Michigan Alcohol Screening Test

Abstract

The Michigan Alcohol Screening Test (MAST) is one of the oldest and most widely recognized self-report instruments developed for the rapid screening of lifetime alcohol-related problems and potential alcohol dependence. Developed by Melvin L. Selzer in 1971, the standard version consists of 25 items designed to assess a broad range of issues stemming from excessive drinking, including interpersonal conflicts, legal troubles, symptomatic drinking behaviors, and treatment history. The MAST is scored objectively, with weighted points assigned to responses indicative of alcohol misuse. Due to its length, several shortened versions, such as the Short MAST (SMAST) and the Brief MAST, have been developed, along with specialized adaptations for adolescents (Adolescent MAST) and the elderly (MAST-G and SMAST-G), making it a versatile tool in clinical and research settings for identifying individuals who may require further assessment for Alcohol Use Disorder (AUD).

Keywords

Michigan Alcohol Screening Test, MAST, Alcoholism, Alcohol Use Disorder, Screening Instrument, Self-Report Questionnaire, Problem Drinking, SMAST, MAST-G, Alcohol Dependence

Authors

Melvin L. Selzer

Purpose

The primary purpose of the Michigan Alcohol Screening Test (MAST) is to provide a quick, reliable method for identifying individuals in the general population, or clinical settings, who have significant alcohol-related problems or are dependent on alcohol. It is designed to evaluate the extent of alcohol misuse by examining the social, legal, and physiological consequences associated with excessive drinking.

The MAST serves as a critical initial step in the diagnostic process, allowing clinicians to determine the severity of drinking behavior and the need for more in-depth diagnostic interviews or intervention strategies. Its various shortened and specialized versions demonstrate its utility across different age groups and clinical environments where rapid assessment is crucial.

Construct

The MAST measures the psychological construct of problematic alcohol use and dependence, as defined by the negative consequences experienced across multiple life domains. Instead of focusing solely on frequency or quantity of consumption, the scale assesses behavioral indicators and outcomes that typically correlate with severe alcohol misuse.

Key dimensions of the construct measured by the MAST include:

• Social and Interpersonal Consequences: Problems with family, friends, or significant others due to drinking.
• Legal and Occupational Issues: Arrests, job loss, or trouble at school/work caused by alcohol.
• Physiological and Symptomatic Behavior: Experiencing blackouts, Delirium Tremens (DTs), liver trouble, or drinking early in the day (before noon).
• Self-Perception and Help-Seeking: Feeling guilty about drinking, perceiving oneself as a “normal drinker,” or seeking help from AA or medical professionals.

Validity

The MAST has demonstrated strong validity across numerous studies since its introduction. Research confirms its effectiveness as a screening tool, particularly in distinguishing between individuals who are alcohol-dependent and those who are not.

Meta-analytic integration, such as that conducted by Teitelbaum & Mullen (2000), supported the high validity of the MAST, especially within psychiatric settings, showing that it reliably correlates with formal diagnostic criteria for Alcohol Use Disorder. Furthermore, studies focusing on specific populations, such as Hirata et al. (2001) regarding the Geriatric Version (MAST-G), confirm that the instrument maintains its predictive power even when modified for specialized demographic groups. The scale exhibits high criterion validity, often correlating strongly with clinical diagnoses made by experts.

Reliability

The MAST is generally regarded as having excellent psychometric properties, including high internal consistency and test-retest reliability. Gibbs (1985) reviewed the reliability and validity of the MAST, confirming its consistent performance in various clinical and non-clinical populations.

The internal consistency, typically measured using Cronbach’s alpha, is consistently reported in the high 0.80s and 0.90s for the full 25-item scale, suggesting that the items reliably measure the same underlying construct of alcohol-related problems. The brevity of the derived scales (SMAST and Brief MAST) generally maintains acceptable reliability while offering increased efficiency in large-scale screening efforts.

