Validation of a substance use disorder screening instrument for use in vocational rehabilitation settings.

Abstract

The study objectives were to develop and validate a substance use disorder screening instrument for vocational rehabilitation customers. Beginning with the Substance Abuse Subtle Screening Inventory-3 (SASSI-3), the authors developed items pertaining to prescription medication misuse and modified other items. Research Method/Design: Data were collected for the cross-sectional cohort study through interviews with a random subsample reinterviewed 14 days later. Complete data sets were collected from 948 customers recruited in Ohio, Illinois, and West Virginia; 128 completed a second interview. Women composed 52% of the sample and 58% were African American; the mean age was 40 years (Ϯ12 years). Customers completed a preliminary version of the new instrument, called the Substance Abuse in Vocational Rehabilitation Screener (SAVR-S), and the Diagnostic Interview Schedule. The authors used Rasch analyses to reduce the instrument to 43 items then divided the sample into a development subsample (used to formulate a scoring routine) and a validation subsample. Results: Sensitivity in detecting substance use disorders was 82% and specificity was 85% in the validation subsample. Conclusions/Implications: The SAVR-S appears to be a valid instrument and minimizes respondent burden while maximizing sensitivity and specificity to substance use disorders. It can assist vocational rehabilitation staff in identifying customers who need professional assessment and help support efforts toward self-sufficiency.

Identifying depression severity risk factors in persons with traumatic spinal cord injury.

“…The Substance Abuse in Vocational Rehabilitation-Screener (SAVR-S; Heinemann, Lazowski, Moore, Miller, & MacAweeney, 2008) was developed to measure drug and alcohol misuse in disability samples. It is based on the Substance Abuse Subtle Screening Inventory-3 (Lazowski, Miller, Boye, & Miller, 1998) which includes items that assess a defensive response style.…”

Consumer perspectives on reasons for unsuccessful VR case closure: An exploratory study

“…Reports were generated using the proprietary algorithms and results ("low", "medium", or "high" probability of having a substance use disorder) were generated. The SAVR-S has a robust sensitivity and specificity for SUD among VR applicants [38].…”

“…A recent study of 1,000 VR applicants in the mid-west found that 22% met the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV-TR) criteria for SUD [38]. These rates alone provide a valid concern for VR pro-fessionals to be aware of the volume of consumers who have either a diagnosed or undiagnosed SUD.…”

Physical Disability and Substance Use Disorders: A Convergence of Adaptation and Recovery

“…This segregated approach may be due to the lack of training that rehabilitation counselors and researchers receive in substance abuse issues and/or vocational rehabilitation policies that may not be inclusive of serving consumers with substance use disorders. Although some rehabilitation researchers have recently focused on substance abuse issues, such research tends to be in the areas of identification of substance use disorders in individuals receiving rehabilitation services (Heinemann, Lazowski, Moore, Miller, & McAweeney, 2008; and accessibility concerns related to substance abuse treatment programs (West, Graham, & Cifu, 2009). Little, if any, research has focused on interventions or strategies for counseling individuals with disabilities and substance use disorders.…”