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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    • "Mothers were recruited at 20-to 28- week gestation, written informed consent obtained, and background data collected for the umbrella study. For the group with alcohol exposure, mothers were screened antenatally based on a minimum score of 11 on the alcohol questions of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) questionnaire (indicating moderate to high risk of substance abuse)—a widely validated World Health Organization (WHO) scale to assess comorbid substance use (Humeniuk et al., 2008; Jackson et al., 2010). In addition to this initial screen, mothers were interviewed and required to have a positive history of alcohol use in any trimester of pregnancy at levels consistent with WHO moderate–severe alcohol use. "
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    • "Interviewers were available at each site who were able to conduct the interview in the chosen language. For the group with alcohol exposure, mothers were identified based on a minimum score of 11 (moderate to high risk of experiencing severe problems as a result of their current pattern of use) on the alcohol questions on the ASSIST questionnaire – a widely validated World Health Organization scale to assess comorbid substance use (Humeniuk et al. 2008; Jackson et al. 2010). "
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