DUI/DWI Offender Test (DDOT)

DUI/DWI Offender

The DUI/DWI Offender Test (DDOT) is an evidence-based assessment instrument or test that focuses explicitly on alcohol and drug use or abuse. It interprets Alcohol Scale, Marijuana Scale, and Drug Scale findings with Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition (DSM-5) Substance Use Disorder classifications. The DDOT also determines if the client (defendant, patient, or offender) was truthful while completing the test. And it measures how well the client manages stress.

The DUI/DWI Offender Test (DDOT) is a brief, self-administered, evidence-based substance (alcohol and other drugs) use or abuse assessment instrument or test. It consists of 117questions and takes around 20 minutes to complete. From test data (answers) input, scored and printed DUI/DWI Offender Test (DDOT) reports are available on-site within 2½ minutes.

An intertwining relationship often exists between DUI/DWI, offender risk and, as warranted, intervention or counseling. DUI/DWI, offender risk assessment usually involves identification of alcohol/drug-related problems. Intervention refers to education, counseling, and treatments that are used to reduce, alleviate, or overcome DUI/DWI offender, risk-related driving problems. When substance (alcohol and drug) use problems exist, they typically involve alcohol (beer, wine and other liquors) and other drugs (marijuana, cocaine, amphetamines, barbiturates, heroin, etc.).

The DUI/DWI Offender Test (DDOT) Alcohol Scale, Drug Scale, and Marijuana Scale independently measure alcohol, drug, and marijuana use, and the severity of abuse. In addition, DDOT contains the DSM-5 Substance Use Disorder classification that incorporates both alcohol and drugs. Substance Use Disorder severity is determined by the number of 11 symptom criteria that are endorsed. For example, endorsement of “two or three” criteria, the client’s substance use severity is classified as “Moderate,” whereas, endorsement of six or more of the 11 criteria symptoms meet the “severe” Substance Use Disorder criteria.

There are important differences between the DDOT Alcohol, Drug, and Marijuana Scales and the DSM-5 Substance Use Disorder. The DDOT Alcohol Scale, Drug Scale, and Marijuana Scale were, specifically, designed for DUI/DWI screening. The DSM-5 based Substance Use Disorder was designed for clinical, substance use patient diagnosis and treatment. The DDOT has been standardized on DUI/DWI offenders. The DSM-5 Substance Use Disorder has not been standardized, specifically, on DUI/DWI offenders. DDOT research, emerged from Driver Risk Inventory-II research, which is extensive, impressive, and ongoing. To meet the needs of treatment facilities, DUI evaluation agencies, and the court system, DSM-5 has also been included in the DDOT.

Dimensional measures use recent time frames (e.g., past year, last month, or now) to measure the severity of alcohol and/or drug use. DDOT uses dimensional or recent measures. In contrast, categorical measures gather long term, or lifetime occurrence information for patient-related treatment planning. DDOT Alcohol, Marijuana, and Drug Scales are “dimensional,” whereas, DSM-5 often uses both. (DUI/DWI Offender Test emphasizes matching of offender’s current “problem severity” and “treatment intensity.”)

The DDOT Driver Risk Scale measures “drive risk,” independently of substance abuse. Some people are, simply, inferior drivers. When an inferior driver drinks or uses drugs excessively, that person becomes a very dangerous driver.

Now that some states have passed medical marijuana (or recreational) use statutes (laws) and decriminalize marijuana laws (statutes), driving under the influence-marijuana is becoming more common. Laboratory studies have identified several, marijuana-related impairments on driving skills, including poor attention spans, impaired hand-eye coordination, and slower rates of tracking objects. Field studies found that driving under the influence-marijuana increases the risk of accidents. Marijuana can be detected in urine, blood, salvia, hair, and sweat. Salvia testing (oral fluid testing) is used throughout Australia to detect the presence of THC. Federal and state driving, "under the influence-marijuana" laws are in place in Australia.

Scale Descriptions

Truthfulness Scale: Measures how truthful the DUI/DWI offender was while completing the DUI/DWI Offender Test (DDOT). This scale identifies guarded and defensive people who attempt to minimize their problems, or fake good. Assessment results can be impacted by “socially desirable responding” (Blanchette, Robinson, Alksnis & Serin, 1997). Most DUI/DWI offender tests do not incorporate a measure of truthfulness (Bishop, 2011). Truthfulness Scale scores at or below the 89th percentile mean all DDOT scale scores are accurate. When the DDOT Truthfulness Scale score is in the 70 to 89th percentile range, other DDOT scale scores are accurate, because they have been truth-corrected. In general, the lower the Truthfulness Scale score, the more accurate DDOT scale scores are. In contrast, when the Truthfulness Scale score is at or above the 90th percentile, this means that all DDOT scales are inaccurate (invalid), because the DUI/DWI offender was overly guarded, read things into test items that aren't there, was minimizing problems or was attempting to "fake good." If not consciously deceptive, offenders with elevated, Truthfulness Scale scores are uncooperative (likely in a passive-aggressive manner), fail to understand or follow instructions, or have a need to appear in a good light. To review, Truthfulness Scale scores at or below the 89th percentile mean that all ,other DDOT scale scores are accurate. One of the first things to check when reviewing a DDOT report is the Truthfulness Scale score.

