Cited by 1,503Substance Abuse Treatment and OutcomesPsychometric Methodologies and TestingAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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New Data from the Addiction Severity Index Reliability and Validity in Three Centers

McLELLAN, A. THOMAS, LUBORSKY, LESTER, CACCIOLA, JOHN, GRIFFITH, JEFFREY, EVANS, FREDERICK, BARR, HARRIET L., OʼBRIEN, CHARLES P.·1985·The Journal of Nervous and Mental Disease

DOI 10.1097/00005053-198507000-00005

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Abstract

The Addiction Severity Index (ASI) is a clinical/research instrument which has been in wide use during the past 6 years to assess the treatment problems found in alcohol- and drug-abusing patients. In a study of male veterans, a preliminary evaluation of the ASI has indicated reliability and validity. The present report presents an expanded examination of these issues; 181 subjects from three treatment centers were studied. Results of concurrent reliability studies indicate that trained technicians can estimate the severity of patients' treatment problems with an average concordance of .89. Test-retest studies show that the information obtained from the ASI is consistent over a 3-day interval, even with different interviewers. Comparisons of the ASI severity ratings and composite measures with a battery of previously validated tests indicate evidence of concurrent and discriminant validity. The reliability and validity results were consistent across subgroups of patients categorized by age, race, sex, primary drug problem, and treatment center. The authors discuss the strengths and limitations of the instrument based upon 5 years of use. The overall conclusion is that the ASI is a reliable and valid instrument that has a wide range of clinical and research applications, and that it may offer advantages in the examination of important issues such as the prediction of treatment outcome, the comparison of different forms of treatment, and the "matching" of patients to treatments…

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“The Addiction Severity Index (ASI) has been used extensively in drug abuse research and its reliability and validity are well-established (McLellan et al., 1985).”
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“established reliability and validity (McLellan et al., 1985; Argeriou et al, 1994; Zanis et al., 1994) and provides indices (referred to as composite scores) of psychiatric, alcohol, drug, medical, interpersonal, employment, and legal problems/functioning in the patient’s lifetime and within the 30 days before assessm…”
Background
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“The ASI has been used to derive and confirm substance use diagnoses in previous research (72).”
MethodInfluential
Substance use treatment outcomes for youth: Integrating personal and environmental predictors
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Ondansetron reduces mood disturbance among biologically predisposed, alcohol-dependent individuals.
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The Alpha-1 Adrenergic Antagonist Doxazosin for Treatment of Cocaine Dependence: A Pilot Study
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Brain mu-opioid receptor binding predicts treatment outcome in cocaine-abusing outpatients
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Attachment Styles in Alcoholic Inpatients
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Schroeder, J., Epstein, D., Umbricht, A., & Preston, K. (2006) · Addictive Behaviours · doi:10.1016/j.addbeh.2005.07.009 · Cited by 63
Increases in body mass index following initiation of methadone treatment
Fenn, J. M., Laurent, J. S., & Sigmon, S. C. (2015) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2014.10.007 · Cited by 62
Marijuana use is associated with risky sexual behaviors in treatment-seeking polysubstance abusers
Andrade, L. F., Carroll, K. M., & Petry, N. M. (2013) · The American Journal of Drug and Alcohol Abuse · doi:10.3109/00952990.2013.803112 · Cited by 56
“Research assistants also administered the Addiction Severity Index (ASI) (43).”
Method
Measurements, Instruments, Scales, and Tests: The Helping Alliance Questionnaire: Psychometric Properties in Patients with Substance Dependence
Oene, G. H. D. W.-V., de Jong, C. A. J., Jörg, F., & Schrijvers, G. (1999) · Substance Use & Misuse · doi:10.3109/10826089909039414 · Cited by 52
Use of the Addiction Severity Index with homeless substance abusers.
Argeriou, M., McCarty, D., Mulvey, K. P., & Daley, M. (1994) · Journal of Substance Abuse Treatment · doi:10.1016/0740-5472(94)90046-9 · Cited by 62
A causal model of the etiology of war-related PTSD
FONTANA, A. F., & Rosenheck, R. A. (1993) · Journal of Traumatic Stress · doi:10.1002/jts.2490060406 · Cited by 62
Sex differences in daily life stress and craving in opioid-dependent patients
Moran, L. M., Kowalczyk, W. J., Phillips, K. A., Vahabzadeh, M., Lin, J.-L., Mezghanni, M., Epstein, D. H., & Preston, K. L. (2018) · The American Journal of Drug and Alcohol Abuse · doi:10.1080/00952990.2018.1454934 · Cited by 61
Context and craving during stressful events in the daily lives of drug-dependent patients
Preston, K. L., Kowalczyk, W. J., Phillips, K. A., Jobes, M. L., Vahabzadeh, M., Lin, J.-L., Mezghanni, M., & Epstein, D. H. (2017) · Psychopharmacology · doi:10.1007/s00213-017-4663-0 · Cited by 61
“During screening, participants completed the Addiction Severity Index (ASI; McLellan et al. 1985) and the Diagnostic Interview Schedule (DIS IV; Robins et al.”
Method
Maternal mental health and children’s internalizing and externalizing behaviors: Beyond maternal substance use disorders
Hser, Y., Lanza, H. I., Li, L.-B., Kahn, E. R., Evans, E., & Schulte, M. T. (2013) · Journal of Child and Family Studies · doi:10.1007/s10826-013-9874-3 · Cited by 61
The Marijuana Screening Inventory (MSI-X): Concurrent, Convergent and Discriminant Validity with Multiple Measures
Alexander, D., & Leung, P. (2006) · The American Journal of Drug and Alcohol Abuse · doi:10.1080/00952990600753594 · Cited by 61
Identifying methadone maintenance clients at risk for poor treatment response: pretreatment and early progress indicators.
Morral, A., Belding, M. A., & Iguchi, M. (1999) · Drug and Alcohol Dependence · doi:10.1016/s0376-8716(98)00176-8 · Cited by 61
“The measure has proven reliable and valid in a variety of studies (McLellan et al., 1985; Kosten et al., 1983; McLellan et al., 1992).”
Background
Assessing the helping alliance and its impact in the treatment of opiate dependence.
Belding, M. A., Iguchi, M. Y., Morral, A., & Mclellan, A. (1997) · Drug and Alcohol Dependence · doi:10.1016/s0376-8716(97)00103-8 · Cited by 61
Self-citation
Coerced treatment for substance abuse problems detected through workplace urine surveillance: is it effective?
Lawental, E., Mclellan, A., Grissom, G. R., Brill, P., & O'Brien, C. P. (1996) · Journal of Substance Abuse · doi:10.1016/s0899-3289(96)90127-3 · Cited by 61
Self-citation
A practical system for monitoring the outcomes of substance use disorder patients
Tiet, Q. Q., Byrnes, H. F., Barnett, P., & Finney, J. W. (2006) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2006.03.002 · Cited by 60
“Evidence supports the validity and reliability of the ASI composite scores (Carey, Cocco, & Correia, 1997; Hendricks, Kaplan, VanLimbeek, & Geerlings, 1989; Hodgins & el-Guebaly, 1992; Kosten, Rounsaville, & Kleber, 1985; McLellan et al., 1985; Stoffelmayr, Mavis, & Kasim, 1994; Zanis, McLellan, Cnaan, & Randall, 1994…”
A Therapeutic Workplace for the Long-Term Treatment of Drug Addiction and Unemployment: Eight-Year Outcomes of a Social Business Intervention
Aklin, W., Wong, C. J., Hampton, J., Svikis, D., Stitzer, M., Bigelow, G., & Silverman, K. (2014) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2014.06.013 · Cited by 60
“At each 30-day assessment, we administered the employment, alcohol/drug, and legal sections of the Addiction Severity Index (ASI) followup (McLellan et al., 1985), an AIDS Risk Questionnaire (Silverman et al., 2002); and a 30- day employment history.”
Method
Differential transitions between cocaine use and abstinence for men and women.
Gallop, R., Crits-Christoph, P., ten Have, T., Barber, J., Frank, A. F., Griffin, M., & Thase, M. (2007) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.75.1.95 · Cited by 60
Personality disorders and medical comorbidity
Frankenburg, F., & Zanarini, M. (2006) · Current Opinion in Psychiatry · doi:10.1097/01.yco.0000228766.33356.44 · Cited by 60
A comparison of African American and non-Hispanic Caucasian cocaine-abusing outpatients.
Petry, N. (2003) · Drug and Alcohol Dependence · doi:10.1016/s0376-8716(02)00255-7 · Cited by 60
Prognostic significance of antisocial personality disorder in cocaine-dependent patients entering continuing care.
McKay, J., Alterman, A., Cacciola, J., Mulvaney, F., & O'Brien, C. (2000) · Journal of Nervous and Mental Disease · doi:10.1097/00005053-200005000-00006 · Cited by 60
Self-citation
Social networks and clinical outcomes of dually diagnosed homeless persons
Trumbetta, S., Mueser, K., Quimby, E., Bebout, R., & Teague, G. (1999) · Behavior Therapy · doi:10.1016/s0005-7894(99)80018-5 · Cited by 60
Adverse Effect of Child Abuse Victimization Among Substance-Using Women in Treatment
Kang, S.-Y.-O., Magura, S., Laudet, A. B., & Whitney, S. (1999) · Journal of Interpersonal Violence · doi:10.1177/088626099014006006 · Cited by 60

