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New Data from the Addiction Severity Index Reliability and Validity in Three Centers
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 ASI has demonstrated reliability and validity (Kosten, Rounsaville & Kleber, 1983; McLellan et al., 1985), including in PGs (Petry, 2007).”
From Subtyping Pathological Gamblers Based on Impulsivity, Depression, and Anxiety (2010) · cites this paper as McLellan et al., 1985
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Determinants of 12-step group affiliation and moderators of the affiliation-abstinence relationship.
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Evaluating the Impact of Case Management Dosage
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“The ASI also has excellent validity, as shown by the relationship between scores from the original ASI and other independent items having clear relationships to the specific problem area (McLellan et al., 1985).”
BackgroundMethodInfluentialDay treatment with contingency management for cocaine abuse in homeless persons: 12-month follow-up.
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Predictors Of Drinking Outcomes Among Alcoholics
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“The Gambling Severity Index (GSI) is a modification of the Addictive Severity Index (ASI), a reliable and valid means of evaluating the severity of addiction related symptoms in a number of domains (McLellan et al., 1985).”
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“The Addiction Severity Index has demonstrated good internal consistency, test–retest reliability, and interrater reliability in different groups of substance abusers (Alterman, Brown, Zaballero, & McKay, 1994; McLellan et al., 1985).”
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“Psychosocial functioning The ASI is a semistructured interview assessing psychosocial functioning in substance abuse patients across 7 domains: medical, employment/financial, alcohol, drugs, legal, family/social, and psychiatric [33,34].”
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“The seven problem areas addressed by the ASI are: medical, education/employment, alcohol, drug, legal, family/social relationships, and psychiatric (McLellan et al., 1985).”
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“(a) The Addiction Severity Index 43 was used to identify and assess seven potential problem areas in the substance abuse group: medical condition, employment/support status, alcohol use, drug use, legal issues, family/social issues, and psychiatric symptoms.”
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Neurobiological Foundations of Behavioral Addictions
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Pilot Trial of Memantine in the Treatment of Posttraumatic Stress Disorder
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“The diagnostic interview included a variety of structured ratings including the Structured Clinical Interview for DSM–IV, Non–Patient edition (SCIDS NP; Spitzer, Williams, Gibbon, & First, 1992), the Addiction Severity Index (ASI, McLellan, 1985), and the CAPS which was mentioned above.”
MethodEvaluating an alcohol and drug treatment program for the homeless: An econometric approach
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Self-citationFeedback Models for Gambling Control: The Use and Efficacy of Online Responsible Gambling Tools
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Human Neurobiological Approaches to Hedonically Motivated Behaviors
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“The ASI has demonstrated adequate to good internal consistency, test-retest, and inter-rater reliabilities (McLellan et al., 1985).”
BackgroundKrupitsky, E. M., Zvartau, E. E., Blokhina, E. A., Verbitskaya, E. V., Tsoy, M., Wahlgren, V., Burakov, A. M., Masalov, D. V., Romanova, T. N., Palatkin, V., et al. (2013) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2013.04.021 · Cited by 42
A Pilot Study of Qigong for Reducing Cocaine Craving Early in Recovery
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“Addiction severity at intake was assessed by the ASI—a standardized clinical interview widely used to assess substance use-related problems in alcohol use, drug use, medical, psychiatric, legal, family/social, and employment domains (McGahan et al., 1982; McLellan et al., 1985).”
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Satisfaction with substance use treatment and 12-step groups predicts outcomes.
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“We used the Addiction Severity Index (ASI) 5th edition, LITE version (McLellan, 1985;McLellan, Luborsky,Woody, & O'Brien, 1980;McLellan et al., 1985), a structured, 40-minute clinical research interview, to assess alcohol, drug, psychiatric, and medical problem severity.”
MethodPrevention and Treatment of “Food Addiction”
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“Baseline demographic parameters were assessed as part of the previously validated [34] Addiction Severity Index (ASI), 5 Edition [35] including age, self-reported race/ ethnicity, gender, education, marital status, and annual income.”
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“The short-term test– retest reliabilities of the ASI severity ratings have been reported to be greater than or equal to .92 for all domains (McLellan et al., 1985).”