Alcohol Scale: Measures alcohol (beer, wine or liquor) use and the severity of abuse. A recently published study found that the Alcohol Scale percentile score is a strong predictor of DUI/DWI offender recidivism (Bishop, 2011). An elevated (70 to 89th percentile) range identifies established and serious drinking problems. Elevated Alcohol Scale scores do not occur by chance.

Alcohol involvement ranges from abstinence (non-drinking) to dependency (Maisto & Saitz, 2003). A history of alcohol problems (e.g., alcohol-related arrests, DUI/DWI convictions) could result in an abstainer (current non-drinker) attaining a low risk scale score. Consequently, safeguards have been built into the DDOT to identify “recovering alcoholics.” For example, the offender’s self-reported court history is summarized in the DDOT report. And, on page three of the DDOT report, the offender's answer to the “recovering alcoholic” question (#115) is printed on the report's third page under “significant items.” In addition, elevated Alcohol Scale paragraphs caution staff to establish if the offender is a recovering alcoholic. If recovering, how long? Obviously the DUI/DWI offender was arrested for a DUI or DWI offense.

Severely, elevated Alcohol, Drug, and Marijuana Scale scores indicate polysubstance abuse, and the highest score usually identifies the offender’s substance of choice. Scores in the severe problem (90 to 100th percentile) range are a malignant, prognostic sign. Elevated (70 to 89th percentile) Alcohol, Drug, and Marijuana Scale scores identify a particularly, dangerous driver. The more elevated scales are, the more serious the prognosis. Add an elevated Driver Risk Scale score to any of these substance-related scores, and you have a very, dangerous driver. Here, you have a person with inferior driving skills who is even, further impaired when drinking or using drugs.

In screening, intervention, and treatment settings, the offender's DDOT Alcohol Scale score can help staff work through offender denial. Many people accept objective, standardized assessment results as opposed to someone’s subjective opinion. This is especially true when it is explained that the DDOT has been administered to thousands of DUI/DWI offenders, and elevated scores don’t happen by chance. The Alcohol Scale can be interpreted independently, or in combination with other DDOT scales.

Drug Scale: Measures drug use and the severity of abuse. Drugs refer to ice, crack, cocaine, ecstasy, amphetamines, barbiturates, heroin, etc. A DUI/DWI can be defined as driving under the influence of any alcohol (beer, wine, or liquor) or drug (prescription and nonprescription) (Nochajski & Stasiewicz, 2006). Dupont (2011) noted that in a 2009 study, approximately one-third (33.0%) of drivers in fatal injury crashes (for whom drug test results were available) tested positive for drugs, other than alcohol. An elevated (70 to 89th percentile), Drug Scale score identifies emerging drug problems. A Drug Scale score in the severe problem (90 to 100th percentile) range identifies established, drug abuse.

A history of drug-related problems (e.g., drug-related arrests, prior DUI/DWI convictions, drug treatment, etc.) could result in an abstainer (current non-user) attaining a low, Drug Scale score. For this reason, precautions have been built into the DDOT, to insure correct identification of “recovering” drug abusers. Many of these precautions are similar to those discussed above, in the Alcohol Scale section. And, the DUI/DWI offender's answer to the “recovering drug abuser” question (#115) is printed on the third page of the DDOT report.

Consequently, elevated Alcohol, Drug, Marijuana, or Substance Use Scales are indicators of co-occurring, polysubstance abuse and, the highest scores usually reflect the offender’s substance of choice. Any, Drug Scale score in the severe problem range must be taken seriously. The Drug Scale can be interpreted independently, or in combination with other DDOT scales.

