Journal Article

Psychometric assessment of the Moroccan version of the car, relax, alone, forget, friends, trouble (CRAFFT) scale among adolescent and young adults with a substance use disorder

El Malki, Hicham, Zarrouq, Btissame, El-Ammari, Abdelfettah, Rhazi, Karima El, Houari, Fatima El, Elgnaoui, Samir, Moutawakkil, Salma Ghofrane

2025

Overview

Background The Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) scale is a widely used screening tool for early identification of alcohol and other drug use, and assessing the risk of substance use disorders in adolescents and young adults. Despite its broad use, translation into several languages, and validation in various settings, no study has yet confirmed the psychometric properties of a Moroccan version. The present research aims to adapt and validate the Moroccan Arabic dialect version of the CRAFFT scale among adolescents and young adults with alcohol and drug use disorder. Methods A total of 302 adolescents and young adults (mean age = 18.36 ± 2.36), including 161 males and 41 females, were recruited from a substance use treatment center in Fez City. Confirmatory Factor Analysis (CFA) was used to assess the factorial structure and model fit, while internal consistency was evaluated using the Kuder-Richardson Formula 20 (KR-20). Convergent validity was examined using gold standard measures, including the International Neuropsychiatric Interview (MINI) and the Hooked-on Nicotine Checklist (HONC). All statistical analyses were performed using JASP software (version 0.17). Results CFA revealed a one-factor structure with a good overall fit (χ²/df = 1.91, Root Mean Square Error of Approximation (RMSEA) = 0.06, Standardized Root Mean Square Residual (SRMR) = 0.03, Comparative Fit Index (CFI) = 0.98, Normed Fit Index (NFI) = 0.97. The model had strong reliability with a KR-20 coefficient of 0.80. Convergent validity was confirmed by a high and significant correlation with the MINI gold standard ( r  = 0.82, p  < 0.001), while a low correlation with the HONC gold standard ( r  = 0.20, p  < 0.001) confirmed the scale’s convergent validity. A cutoff score of 4 or higher on the CRAFFT was identified as optimal for balancing sensitivity (78.35%) and specificity (91.67%), achieving a Youden index of 0.70. Conclusion The psychometric properties of the Moroccan version of the CRAFFT confirm that it is a valid tool for screening the early detection of alcohol and drug use and for assessing the risk of substance use disorders in adolescents and young adults.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adaptation / Addictology / Adolescence / Adolescent / Adolescents / Adults / Alcohol / Alcohol use / Arabic language / Child development / Clinical assessment / Confirmatory factor analysis / Convergent validity / CRAFFT / Dialects / Discriminant analysis / Disorders / Drug / Drug abuse / Drug use / Drugs / Drugs and youth / Electronic cigarettes / Factor analysis / Factor Analysis, Statistical / Factor structure / Female / Friendship / Gold / Health Psychology / Humans / Indexes / Languages / Male / Marijuana / Measures / Medical research / Medical screening / Medical treatment / Medicine / Medicine & Public Health / Medicine, Experimental / Morocco / Nicotine / Pharmacology/Toxicology / Prescription drugs / Property / Psychiatric Status Rating Scales - standards / Psychiatry / Psychometrics / Psychopharmacology / Public Health / Quantitative psychology / Questionnaires / Reliability / Reproducibility of Results / Revisions / Risk assessment / Social Work / Students / Substance abuse treatment / Substance use disorder / Substance-Related Disorders - diagnosis / Substance-Related Disorders - psychology / Surveys and Questionnaires / Teenagers / Tobacco / Validity / Vaping / Young Adult / Young adults / Youth