Behind the Alcohol Cost Calculator for Kids:
Methods Used to Calculate Community-Specific Estimates for the Prevalence and Impact of Serious Alcohol Problems Among Youth Ages 12 to 20
Alcohol is often abused by adolescents and frequently results in adverse consequences. To help sharpen understanding of the impact of adolescent drinking on communities, Ensuring Solutions to Alcohol Problems, an initiative based at The George Washington University Medical Center, devised a calculator that shows how many teens are affected by serious alcohol problems.1 The Alcohol Cost Calculator provides concrete information, grounded in research, about the impact of alcohol problems and what other negative outcomes are more likely to affect them. It shows:
- How common alcohol problems are in adolescents in three age groups: 12-15, 16-17, and 18-20.
- How many more school days children with alcohol problems miss per year.
- How much more likely children with alcohol problems are to drive under the influence of alcohol, to abuse illegal drugs, and to have contact with the juvenile justice system.
- How many of children with alcohol problems are not receiving treatment.
- The likelihood of children with alcohol problems having other problems such as depression, suicidality, conduct disorder, and increased risk taking activities.
This document describes in detail the methods that Ensuring Solutions uses to derive these estimates.
Limitations of Survey Data
Ensuring Solutions draws upon two large government-sponsored epidemiological surveys, the National Household Survey on Drug Abuse (NHSDA), now known as the National Survey on Drug Use and Health (NSDUH)2, and the National Comorbidity Survey (NCS)3, to create an online tool that provides estimates of the prevalence of alcohol-related problems among American adolescents.
These two scientifically rigorous surveys collect information only about what respondents tell the survey administrators. The accuracy of such self-report information depends on respondents' truthfulness and memory.
The surveys only sample civilian, non-institutionalized populations in the United States. People living in institutions (such as youth in juvenile detention or correctional facilities, adolescent drug or mental health treatment centers), those with no permanent residence (homeless or run-away youth) and active military personnel are not represented by these surveys.
Since these surveys were constructed to provide national estimates, it is very difficult to have any confidence that these estimates apply to very small populations or for youth with characteristics very different from the national sample. For example, it would not be a good idea to rely on the Alcohost Calculator for Kids to estimate alcohol-related problems in a small middle school. Ethnicity, gender, rural/urban environment, community risk and resiliency factors can substantially alter the prevalence to teen alcohol problems. More...
Many states and communities have undertaken surveys of youthful alcohol and other drug use. Data from local surveys can refine and supplement estimates from the Alcohol Cost Calculator for Kids.
Center for Substance Abuse Prevention. State Prevention Profiles and Data.
Center for Substance Abuse Treatment. State Information.
Center for Disease Control and Prevention. Youth Risk Behavior Surveillance System
Sources of data
Ensuring Solutions draws upon two large government-sponsored epidemiological surveys, the National Household Survey on Drug Abuse (NHSDA) and the National Comorbidity Survey (NCS) to create an online tool that provides estimates of the prevalence of alcohol-related problems among American adolescents (www.alcoholcostcalculator.org/kids/). In 2003, the federal Department of Health and Human Services Substance Abuse and Mental Health Administration (SAMSHA) renamed the NHSDA. It is now known as the National Survey on Drug Use and Health (NSDUH). Both names are used on this Website.
The Substance Abuse and Mental Health Services Administration (SAMHSA) of the Department of Health and Human Services conducts the NSDUH annually on a nationally representative sample of people residing in households in all 50 states and the District of Columbia. SAMHSA produces publicly available data each year based on a representative subgroup of about 57,000 of the NSDUH respondents.4 These datasets allow researchers to generate detailed estimates of the prevalence, linkages, and consequences of alcohol, tobacco and illicit drug use (including marijuana, cocaine, heroin, hallucinogens, inhalants, pain relievers, tranquilizers, stimulants, and sedatives) in the civilian, non-institutionalized U.S. population.
For the Adolescent Alcohol Cost Calculator, Ensuring Solutions analyzed the 2002 NSDUH data. All respondents in the 2002 survey who were between 12 and 20 years of age (24,612), are included in analyses.
