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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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Reed, D. D., Naudé, G. P., Gelino, B. W., & Amlung, M. T. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108632591.011 · Cited by 48
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Shek, D. T. L., Chan, E., & Wong, R. H. Y. (2012) · TheScientificWorldJournal · doi:10.1100/2012/571434 · Cited by 37
“The Addiction Severity Index (ASI)—Gambling Section—is a standardized and semistructured instrument which is widely used to evaluate the intake status for clients seeking substance use treatment [33, 34].”
BackgroundKhan, R., Chatton, A., Thorens, G., Achab, S., Nallet, A., Broers, B., Calzada, G., Poznyak, V., Zullino, D., & Khazaal, Y. (2012) · Substance Abuse Treatment, Prevention, and Policy · doi:10.1186/1747-597x-7-14 · Cited by 37
“Several domains or scores derived from the ASSIST together with scores from other questionnaires namely, the AUDIT, the MINI-Plus, the Fagerström and the ASI were used in the validation process.”
InfluentialA retrospective case control study of alcohol relapse and spiritual growth.
Sterling, R. C., Weinstein, S. P., Losardo, D., Raively, K., Hill, P. C., Petrone, A., & Gottheil, E. (2007) · American Journal on Addictions · doi:10.1080/10550490601080092 · Cited by 37
Factors influencing initial and longer-term responses to substance abuse treatment: a path analysis
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“Information about maternal cocaine and other drug use was obtained both from abstraction of medical records and from the birth mother’s self-report at recruitment in the immediate postpartum period using the Addiction Severity Index (McLellan et al., 1985) and the Drug Grid (Coles et al.”
MethodInfluentialManhapra, A., Stefanovics, E. A., & Rosenheck, R. A. (2015) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2015.08.036 · Cited by 28
“Psychiatric symptom severity and use of alcohol or illicit drugs was assessed by items from composite subscales of the Addiction Severity Index (ASI; McLellan et al., 1985).”
MethodMagnée, E. H. B., Oene, G. H. D. W.-V., Wijdeveld, T. G. M., Coenen, A., & Jong, C. D. D. (2015) · American Journal on Addictions · doi:10.1111/ajad.12243 · Cited by 36
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Gender differences among in- and out-of-treatment opioid-addicted individuals
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Sex, Touch, and HIV Risk Among Ecstasy Users
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“A structuredsurvey was used for data collection and was developed specifically for the study based on existing validated instruments used in the field (Dennis et al., 1995; McLellan et al., 1985; Needle et al., 1995), as well as on pilot research among a similar population of ecstasy users.”
MethodChallenges in motivating treatment enrollment in community syringe exchange participants
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“substance abusers in both clinical and research samples (Appleby, Dyson, Altman, & Luchins, 1997; Alterman et al., 2000; McLellan et al., 1985).”
BackgroundPsychiatric Comorbidity in Opiate Addicts
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Bridging waitlist delays with Interim Buprenorphine Treatment: Initial feasibility
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“the Addiction Severity Index (McLellan et al., 1985), a semi-structured interview”
Perceived stress and substance use in methadone-maintained smokers
Moitra, E., Anderson, B. J., & Stein, M. D. (2013) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2013.08.010 · Cited by 34
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DeMarce, J. M., Burden, J. L., Lash, S. J., Stephens, R. S., & Grambow, S. C. (2007) · Addictive Behaviors · doi:10.1016/j.addbeh.2006.11.015 · Cited by 34
Revolving Roles in Drug-Related Crime: The Cost of Chronic Drug Users as Victims and Perpetrators
French, M. T., McCollister, K. E., Alexandre, P. K., Chitwood, D. D., & McCoy, C. B. (2004) · Journal of Quantitative Criminology · doi:10.1023/b:joqc.0000037732.00489.ad · Cited by 25
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Gutman, M., McKay, J., Ketterlinus, R. D., & Mclellan, A. (2003) · Evaluation review · doi:10.1177/0193841x03259030 · Cited by 35
“The ASI has demonstrated good internal consistency, test-retest, and interrater reliabilities in different groups of substance abusers, with regard to lifetime and prior 30-day items (Alterman et al. 1994; McLellan et al. 1985).”
