{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T09:15:26Z","timestamp":1771319726194,"version":"3.50.1"},"reference-count":59,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2026,12,3]],"date-time":"2026-12-03T00:00:00Z","timestamp":1796256000000},"content-version":"am","delay-in-days":367,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#am"},{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100016156","name":"U.S. Army Medical Research and Development Command","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016156","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alcohol, Clinical and Experimental Research"],"published-print":{"date-parts":[[2025,12]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n High rates of alcohol\u2010related problems have been reported among US service members (\n SMs<\/jats:styled-content>\n ). Screening questions on drinking and related behaviors can help identify individuals at\u2010risk for alcohol\u2010related problems. However, brief alcohol screeners, such as the alcohol use disorders identification test\u2010consumption (\n AUDIT<\/jats:styled-content>\n \u2010C) and the 4\u2010item rapid alcohol problems screening (\n RAPS<\/jats:styled-content>\n \u20104), have not been adequately and concurrently validated among active\u2010duty\n SMs<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n From October to December 2021, 19,465 active\u2010duty soldiers (including activated reserve soldiers) completed anonymous command\u2010directed e\u2010surveys (response rate=\u200931%); two random samples were drawn and sex\u2010stratified. The\n AUDIT<\/jats:styled-content>\n \u2010C,\n RAPS<\/jats:styled-content>\n \u20104, depression (\n PHQ2<\/jats:styled-content>\n ), anxiety (\n GAD2<\/jats:styled-content>\n ), and suicidal thoughts (2\u2010item\n CSSRS<\/jats:styled-content>\n ) were analyzed to assess convergent validity and clinical utility of the\n AUDIT<\/jats:styled-content>\n \u2010C versus\n RAPS<\/jats:styled-content>\n \u20104.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Findings indicate fair\u2010to\u2010moderate (\n \u03c6<\/jats:italic>\n \u2009=\u20090.310\u20130.399) convergence between screeners among males and weak\u2010to\u2010fair (\n \u03c6<\/jats:italic>\n \u2009=\u20090.227\u20130.391) convergence among female soldiers. Among male soldiers, the best level of agreement between screeners, albeit fair in concordance, was\n AUDIT<\/jats:styled-content>\n \u2010C\u2009\u2265\u20096 (weighted kappa\u2009=\u20090.381\u20130.399). Among female soldiers,\n AUDIT<\/jats:styled-content>\n \u2010C\u2009\u2265\u20094 or 5 demonstrated the best concordance with\n RAPS<\/jats:styled-content>\n \u20104 (weighted kappa\u2009=\u20090.384\u20130.380, respectively). Importantly, however, less than one\u2010third of soldiers screened positive by both\n AUDIT<\/jats:styled-content>\n \u2010C and\n RAPS<\/jats:styled-content>\n \u20104; over two\u2010thirds had discordant screening results. Although both screeners were independently and positively associated with risk for suicidal thoughts, depression, and\/or anxiety, the\n RAPS<\/jats:styled-content>\n \u20104 demonstrated stronger association with suicidal thoughts than\n AUDIT<\/jats:styled-content>\n \u2010C.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The AUDIT\u2010C and RAPS\u20104 each capture unique but interrelated aspects of drinking behaviors. The RAPS\u20104 appears advantageous by including clinically oriented questions that have shown to strongly correlate with AUD risk, and in this study demonstrated strong correlations with risk for other mental health conditions. In contrast, the AUDIT\u2010C is only limited to consumption\u2010focused items. While the AUDIT\u2010C is currently mandated primary alcohol screener in military settings, the stronger correlation of RAPS\u20104 with related behavioral health outcomes warrants further research and consideration as a preferable primary screener among SMs.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/acer.70195","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T17:55:26Z","timestamp":1764784526000},"page":"2738-2753","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessment of the validity and clinical utility of AUDIT\u2010C versus RAPS\u20104 alcohol screeners among active\u2010duty US Army soldiers"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7866-8682","authenticated-orcid":false,"given":"Farifteh Firoozmand","family":"Duffy","sequence":"first","affiliation":[{"name":"Center for Military Psychiatry and Neuroscience, Military Psychiatry Branch Walter Reed Army Institute of Research Silver Spring Maryland USA"},{"name":"TechWerks LLC Arlington Heights Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles W.","family":"Hoge","sequence":"additional","affiliation":[{"name":"Center for Military Psychiatry and Neuroscience, Military Psychiatry Branch Walter Reed Army Institute of Research Silver Spring Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie A. Q.","family":"Gomez","sequence":"additional","affiliation":[{"name":"Defense Centers for Public Health \u2013 Aberdeen Aberdeen Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew R.","family":"Beymer","sequence":"additional","affiliation":[{"name":"Defense Centers for Public Health \u2013 Aberdeen Aberdeen Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie A.","family":"Bricault","sequence":"additional","affiliation":[{"name":"Center for Military Psychiatry and Neuroscience, Military Psychiatry Branch Walter Reed Army Institute of Research Silver Spring Maryland USA"},{"name":"TechWerks LLC Arlington Heights Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7931-8897","authenticated-orcid":false,"given":"Kristiana D.","family":"Carrasquillo","sequence":"additional","affiliation":[{"name":"Center for Military Psychiatry and Neuroscience, Military Psychiatry Branch Walter Reed Army Institute of Research Silver Spring Maryland USA"},{"name":"TechWerks LLC Arlington Heights Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua E.","family":"Wilk","sequence":"additional","affiliation":[{"name":"Center for Military Psychiatry and Neuroscience, Military Psychiatry Branch Walter Reed Army Institute of Research Silver Spring Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy Millikan","family":"Bell","sequence":"additional","affiliation":[{"name":"Defense Centers for Public Health \u2013 Aberdeen Aberdeen Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phillip J.","family":"Quartana","sequence":"additional","affiliation":[{"name":"Center for Military Psychiatry and Neuroscience, Military Psychiatry Branch Walter Reed Army Institute of Research Silver Spring Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2009.02.013"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjem.2018.08.001"},{"key":"e_1_2_13_4_1","volume-title":"Diagnostic and statistical manual of mental disorders","author":"American Psychiatric Association","year":"1994"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_13_6_1","unstructured":"Babor T.F. Higgins\u2010Biddle J.C. Saunders J.B.&Monteiro M.G.(2001)AUDIT: the alcohol use disorder identification test: guidelines for use in primary health care (second edition). World Health Organization No. WHO\/MSD\/MSB\/01.6 a."},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-301"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.7.821"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530\u20100277.2007.00403.x"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.3109\/10826084.2013.796990"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.158.16.1789"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0376\u2010\u20108716(95)01199\u20104"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ALC.0000036300.26619.78"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.02.025"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ALC.0000127410.84505.2A"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2013.01.012"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2005.01.006"},{"key":"e_1_2_13_18_1","unstructured":"Department of Defense. (2021)2021 demographics profile of the military community. Available from:https:\/\/download.militaryonesource.mil\/12038\/MOS\/Reports\/2021\u2010demographics\u2010report.pdf"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102022\u2010068619"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.5888\/pcd11.140329"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ab.21436"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.20837"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/21635781.2014.897205"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsad2022.83.202"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1037\/ser0000331"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.13901"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1037\/ser0000584"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.300.6.663"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0182162"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.1398"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13722\u2010016\u20100066\u20105"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.0895"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2008.01.001"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/alcalc\/ags082"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-149-12-200812160-00007"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLR.0000093487.78664.3C"},{"issue":"2","key":"e_1_2_13_37_1","first-page":"5","article-title":"2015 