The other major data source, the NCS, is conducted on a nationally representative sample of 8,098 respondents 15-54 years of age who participated in a detailed diagnostic interview between 1990 and 1992. The Survey Research Center (SRC) at the University of Michigan conducted the NCS under the direction of Ron Kessler (now at Harvard University).5 The National Institute on Mental Health, the National Institute on Drug Abuse and the W.T. Grant Foundation funded the study. In addition to diagnostic information on alcohol use and misuse, the NCS collected data on lost productivity, mental illness, and social problems.
Both surveys have sampling weights applied to the data for each respondent, meaning that each respondents answer adjusted to represent the population that respondent is from. The data might be weighted on the basis of any demographic characteristics such as gender, race, age, and other relevant characteristics depending on how the sampling was done. The assignment of weights to each respondent accounts for over and under representation of people like the respondent in the population. The unweighted sample in these instances is not representative of the target population, and the weighted data must be used. Thus, unless otherwise specified, for both surveys the weighted data is used.
In the 2002 NSDUH 3,570,262 individuals, or 9.6 percent of the population aged 12-20 met the DSM IV diagnostic criteria for alcohol abuse or dependence disorder.
The NCS was conducted in multiple parts with different weights applied to each part. The first part includes a Diagnostic Interview, the second part is a Risk Assessment Interview, and the final was a Tobacco Supplement Interview. Only the Diagnostic Interview and the Risk Assessment Interview were used in the Adolescent calculator with different weights applied to each. The weighted data for the NCS Diagnostic Interview segment had 1307 respondents, with 161 classified as alcohol abusing or dependent. The weighted Risk Assessment Interview segment of the NCS had 940 respondents, with 113 classified as alcohol abusing or dependent.
Both the NSDUH and the NCS datasets are part of the Substance Abuse and Mental Health Data Archive maintained by the Inter-university Consortium for Political and Social Research at the University of Michigan (www.icpsr.umich.edu/SAMHDA) and were downloaded from that site. Ensuring Solutions used SAS (Version 8.2, SAS Institute, Inc, Cary, NC) to analyze NCS data and SDA (Version 1.3, University of California, Berkley) to analyze the NSDUH.
Although both datasets were used, it is important to note that the NCS cannot be directly compared with the NSDUH because the criterion used to classify alcohol abuse and alcohol dependence is different between the surveys. The NSDUH uses the most recent criteria available in the diagnostic and statistical manual for mental disorders (DSM-IV) while the NCS uses the criteria from the DSM-III-R (which was the most recent manual at the time the NCS was conducted). The criteria for abuse or dependence in DSM-IV were expanded to include drinking despite recurrent social, interpersonal, and legal problems as a result of alcohol use. Thus, some of the questions that are used to assess alcohol abuse or dependence in the NSDUH were not asked by the NCS, thus they are not directly connectable and thus information from the NCS cannot reliably be applied to estimates from the NSDUH.6
Additionally, no age-group specific analyses are conducted with the NCS data due to its substantially smaller sample size.
Prevalence of alcohol dependence and alcohol abuse
The NSDUH survey has a number of items meant to assess alcohol abuse and dependence. This is accomplished by asking respondents questions that are based on the standard diagnostic manual for mental and substance abuse problems, the DSM 4th edition, criteria for substance abuse and dependence.
Specifically, a respondent was defined as alcohol dependent if the respondent reported a positive response to 3 or more of these dependence criteria:
- (1) Spent a great deal of time over a period of a month getting, using, or getting over the effects of the substance.
- (2) Unable to keep set limits on substance use or used more often than intended.
- (3) Needed to use substance more than before to get desired effects or noticed that using the same amount had less effect than before.
- (4) Unable to cut down or stop using the substance every time he or she tried or wanted to.
- (5) Continued to use substance even though it was causing problems with emotions, nerves, mental health, or physical problems.
- (6) Reduced or gave up participation in important activities due to substance use.
- (7) A question assessing withdrawal symptoms was asked if the respondent reporting using several specific substances (alcohol, pain relievers, cocaine, heroin, sedatives, and stimulants).