Factor Analysis

Factor Analysis has been performed on the MAST to determine the underlying structure of alcohol problems the scale captures. Early work by Zung (1980) in a psychiatric outpatient population explored the factor structure, helping to validate the multidimensional nature of the scale.

Further research, such as that by Thurber, Snow, Lewis, & Hodgson (2001), examined the item characteristics, confirming that while the MAST is often treated as unidimensional for scoring purposes, it captures several distinct clusters of alcohol-related issues, including loss of control, social/marital problems, and severe clinical manifestations (like Delirium Tremens). This structural complexity supports its comprehensive approach to screening for AUD.

Instrument

Test Type: Self-report screening instrument

Format: Questionnaire, typically Yes/No response format, with weighted scoring (0 to 5 points per item).

Language Available: Primarily English, but translated versions exist for clinical use globally.

Population Group: General population, clinical outpatients, psychiatric patients, adolescents, and geriatric populations.

Age Group: Typically adults (MAST, SMAST), but specific versions exist for adolescents and older adults (MAST-G).

Population Details: The original MAST is 25 items. The Brief MAST (Pokorny et al., 1972) is 10 items. The Short MAST (SMAST, Selzer et al., 1975) is 13 items. The Geriatric MAST (MAST-G, Joseph et al., 1995) is 24 items, adapted to reflect age-specific alcohol consequences.

Test Methodology: Responses are scored, and a total score is calculated. A score of 5 or more points generally indicates potential alcohol problems, while scores of 7 or more often suggest dependency requiring clinical follow-up. Specific scoring criteria vary slightly between the original MAST and its various revisions.

Keywords

MAST, Screening, Alcohol Problems, Selzer 1971, Alcohol Abuse, AUD, DTs, Psychometrics, Substance Use

Authors

Author ORCID Identifier: Not provided in source material.

Affiliation Email addresses: Not provided in source material.

Correspondence Address: Not provided in source material.

Permissions & Fee and Test Year

The Michigan Alcohol Screening Test (MAST) was first published in 1971 by Melvin L. Selzer. Due to its age and widespread use in public health and research, the core instrument is often considered to be in the public domain or is freely available for non-commercial research and clinical screening purposes. Users should, however, confirm permissions if using revised or specialized versions that may have been copyrighted more recently.

The original PDF of the MAST (25 item version) can be downloaded here: http://www.integration.samhsa.gov/clinical-practice/sbirt/Mast.pdf

The original PDF of the Brief MAST (Pokorny et al., 1972) can be downloaded here: http://www.alcoholandcrime.org/images/uploads/pdf_tools/brief_mast.pdf

The original PDF of the MAST-Geriatric Version (MAST-G) can be downloaded here: http://www.sbirttraining.com/sites/sbirttraining.com/files/MAST-G.pdf

Reference’s

The development and validation of the MAST and its subsequent versions are supported by the following literature:

