The utility of the Substance Abuse Subtle Screening Inventory-3 for use with individuals with brain injury

Abstract

The utility of the Substance Abuse Subtle Screening Inventory (SASSI-3) for the use with individuals with traumatic brain injuries (TBI) was investigated. The SASSI-3 was administered to 78 subjects prior to discharge from inpatient rehabilitation. The SASSI-3 diagnosis of chemical dependency was compared with the diagnosis of staff psychologists. Lower accuracy, sensitivity, and specificity were found in SASSI-3 diagnosis for the subjects with brain injury, as compared to a normative sample of persons with disabilities participating in a vocational rehabilitation programme. When a diagnosis of 'dependence or abuse' was used, accuracy of the SASSI-3 increased. Comparison of diagnosis based on SASSI-3 versus Blood Alcohol Level (BAL) at the time of injury showed comparable accuracy; however, BAL was found to have higher specificity. For dependence or abuse, BAL continued to be more specific than the SASSI-3; however, the SASSI-3 was more sensitive. Based on these findings, a clinical approach to screening using both BAL and the SASSI-3 is discussed.

The Substance Abuse Subtle Screening Inventory–3 and Stages of Change: A Screening Validity Study

“…The instrument is said to have good predictive criterion‐related validity if scores on a scale accurately predict some future event. Criterion variables used in the peer‐reviewed SASSI‐3 studies include staff psychologists’ diagnoses (Arenth, Bogner, Corrigan, & Schmidt, 2001), Cottler's (2000) Composite International Diagnostic Interview‐Substance Abuse Module (see Clements, 2002), and the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev. ; American Psychiatric Association, 2000; see Spitzer, Williams, Gibbon, & First, 1992; see also Ashman, Schwartz, Cantor, Hibbard, & Gordon, 2004).…”

A Rasch Analysis of the Substance Abuse Subtle Screening Inventory–3

“…; American Psychiatric Association, 2000). However, these high accuracy, sensitivity, and specificity rates have not been replicated by independent researchers (Arneth et al, 2001; Clements, 2002; Svanum & McGrew, 1995). Independent researchers (Arneth et al, 2001; Clements, 2002; Feldstein & Miller, 2007; Gray, 2001; Laux, Salyers, & Kotova, 2005; Svanum & McGrew, 1995) seem to question the SASSI‐3's reliability and validity in the context of that which is published by the SASSI Institute.…”

“…G. Miller & Lazowski, 1999). The SASSI‐3's psychometric properties have been studied by several independent researchers (Arneth, Bogner, Corrigan, & Schmidt, 2001; Clements, 2002; Feldstein & Miller, 2007; Gray, 2001; Laux, Perera‐Diltz, Smirnoff, & Salyers, 2005; Laux, Salyers, & Kotova, 2005; Lazowski, Miller, Boye, & Miller, 1998; Peters et al, 2000; Svanum & McGrew, 1995) and have been found to differ, at times significantly, from those reported in the SASSI‐3 manual (F. G. Miller & Lazowski, 1999).…”

Does subtle screening for substance abuse work? A review of the Substance Abuse Subtle Screening Inventory (SASSI)

“…The 36 located studies and two SASSI manuals spanned a wide variety of samples. The adult studies included college students [11–17], pregnant women [9,18–21], mothers of young children [22], community residents [3,13], members of Alcoholics Anonymous [23–26], couples [27], people with traumatic brain injury [28–30] and adults in addiction treatment [3,13,25,26,31], psychiatric settings [3,13,16], correctional programs [3,13,32–34] and welfare or child protective services [9,19,35]. The adolescent studies comprised samples from community or high school [23,36–40], substance abuse [4,23,38,41,42], psychiatric in‐patient [4,38,42–44] and correctional settings [4,34,38,42,44–46].…”