A respondent was classified as alcohol abusers if they reported a positive response to one or more of the following four abuse criteria:
- (1) Respondent reported having serious problems due to substance use at home, work or school
- (2) Respondent reported using substance regularly and then did something where substance use might have put them in physical danger
- (3) Respondent reporting substance use causing actions that repeatedly got them in trouble with the law
- (4) Respondent reported having problems caused by substance use with family or friends and continued to use substance even though it was thought to be causing problems with family and friends
Ensuring Solutions calculated the prevalence of alcohol problems in three age groups. The NSDUH estimates that overall among American adolescents 9.6 percent have an alcohol abuse or dependence disorder. However the estimates are different in different age groups. Among the youngest teens in the analysis, ages 12-15, 3.2 percent have an alcohol abuse or dependence disorder, in the middle age ranges (16-17) the prevalence is 11.7 percent, and in the oldest age group (18 to 20) the prevalence is 17.0 percent.
Respondents to the NSDUH were also asked if they have ever received treatment or counseling for use of alcohol or any drug (excluding cigarettes). This question was only asked of respondents that had indicated a use of any drug or alcohol at some point in their lifetimes. The number of alcohol abusing or dependent teens that are untreated was derived by multiplying the percentage of alcohol abusing or dependent teens answering "no" to this question times the number of alcohol abusing or dependent teens estimated in the population.
Driving under the influence of alcohol
The NSDUH surveys asked respondents if during the past 12 months they have driven a vehicle while under the influence of alcohol only or a combination of alcohol and illegal drugs. The number of excess incidents of driving under the influence of alcohol were calculated by subtracting the percentage of non-alcohol abusing or dependent teens reporting these incidents from the percentage of alcohol abusing or dependent teens reporting the same. This percentage was then applied to the alcohol abusing or dependent population to derive an excess number of these incidents.
Respondents to the NSDUH were asking if they had ever smoked cigarettes, and if so, had they smoked in the past 30 days. The NSDUH also assessed levels of smoking among teens, asking teens who reported smoking in the past 30 days how many cigarettes they smoked on average per day, which was collapsed into more or less than 16 cigarettes per day. The number of alcohol abusing or dependent teens that reported having ever smoked, having smoked in the past 30 days, and how many cigarettes smoked is derived in the same way as above.
Involvement with illegal drugs
The NSDUH assessed whether respondents were abusing or dependent on a comprehensive list of illegal drugs (including marijuana, cocaine, heroin, hallucinogens, inhalants, pain relievers, tranquilizers, stimulants, and sedatives). The number of excess cases of abuse or dependence on illegal drugs was determined in the same manner as above.
The NSDUH also asks respondents whether they have sold illegal drugs one or more times in the previous 12 months. The number of excess cases of selling illegal drugs was determined in the same manner as above.
Problems with law enforcement
The NSDUH also asked respondents if they had ever been arrested or booked for breaking the law (excluding minor traffic violations). The question specified that being 'booked' meant taken into custody and processed by the police or by someone connected with the courts, even if they were released afterwards.
The NSDUH asks a special series of questions about unlawful behaviors in the past 12 months, the questions asked differed slightly depending on whether the respondent was younger than 18 or 18 and older. Questions asked of both groups include the number of times they had attacked someone with the intent to seriously hurt them, the number of times they had carried a handgun, and the number of times they had stolen or tried to steal items worth $50 or more. The number of excess cases of being arrested or booked for breaking the law and unlawful behaviors was determined in the same way as the excess incidents of driving under the influence of alcohol was determined.
School achievement and attitudes.
NSDUH asks respondents a number of questions about school attendance and school attitudes. Respondents are how many whole days in the 30 days prior to the interview did they not go to school due to sickness or injury, and the same for days they did not go to school due to skipping or cutting school. The answers to these two questions are added together and annualized to produce 10-month estimates of the total number of school days missed (two month summer vacations were not included in the estimates). The number of excess school days missed all year for students with alcohol abuse or dependence disorders was calculated by subtracting the non alcohol abusing or dependent students missed school days from the alcohol abusing or dependent students missed school days.
Respondents under age 18 are asked a series of questions about school performance and attitudes toward school. Respondents are asked whether they attended school and what was their average grade point average (GPA) in the most recent grading period. Categories were formed for self-reported GPA of B- and above or C+ and below. Respondents are also asked whether they generally liked school, whether they felt what they were learning was important, and whether the things they were learning were of interest. All responses were dichotomized between very/somewhat positive and somewhat/very negative.