• Bradley, KA; Boyd-Wickizer, J; Powell, SH; Burman, ML. (1998) ‘Alcohol screening questionnaires in women: A critical review’‚ Journal of the American Medical Association 280(2): 166-171.
• Gibbs LE. Validity and reliability of the Michigan Alcoholism Screening Test: A review. Drug Alcohol Depend 1985; 12:279-85.
• Hirata, E.S.; Almeida, O.P.; Funari, R.R.; Klein, E.L. (2001) ‘Validity of the Michigan Alcoholism Screening Test (MAST) for the Detection of Alcohol-Related Problems among Male Geriatric Outpatients’‚ American Journal of Geriatric Psychiatry 9:30-34.
• Maisto, S.A.‚ Connors, G.J. & Allen, J.P. (1995) ‘Contrasting self-report screens for alcohol problems: A review’‚ Alcoholism: Clinical and Experimental Research‚ 19(6):1510-1516.
• Pokorny, A.‚ et al. (1972). “The Brief MAST: A shortened version of the Michigan Alcoholism Screening Test‚” 27(12) American Journal of Psychiatry 342-345.
• Selzer, M.L. (1971). ‘The Michigan Alcoholism Screening Test (MAST): The quest for a new diagnostic instrument’‚ American Journal of Psychiatry‚ 127:1653-1658.
• Selzer, M.L.‚ Vinokur, A.‚ and van Rooijen, L.‚ (1975). Self-Administered Short Version of the Michigan Alcoholism Screening Test (SMAST). Journal of Studies on Alcohol‚ 36:117-126.
• Teitelbaum, L. & Mullen, B. (2000) ‘Validity of the MAST in psychiatric settings: A META-analytic integration’‚ Journal of Studies on Alcohol‚ 61(2):254-261.
• Thurber, S.‚ Snow, M.‚ Lewis, D.‚ & Hodgson, J. M. (2001). Item characteristics of the Michigan Alcoholism Screening Test. Journal of Clinical Psychology‚ 57‚ 139-144.
• Zung, B. J. (1980). Factor structure of the Michigan Alcoholism Screening Test (MAST) in a psychiatric outpatient population. Journal of Clinical Psychology‚ 36‚ 1024-1030.

Items of the Michigan Alcohol Screening Test

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way. These items reflect the standard 25-item version of the MAST.

1. Do you enjoy drinking now and then? Yes, NO
2. Do you feel you are a normal drinker? (“normal” – drink as much or less than most other people) Yes, NO (2)*
3. Have you ever awakened the morning after some drinking the night before and found that you could not remember a part of the evening? Yes, NO (2)
4. Does your wife, husband, a parent, or other near relative ever worry or complain about your drinking? Yes, NO (1)
5. Can you stop drinking without a struggle after one or two drinks? Yes, NO (2)*
6. Do you ever feel guilty about your drinking? Yes, NO (1)
7. Do friends or relatives think you are a normal drinker? Yes, NO (2)*
8. Are you able to stop drinking when you want to? Yes, NO (2)*
9. Have you ever attended a meeting of Alcoholics Anonymous (AA)? Yes, NO (5)
10. Have you gotten into physical fights when drinking? Yes, NO (1)
11. Has you drinking ever created problems between you and your wife, husband, a parent, or other relative? Yes, NO (2)
12. Has your wife, husband (or other family members) ever gone to anyone for help about your drinking? Yes, NO (2)
13. Have you ever lost friends because of your drinking? Yes, NO (2)
14. Have you ever gotten into trouble at work or school because of drinking? (2)
15. Have you ever lost a job because of drinking? Yes, NO (2)
16. Have you ever neglected your obligations, your family, or your work for two or more days in a row because you were drinking? Yes, NO (2)
17. Do you drink before noon fairly often? Yes, NO (1)
18. Have you ever been told you have liver trouble? Cirrhosis? Yes, NO (2)
19. After heavy drinking have you ever had Delirium Tremens (D.T.s) or severe shaking, or heard voices, or seen things that are really not there? Yes, NO (2)**
20. Have you ever gone to anyone for help about your drinking? Yes, NO (5)
21. Have you ever been in a hospital because of drinking? Yes, NO (5)
22. Have you ever been a patient in a psychiatric hospital or on a psychiatric ward of a general hospital where drinking was part of the problem that resulted in hospitalization? Yes, NO (2)
23. Have you ever been seen at a psychiatric or mental health clinic or gone to any doctor, social worker, or clergyman for help with any emotional problem, where drinking was part of the problem? Yes, NO (2)
24. Have you ever been arrested for drunk driving, driving while intoxicated, or driving under the influence of alcoholic beverages? (If YES, How many times?___) Yes, NO (2) ***
25. Have you ever been arrested, or taken into custody even for a few hours, because of other drunk behavior? (If YES, How many times?___) Yes, NO (2)***

* Alcoholic response is negative

** 5 points for Delirium Tremens

*** 2 points for each arrest