Substance Use Disorder: Classifies DUI/DWI offenders as having a Diagnostic and Statistical Manual, 5th Edition (DSM-5) Substance Use Disorder, when they meet DSM-5 criteria. The DUI/DWI Offender Test (DDOT), Substance Use Disorder classification is, entirely, based upon DSM-5 classification criterion. When a DUI/DWI offender admits to one or more of the DSM-5 Substance Use Disorder criteria, (symptoms) that offender meets the criteria for a substance use Disorder. The severity of an offender’s disorder is determined by how many of the 11 Substance Use Disorder symptoms they endorse. There is an important difference between the DSM-5 Substance Use Disorder and the DDOT Alcohol Scale, Drug Scale, and Marijuana Scale, which involves the DSM-5 Substance Use Disorder, including both alcohol and drugs. Whereas, DDOT’s Alcohol, Drug, and Marijuana Scales are unilateral, in that the DDOT Alcohol Scale focuses, exclusively, upon drinking, and the DDOT Drug Scale focuses, exclusively, on drugs (prescription and nonprescription) use. This difference is important, because DDOT Alcohol, Drug, and Marijuana Scales' problem severity can be matched to equivalent treatment levels. Matching problem severity with coequal treatment intensity is important for optimum, intervention (classes, meetings, etc.) success. DDOT Alcohol, Drug, and Marijuana Scales measure the severity of abuse. For background, there are several levels of interpretation, which range from viewing the DDOT as a self-report, to interpreting scale elevations and scale inter-relationships.

Marijuana (Cannabis) Scale: Some states (e.g. Colorado, Washington) have passed recreational statutes or laws. Other states will likely follow. Marijuana analogies to drug-driving laws, setting driver blood limits for marijuana’s psychoactive chemical, are likely.

Marijuana is the most, commonly detected non-alcohol drug in drivers, yet its role in driver safety is still unclear. A now famous Columbia University study found drivers who tested positive for marijuana use, or reported driving within three hours of marijuana use, are twice as likely as non-marijuana users to be involved in motor vehicle crashes. And now, there seems to be a growing consensus that marijuana use, before driving, may double the risk of vehicular accidents – and, combining marijuana use and alcohol is even, more dangerous.

Nevertheless, more marijuana-driving research is needed. To date, the marijuana-driver-safety issue is compromised by different methodologies, procedures, and policies. Early studies assessed marijuana use by measuring driver’s urine samples, which contained only inactive THC metabolites that may not have reflected marijuana use. Blood samples that detected active THC metabolites show significant driver-crash relationships at high THC concentrations. Future research should resolve many of these concerns. Australia has instituted roadside salvia testing for marijuana throughout the country.

Roadside saliva testing for marijuana (cannabis) can legally be conducted in every, Australian state and territory. Marijuana (cannabis) can be detected in people’s urine, blood, salvia, hair, and sweat. On a roadside, one of the easiest and cheapest methods of detecting marijuana use is salvia testing (or oral fluid testing). A sample of salvia is taken by placing a collections device in the mouth, and results take about five minutes. The salvia test detects the presence of THC. In Australia, if the salvia test is positive, further samples of salvia or urine may be taken by trained staff. These second samples must be verified, before a person can be charged. THC can be detected in oral fluids for up to several hours after consumption. Australian studies have shown rates of marijuana (cannabis) use, among drivers killed in crashes, ranged from 11% to 13.5%.

A Marijuana Scale is included in the DUI/DWI Offender Test (DDOT) as an important component of driver risk. The Marijuana Scale can be used independently or in combination with other DDOT scales.

Driver Risk Scale: Measures driving risk, e.g., aggressive, irresponsible, or careless drivers. This scale (measure) is independent of Alcohol, Drug, Marijuana, and Substance Use. Some people are, simply, poor drivers. Elevated (70th percentile and higher), Driver Risk Scale scores identify problem-prone drivers. Severe problem (90 to 100th percentile) scorers are dangerous drivers. When the Driver Risk Scale is elevated and any substance (alcohol/drug) use scale is also elevated, that person’s marginal driving skills are, further, impaired by substance use or abuse.

According to the National Highway Traffic Safety Administration (NHTSA), which is the highest federal authority in the DUI/DWI field – “the Driver Risk Inventory (DRI) is the only major DUI/DWI test that has a Driver Risk Scale (Popkin, Kanneberg, Lacey & Waller, 1988).“ Consequently, other DUI/DWI offender tests do not identify abstaining, but dangerous drivers. The DDOT Driver Risk Scale evolved from the DRI Driver Risk Scale, so there are now two, major DUI/DWI tests that contain a Driver Risk Scale.

The Driver Risk Scale provides considerable insight into DUI/DWI offender driving status. DUI/DWI offenders tend to have poor driving records, both prior to and after their DUI/DWI arrests. (Caviaola, Stohmetz & Abreo, 2007). The Driver Risk Scale can be interpreted independently, or in combination with other, elevated DDOT scale. A particularly, unstable and perilous driving profile involves an elevated (70th percentile and higher) Driver Risk Scale, along with an elevated Alcohol, Drug, Substance Use, or Marijuana Scale score. This profile defines a dangerous driver. And, as a general rule, the higher a scale score, the more serious the driving problems it represents.