The sample size for the NCS is very small, and for this reason age breakdowns are not a possibility. However, we can use this information to give some idea of the risks American adolescents with alcohol problems face. The NCS is used to derive non-age specific estimates of the percentage of American adolescents ages 15-20 with alcohol abuse or dependence problems that have negative outcomes such as suicidal thinking, suicide attempts, conduct disorder, problems with family school or work, and accidents or injuries. These are simply the percentage of young people abusing or dependent upon alcohol aged 15-20 who experienced these problems.
Prevalence of alcohol problems by age groups
The percentage of youth reporting an alcohol abuse or dependence disorder is listed below.
|Age Group||2002 Estimate|
A startling majority of youth with alcohol problems in all three age groups do not report ever having treatment. Eighty eight percent of the alcohol abusing and dependent youth in the young (12-15) age group and eighty three percent in the middle (16-17) age groups reported not ever receiving treatment for their alcohol problem. Additionally, eighty four percent of the oldest age group (18-20) reported not ever receiving treatment. The calculator provides an estimate of the number of people untreated by applying the prevalence of being untreated to the number of people in the population with alcohol problems.
|Age Group||Prevalence of alcohol problems per 1000 youth in age group||Prevalence of alcohol problems that go untreated|
School achievement and productivity.
Students with alcohol abuse or dependence problems miss substantially more school days than students without these disorders. Alcohol abusing or dependent students between the ages of 12 and 20 missed 23 school days per school year while students without alcohol problems missed 13 days per year, a difference of 10 days per student per year.8
Overall, adolescents between the ages of 12 and 18 with alcohol problems were significantly more likely to report that they did not like school (44% vs. 20%), did not feel that school work was important (24% vs. 11% ), found school or work boring (41%% vs. 23%) and have grades of C+ or below(46% vs. 29%). All comparisons for 12 to 15 year olds and 16 to 17 year olds are highly significant between those with serious alcohol problems and those with none.
The Educational Impact of Serious Alcohol Problems
|Youth with serious alcohol problems||Youth without serious alcohol problems||Difference9|
|Negative attitude toward school||48.1%||18.8%||29.3%|
|Grades of C or below||56.5%||27.7%||28.8%|
|Youth with serious alcohol problems||Youth without serious alcohol problems||Difference10|
|Negative attitude toward school||42.3%||22.1%||20.2%|
|Grades of C or below||39.8%||30.4%||9.4%|
Driving under the influence of alcohol
Young people with alcohol abuse or dependence disorders are much more likely to drive under the influence of alcohol alone or drugs and alcohol combined than youth without alcohol disorders (58% vs. 8%)11. The calculator uses estimates from the NSDUH to determine the excess incidents of driving under the influence of alcohol in youth with alcohol problems. This is done by determining the percent difference in driving under the influence and applying that percent to the number of people in that age group estimated to have an alcohol abuse or dependence problem.
|Age Group||DUI in alcohol abusing or dependent youth||DUI in non-alcohol abusing or dependent youth||Difference12||Excess cases of DUI per 1000 youth in each age group|
Overall young people with alcohol problems are twice as likely to report having ever smoked (89.9% vs. 40%)13 and having smoked in the past 30 days (68.6% vs. 42.8%)14. The differences were even more pronounced when evaluating the different age groups, with people aged 12-15 with alcohol problems being more than 3 times more likely to report ever smoking than their peers without alcohol problems (86.0% vs. 22.2%). In terms of heavy smoking, young people with alcohol problems were more likely to be heavy smokers, defined as more than a half a pack a day (17% vs. 13.7%)15. The calculator uses estimates from the NSDUH to determine the excess incidents of smoking in youth with alcohol problems. This is done by determining the percent difference in incidence of smoking and applying that percentage to the number of people in that age group estimated to have an alcohol abuse or dependence problem.