Authors: McLELLAN, A. T., LUBORSKY, L., CACCIOLA, J., GRIFFITH, J., EVANS, F., BARR, H. L., & OʼBRIEN, C. P.
Affiliations: Philadelphia VA Medical Center (US)
Venue: The Journal of Nervous and Mental Disease
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1985-07
Volume: 173
Issue: 7
Pages: 412-423
ISSN: 0022-3018 (ISSN-L)
DOI: 10.1097/00005053-198507000-00005
OpenAlex: W2144736441
Cited by: 1,503
References: 0
Citations by year: 2026: 8 · 2025: 5 · 2024: 14 · 2023: 11 · 2022: 15 · 2021: 24 · 2020: 63 · 2019: 21 · 2018: 32 · 2017: 25 · 2016: 32 · 2015: 43 · 2014: 52 · 2013: 54 · 2012: 49
FWCI: 3.27
Type: journal article
Language: en
Open access: closed
Locations: The Journal of Nervous and Mental Disease (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute on Drug Abuse (DAO2554)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: Addiction Severity Index, alcohol abuse, drug abuse, treatment challenges, reliability statistics, validity, concurrent validity, discriminant validity, test-retest reliability, inter-rater concordance, veterans, addiction treatment, treatment outcome prediction, patient-treatment matching
MeSH terms: Adult, Alcoholism, Mental Disorders, Divorce, Employment, Evaluation Studies as Topic, Female, Hospitalization, Humans, Male, Marriage, Psychiatric Status Rating Scales, Psychological Tests, Psychometrics, Social Adjustment, Social Control, Formal, Substance-Related Disorders

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New Data from the Addiction Severity Index Reliability and Validity in Three Centers

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