Adaptation and Validation of the Screening Test for Problems Related to Alcohol Consumption in Parents through the Perception of Children (CAST-6)

Main Article Content

Angélica Susana López-Arellano
Karla Selene López-García
Jorge Ameth Villatoro Velázquez
Rosa María Díaz Hurtado


Introduction: children of parents with alcohol use problems are a population susceptible to risk factors that can affect their current and adult lives. The Children of Alcoholics Screening Test (CAST-6) is a screening test that allows detecting alcohol-related problems in parents through the perception of their children; however, this questionnaire has not been validated for the Mexican population.

Objective: the main objective is to adapt and validate the Test of Alcohol-Related Problems of Parents through the perception of children CAST-6 in Mexican adolescents, distinguishing between the father and the mother.

Method: the sample consisted of 307 adolescents from public high schools, with a mean age of 12.7 years. Reliability analysis and exploratory factor analysis were performed.

Results: the exploratory factor analysis of the CAST-6 Dad yielded a single factor with 53.1% of variance explained, and the CAST-6 Mom presented a single factor with 46.1% of variance explained. Both tests presented a Cronbach’s Alpha of .82 and .76 respectively.

Discussion and conclusion: the CAST-6 Dad and CAST-6 Mom are accurate and validity for screening use in Mexican population in research field and clinical work, and to positively impact the future health of adolescents and families with alcohol problems.

adolescent ,  alcohol drinking ,  underage drinking ,  family ,  population ,  school age
Published: Oct 3, 2023

Article Details

How to Cite
López-Arellano, A. S., López-García, K. S. . ., Villatoro Velázquez, J. A., & Díaz Hurtado, R. M. . (2023). Adaptation and Validation of the Screening Test for Problems Related to Alcohol Consumption in Parents through the Perception of Children (CAST-6). Revista Internacional De Investigación En Adicciones, 9(2), 128–136.
Original Articles
Author Biographies

Karla Selene López-García, Universidad Autónoma de Nuevo León, Facultad de Enfermería, México.

Profesora e investigadora en la linea de drogas licitas e ilicitas

Jorge Ameth Villatoro Velázquez, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México.


Rosa María Díaz Hurtado, Hospital Clínic de Barcelona. Departamento: Servicio de Psiquiatría y Psicología Infanto-Juvenil. Universidad de Barcelona, España.



Andreasen, N. C., Endicott, J., Spitzer, R., & Winokur, G. (1977). The Family History Method Using Diagnostic Criteria. Reliability and validity. Archives of General Psychiatry, 34(10), 1229.

Armendáriz-García, N. A., Almanza-López, J. B., Alonso-Castillo, M. T. de J., Oliva-Rodríguez, N. N., Alonso-Castillo, M. M., & López-Cisneros, M. A. (2015). La historia familiar y la conducta de consumo de alcohol como factor sociocultural en el adolescente. Perspectiva de enfermería. Aquichan, 15(2), 214-222.

Armendáriz-García, N. A., Alonso-Castillo, M. M., Alonso-Castillo, B. A., López-Cisneros, M. A., Rodríguez-Puente, L. A., & Méndez-Ruiz, M. D. (2014). La familia y el consumo de alcohol en estudiantes universitarios. Ciencia y Enfermería, XX(3), 109-118.

Babor, T., De la Fuente, J., Saunder, J., & Grant, M. (1989). AUDIT The Alcohol Use Disorders Identification Test: Guidelines for use in primary health care. WHO/MNH/DAT 89.4 World Health Organization, Geneva.

Babor, T., Higgins-Biddle, J., Saunders, J., & Monteiro, M. (2001). AUDIT Cuestionario de Identificación de los Transtornos debidos al Consumo de Alcohol. Pautas para su utilización en Atención Primaria. Organización Mundial de La Salud.

Bendtsen, P., Damsgaard, M. T., Tolstrup, J. S., Ersbøll, A. K., & Holstein, B. E. (2013). Adolescent alcohol use reflects community-level alcohol consumption irrespective of parental drinking. Journal of Adolescent Health, 53(3), 368-373.

Capaldi, D. M., Tiberio, S. S., Kerr, D. C. R., & Pears, K. C. (2016). The relationships of parental alcohol versus tobacco and marijuana use with early adolescent onset of alcohol use. Stud. Alcohol Drugs, 77(1), 95-103.

De la Fuente, J., & Kershenobich, D. (1992). El alcoholismo como problema médico. Revista Facultad de Medicina, 35(2), 47-51.