|Age Group||Percentage of youth with serious alcohol problems who smoke||Percentage of youth without serious alcohol problems who smoke||Difference (Percentage)16||Excess number of people who have ever smoked per 1000 youth each in age group|
|Age Group||Percentage of youth with serious alcohol problems who smoke heavily||Percentage of youth without serious alcohol problems who smoke heavily||Difference (Percentage)17||Excess number of people who smoke heavily per 1000 youth in each age group|
Abuse of or dependence on illegal drugs
The NSDUH assessed whether respondents were abusing or dependent on a comprehensive list of illegal drugs (including marijuana, cocaine, heroin, hallucinogens, inhalants, pain relievers, tranquilizers, stimulants, and sedatives). Young people with alcohol abuse or dependence disorders are much more likely to also be classified as abusing or being dependent upon illegal drugs than youth without alcohol disorders (overall prevalence is 34 percent versus 4 percent for non alcohol abusing or dependent youth).18 Young people with alcohol disorders are almost nine times as likely to meet DSM IV diagnostic criteria drug dependence or abuse as youth without these disorders. The calculator uses estimates from the NSDUH to determine the excess incidents of drug abuse or dependence in youths with alcohol problems. The same procedure used for determining the excess cases of driving under the influence was used in this instance and to calculate the excess contacts with law enforcement.
|Age Group||Percentage of drug problems in youth with serious alcohol problems||Percentage of drug problems in youth without serious alcohol problems||Difference (Percentage)19||Excess cases of drug problems per 1000 youth in each age group|
Problems with law enforcement
The NSDUH also asked respondents if they had ever been arrested or booked for breaking the law (excluding minor traffic violations). The question specified that being 'booked' meant taken into custody and processed by the police or by someone connected with the courts, even if they were released afterwards. Young people abusing dependent upon alcohol were much more likely to have had this kind of contact with the law than non abusing or dependent youth (34% vs.10%).20 The number of excess cases of being arrested or booked for breaking the law was determined in the same way as the excess incidents of driving under the influence of alcohol was determined.
|Age Group||Percentage of youth with serious alcohol problems who have contact with law enforcement||Percentage of youth without serious alcohol problems who have contact with law enforcement||Difference (Percentage)21||Excess law enforcement contacts per 1000 youth in each age group|
Other questions about unlawful behaviors in the past 12 months also show large differences by alcohol abuse status. Overall young people with alcohol problems are substantially more likely to report one or more instances of attacking someone with the intent to harm (21.4% vs. 6.4%),almost four times as likely to report carrying a handgun at least once, (10.6% vs. 2.8%) and over six times more likely to report stealing or trying to steal items worth $50 or more (24.3% vs. 3.6%). In terms of selling illegal drugs, overall young people with alcohol problems were ten times more likely to report selling drugs than youth without these problems (28.2% vs. 2.9%).22
Emergency department use
Youth with alcohol problems reported use of hospital emergency services nearly 50% more often than their peers. They report an average of 0.75 ER visits annually compared to adolescents with no serious alcohol problems rate of 0.56 times annually.23
|Age Group||ER use rate among youth with serious alcohol problems||ER use rate among youth without alcohol problems||Difference24||Extra number of ER visits per 1000 youth in each age group|
The NCS Data
The “additional risks” page section of the Calculator includes estimates of some of the negative outcomes of alcohol use among adolescents aged 15-20. These estimates are simply the percentage of adolescents abusing alcohol that report each outcome.
|Percent of youth with alcohol use disorder||Percent of youth with no alcohol use disorder||Number with the problem for every 100 youth with serious alcohol problems||Number with the problem for every 100 youth with no serious alcohol problems|
|Serious trouble with police||20.1%||3.1%||20||3|
|Hospitalization for MH/SA/emotional||8.1%||2.8%||8||3|
|Carrying a weapon||20.1%||5.8%||20||6|
|Having different sex partners||79.6%||49.8%||80||50|
Adolescents with alcohol abuse and dependence disorders are more likely to have a host of negative outcomes. One of the more serious problems linked with alcohol use in this sample is conduct disorder. Conduct disorder is a psychological problem that 43 percent of alcohol abusing or dependent adolescents were diagnosed with in our sample. Conduct disorder is defined as a persistent pattern of rule breaking and violations of the rights of others. Conduct disorder is important because not only does it cause problems in childhood but is also related to rule breaking and criminal behavior later on in life. Thus it should be unsurprising that a greater percentage (20%) of alcohol abusing or dependent adolescents reported serious trouble with the police.