Department of Defense Health Related Behaviors Survey (HRBS)","volume":"8","author":"Meadows S.O.","year":"2018","journal-title":"RAND Health Quarterly"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.18.2141"},{"key":"e_1_2_13_39_1","unstructured":"National Institute on Alcohol Abuse and Alcoholism (NIAAA). (2021)Rethinking drinking: alcohol and your health (publication no. 21\u2010AA\u20103770). U.S. Department of Health and Human Services. Available from:https:\/\/www.niaaa.nih.gov\/sites\/default\/files\/publications\/niaaa_rethinking_drinking.pdf"},{"key":"e_1_2_13_40_1","unstructured":"National Survey on Drug Use and Health. (2018)Substance Abuse and Mental Health Services Administration key substance use and mental health indicators in the United States: results from the 2018 National Survey on Drug Use and Health HHS publication no. PEP19\u20105068 NSDUH Series H\u201054. Rockville MD: Center for Behavioral Health Statistics and Quality 2019a."},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530\u20100277.2009.01045.x"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.3109\/10826084.2015.1023458"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph7041392"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22292"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2011.1011170"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360\u20100443.2010.02899.x"},{"key":"e_1_2_13_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.2006.00295.x"},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.7205\/MILMED\u2010D\u201013\u201000400"},{"key":"e_1_2_13_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2008.10.017"},{"key":"e_1_2_13_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.13269"},{"key":"e_1_2_13_51_1","unstructured":"Substance Abuse and Mental Health Services Administration. (2019)Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health(HHS Publication No. PEP19\u20105068 NSDUH Series H\u201054). Center for Behavioral Health Statistics and Quality. Available from:https:\/\/www.samhsa.gov\/data\/report\/2018\u2010nsduh\u2010annual\u2010national\u2010report"},{"key":"e_1_2_13_52_1","unstructured":"The Management of Substance Use Disorders Workgroup. (2015)VA\/DoD clinical practice guideline for the management of substance use disorders(Version 3.0). U.S. Department of Veterans Affairs and Department of Defense. Available from:https:\/\/www.healthquality.va.gov\/guidelines\/MH\/sud\/"},{"key":"e_1_2_13_53_1","unstructured":"The Management of Substance Use Disorders Workgroup. (2021)VA\/DoD clinical practice guideline for the management of substance use disorders(Version 4.0). U.S. Department of Veterans Affairs and Department of Defense. Available from:https:\/\/www.healthquality.va.gov\/guidelines\/MH\/sud\/"},{"key":"e_1_2_13_54_1","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2010.54"},{"key":"e_1_2_13_55_1","unstructured":"US Department of Health and Human Services Food and Drug Administration. (2007)Statistical guidance on reporting results from studies evaluating diagnostic tests\u2010guidance for industry and FDA staff. Available from:https:\/\/www.fda.gov\/regulatory\u2010information\/search\u2010fda\u2010guidance\u2010documents\/statistical\u2010guidance\u2010reporting\u2010results\u2010studies\u2010evaluating\u2010diagnostic\u2010tests\u2010guidance\u2010industry\u2010and\u2010fda"},{"key":"e_1_2_13_56_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.16789"},{"key":"e_1_2_13_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2018.04.011"},{"key":"e_1_2_13_58_1","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22337"},{"key":"e_1_2_13_59_1","doi-asserted-by":"publisher","DOI":"10.1136\/jramc\u20102018\u2010001024"},{"key":"e_1_2_13_60_1","volume-title":"Global status report on alcohol and health 2018","author":"World Health Organization","year":"2018"}],"container-title":["Alcohol, Clinical and Experimental Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acer.70195","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/acer.70195","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/am-pdf\/10.1111\/acer.70195","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acer.70195","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T08:35:15Z","timestamp":1771317315000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acer.70195"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":59,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1111\/acer.70195"],"URL":"https:\/\/doi.org\/10.1111\/acer.70195","archive":["Portico"],"relation":{},"ISSN":["2993-7175","2993-7175"],"issn-type":[{"value":"2993-7175","type":"print"},{"value":"2993-7175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]},"assertion":[{"value":"2025-05-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}