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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Method
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Background
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Background
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Background
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Background
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Method
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Background
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Self-citation
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Method
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MethodInfluential
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MethodInfluential
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BackgroundMethod
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Method
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Contingency management delivered by community therapists in outpatient settings
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“, 1996) and the Addiction Severity Index (ASI) (McLellan et al., 1985).”
BackgroundMethod
A randomized controlled trial of interim methadone maintenance: 10-Month follow-up.
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Outcomes and costs of matching the intensity of dual-diagnosis treatment to patients' symptom severity.
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Predictors of Physical Functioning Among Adults With Severe Mental Illness
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Identifying pregnant women at risk for early attrition from substance abuse treatment.
Kissin, W. B., Svikis, D., Moylan, P. L., Haug, N., & Stitzer, M. (2004) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2004.03.007 · Cited by 52
“Adequate reliability and validity have been reported (McLellan et al., 1985).”
Background
Role induction: a method for enhancing early retention in outpatient drug-free treatment.
Katz, E. C., Brown, B., Schwartz, R., Weintraub, E., Barksdale, W., & Robinson, R. (2004) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.72.2.227 · Cited by 52
Outcomes with the ARISE Approach to Engaging Reluctant Drug‐ and Alcohol‐Dependent Individuals in Treatment
Landau, J., Stanton, M., Brinkman-Sull, D. C., Ikle, D., Mccormick, D., Garrett, J., Baciewicz, G., Shea, R. R., Browning, A., & Wamboldt, F. (2004) · The American Journal of Drug and Alcohol Abuse · doi:10.1081/ada-200037533 · Cited by 52
Abstinence reinforcement maintenance contingency and one-year follow-up.
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“They also completed a battery of assessment instruments: the Addiction Severity Index (ASI; McLellan et al., 1985), National Institute on Mental Health Diagnostic Interview Schedule (DIS; Helzer et al.”
Method
Self-help group attendance and participation among cocaine dependent patients.
Weiss, R. D., Griffin, M., Gallop, R., Onken, L., Gastfriend, D., Daley, D. C., Crits-Christoph, P., Bishop, S., & Barber, J. P. (2000) · Drug and Alcohol Dependence · doi:10.1016/s0376-8716(99)00154-4 · Cited by 52
Modified Therapeutic Community for Mentally Ill Chemical Abusers: Outcomes and Costs
French, M., Sacks, S., de Leon, G., Staines, G., & McKendrick, K. (1999) · Evaluation & the Health Professions · doi:10.1177/016327879902200104 · Cited by 52
“The CTCR interview is based on, and extends, similar self-report interviews, such as the Addiction Severity Index (ASI) (McLellan et al., 1985) and the Drug Abuse AIDS-Risk Reduction (DATAR) (Simpson et al.”
Method
The Addiction Severity Index as a screen for trauma and posttraumatic stress disorder.
Najavits, L., Weiss, R., Reif, S., Gastfriend, D., Siqueland, L., Barber, J., Butler, S., Thase, M., & Blaine, J. (1998) · Journal of Studies on Alcohol · doi:10.15288/jsa.1998.59.56 · Cited by 52
Incentives for Viral Suppression in People Living with HIV: A Randomized Clinical Trial
Silverman, K., Holtyn, A. F., Rodewald, A. M., Siliciano, R. F., Jarvis, B. P., Subramaniam, S., Leoutsakos, J., Getty, C., Ruhs, S., Marzinke, M. A., et al. (2019) · AIDS and Behavior · doi:10.1007/s10461-019-02592-8 · Cited by 51
“At intake we administered the Beck Depression Inventory (BDI) to screen for depression [28], the test of functional health literacy in adults (TOFHLA) to measure health literacy [29], a computerized delay discounting task to assess impulsivity [30], the wide range achievement (WRAT) test to assess academic skill level…”
The Impact of Buprenorphine/Naloxone Treatment on HIV Risk Behaviors among HIV-Infected, Opioid-Dependent Patients
Edelman, E. J., Chantarat, T., Caffrey, S., Chaudhry, A., O'Connor, P. G., Weiss, L., Fiellin, D., & Fiellin, L. (2014) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2014.03.006 · Cited by 51
Measuring addiction propensity and severity: The need for a new instrument☆
Conway, K. P., Levy, J. A., Vanyukov, M. M., Chandler, R. K., Rutter, J. L., Swan, G. E., & Neale, M. C. (2010) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2010.03.011 · Cited by 53
“Addiction Severity Index (ASI) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .”
