A Study of DUI Offenders: Preliminary Results of an Alcohol Problem Computerized Screening

Carrie Petrucci, Ph.D., Senior Research Associate, EMT, cpetrucci@emt.orgTim Ho, Data Manager, EMT, tho@emt.org

October 11th, 2007

Project funded by a grant from the California Office of Traffic Safety to Superior Court of Orange County. The evaluation is subcontracted through CSULB, Connie

Ireland, Ph.D., and Libby Deshenes, Ph.D., Principal Investigators

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Today’s Presentation

Brief overview of Orange County DUI courts

Description of computerized screening process

Preliminary findings from first 143 screenings

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Goals of the Orange County DUI Court

To reduce recidivism among nonviolent adult and underage DUI offenders

To reduce alcohol abuse among nonviolent adult and underage DUI offenders

To increase the likelihood of successful rehabilitation through early, continuous and intensive judicially supervised treatment, periodic alcohol/drug testing and the use of graduated incentives and sanctions

(Orange County DUI Court Manual, p. 4).

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The Orange County DUI Court Model

Based on successful drug court model Includes:

Treatment services (group and one-on-one) Intensive probation services Judicial monitoring Alcohol testing Case management by DUI court team Manualized program / sanctions, incentives

A problem-solving court approach

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Summary of Findings from 2-Year Evaluation of Harbor Court

Harbor Court began in October 2004 North Court began in January 2007 2-year Harbor findings are preliminary due to small

sample sizes First 2-year Harbor preliminary results show:

high retention and graduation rates compared to other published studies

low overall recidivism as well as low DUI recidivism Further analyses with larger sample sizes needed to

examine the change theory more thoroughly

Computerized Screening

Introduction

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Computerized Screening Tool

Practice purpose To identify low and high risk groups for future

resource allocation Using standardized alcohol screenings

Evaluation purpose To determine if differences occur across low

and high risk groups on sanctions, program completion, and recidivism

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Computer Set-up in North Court

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Computer Set-up in Harbor Court

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How Screenings Are Implemented

On laptops In the court room or in a room close by Self-administered by clients Also includes voice-over for clients with low-

literacy In English and Spanish (can be in any

language) Takes 20-30 minutes

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When Screenings are Implemented

Post-arraignment During DUI court evaluation process Preferably before potential participants have

declined the program All participants are legally eligible, but

perhaps not SUITABLE Scoring sheets immediately passed on to

treatment staff for evaluation of suitability

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Screenings to Identify Alcohol Problems Includes standardized alcohol screenings plus

depression: RIASI (Research Institute on Addictions Self-Inventory) CAGE (Cut-down, Annoyed, Guilt, Eye-Opener) AUDIT (Alcohol Use Disorders Identification Test) RTC (Readiness to Change) AASE (Alcohol Abstinence Self-Efficacy) CES-D (Depression)

All are public domain except RIASI which is used with permission of author

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Low / High Risk Groups based on Screenings Cut-off scores are used by clinicians to

determine low or high risk groups for each instrument

A one page “cheat sheet” for cut-off score interpretation provided to clinicians

AASE does not have cut-offs All others do

Preliminary Findings

Based on the first 143 screenings

77 from Harbor Court

66 from North Court

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Screening Reliabilities

Scale Cronbach’s α Number of ItemsRIASI Total Score .727 49AASE Negative Affect .895 5AASE Social Positive .830 5AASE Physical .818 5AASE Withdrawal Urges .817 5CES-D Depression .742 10CAGE Total .449 4AUDIT Total .828 10AUDIT Drinking .657 3AUDIT Problems .807 7

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Readiness-to-change group differences in alcohol problems scoresScale Contemplation

Avg. scoreAvg. (SD)

ActionAvg. scoreAvg. (SD)

45 cases 97 cases

RIASI

Total* 22.6 (7.6) 17.9 (8.4)

Recidivism* 7.5 (2.5) 6.0 (2.6)

CAGE 3.0 (.87) 2.8 (.94)

AUDIT

Total* 20.3 (7.5) 15.3 (8.0)

Drinking* 7.3 (2.6) 5.0 (3.1)

Problems* 13.0 (6.0) 10.3 (5.9)

CES-D 10.8 (6.4) 9.6 (6.1)

AASE

Negative* 14.6 (5.2) 16.5 (4.9)

Social Positive* 13.7 (4.6) 16.7 (4.4)

Physical* 17.5 (4.5) 19.2 (4.3)

Withdrawal* 15.3 (4.4) 17.0 (4.5)

* Significant differences found

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Risk Group Contemplation45 cases

Action97 cases

Total142 cases

% N % N % N

RIASI Total

Low risk 2% (1) 14% (14) 11% (15)

High risk 9+ 98% (44) 86% (83) 89% (127)

RIASI Recidivism

Low risk 2% (1) 9% (9) 7% (10)

High risk 3+ 98% (44) 91% (88) 93% (132)

CAGE

Low risk 4% (2) 6% (6) 6% (8)

High risk 2+ 96% (43) 94% (91) 94% (134)

AUDIT

No risk (7 or lower) 4% (2) 18% (17) 13% (19)

Low risk (8 – 15) 27% (12) 39% (38) 35% (50)

Medium risk (16 – 19) 7% (3) 12% (12) 11% (15)

Alcohol dependence (20+) 62% (28) 31% (30) 41% (58)

CES-D

Low risk 51% (23) 56% (54) 54% (77)

High risk 10+ 49% (22) 44% (43) 46% (65)

Readiness-to-change group differences in risk groups

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AUDIT risk group differences in AASE self efficacy scores

No risk

(7 or lower)

(n=20)

Low risk

(8-15)

(n=50)

Moderate risk

(16-19)

(n=15)

Alcohol Dependence (20+)

(n=58)

Mean (SD) Mean (SD) Mean (SD) Mean (SD)

AASE Negative Affect*

19.8 4.7 18.0 4.6 12.5 3.6 13.9 4.6

AASE Social Positive*

18.3 4.9 16.6 4.2 15.0 4.4 14.4 4.7

AASE Physical*

21.3 2.8 20.0 4.0 17.7 439 17.0 4.6

AASE Withdrawal urges*

19.3 4.3 17.6 4.2 15.3 4.8 15.0 4.3

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Conclusions

Vast majority of DUI participants fall into the broad “high risk” category of alcohol problems

About 10% scored in the “no alcohol problem” area 40% of DUI participants have “alcohol dependence”

(considered high risk) (per AUDIT) 68% of participants are at highest risk for continued

alcohol use or DUI recidivism (per RIASI). This information needs to be confirmed with

subsequent clinical diagnoses

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Conclusions

Information from two or more of the instruments will likely be needed to determine low/high risk groups

Continued analyses and validity discussions with the therapists/DUI court team are needed to define low/high risk groups

Half of the participants are scoring within the clinically suggested cut-off for depressive symptoms

This is similar to other study findings and suggests a need for treatment, as well as a high prevalence of risk for psychological distress among people with DUI’s

Collecting assessments until next year