Validation of Alcohol Use Disorders Identification Test (AUDIT) in Brazilian Colleges: Network Analysis, Measurement Invariance and Screening Efficiency

Abstract

This study examined the psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT) among a diverse sample of Brazilian college students. Specifically, the objectives of the present study were; (i) to examine the factor structure of AUDIT through confirmatory factor analysis and network analysis, (ii) to assess invariance of gender, sexual orientation and university (private vs. public, field of study), and relationship status; using multigroup confirmatory factor analysis, and (iii) to evaluate convergent, criterion, discriminant, and predictive validity. A total of 2,252 college students completed a sociodemographic questionnaire, the AUDIT, and additional measures of harmful alcohol consumption. The findings revealed that the three-factor AUDIT structure demonstrated the most robust fit and internal consistency across various student subgroups. Invariance was observed in all analyzed subgroups, with network analysis revealing consistent patterns of item clustering. The AUDIT also exhibited strong reliability (α = 0.817; ω = 0.827). The receiver operating characteristic curve analysis indicated that the optimal cutoff for harmful use was > 6, while it was > 7 for alcohol dependence, with the scores remaining consistent across diverse student subgroups. The AUDIT demonstrated robust correlations with the CAGE Questionnaire and total DSM-5 symptom scores (criterion validity), as well as with other measures of frequency of alcohol use (weekday and weekend) using timeline follow-back (convergent validity). A moderate correlation was observed for discriminant validity with attitudes towards alcohol use. The findings suggest that the AUDIT serves as a suitable instrument for screening potentially harmful alcohol use among diverse student subgroups.