Suicide is already a serious problem for American teens. Our data suggests that both suicidal thoughts (35%) and suicidal attempts (19%) are increased among alcohol abusing and dependent adolescents. There is an increased prevalence of accidents, injuries, and poisoning among alcohol abusing and dependent adolescents as well. A greater percent of alcohol abusing and dependent adolescents also report having at some point in life being admitted to a hospital for emotional, substance use, or alcohol problems. Adolescents with alcohol abuse or dependence problems are also more likely to report difficulty concentrating either sometimes or often (45%) than their non abusing or dependent peers (28%).26
The NSDUH is the only survey that regularly produces estimates of drug use among members of the civilian, non-institutionalized population aged 12 and older of the United States. However, use of survey data such as the NSDUH has certain limitations. First, the survey collects data on self-reports of drug use, and this depends on respondents' truthfulness and memory. The validity of self-report drug use data has been established in previous research (see Turner, Lessler, and Gfroerer, 1992)27 but some under- and over reporting may have occurred. Second, because the population that participated in the survey is the civilian, non institutionalized population of the United States, a small proportion (less than 2 percent) of the population has been excluded. Specifically those living in institutions (e.g., prisons, nursing homes, treatment centers), those with no permanent residence (e.g., homeless people), and active military personnel are not represented in this survey. As a result, estimates of substance use derived from the NSDUH may be slightly lower, as studies have demonstrated that alcohol and illicit drug use in populations living in institutional settings and those with no permanent residence differed significantly from that of the household population (National Institute on Drug Abuse, 1993).28
The Adolescent calculator gives a very general estimate of the extent of the problem of alcohol abuse and dependence in American adolescents. This is a tool that can provide community groups with estimates of the extent of alcohol problems among American adolescents. It can also point to associations with serious problems that are more likely to impact young people with alcohol problems. This problem clearly represents a significant danger to the health and welfare of American adolescents, and given the difficulties that adolescents with untreated alcohol problems face, it is important that politicians, communities, and families work to improve access to treatment for alcohol-related problems.
Eric Goplerud, PhD
Director, Ensuring Solutions to Alcohol Problems
- Throughout this paper and The Alcohol Cost Calculator, the terms "alcohol use disorder" and "alcohol problems" will be used interchangeably to refer to persons who meet the diagnostic criteria specified in the Diagnostic and Statistical Manual (4th Ed.) for alcohol dependence disorder and alcohol abuse disorder.
DSM-IV Criteria for Alcohol Abuse:
A maladaptive pattern of alcohol abuse leading to clinically significant impairment or distress, as manifested by one or more of the following, occurring within a 12-month period:
- Recurrent alcohol use resulting in failure to fulfil major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions or expulsions from school; or neglect of children or household).
- Recurrent alcohol use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine).
- Recurrent alcohol-related legal problems (e.g., arrests for alcohol-related disorderly conduct).
- Continued alcohol use despite persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the alcohol (e.g., arguments with spouse about consequences of intoxication or physical fights).
These symptoms must never have met the criteria for alcohol dependence.
DSM-IV Criteria for Alcohol Dependence:
A maladaptive pattern of alcohol use, leading to clinically significant impairment or distress, as manifested by three or more of the following seven criteria, occurring at any time in the same 12-month period:
Tolerance, as defined by either of the following:
- A need for markedly increased amounts of alcohol to achieve intoxication or desired effect.
- Markedly diminished effect with continued use of the same amount of alcohol.
Withdrawal, as defined by either of the following:
- The characteristic withdrawal syndrome for alcohol (refer to DSM-IV for further details).
- Alcohol is taken to relieve or avoid withdrawal symptoms.
Alcohol is often taken in larger amounts or over a longer period than was intended.
There is a persistent desire or there are unsuccessful efforts to cut down or control alcohol use.
A great deal of time is spent in activities necessary to obtain alcohol, use alcohol or recover from its effects.
Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the alcohol (e.g., continued drinking despite recognition that an ulcer was made worse by alcohol consumption).
