders, COD）评估的新方法。研究人员先确定德克萨斯基督教大学药物筛查量表（Texas Christian University Drug Screen, TCUDS）可作为共病障碍筛查中适配的物质滥用筛查组分，随后对三种可选的精神障碍筛查组分进行测试：个体需求整体评估（Global Appraisal of Individual Needs, GSS 1.0版）、心理健康筛查表（Mental Health Screening Form, MHSF）以及改良版MINI筛查量表（Modified MINI Screen, MMS）。研究以被学界广泛认可的精神障碍精准评估工具——DSM-IV结构化临床访谈（Structured Clinical Interview for DSM-IV, SCID）作为参照标准，对上述三款筛查工具进行评估。此外，研究人员还从三款筛查工具中提取条目，开发了两款新增工具：针对任意精神障碍的CODSI-MD，以及针对重度精神障碍的CODSI-SMD。本次实际测试在4个不同站点开展，共纳入280名参与监狱附属物质滥用治疗项目的新入组人员。评估指标包括灵敏度（sensitivity）、特异度（specificity）以及整体准确率（overall accuracy），分别指正确识别共病障碍阳性个体的能力、正确识别共病障碍阴性个体的能力，以及所有受试者的正确识别占比。为评估种族因素对筛查结果的影响，研究人员还使用了拉美裔与非裔美国人占比更高的样本开展了补充研究。