A self-test questionnaire to aid in the evaluation of patterns of Alcohol consumption. This instrument is an adaptation of the MAST test. No claims as to the validity of the results and the results should be considered only as an “indicator” as to the presence or absence of Alcoholism.
If your test results are strongly suggestive or compatible with a diagnosis of Alcoholism, you are urged to seek further help for evaluation and diagnosis.
1. Do you feel that you are a normal drinker? No = 1 point
2. Have you ever awakened the morning after some drinking the night before and found that you could not remember a part of the evening before? Yes = 2 points
3. Have your relatives ever worried or complained about your drinking? Yes = 1 point
4. Can you stop drinking without a struggle after one or two drinks? No = 1 point
5. Do friends or relatives think you are a normal drinker? No = 1 point
6. Have you ever felt bad about your drinking? Yes = 1 point
7. Have you ever tried to limit your drinking to certain times of the day or to certain places? Yes = 1 point
8. Have you gotten into fights when drinking? Yes = 1 point
9. Has drinking ever created problems with you and your spouse? Yes = 1 point
10. Has anyone in your family ever gone to anyone for help about your drinking? Yes = 2 points
11. Have you ever lost friends or girlfriends/boy-friends because of drinking? Yes = 1 point
12. Have you ever gotten into trouble at work because of drinking? Yes = 1 point
13. Have you ever lost a job because of drinking? Yes = 2 points
14. Have you ever neglected your obligations, your family, or your work for two or more days in a row because of drinking? Yes = 2 points
15. Have you always been able to stop drinking when you wanted to? No = 2 points
16. Have you ever taken a drink the morning after to ease a hangover from the night before? Yes = 2 points
17. Have you ever had DT’s, severe shaking, heard voices or seen things that weren’t there after heavy drinking? Yes = 3 points
18. Have you ever gone to anyone for help about your drinking? Yes = 3 points
19. Have you ever been in a hospital because of drinking? Yes = 3 points
20. 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? Yes = 2 points
21. Have you ever been seen as a psychiatric or mental health clinic, or gone to a doctor, social worker, or clergyman for help with an emotional problem in which drinking played a part? Yes = 2 points
22. Have you ever been arrested, even for a few hours because of drunk behavior? Yes = 2 points
23. Have you ever been arrested for drunk driving or driving after drinking? Yes = 2 points
ENTER YOUR TOTAL SCORE____________
SCORES OF:
- 0-5 PROBABLY NON-ALCOHOLIC
6-9 SUGGESTIVE OF ALCOHOLISM
10+ “DIAGNOSTIC” OF ALCOHOLISM
There is considerable room for weighting of importance of the individual questions. The scoring is considered generous, that is, more likely to result in false negatives than false positives. It is only to give you an idea.