American Psychiatric Association. 1994. Diagnostic and Statistical Manual of Mental Disorders (4th ed.) (DSM-IV). Washington, D.C.: APA.
- U.S. Dept. of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies. 2003. National Household Survey on Drug Abuse, 2001. Research Triangle Park, NC: Research Triangle Institute.
- Kessler, Ronald C. 2000. National Comorbidity Survey, 1990-1992 [Computer file]. Conducted by University of Michigan, Survey Research Center. ICPSR ed. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [producer and distributor].
- Available online at: http://webapp.icpsr.umich.edu/cocoon/SAMHDA-SERIES/00064.xml#das
- Kessler, R.C. 2000. The National Comorbidity Survey of the United States. International Review of Psychiatry. 6 (1994): 365-376.
- The NCS diagnoses were based on a modified version of the Composite International Diagnostic Interview (the UM-CIDI. All NCS diagnoses use DSM III-R criteria, the predecessor to the DSM-IV, which is used by the NHSDA to diagnose serious alcohol problems. The 2002 NHSDA include a common set of questions about alcohol use that are sufficient to construct DSM IV diagnoses of alcohol dependence disorder and alcohol abuse disorder during the year prior to the interview (sampling, diagnostic algorithm, and reliability studies). Available from the World Wide Web: http://www.icpsr.umich.edu/SDA/SAMHDA/03903-0001/CODEBOOK/3903.htm
- χ2=1093, p=.00
- χ2=9507408, p=.000.
- Negative attitude toward school: χ2 = 181, p =.00
Classes uninteresting: χ2 = 104, p =.00
School/work unimportant: χ2 = 128, p =.00
Grades of C+ or below: χ2 = 134, p =.00
- Negative attitude toward school: χ2 = 119, p =.00
Classes uninteresting: χ2 = 70, p =.00
School/work unimportant: χ2 = 31, p =.00
Grades of C+ or below: χ2 = 22, p =.00
- χ2=5598, p.00
- young- χ2 = 1573, p =.00; middle- χ2 = 1026, p =.00; oldest- χ2 = 1419, p =.00
- χ2 =809, p=.00
- χ2 =2818, p =.00
- χ2 = 9.4, p =.00
- young- χ2 = 809, p =.000; middle- χ2 = 383, p =.000; oldest- χ2 = 365, p =.000
- young- χ2 = 23 p =.000; middle- χ2 =10, p =.000; oldest- χ2 = 25, p =.000
- χ2 = 3056, p =.000
- young- χ2 =2207, p =.000; middle- χ2 =731, p =.000; oldest- χ2 =607, p =.000
- χ2 =1279, p =.000
- young- χ2 =284, p =.000; middle- χ2 =294, p =.000; oldest- χ2 =296, p =.000
- Attack someone with the intent to harm: ages 12-17: χ2 = 504, p =.00; ages 18-20: χ2 = 171, p =.00
Carried a handgun at least once: χ2 = 185, p =.00
Stole or attempted to steal at least $50 worth of items: χ2 = 899, p =.00
Sold illegal drugs: χ2 = 1490, p =.00
- t = 6.7, p = .000
- young-t = 3.7, p = .000; middle-t = 4.4, p = .000, t = 3.1, p = .000
- Chi squares for NCS data
Conduct disorder χ2=84, p<.0001 Suicidal thoughts χ2=43, p<.0001 Suicide attempts χ2=54, p<.0001 Serious trouble with police χ2=59, p<.0001 Hospitalization for MH/SA/emotional χ2=8.6, p<.0033 Accidents, injuries, poisoning χ2=4.7, p=.0296 Carrying a weapon χ2=29, p<.0001 Having different sex partners χ2=56, p<.0001
- χ2=12, p<.0003
- Turner, C.F., Lessler, J.T. & Gfoerer, J.C. (1992). Survey measurement of drug use: Methodological studies.National Institute on Drug Abuse, DHHS Publication No. (ADM) 92-1929.
- National Institute on Drug Abuse (1993). National survey results on drug use from the monitoring the future study, 1975-1992: Volume 1, secondary students. Rockville, MD: U.S. Department of Health and Human Services.