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The Dartmouth Assessment of Lifestyle Instrument (DALI) is an 18-item questionnaire which contains 2 scales: one for assessing current alcohol use disorders and the second for assessing drug (i.e., marijuana and cocaine) use disorders in people with severe mental illnesses. The nine alcohol questions are summed and possible scores range from -4 to +6. Anyone scoring 2 or higher on the alcohol scale is at high risk for having a current alcohol use disorder (a diagnosis of abuse or dependence). The 8 questions which comprise the drug scale yield possible scores of +4 to -4. People scoring above -1 on this scale are at high risk for cannabis and/or cocaine use disorders.

The instrument as administered also contains 3 non-scored questions (2-4) used to establish the frame for the interview. Two items (5 and 12) are weighted on both scales, so the score from these responses should be placed in both the alcohol and drug columns. Response scores for each question can be either positively or negatively weighed (multiplied by either +1 or -1). The weight for each item appears alongside the box provided for entering the response score for that item.

Because the DALI contains such a small number of items, this scale is sensitive to missing data. For this reason, the DALI’s accuracy is improved by providing a correction value for all items to which the subject does not respond in a scorable manner (e.g., “I don’t know” or “I don’t want to answer that.”) The correction value for each item is different, and is listed adjacent to each question. If the subject refuses to answer a question, or claims not to know the answer, a specific correction value is assigned to that item. Thus, for example, the first question asks whether a subject wears seatbelts when riding in a car. If he or she says that they don’t know whether they wear a seatbelt when riding in a car (“don’t know”) or say that they never ride in cars (“not applicable”), they are given a value of .41 on question 1. That value is then multiplied by the positive weight (+1) for the alcoholism scale. Refusing to answer question 6, on the other hand, yields a correction value of 1.61, which is then multiplied by the positive weight (+1).

These procedures sound more complicated then they will be. Because of the brevity of the instrument, most people will answer all the questions and the correction values will not be needed. When clients provide yes or no responses, or the number value asked for, the scoring is very straightforward. After a few administrations, adding up client scores will be very simple, and should only take one or two minutes.

The reference for this instrument is: Rosenberg, S.D., Drake, R.E., Wolford, G.L., Mueser, K.T., Oxman, T.E., Vidaver, R.M., Carrieri, K.L., & Luckoor, R. (1998). The Dartmouth Assessment of Lifestyle Instrument (DALI): A substance use disorder screen for people with severe mental illness. American Journal of Psychiatry, 155, 232-238.

Photo: Joseph Mehling (Dartmouth Staff Photographer)

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The DALI

Dartmouth Assessment of Lifestyle Instrument

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