In conclusion, it was noted that here are several levels of DDOT interpretation. They range from viewing the DDOT as a self-report to interpreting scale elevations and inter-relationships. Staff can then put a DUI/DWI offender DDOT profile within the context of offenders driving circumstances.

DUI/DWI Offender Test

Matching Problem Severity & Treatment Intensity

Objective, standardized, and computer assisted assessment (screening, evaluation or testing) makes accurate, efficient, and timely client screening possible. Judges (probation officers and mental health professionals) may refer clients (offenders, patients) for screening, evaluation, or assessment. In most counseling and treatment settings, clients are screened to determine the presence of problems, and if problems are present, to measure problem severity. Contingent upon the assessment (DUI/DWI Offender Test) results, clients can then be referred to appropriate levels of intervention or treatment. Like emergency room triage, clients with serious problems are referred to more, intensive treatment programs.

It has been shown that placing clients in wrong. treatment intensity programs can be detrimental to both the client and society (Andrews, Bonta & Hoge, 1990). When low risk clients were placed in high risk (intensive) treatment programs, low risk clients had a higher likelihood of relapse. Low risk clients are better served in low intensity programs. Similarly, high risk (serious problems) clients benefit most, when placed in intensive treatment programs.

This sounds obvious, yet is it? If an evaluator does not use a test containing a Truthfulness Scale, how does that evaluator determine if the client provided accurate and honest information? Some evaluators maintain that their education and experience enables them to make these determinations. Other evaluators are not so naïve, and rely more on test truthfulness measures that have demonstrated reliability and validity. Few would dispute the statement that "many clients" minimize their problems and attempt to "fake good." It is important to know if obtained information is accurate. Only then can we rely upon such information to identify problems and determine their severity. Accurate assessment must be done to refer clients to appropriate counseling and treatment programs.

Automated (computer scored) assessment instruments or tests can establish client truthfulness (while being tested) and concurrently identify problems and, their severity. Truthfulness Scales are considered by many, as a necessary condition for client placement in intervention and treatment programs that will be most effective for them.

RISK LEVEL CLASSIFICATION

Each DUI/DWI Offender Test Scale score is classified in terms of the risk it represents. These risk level classifications are individually calculated for each of the empirically-based scales, each time an DUI/DWI Offender Test is scored.

A problem is not identified until a Scale’s score (percentile) is at (or above) the 70th percentile. Percentile scores are obtained from a database of score distributions. Scores in the 70 to 90th percentile range represent problems for which specific intervention and/or treatment recommendations (or referrals) are made. Severe problems are identified with Scale scores in the 91 to 100th percentile range. Recommendations are intensified for severe problem scale scores.

Assessment or screening instruments have been adapted to the settings in which they are used and to the type of offenders evaluated. This has resulted in the unique application of psychometrics and software programming to develop meaningful assessments or screening tests that are appropriate to each offender populations testing milieu. In brief, this means we have gone beyond just evaluating alcohol and drugs and now include measures (scales) that are unique to each of the offender populations. For example, we have different tests for adult probation, juvenile probation, parole departments and prison inmates. In addition, we now have specialty tests for sex offenders, domestic violence perpetrators and shoplifters.

Research Citations

Bishop, N. (2011). Predicting multiple DUI offenders using the Florida DRI. Substance Use & Misuse (46), 696-703.

Blanchette, K. Robinson, D., Alksnis, C., Serin, R. (1997). Assessing Treatment Outcome Among Family Violence Offenders: Reliability and Validity of a Domestic Violence Treatment Assessment Battery. Correctional Service of Canada.

Caviaola, A., Stohmetz, D., Abreo, S. (2007). Comparison of DWI offenders with non-DWI individuals on the MMPI-2 and the Michigan Alcoholism Screening Test. Addictive Behaviors 28:971-977.

Dupont, R.L. (2011). Drugged Driving Research: A White Paper. Retrieved from
http://www.whitehouse.gov/sites/default/files/ondcp/issues-content/drugged-driving/nida_dd_paper.pdf, September 7, 2011.

Maisto, S., Saitz, R. (2003), Alcohol use disorders: screening and diagnosis. The American Journal of Addiction 12:S12-S25.

Nochajski, T., Stasiewicz, P. (2006). Relapse to driving under the influence (DUI): A review. Clinical Psychology Review 26: 179-195.