MethodInfluential
Trading apples for oranges?
Jofre‐Bonet, M., & Petry, N. M. (2007) · Journal of Economic Behavior & Organization · doi:10.1016/j.jebo.2006.05.002 · Cited by 47
Measuring treatment process in cognitive-behavioral and interactional group therapies for adolescent substance abusers.
Kaminer, Y., Blitz, C., Burleson, J., Kadden, R. M., & Rounsaville, B. (1998) · Journal of Nervous and Mental Disease · doi:10.1097/00005053-199807000-00004 · Cited by 51
Assessment of Substance Misuse
Grigsby, T., Sussman, S., Chou, C.-P., & Ames, S. L. (2017) · Springer eBooks · doi:10.1007/978-3-319-55980-3_11 · Cited by 51
A Randomized Trial of Oral Naltrexone for Treating Opioid‐Dependent Offenders
Coviello, D. M., Cornish, J. W., Lynch, K. G., Alterman, A. I., & O’Brien, C. P. (2010) · The American Journal on Addictions · doi:10.1111/j.1521-0391.2010.00070.x · Cited by 50
Self-citation
Abstinence-Contingent Reinforcement and Engagement in Non-drug Related Activities among Illicit Drug Abusers
Rogers, R. E., Higgins, S., Silverman, K., Thomas, C. S., Badger, G., Bigelow, G., & Stitzer, M. (2008) · Psychology of Addictive Behaviors · doi:10.1037/0893-164x.22.4.544 · Cited by 50
Motivation for Treatment in Substance-Dependent Patients
Oene, G. H. D. W.-V., Schippers, G., Jong, C. D. D., & Schrijvers, G. (2002) · European Addiction Research · doi:10.1159/000049482 · Cited by 50
Predicting treatment retention of women dependent on cocaine.
Roberts, A. C., & Nishimoto, R. H. (1996) · The American Journal of Drug and Alcohol Abuse · doi:10.3109/00952999609001662 · Cited by 50
Mental health status and community adjustment after treatment in a residential treatment program for homeless veterans.
Leda, C., & Rosenheck, R. A. (1992) · American Journal of Psychiatry · doi:10.1176/ajp.149.9.1219 · Cited by 50
Does mandating offenders to treatment improve completion rates?
Coviello, D. M., Zanis, D. A., Wesnoski, S. A., Palman, N., Gur, A., Lynch, K. G., & McKay, J. R. (2013) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2012.10.003 · Cited by 49
Associations of Maternal Prenatal Drug Abuse With Measures of Newborn Brain Structure, Tissue Organization, and Metabolite Concentrations
Peterson, B. S., Rosen, T. S., Dingman, S., Toth, Z., Sawardekar, S., Hao, X., Liu, F., Xu, D., Dong, Z., Peterson, J. B., et al. (2020) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/jamapediatrics.2020.1622 · Cited by 85
Some of the people, some of the time: field evidence for associations and dissociations between stress and drug use
Furnari, M. A., Epstein, D. H., Phillips, K. A., Jobes, M. L., Kowalczyk, W. J., Vahabzadeh, M., Lin, J., & Preston, K. L. (2015) · Psychopharmacology · doi:10.1007/s00213-015-3998-7 · Cited by 49
Alexithymia is not a stable personality trait in patients with substance use disorders
de Haan, H., Joosten, E. A. G., Wijdeveld, T. A. G. M., Boswinkel, P. B., van der Palen, J. A. M., & de Jong, C. A. J. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2011.09.027 · Cited by 64
Depressive Symptoms, Substance Use and HIV-Related High Risk Behaviors among Opioid-Dependent Individuals: Results from the Clinical Trials Network
Pilowsky, D., Wu, L.-T., Burchett, B. M., Blazer, D., & Ling, W. (2011) · Substance Use & Misuse · doi:10.3109/10826084.2011.611960 · Cited by 49
“These variables were part of the Psychiatric Domain of the Addiction Severity Index (ASI)—a standardized clinical interview widely used to assess substance-use-related problems (McGahan, Parante, & McLellan, 1982; McLellan et al., 1985).”