BackgroundSelf-citationSymptom Severity, Amount of Treatment, and 1-Year Outcomes Among Dual Diagnosis Patients
Timko, C., & Moos, R. (2002) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1023/a:1021275516753 · Cited by 35
“, consistent across testing occasions and raters), and clinically useful estimates of problem severity (McLellan et al., 1985; McLellan, Luborsky, Woody, & O’Brien, 1980; Stoffelmayr, Mavis, & Kasim, 1994).”
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“Results revealed that at baseline, participants in the DUAL group had more severe problems than the PSUD group in alcohol, medical condition, family/ social relationships, employment/support, and psychiatric status areas on the ASI.”
MethodInfluentialLundy, A. C., Gottheil, E., Mclellan, A., Weinstein, S. P., Sterling, R. C., & Serota, R. (1997) · Journal of Nervous and Mental Disease · doi:10.1097/00005053-199707000-00007 · Cited by 35
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Neurobiology of Substance Addictions
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Prevention and Treatment of Compulsive Buying Disorder
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Tanning as an Addiction: The State of the Research and Implications for Intervention
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Multiple Memory Systems, Addiction, and Health Habits: New Routes for Translational Science
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Using iPSC‐derived human DA neurons from opioid‐dependent subjects to study dopamine dynamics
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“Inclusion criteria for all participants aged 21 – 65 years old were as follows: for the opioid-dependent group only, enrollment in a substance abuse treatment protocol at the NIDA (National Institute of Drug Abuse) Intramural Research Program; for the nondrug users, no lifetime history of drug dependence as indicated…”
Contingency management treatments decrease psychiatric symptoms
Petry, N., Alessi, S. M., & Rash, C. J. (2013) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0032499 · Cited by 34
Recognizing the Need for Prisoner Input in Correctional Research
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HIV+ Men and Women Show Different Performance Patterns on Procedural Learning Tasks
Martin, E., Gonzalez, R., Vassileva, J., & Maki, P. (2010) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803395.2010.493150 · Cited by 34
“Addiction Severity Index (McLellan et al., 1985).”
Disordered Gambling and Its treatment
Petry, N. (2009) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2009.02.005 · Cited by 34
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Models of intervention and care for psychostimulant users, 2nd edition - monograph series no. 51
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“With respect to more distal measures, the cumulative measure was not seen to be related to the number of days of alcohol or drug use, the number of days reported experiencing alcohol related problems, or ASI Alcohol or Drug composite scores at 3-month follow-up.”
MethodInfluentialStahler, G. J., Shipley, T. E., Kirby, K., Godboldte, C., Kerwin, M. E., Shandler, I., & Simons, L. (2005) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2004.12.003 · Cited by 34
“99) and has been extensively used as a treatment outcome measure (Allen & Litten, 1993; McLellan et al., 1985).”
MethodStanger, C., Kamon, J., Dumenci, L., Higgins, S., Bickel, W., Grabowski, J., & Amass, L. (2002) · Drug and Alcohol Dependence · doi:10.1016/s0376-8716(01)00201-0 · Cited by 34
“Interviewers used the Addiction Severity Index (ASI; McLellan et al., 1985), a measure that generates composite scores in the following areas: medical, employment, alcohol use, drug use, legal, family/ social, and psychiatric.”
COERCION AND DRUG TREATMENT FOR POSTPARTUM WOMEN
Nishimoto, R. H., & Roberts, A. C. (2001) · The American Journal of Drug and Alcohol Abuse · doi:10.1081/ada-100103125 · Cited by 29
“Previous research has shown the ASI to be both reliable and valid (45).”
MethodModified therapeutic community for homeless mentally ill chemical abusers: emerging subtypes.
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Moving Substance-Abusing Women from Welfare to Work
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Screening for Patients with Alcohol Problems: Severity of Patients Identified by the Cage
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Considering the Overlap and Nonoverlap of Compulsivity, Impulsivity, and Addiction
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Predictors of Outcome after Short-term Stabilization with Buprenorphine
Hillhouse, M. P., Canamar, C. P., & Ling, W. (2012) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2012.08.016 · Cited by 33
“The ASI-Lite is a standardized, multidimensional, semi-structured, comprehensive clinical interview designed to provide clinical information for formulating treatment plans as well as problem severity profiles in domains commonly affected by substance abuse (McLellan et al., 1985).”
