BB #3 Assessments Replies
ADOLESCENT SUBSTANCE ABUSE SUBTLE SCREENING INVENTORY (sassi-a2)
The National Center for Drug Abuse states that in 2020, 47% of adolescents had used an illegal drug by the time they graduated from high school. They also report that American teenagers consume 11% of alcohol annually in the US and alcohol is almost always a factor in the three leading causes of death among adolescents (accidents, homicides, and suicides). Given the risk factors that drug and alcohol use present, early intervention is critical to prevent at risk behaviors from manifesting into larger problems in adulthood. In order to reduce the risks it is necessary to have an effective way to accurately identify those that have a probability for substance abuse. One of the most widely used instruments is the Adolescent Substance Abuse Subtle Screening Inventory (SASSI-A2).
1
General Information
Identifies probability of substance abuse among adolescents aged 12 to 18 years
Developed by Glenn Miller, PhD
Developed after 14 years of research and is compliment to adult version of SASSI
First published in 1990
Source: drugabuse.gov
The Adolescent Substance Abuse Subtle Screening Inventory (SASSI-A2) is a test to screen for high or low probability of a substance use disorder in teens ages 12 to 18. The test is described as effective in identifying the probability even when individuals deny or deliberately try and conceal their substance use. It is similar to the adult version which is currently on the 4th edition. The test was developed by Glenn Miller, PhD. Dr. Miler was working in a DWI program and realized the need to develop a screening tool to identify individuals that might need to be referred for treatment. In 1988 he published the first SASSI test after 12 years of research. Two years later he developed the SASSI-A which was the original test for adolescents. Today the SASSI Institute administers, researches and trains individuals on this test (The SASSI Institute, n.d.).
2
Test Description
Two part questionnaire:
Part 1 – 16 rating-scale questions (0 to 4)
Part 2 – 72 binary questions (True-False)
Measures 12 sub-scales
Time to complete = 20 mins
Cost = $150
Separate interpretation criteria for male and females
The SASSI-A2 is a two page test. The first page contains 16 rating-scale questions (The SASSI Institute, n.d.). These include rating questions regarding used to measure the frequency of alcohol (FVA) and other drug use (FVOD). The frequency measures are never, once or twice, several times, repeatedly. The second page contains 72 true-false questions used to measure 10 specific sub-scales. These additional scales include Family-Friends Risk scale (FRISK), Attitudes scale (ATT), Symptoms scale (SYM), Obvious Attributes scale (OAT), Subtle Attributes scale (SAT), Defensiveness scale (DEF), Supplemental Addiction Measure scale (SAM), Correctional scale (COR), Validity Check scale (VAL) and Secondary Classification scale (SCS) (Perera-Diltz & Perry, 2011). The instrument is administered, scored and interpreted in approximately 20 minutes. The cost for the introductory kit is $150 which includes the SASSI-A2 user guide, 25 questionnaires and profiles, scoring key and a sample score questionnaire and profile (The SASSI Institute, n.d.). A separate interpretation and profile sheets is required dependent on whether the adolescent is male or female. The person administering the test shall meet the level B qualification requirements (The SASSI Institute, n.d.).
3
Test Psychometrics
A2 version updated to be normed on adolescents from both genders representing ethnic backgrounds
Test claims to be 94% accurate
Test-retest reliability ranging from .81 to .92
Overall alpha coefficient = 0.75
Validated with comparison to clinical diagnoses
Not significantly affected by gender, age, ethnic group membership, education, or prior history of law violation.
In the second version (A2) the norm group (N=856) was updated to included adolescents from both genders representing various ethnic backgrounds. The test claims to be 94% accurate and this is based on comparing the test results with those that had already received a clinical diagnosis for substance use disorder. The User Guide indicates a 98% positive predictive power, 11% false positive and 5% false negative rates. The test-retest reliability score ranged from .81 to .92. The overall alpha coefficient for the test was 0.75 with the individual subscales ranging from 0.63 to 0.95. To validate the test, the developers compared results for individuals who took the exam to those that had a clinical diagnosis of substance abuse disorder. Research findings indicated that the accuracy of the SASSI-A2 was no significantly affected by gender, age, ethnic group membership, education, employment status, and prior history of law violation (Estimates of the Reliability and Criterion Validity of the Adolescent SASSI-A2, n.d.).
4
Test Concerns
Low percentage of minorities in norm group.
Should not be the sole determinant on whether an adolescent has a substance use disorder.
Debate on whether this test provides any more evidence than free and public available screening instruments.
Research is limited.
Even though the test promotes that the norm group included adolescents from both genders that represented ethnic backgrounds, a significant portion of the norm group were Caucasian (64%) and Hispanic (20%). Only five (5) African Americans were included in the norm, this represents less than 1% of the entire norm sample (Perera-Diltz & Perry, 2011). In addition, there appears to be a lack of biracial and/or multiracial groups among the norm group. The SASSI-A2 can be misused in that some screeners will use the test as the sole determinant of a substance use disorder and is used to direct treatment decisions and potentially even legal matters related to adolescents. Some experts believe that the SASSI-A2 test does not provide any advantage of identifying substance use disorders when compared to other public domain screening instruments that are free of charge (Feldstein & Miller, 2007).
5
Biblical Reference
Eye has not seen, nor ear heard, nor have entered into the heart of man the things which God has prepared for those who love Him. (1 Corinthians 2:9, NIV)
The SASSI-A2 is about being able to identify those adolescents that may have a high probability of substance abuse. Through the love that I have in God, he can prepare me and my ability to not only facilitate this type of test but be able to see and hear what he has prepared for me to help with.
6
References
Estimates of the Reliability and Criterion Validity of the Adolescent SASSI-A2. (n.d.). Retrieved June 18, 2020, from https://sassi.com/wp-content/uploads/2018/07/Estimates-of-the-Reliability-and-Criterion-Validity-of-the-Adolescent-SASSI-A2-5-2-17.pdf
Feldstein, S. W., & Miller, W. R. (2007). Does subtle screening for substance abuse work? A review of the Substance Abuse Subtle Screening Inventory (SASSI). Addiction, 102(1), 41–50. https://doi.org/10.1111/j.1360-0443.2006.01634.x
Perera-Diltz, D. M., & Perry, J. C. (2011). Screening for Adolescent Substance-Related Disorders Using the SASSI-A2: Implications for Nonreporting Youth. Journal of Addictions & Offender Counseling, 31(2), 66–79. https://doi.org/10.1002/j.2161-1874.2011.tb00068.x
The SASSI Institute. (n.d.). Retrieved June 18, 2020, from https://sassi.com/sassi-a2/
7