Appendix H
Screening and Assessment Instruments
(^)
A screening instrument is meant to identify early
signs of a disease or health condition and
distinguish between individuals who require no
intervention and those who may require a brief
intervention or more intensive treatment.^1 In
contrast, an assessment instrument should be
utilized once a patient has been screened for a
condition--in this case, risky substance use--as a
necessary precursor to the initiation of an
intervention or treatment.^2 The goals of the
assessment are to help health care professionals
determine the nature, stage and severity of a
condition and whether the patient meets clinical
criteria for an addiction diagnosis; establish
whether co-occurring mental health or other
medical problems exist; and allow for the
development of an appropriate and specific
treatment plan.^3
Despite this theoretical distinction between
screening and assessment, the term screening
often is used to subsume the concept of
assessment or interchangeably with the term in
the clinical and research literatures. Instruments
designed to screen for risky substance use and
those designed to assess symptoms of addiction
frequently do not fit neatly into these two
categories. For example, many instruments that
are described as screening tools use diagnostic
criteria for addiction* to evaluate their validity
rather than measures of risky substance use. In
addition, some instruments are designed to
measure risky use or addiction across substances
(typically not including nicotine), whereas
others are more substance specific; none
measures all substances that may be involved in
risky use or addiction as a unified dimension.
With these caveats in mind, the following
review attempts to lay out the characteristics of
commonly-used instruments and specify, when
- Primarily based on the Diagnostic and Statistical
Manual of Mental Disorders (DSM).