Validation of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)

Drug and Alcohol, Services Council, Adelaide, Australia.
Addiction (Impact Factor: 4.74). 07/2008; 103(6):1039-47. DOI: 10.1111/j.1360-0443.2007.02114.x
Source: PubMed


The concurrent, construct and discriminative validity of the World Health Organization's Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were examined in a multi-site international study.
One thousand and 47 participants, recruited from drug treatment (n = 350) and primary health care (PHC) settings (n = 697), were administered a battery of instruments.
Measures included the ASSIST; the Addiction Severity Index-Lite (ASI-Lite); the Severity of Dependence Scale (SDS); the MINI International Neuropsychiatric Interview (MINI-Plus); the Rating of Injection Site Condition (RISC); the Drug Abuse Screening Test (DAST); the Alcohol Use Disorders Identification Test (AUDIT); the Revised Fagerstrom Tolerance Questionnaire (RTQ); and the Maudsley Addiction Profile (MAP).
Concurrent validity was demonstrated by significant correlations between ASSIST scores and scores from the ASI-Lite (r = 0.76-0.88), SDS (r = 0.59), AUDIT (r = 0.82) and RTQ (r = 0.78); and significantly greater ASSIST scores for those with MINI-Plus diagnoses of abuse or dependence (P < 0.001). Construct validity was established by significant correlations between ASSIST scores and measures of risk factors for the development of drug and alcohol problems (r = 0.48-0.76). Discriminative validity was established by the capacity of the ASSIST to discriminate between substance use, abuse and dependence. Receiver operating characteristic (ROC) analysis was used to establish cut-off scores with suitable specificities (50-96%) and sensitivities (54-97%) for most substances.
The findings demonstrated that the ASSIST is a valid screening test for identifying psychoactive substance use in individuals who use a number of substances and have varying degrees of substance use.

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Available from: Michael Farrell, Sep 29, 2015
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    • "The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) is a self-report instrument that assesses past and current substance use, problems related to use, potential future risk, and dependence (Henry-Edwards et al. 2003). Internal consistency coefficients range from Cronbach's α of 0.77 for the hallucinogens scale to 0.94 for the opioids and amphetamines scales (Humeniuk et al. 2008). "
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    • "The results also depend on self-reported substance use. Although the ASSIST has demonstrated validity (Humeniuk et al. 2008), it was designed under the assumption that marijuana use is illegal. To the extent that cardholders and non-cardholders differ in the accuracy of their reports, it will bias comparisons between the groups. "
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    • "Scores of 27 or higher suggest high risk of dependence and likelihood of health, social, financial, legal and relationship problems as a result of their substance use. The ASSIST has excellent psychometric properties (Humeniuk et al., 2008). "
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