Elgán, T. H., Berman, A. H., Jayaram-Lindström, N., Hammarberg, A., Jalling, C., & Källmén, H. (2021). Psychometric properties of the short version of the children of alcoholics screening test (CAST-6) among Swedish adolescents. Nordic Journal of Psychiatry, 75(2), 155-158.

Elgán, T. H., Kartengren, N., Strandberg, A. K., Ingemarson, M., Hansson, H., Zetterlind, U., & Gripenberg, J. (2016). A web-based group course intervention for 15-25-year-olds whose parents have substance use problems or mental illness: Study protocol for a randomized controlled trial. BMC Public Health, 16(1).

Getachew, S., Lewis, S., Britton, J., Deressa, W., & Fogarty, A. W. (2019). Prevalence and risk factors for initiating tobacco and alcohol consumption in adolescents living in urban and rural Ethiopia. Public Health, 174, 118-126.

Gray, J. R., & Grove, S. K. (2020). Burns and Grove’s The Practice of Nursing Research Appraisal, Synthesis, and Generation of Evidence (9th Ed.). ELSEVIER.

Grupos de familia Al-Anon. (2022). Manual de servicio de AL ANON y ALATEEN 2022-2025 (, Ed.; v2 ed.).

Haugland, S. H., & Elgán, T. H. (2021). Prevalence of parental alcohol problems among a general population sample of 28,047 norwegian adults: Evidence for a socioeconomic gradient. International Journal of Environmental Research and Public Health, 18(10).

Haugland, S. H., Carvalho, B., Stea, T. H., Strandheim, A., & Vederhus, J. K. (2021). Associations between parental alcohol problems in childhood and adversities during childhood and later adulthood: a cross-sectional study of 28047 adults from the general population. Substance Abuse: Treatment, Prevention, and Policy, 16(1).

Hodgins, D. C., Maticka-Tyndale, E., El-Guebaly, N., & West, M. (1993). The CAST-6: development of a short-form of the Children of Alcoholics Screening Test. Addictive Behaviors, 18, 337-345.

Hodgins, D., & Shimp, L. (1995). Identifying adult children of alcoholics: methodological review and a comparison of the CAST-6 with other methods. Addiction, 90(2), 255-267.

Homel, J., & Warren, D. (2019). The relationship between parent drinking and adolescent drinking: differences for mothers and fathers and boys and girls. Substance Use and Misuse, 54(4), 661-669.

Jones, J. W. (1981). The Children of Alcoholics Screening Test (CAST). Family Recovery Press, Chicago.

Kim, S., Chae, W., Min, S. H., Kim, Y., & Jang, S. I. (2020). Alcohol consumption frequency of parents and stress status of their children: Korea national health and nutrition examination survey (2007-2016). International Journal of Environmental Research and Public Health, 17(1).

Li, P., Becker, J. B., Heitzeg, M. M., McClellan, M. L., Reed, B. G., & Zucker, R. A. (2017). Gender differences in the transmission of risk for antisocial behavior problems across generations. PLoS ONE, 12(5).

Lund, I. O., Eilertsen, E. M., Gjerde, L. C., Torvik, F. A., Røysamb, E., Reichborn-Kjennerud, T., & Ystrom, E. (2020). Maternal drinking and child emotional and behavior problems. Pediatrics, 145(3).

Mahedy, L., MacArthur, G. J., Hammerton, G., Edwards, A. C., Kendler, K. S., Macleod, J., Hickman, M., Moore, S. C., & Heron, J. (2018). The effect of parental drinking on alcohol use in young adults: the mediating role of parental monitoring and peer deviance. Addiction, 113(11), 2041-2050.

Mann, R., Sobell, L., Sobell, M., & Pavan, D. (1985). Reliability of a family tree questionnaire for assessing family history of alcohol problems. Drug and Alcohol Dependence, 15(1-2), 61-67.

Mondragón, R., Medina-Mora, M. E., Villatoro, J. A., Bustos, M., Tiburcio, M., & Gómez-Maqueo, E. L. (2022). Problematic alcohol use in Mexican students:Transmission from parents to children. Salud Mental, 45(1), 19-28.

Natera-Rey, G., Borges, G., Medina-Mora, E., Solís-Rojas, L., & Tiburcio-Sainz, M. (2001). La influencia de la historia familiar de consumo de alcoholen hombres y mujeres. Salud Publica Mex, 43, 17-26.,mujeres%20tuvieron%20antecedentes%20familiares%20de

Olivares, J. U., Baena, B. C., Úrsua, M. P., & Falcón, C. M. (2018). Family structure and alcohol consumption among adolescents. Health and Addictions / Salud y Drogas, 18(1), 107-118.