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“It demonstrated high interrater reliability (14) and has been used across different populations including homeless substance abusers (15) and substance abusers with mental illness (16).”
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“…medical, psychiatric, and drug-use histories; physical examination; standard laboratory screens; and a battery of assessment instruments, including the Addiction Severity Index (McLellan et al., 1985) and Diagnostic Interview Schedule (Version IV; Robins, Cottler, Bucholz, & Compton, 1995).”
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“The predictor variables (sociodemographic, consumption history, health, legal/judicial, and family) were measured by means of the patient’s clinical history constructed from items of the Addiction Severity Index, ASI (McLellan et al., 1985).”
MethodMclellan, A., Gutman, M., Lynch, K., McKay, J., Ketterlinus, R. D., Morgenstern, J., & Woolis, D. D. (2003) · Evaluation review · doi:10.1177/0193841x03259029 · Cited by 33
“Table 2 presents the baseline, 6-month, and 12-month values of the outcome measures in the study, which included ASI composite scores and individual ASI items selected for their relevance to the goals of the CWF program.”
BackgroundMethodInfluentialSelf-citationSubstance abuse treatment for criminal offenders: An evidence-based guide for practitioners.
Springer, D. W., McNeece, C. A., & Arnold, E. M. (2003) · American Psychological Association eBooks · doi:10.1037/10569-000 · Cited by 35
Name-based reporting of HIV-positive test results as a deterrent to testing.
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The Addiction Severity Index: reliability and validity in a Dutch alcoholic population.
DeJong, C., Willems, J. C. E. W., Schippers, G. M., & Hendriks, V. M. (1995) · International Journal of the Addictions · doi:10.3109/10826089509048747 · Cited by 33
Behavioral Economics and Addictive Disorders
Jarmolowicz, D. P., & Schneider, T. D. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108632591.005 · Cited by 42
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“Participants completed self- and experimenter-administered instruments at intake, including a Smoking History and Demographic Questionnaire, the Addiction Severity Index [49], the Fagerström Test for Nicotine Dependence [50,51], the Minnesota Nicotine Withdrawal Questionnaire [MNWQ] [52], the Nicotine Dependence Syndr…”
Sajatovic, M., Levin, J. B., Sams, J., Cassidy, K., Akagi, K., Aebi, M. E., Ramirez, L., Safren, S., & Tatsuoka, C. (2015) · Bipolar Disorders · doi:10.1111/bdi.12326 · Cited by 32
“We also examined possible demographic (age, gender, ethnicity, and education) and clinical (YMRS, BPRS, MADRS, DAI, ASI, and Charlson) correlates of discrepant TRQ and MEMS scores.”
MethodInfluentialAntipsychotic drugs in cocaine dependence: a systematic review and meta-analysis.
Alvarez, Y., Pérez-Mañá, C., Torrens, M., & Farré, M. (2013) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2012.12.013 · Cited by 32
“The efficacy of antipsychotic drugs on cocaine use measured by Addiction Severity Index (ASI) was assessed in six studies (Fig.”
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Effects of Gender and Level of Parental Involvement Among Parents in Drug Treatment
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“The Addiction Severity Index (ASI) (27) was used at baseline and followup to assess the severity of drug and alcohol use.”
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The effectiveness of two intensities of psychosocial treatment for cocaine dependence.
Coviello, D. M., Alterman, A., Rutherford, M., Cacciola, J., McKay, J. R., & Zanis, D. A. (2001) · Drug and Alcohol Dependence · doi:10.1016/s0376-8716(00)00136-8 · Cited by 32
Self-citationPatient treatment choice and compliance. Data from a substance abuse treatment program.