Method
Interval Estimation for a Difference Between Intraclass Kappa Statistics
Dormer, A., & Zou, G. (2002) · Biometrics · doi:10.1111/j.0006-341x.2002.00209.x · Cited by 49
Response to Methadone Maintenance and Counseling in Antisocial Patients With and Without Major Depression
Alterman, A., Rutherford, M., Cacciola, J., McKay, J., & Woody, G. (1996) · Journal of Nervous and Mental Disease · doi:10.1097/00005053-199611000-00007 · Cited by 49
Self-citation
Validation of the Addiction Severity Index in French-speaking alcoholic patients.
Daeppen, J., Burnand, B., Schnyder, C., Bonjour, M., Pécoud, A. R., & Yersin, B. (1996) · Journal of Studies on Alcohol · doi:10.15288/jsa.1996.57.585 · Cited by 45
A motivational intervention trial to reduce cocaine use.
Stein, M., Herman, D. S., & Anderson, B. (2009) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2008.05.003 · Cited by 49
Chapter 7. Are twelve step programs appropriate for disenfranchised groups? Evidence from a study of posttreatment mutual help involvement
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Co-occurring psychiatric and substance use disorders among male detainees in Italy
Piselli, M., Elisei, S., Murgia, N., Quartesan, R., & Abram, K. M. (2009) · International Journal of Law and Psychiatry · doi:10.1016/j.ijlp.2009.01.006 · Cited by 47
Gender differences in neurocognitive functioning among alcohol-dependent Russian patients.
Flannery, B., Fishbein, D., Krupitsky, E., Langevin, D., Verbitskaya, E., Bland, C., Bolla, K., Egorova, V., Bushara, N., Tsoy, M., et al. (2007) · Alcoholism: Clinical and Experimental Research · doi:10.1111/j.1530-0277.2007.00372.x · Cited by 48
Psychiatric Comorbidity Is Associated With Drug Use and HIV Risk in Syringe Exchange Participants
Disney, E. R., KIDORF, M. S., Kolodner, K., King, V. L., Peirce, J. M., Beilenson, P. L., & Brooner, R. K. (2006) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000230396.17230.28 · Cited by 43
“The composite severity scores have good to excellent reliability and validity (McLellan et al., 1985).”
Background
Cognitive-behavioral therapy for PTSD in the real world: do interpersonal relationships make a real difference?
Monson, C., Rodriguez, B. F., & Warner, R. (2005) · Journal of Clinical Psychology · doi:10.1002/jclp.20096 · Cited by 48
“Alcohol abuse was measured with a composite score from the Addiction Severity Index (ASI), a widely used and well-validated measure of substance abuse outcomes (McLellan et al., 1985).”
Method
Intensity of acute services, self-help attendance and one-year outcomes among dual diagnosis patients.
Timko, C., & Sempel, J. M. (2004) · Journal of Studies on Alcohol · doi:10.15288/jsa.2004.65.274 · Cited by 48
A randomized trial of a telecommunications network for pregnant women who use cocaine.
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Outcome Trajectories in Drug Court: Do All Participants Have Drug Problems?
DeMatteo, D., Marlowe, D., Festinger, D., & Arabia, P. L. (2009) · Criminal Justice and Behavior · doi:10.1177/0093854809331547 · Cited by 47
Ethnic differences in the effects of spiritual well-being on long-term psychological and behavioral outcomes within a sample of homeless women.
Douglas, A. N., Jimenez, S., Lin, H.-J., & Frisman, L. (2008) · Cultural diversity & ethnic minority psychology · doi:10.1037/1099-9809.14.4.344 · Cited by 47
Client retention in residential drug treatment for Latinos.
Amodeo, M., Chassler, D., Oettinger, C., Labiosa, W., & Lundgren, L. (2008) · Evaluation and Program Planning · doi:10.1016/j.evalprogplan.2007.05.008 · Cited by 47

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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