Omkarappa, D. B., Rentala, S., & Nattala, P. (2022). Effectiveness of psychosocial intervention for internalizing behavior problems among children of parents with alcohol dependence: Randomized controlled trial. World Journal of Clinical Cases, 10(16), 5306-5316.

Omkarappa, D., & Rentala, S. (2019). Anxiety, depression, self-esteem among children of alcoholic and nonalcoholic parents. Journal of Family Medicine and Primary Care, 8(2), 604.

Omkarappa, D., Rentala, S., & Nattala, P. (2019). Social competence among children of alcoholic and nonalcoholic parents. Journal of Education and Health Promotion, 8(1).

Orcasita, L. T., Lara, V., Suárez, A., & Palma, D. M. (2018). Factores psicosociales asociados a los patrones de consumo de alcohol en adolescentes escolarizados. Psicología Desde El Caribe, 35, 55-48.

Raitasalo, K., Holmila, M., Jääskeläinen, M., & Santalahti, P. (2019). The effect of the severity of parental alcohol abuse on mental and behavioural disorders in children. European Child and Adolescent Psychiatry, 28(7), 913-922.

Ramstedt, M., Raninen, J., Larm, P., & Livingston, M. (2023). Children with problem-drinking parents in a Swedish national sample: is the risk of harm related to the severity of parental problem drinking? European Journal of Public Health.

Rodríguez-Franco, L., & Padilla, E. M. (2003). Detección de problemas relacionados con el alcohol en la familia a través de los hijos. Revista de Psicopatología y Psicología Clínica, 8, 139-152.

Rzeszutek, M., Lis-Turlejska, M., Pięta, M., Hoy, A. Van, Zawistowska, M., Drabarek, K., Kozłowska, W., Szyszka, M., & Frąc, D. (2021). Profiles of Posttraumatic Stress Disorder (PTSD), Complex Posttraumatic Stress Disorder (CPTSD), and Subjective Well-Being in a Sample of Adult Children of Alcoholics. Psychological Trauma: Theory, Research, Practice, and Policy.

Secretaría de Gobernación. (2014). Reglamento de la Ley General de Salud en materia de investigación para la salud. Nuevo reglamento publicado en el Diario Oficial de la Federación el 6 de enero de 1987. In DOF 02-04-2014.

Sher, K. J., & Descutner, C. (1986). Reports of paternal alcoholism: Reliability across siblings. Addictive Behaviors, 11(1), 25-30.

Soriano-Sánchez, J., & Jiménez-Vázquez, D. (2022). Predictores del consumo de alcohol en adolescentes: una revisión sistemática de estudios transversales. Revista Estudios Psicológicos, 2(4), 73-86.

Staff, J., & Maggs, J. L. (2020). Parents Allowing Drinking Is Associated With Adolescents’ Heavy Alcohol Use. Alcoholism: Clinical and Experimental Research, 44(1), 188-195.

Telumbre-Terrero, J., López-Cisneros, M., Castillo-Arcos, L., Sánchez Becerra, A., & Sánchez-Domínguez, J. (2019). Historia familiar y consumo de alcohol en adolescentes Family history and alcohol consumption in adolescents. Salud Uninorte, 35(1), 72-83.

Thapa, S., Selya, A. S., & Jonk, Y. (2017). Time-varying effects of parental alcoholism on depression. Preventing Chronic Disease, 14(12).

Vederhus, J. K., Haugland, S. H., & Timko, C. (2022). A mediational analysis of adverse experiences in childhood and quality of life in adulthood. International Journal of Methods in Psychiatric Research, 31(1).

Vederhus, J. K., Timko, C., & Haugland, S. H. (2021). Adverse childhood experiences and impact on quality of life in adulthood: development and validation of a short difficult childhood questionnaire in a large population-based health survey. Quality of Life Research, 30(6), 1769-1778.

Wlodarczyk, O., Schwarze, M., Rumpf, H. J., Metzner, F., & Pawils, S. (2017). Protective mental health factors in children of parents with alcohol and drug use disorders: A systematic review. PLoS ONE, 12(6), 1-15. Public Library of Science.

Zuquetto, C. R., Opaleye, E. S., Feijó, M. R., Amato, T. C., Ferri, C. P., & Noto, A. R. (2019). Contributions of parenting styles and parental drunkenness to adolescent drinking. Brazilian Journal of Psychiatry, 41(6), 511-517.