Validation of the Alcohol, Smoking And Substance Involvement Screening Test (ASSIST).
OBJECTIVE
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.


METHODS
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.


METHODS
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).


RESULTS
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.


CONCLUSIONS
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.
Humeniuk
Rachel
R
Drug and Alcohol, Services Council, Adelaide, Australia. rachel.humeniuk@adelaide.edu.au
Ali
Robert
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Babor
Thomas F
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Farrell
Michael
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Formigoni
Maria L
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Jittiwutikarn
Jaroon
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de Lacerda
Roseli B
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Ling
Walter
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Marsden
John
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Monteiro
Maristela
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Nhiwatiwa
Sekai
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Pal
Hemraj
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Poznyak
Vladimir
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Simon
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D000328:Adult; D003431:Cross-Cultural Comparison; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011320:Primary Health Care / Q000379:methods*; D011594:Psychometrics; D012720:Severity of Illness Index; D015813:Substance Abuse Detection / Q000379:methods*; D016320:Substance Abuse Treatment Centers / Q000379:methods*; D019966:Substance-Related Disorders / Q000517:prevention & control* / Q000523:psychology; D014944:World Health Organization