Diagnostic Performance of the Rutgers Alcohol Problem Index (RAPI) in Detecting DSM-5 Alcohol Use Disorders among College Students

Background and objectives: The DSM-5 Alcohol Use Disorder criteria (AUD) have been modified to reflect a single diagnosis, which may alter how AUDs are detected within our screening measures. The Rutgers Alcohol Problem Index (RAPI) is one of the most widely used screening measures of alcohol problems in college students. The present study sought to evaluate the diagnostic performance of the RAPI in detecting DSM-5 AUDs in college students. Methods: Participants (n = 396; 52% male) were past year drinkers in college either full or part-time. They were asked to fill out a one-hour anonymous packet of questionnaires. Results: The RAPI performed slightly better in the detection of DSM-5 AUDs (AUROC = 0.828; SE = 0.20) in comparison to any DSM-IV AUD (0.791; SE = 0.022; 95% CI, 0.748 - 0.835). The performance of the RAPI was lower when detecting frequency (AUROC = 0.719; SE = 0.025) or quantity of alcohol use (AUROC = 0.758; SE = 0.024) in comparison to detecting DSM-5 AUDs. Gender differences emerged in the identification of optimal RAPI cut-off scores. Findings indicate that an overall RAPI score of 4 be used for female college students and an overall score of 6 be used for male college students in the detection of DSM-5 AUDs. Discussion and conclusions: This is the first study to evaluate the performance of the RAPI in identifying DSM-5 AUDs in college students. Study findings indicate that the RAPI provides reasonably good discrimination in classifying DSM-5 AUDs in college students.