Clinical Utility. The SASSI-3 has been found
to be valid and reliable among patients in a
variety of clinical settings.* 73 It has been found
to be 93 percent accurate at identifying
individuals who are likely to have addiction
involving alcohol or other drugs (excluding
nicotine);^74 and 97 percent accurate at
classifying patients who met diagnostic criteria
for substance dependence. The SASSI-3
demonstrates a 92 percent test-retest reliability
rate and 93 percent internal reliability rate.^75
One study found that it correctly identified 69.8
percent of cases with addiction (sensitivity) and
62.0 percent of cases without addiction
(specificity).^76
SASSI-A has not undergone extensive empirical
examination.^77 According to its manual, the
screening tool can identify accurately up to 95
percent of 12- to 18-year olds with addiction
(sensitivity) and 89 percent of those without
addiction (specificity).^78
Some research has questioned the effectiveness
of the subtle items of the SASSI instruments in
helping to detect addiction among adults and
adolescents.^79
Problem-Oriented Screening Instrument
for Teenagers (POSIT)
The Problem-Oriented Screening Instrument for
Teenagers was developed by the National
Institute on Drug Abuse (NIDA) in 1991 as a
screening instrument.^80 It can identify potential
problems in adolescents between the ages of 12
and 19 and covers 10 areas, including alcohol
and other drug use (excluding nicotine), physical
health and social relations.† 81 The POSIT
- Participants were drawn from clinical settings
across the country including addiction treatment
centers, general psychiatric hospitals, dual-diagnosis
hospitals, vocational rehabilitation programs, sex-
offender treatment programs and correctional centers;
responses to the instrument were compared to DSM-
based clinical criteria.
† The 10 domains relate to substance use, mental
health status, physical health status, aggressive
behavior/delinquency, social skills, family relations,
educational status, vocational status, peer relations
and leisure/recreation.
questionnaire used most often is made up of 139
yes/no items and takes 20 to 30 minutes to
administer.^82 There are two versions of POSIT’s
substance use screening domain: a 17-question
version and an 11-question version.^83Practitioners can score the instrument in a matter
of minutes. The POSIT tool is not copyrighted
and is available free of charge through NIDA. It
does not require training to administer.^84Populations and Settings Served. POSIT can
be used in school, juvenile justice, family court,
medical, psychiatric and addiction treatment
settings.^85Clinical Utility. Examinations of the POSIT
among 12- to 19 year-olds demonstrate the
instrument’s validity and reliability in screening
for symptoms of addiction.^86 Using the 17-item
version of the substance use scale, a cut-off
score of two accurately classified 84 percent of
cases of addiction‡ in adolescents (95 percent
sensitivity, 79 percent specificity). For the 11-
item scale, a cut-off score of two was found to
be 85 percent accurate at identifying addiction
(91 percent sensitivity; 82 percent specificity).^87Drug Use Screening Inventory (DUSI)
The Drug Use Screening Inventory was
developed in 1990 to screen and/or assess
adolescents in need of help for risky use of
alcohol and other drugs (excluding nicotine) or
addiction involving these substances.^88 It has
been revised to identify the severity of substance
involvement in adult and adolescent populations.
The instrument includes 159 items and takes 20
to 40 minutes to complete.^89DUSI measures problems across 10 domains:
alcohol and other drug use (excluding nicotine),
behavior problems, health status, psychiatric
disorders, school adjustment, work adjustment,§
family adjustment, peer relationships, social
competence and leisure and recreation.^90 DUSI‡ Based on DSM criteria.
§ The adolescent version of the DUSI does not
measure work adjustment.