Sterling, R. C., Gottheil, E., Glassman, S. D., Weinstein, S. P., & Serota, R. (1997) · American Journal on Addictions · doi:10.3109/10550499709137028 · Cited by 32
Defulio, A., Devoto, A., Traxler, H. K., Cosottile, D. W., Fingerhood, M. I., Nuzzo, P. A., & Dallery, J. (2021) · Preventive medicine reports · doi:10.1016/j.pmedr.2021.101318 · Cited by 31
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Mutchler, M. G., McKay, T., Candelario, N., Liu, H., Stackhouse, B., Bingham, T. A., & Ayala, G. (2011) · Sexual and Gender Diversity in Social Services · doi:10.1080/10538720.2011.560100 · Cited by 28
“We used modified items from the Addiction Severity Index (ASI) to determine the frequency of alcohol and substance use during sex in the past three months; content validity has been well-established for the ASI (McLellan et al., 1985).”
MethodPredicting Treatment Outcome in Stimulant Dependence
Reske, M., & Paulus, M. (2008) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1441.011 · Cited by 31
Stimulant use and HIV risk behavior: the influence of peer support group participation.
Lyons, T., Chandra, G., & Goldstein, J. (2006) · AIDS Education and Prevention · doi:10.1521/aeap.2006.18.5.461 · Cited by 31
“SUBSTANCE USE A modified version of the Addiction Severity Index (ASI; McLellan et al., 1985) assessed substance use and subjective need for treatment.”
MethodKleyn, J., Schwebke, J., & Holmes, K. (1993) · Addiction · doi:10.1111/j.1360-0443.1993.tb02080.x · Cited by 31
Family functioning as a predictor of progress in substance abuse treatment.
Costantini, M., Wermuth, L., Sorensen, J. L., & Lyons, J. S. (1992) · Journal of Substance Abuse Treatment · doi:10.1016/0740-5472(92)90027-l · Cited by 31
“They provide a clinical profile of the patient’s treatment needs by using a lo-point (0 to 9) interviewer rating of problem severity (McLellan et al., 1985).”
BackgroundMethodCaudill, B. D., Hoffman, J. A., Hubbard, R., Flynn, P., & Luckey, J. (1994) · The American Journal of Drug and Alcohol Abuse · doi:10.3109/00952999409106019 · Cited by 31
Social support and depression in men during alcoholism treatment.
Booth, B., Russell, D. W., Yates, W., Laughlin, P., Brown, K., & Reed, D. (1992) · Journal of Substance Abuse · doi:10.1016/0899-3289(92)90028-v · Cited by 31
A comparison of delay discounting among substance users with and without suicide attempt history
Liu, R. T., Vassileva, J., Gonzalez, R., & Martin, E. M. (2012) · Psychology of Addictive Behaviors · doi:10.1037/a0027384 · Cited by 30
“History of suicide attempts was indexed from the Addiction Severity Index (ASI; McLellan et al., 1985), a semistructured interview that assesses severity of alcohol and drug use, indices of employment, social and psychiatric status, and includes a question that asks whether the participant has…”
Concurrent and Predictive Validity of the Addiction Severity Index in Pathological Gamblers
Petry, N. M. (2007) · The American Journal on Addictions · doi:10.1080/10550490701389849 · Cited by 30
Lee, C., Lin, C., Koós, M., Nagy, L., Kraus, S. W., Demetrovics, Z., Potenza, M. N., Ballester‐Arnal, R., Batthyány, D., Bergeron, S., et al. (2023) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2023.06.033 · Cited by 37
The aggressor at the mirror: Psychiatric correlates of deliberate self-harm in male prison inmates
Verdolini, N., Murru, A., Attademo, L., Garinella, R., Pacchiarotti, I., Bonnín, C. D. M., Samalin, L., Pauselli, L., Piselli, M., Tamantini, A., et al. (2017) · European Psychiatry · doi:10.1016/j.eurpsy.2017.04.002 · Cited by 32
Estévez, N., Eich‐Höchli, D., Dey, M., Gmel, G. E., Studer, J., & Mohler‐Kuo, M. (2014) · PLoS ONE · doi:10.1371/journal.pone.0089298 · Cited by 30
“Furthermore, family histories for alcohol abuse and psychiatric problems were assessed for the mother, father and siblings, as well as for paternal and maternal grandparents, uncles and aunts, based upon questions adopted from the Addiction Severity Index (ASI) [27].”
Method
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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