Alcohol-related problems have traditionally been conceptualized and measured by an effect indicator model. That is, it is generally assumed that observed indicators of alcohol problems are caused by a latent variable. However, there are reasons to think that this construct is more accurately conceptualized as including at least some causal indicators, in which observed indicators cause the latent variable. The present study examined the measurement model of a well-known alcohol consequences questionnaire, the Rutgers Alcohol Problem Index. Participants were 703 students from a large public university in the Northeast mandated to an alcohol intervention. We conducted a zero tetrad test to examine a measurement model consisting solely of effect indicators and a model with both causal and effect indicators. Overall, the results suggested the hybrid model fit the data better than a model with only effect indicators. These findings have implications regarding the theoretical underpinnings of alcohol-related consequences.