Most screening and assessment instruments were developed and tested in adult male populations. These instruments vary in their ability to detect substance use disorders and other problems among different populations. Gender, age, ethnicity, literacy, and physical or cognitive inability may affect the ability of the instrument to identify and address problems.
For women, using a longer, more flexible format is often useful, particularly to explore unanticipated issues that may arise. Females are more likely to have trauma-related problems and co-occurring (mental health and substance abuse) disorders. In addition, females are also more likely to be affected by poverty, abuse histories, unstable social supports, and medical problems.