NDACAN Measure Details

Description:

The Addiction Severity Index (ASI), Self-Report Form (McLellan et al. 1992) is a tool widely used in the addiction field and comprises 36 self-report items that assess problems in six areas: (1) medical status, (2) employment/support status, (3) drug/alcohol use, (4) legal status, (5) family/social relationships, and (6) psychiatric status. Most questions ask the parent in a yes/no or open-ended format to report on his or her activities in the past 30 days. Examples of questions on the ASI include “How many days have you experienced employment problems in the past 30?” and “How many days have you been treated in an outpatient setting for alcohol or drugs in the past 30?” Administration time for the ASI Self Report is 10 to 15 minutes, and a paraprofessional can administer the report. Items are comparable to the full ASI, but the self-report version eliminates questions on family history and interviewer ratings. Internal consistency reliability for the full ASI is generally acceptable across studies, ranging from a low of 0.44 (Luo et al. 2010) to 0.89 (Leonhard et al. 2000). The psychiatric status, medical status, and drug/alcohol use subscales generally have higher reliability than the other subscales (Makela 2004). Makela (2004) also notes that many of the lower reliabilities come from studies of the homeless or patients with mental health issues, or from studies in Europe using translated versions of the ASI. The authors report that concurrent and discriminative validities were demonstrated with respect to a number of other measures for both composite scores and severity ratings. They also note that the ASI demonstrates good specificity and sensitivity (McLellan et al. 1980). The norming sample was made up of adults and represented a range of socioeconomic and marital statuses, living situations, and ethnicities; the participants abused a range of substances (McLellan et al. 1980). The ASI is widely used in clinical settings and by the Drug Evaluation Network System (DENS), a project that aims to gather clinical information on patients presenting for substance abuse treatment and the treatment programs they attend (Carise et al. 1999). DENS has collected more than 38,000 ASIs from about 100 treatment programs in 20 U.S. states. The ASI was also used in RPG1.

Citations

McLellan, A. T., Kushner, H. Metzger, D., Peters, R., Smith, I., Grissom, G., Pettinati, H., & Argeriou, M. (1992). The fifth edition of the addiciton severity index. Journal of Substance Abuse Treatment, 9(3), 199-213. doi: https://doi.org/10.1016/0740-5472(92)90062-S

Carise, D., McLellan, A. T., Gifford, L. S., & Kleber, H. D. (1999). Developing a national addiction treatment information system: an introduction to the drug evaluation network system. Journal of Substance Abuse Treatment, 17(1-2), 67-77. doi: 10.1016/S0740-5472(98)00047-6



Luo, W., Wu, Z., & Wei, X. (2010). Reliability and validity of the Chinese version of the addiction severity index. Journal of Acquired Immune Deficiency Syndromes, 53, S121-S125. doi: 10.1097/QAI.0b013e3181c7dfca



McLellan, A. T., Luborsky, L., Woody, G. E., & O'Brien, C. P. (1980). An improved diagnostic evaluation instrument for substance abuse patients: The Addiction Severity Index. Journal of Nervous and Mental Disease, 168(1), 26-33. doi: http://dx.doi.org/10.1097/00005053-198001000-00006