Methods and Techniques

Validation and performance of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) among adolescent primary care patients

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Corresponding Author

Jan Gryczynski

Friends Research Institute, Baltimore, MD, USA

Correspondence to: Jan Gryczynski, Friends Research Institute, Inc., 1040 Park Avenue, Suite 103, Baltimore, MD 21201, USA. E-mail: [email protected]Search for more papers by this author

Sharon M. Kelly,

Sharon M. Kelly

Friends Research Institute, Baltimore, MD, USA

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Shannon Gwin Mitchell,

Shannon Gwin Mitchell

Friends Research Institute, Baltimore, MD, USA

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Arethusa Kirk,

Arethusa Kirk

Total Health Care, Baltimore, MD, USA

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Kevin E. O'Grady,

Kevin E. O'Grady

University of Maryland, College Park, MD, USA

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Robert P. Schwartz,

Robert P. Schwartz

Friends Research Institute, Baltimore, MD, USA

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Jan Gryczynski,

Corresponding Author

Jan Gryczynski

Friends Research Institute, Baltimore, MD, USA

Correspondence to: Jan Gryczynski, Friends Research Institute, Inc., 1040 Park Avenue, Suite 103, Baltimore, MD 21201, USA. E-mail: [email protected]Search for more papers by this author

Sharon M. Kelly,

Sharon M. Kelly

Friends Research Institute, Baltimore, MD, USA

Search for more papers by this author

Shannon Gwin Mitchell,

Shannon Gwin Mitchell

Friends Research Institute, Baltimore, MD, USA

Search for more papers by this author

Arethusa Kirk,

Arethusa Kirk

Total Health Care, Baltimore, MD, USA

Search for more papers by this author

Kevin E. O'Grady,

Kevin E. O'Grady

University of Maryland, College Park, MD, USA

Search for more papers by this author

Robert P. Schwartz,

Robert P. Schwartz

Friends Research Institute, Baltimore, MD, USA

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First published: 14 October 2014

https://doi.org/10.1111/add.12767

Citations: 71

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Abstract

Background and Aims

The World Health Organization's Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) has strong support as a clinical screening tool and research instrument, but has only been validated with adults. This study evaluated the ASSIST and ASSIST-Lite in an adolescent population.

Design

Internal consistency, concurrent validity, discriminant validity and diagnostic accuracy were examined for tobacco, alcohol and cannabis ASSIST scores. An abbreviated version (the ASSIST-Lite) was evaluated for cannabis.

Setting

Three community health centers in Baltimore, MD, USA.

Participants

A total of 525 primary care patients, ages 12–17 years.

Measurements

Measures included the ASSIST, the CRAFFT screening tool and items from the Composite International Diagnostic Interview (CIDI) corresponding to substance use disorder criteria in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition.

Findings

The ASSIST had good internal consistency (α = 0.68–0.88), good concurrent validity with the CRAFFT (r = 0.41–0.76; P < 0.001), and was able to discriminate between gradations of cannabis problem severity. In receiver operating characteristics analysis of optimal clinical cut-points, the ASSIST accurately identified tobacco, alcohol and cannabis use disorders (sensitivities = 95–100%; specificities = 79–93%; area under the curve [AUC] = 0.90–0.94), but did so at minimally low cut-points (indicative of any use in the past 3 months). The ASSIST-Lite performed similarly to the ASSIST in identifying cannabis use disorders (sensitivity = 96%; specificity = 88%; AUC = 0.92), also at a minimally low cut-point. However, confirmatory factor analysis of the ASSIST indicated poor model fit.

Conclusions

The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is promising as a research and screening/brief assessment tool with adolescents, but revisions to clinical risk thresholds are warranted. The ASSIST-Lite is sufficiently informative for rapid clinical screening of adolescents for cannabis use disorders.

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Volume110, Issue2

February 2015

Pages 240-247

Validation and performance of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) among adolescent primary care patients

Correction(s) for this article

Corrigendum

Abstract

Background and Aims

Design

Setting

Participants

Measurements

Findings

Conclusions

References

Citing Literature

References

Information

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Validation and performance of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) among adolescent primary care patients

Correction(s) for this article

Corrigendum

Abstract

Background and Aims

Design

Setting

Participants

Measurements

Findings

Conclusions

References

Citing Literature

References

Related

Information