Improving alcohol screening for college students: Screening for alcohol misuse amongst college students with a simple modification to the CAGE questionnaire

ABSTRACT

Objective: To improve the CAGE (Cut down, Annoyed, Guilty, Eye opener) questionnaire's predictive accuracy in screening college students. Participants: The sample consisted of 219 midwestern university students who self-administered a confidential survey. Methods: Exploratory factor analysis, confirmatory factor analysis, receiver operating characteristics (ROC), and Cronbach's alpha were used to analyze factor structure, validity, and reliability. Results: The modified CAGE correctly classified students with alcohol abuse (“AA students”; area under the curve [AUC] = 0.7765) and students with alcohol dependency (“AD students”; AUC = 0.8392) more often than CAGE (AA students: AUC = 0.6977; AD students: AUC = 0.7437), and these differences are statistically significant (AA students: χ²(1) = 14.72, p < .001; AD students: χ²(1) = 7.71, p < .01). Using 2-point cut scores, CAGE correctly identified 59.38% of AD students as AD, whereas the modified CAGE correctly identified 87% of AD students as AD. Using 1-point cut scores, CAGE correctly identified 65% AA students, whereas the modified CAGE identified 85.29%. Conclusions: The modified CAGE has better accuracy than CAGE in predicting AA and AD among college populations.     

The impact of distance on acquisition performance

A challenge in interpreting research is that the construct of ‘distance’ has multiple dimensions that influence acquisition performance. We expand Ghemawat's (2001) typology of distance with its dimensions of cultural, administrative, geographic, and economic distance (CAGE) from a review of 61 empirical research studies of how distance affects acquisition performance. We identify different impacts of distance dimensions on acquisition performance to find that distance dimensions are interdependent. As a result, context matters, when considering the impact of distance on acquisition performance. Supporting institutional theory, the direction of distance may matter, as the results may be different for acquirers in developed and emerging economies. Additional implications for research and management practice are identified.