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“The instrument has been shown to be a valid and reliable evaluation instrument with methadone subjects and capable of measuring change in patient psychosocial functioning (McLellan, Luborsky, O’Brien, & Woody, 1980; McLellan et al., 1985; Woody, McLellan, Luborsky, & O’Brien, 1987).”
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Substance Use and the Quality of Patient-Provider Communication in HIV Clinics
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“The ASI has been extensively validated [29,30] and has good test–retest reliability over time [31].”
BackgroundPerceived Neighborhood Fear and Drug Use Among Young Adults
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Males and females differ in response to opioid agonist medications.
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Ondansetron for Reduction of Drinking Among Biologically Predisposed Alcoholic Patients
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Relationships of personality disorders with problem severity in methadone patients.
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Schulte, E. M., Schiestl, E. T., & Gearhardt, A. N. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108632591.035 · Cited by 43
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“Diet was measured with the Diet Habit Survey (DHS),(47) exercise with the International Physical Activity Questionnaire (IPAQ) short form,(48,49) smoking with the Fagerstrom Test for Nicotine Dependence,(50,51) and substance use with the Addiction Severity Index.(52,53) The IPAQ scoring used version 2, April 2004 avai…”
InfluentialLynch, M. E., Kable, J., & Coles, C. (2015) · Neurotoxicology and Teratology · doi:10.1016/j.ntt.2015.07.008 · Cited by 38
“Possession of a driver's license, another indicator of independence, was available from the Addiction Severity Index (ASI) (McLellan, et al., 1985).”
BackgroundInfluential‘I'm a sick person, not a bad person’: patient experiences of treatments for alcohol use disorders
Mccallum, S. L., Mikocka-Walus, A., Gaughwin, M., Andrews, J., & Turnbull, D. (2015) · Health Expectations · doi:10.1111/hex.12379 · Cited by 38
Lofwall, M., Babalonis, S., Nuzzo, P. A., Siegel, A. J., Campbell, C. L., & Walsh, S. (2013) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2013.05.010 · Cited by 38
Butler, S., Villapiano, A., & Malinow, A. (2009) · Journal of addiction medicine · doi:10.1097/adm.0b013e3181902844 · Cited by 38
Underwood, L. A., Barretti, L. M., Storms, T. L., & Safonte-Strumolo, N. (2004) · Trauma Violence & Abuse · doi:10.1177/1524838004264344 · Cited by 37
Gender Differences in Dually-Diagnosed Clients Receiving Chemical Dependency Treatment
DiNitto, D., Webb, D. K., & Rubin, A. (2002) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2002.10399942 · Cited by 38
Sequential validation of cluster analytic subtypes of homeless veterans
Humphreys, K. (1995) · doi:10.1007/bf02506923 · Cited by 38
Validation of the Teen Addiction Severity Index (T-ASI): Preliminary Findings
Kaminer, Y., Wagner, E., Plummer, B., & Seifer, R. (1993) · American Journal on Addictions · doi:10.3109/10550499309113946 · Cited by 38
Real-time assessment of alcohol drinking and drug use in opioid-dependent polydrug users
Preston, K. L., Jobes, M. L., Phillips, K. A., & Epstein, D. H. (2016) · Behavioural Pharmacology · doi:10.1097/fbp.0000000000000250 · Cited by 37
“For the same reason, we used Kendall’s-τ to compare EMA summary measures with baseline measure of alcohol-use history from the ASI.”
MethodInfluentialDrug use practices and wound care experiences in the age of xylazine adulteration
Jawa, R., Ismail, S., Shang, M., Murray, S., Murray-Krezan, C. M., Zheng, Y., Mackin, S., Washington, K., Alvarez, P., Dillon, J., et al. (2024) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2024.112390 · Cited by 41
Craving in gambling disorder: A systematic review
Mallorquí‐Bagué, N., Mestre‐Bach, G., & Testa, G. (2023) · Journal of Behavioral Addictions · doi:10.1556/2006.2022.00080 · Cited by 45
Metadata
- 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
- Published
- 1985-07
- Volume
- 173
- Issue
- 7
- Pages
- 412-423
- ISSN
- 0022-3018 (ISSN-L)
- 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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