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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Background
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Method
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Method
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Influential
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Background
Addiction Severity Index Recent and Lifetime summary indexes based on nonparametric item response theory methods.
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Background
Nefazodone treatment of cocaine dependence with comorbid depressive symptoms.
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Background
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Method
The Severity Index
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Background
Predicting Addiction Severity Index (ASI) Interviewer Severity Ratings for a computer-administered ASI
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Self-citation
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InfluentialSelf-citation
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Background
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Background
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BackgroundInfluential
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“The validity and reliability of the ASI are well established (McLellan et al., 1985).”
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Background
Intensive Intervention for Alcohol-Dependent Smokers in Early Recovery: A Randomized Trial
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Self-citation
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“Applicants were screened by telephone and in two on-site visits that included medical, psychiatric, and drug use histories; a physical examination; urine and blood screens; and a battery of assessment instruments, including the Addiction Severity Index (McLellan et al., 1985) and the Diagnostic Interview Schedule (Rob…”
Method
Validation of the Spanish Addiction Severity Index Multimedia Version (S–ASI–MV)
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“, 2001) but differs from results observed in the initial test of the original ASI (McLellan et al., 1985).”
MethodResultInfluential
Contingency management reduces injection-related HIV risk behaviors in heroin and cocaine using outpatients.
Ghitza, U. E., Epstein, D., & Preston, K. (2008) · Addictive Behaviours · doi:10.1016/j.addbeh.2007.11.009 · Cited by 27
“…to the trial included medical, psychiatric, and drug-use histories, a physical examination, urine and blood screens, and a battery of assessment instruments, including the Addiction Severity Index (ASI; (McLellan et al., 1985)) and the Diagnostic Interview Schedule (DIS-IV; (Robins, 1995)).”
Method
Asian Americans in community-based substance abuse treatment: service needs, utilization, and outcomes.
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Interaction Effects of Treatment Setting and Client Characteristics on Retention and Completion
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Continuous, categorical, and time to event cocaine use outcome variables: degree of intercorrelation and sensitivity to treatment group differences.
McKay, J. R., Alterman, A., Koppenhaver, J., Mulvaney, F., Bovasso, G. B., & Ward, K. M. (2001) · Drug and Alcohol Dependence · doi:10.1016/s0376-8716(00)00156-3 · Cited by 27
“The ASI has demonstrated good internal consistency, test–retest, and interrater reliabilities in different groups of substance abusers (McLellan et al., 1985; Alterman et al., 1994).”
Background
MEASURING READINESS FOR CHANGE AMONG CRACK COCAINE USERS: A DESCRIPTIVE ANALYSIS
Siegal, H., Li, L., Rapp, R., & Saha, P. (2001) · Substance Use & Misuse · doi:10.1081/ja-100104085 · Cited by 27
“drug, legal, family, and psychiatric—and have been shown to be both reliable and valid indicators of substance users’ functioning levels (23,24).”
Background
Characterizing "nonresponsive" methadone patients.
Belding, M. A., McLellan, A., Zanis, D. A., & Incmikoski, R. (1998) · Journal of Substance Abuse Treatment · doi:10.1016/s0740-5472(97)00292-4 · Cited by 27
Self-citation
Test‐Retest Reliability of the Addiction Severity Index Composite Scores Among Clients in Residential Treatment
McCusker, J., Bigelow, C., Servigon, C., & Zorn, M. (1994) · American Journal on Addictions · doi:10.1111/j.1521-0391.1994.tb00241.x · Cited by 27
Validation of the Teen Addiction Severity Index (T-ASI)
Kaminer, Y., Wagner, E., Plummer, B., & Seifer, R. (1993) · American Journal on Addictions · doi:10.1111/j.1521-0391.1993.tb00427.x · Cited by 27
Who benefits from extended continuing care for cocaine dependence?
McKay, J. R., Van Horn, D. H. A., Lynch, K. G., Ivey, M., Cary, M. S., Drapkin, M., & Coviello, D. (2014) · Addictive Behaviors · doi:10.1016/j.addbeh.2013.11.019 · Cited by 26
“Demographic treatment variables—The Addiction Severity Index (ASI; McLellan, Luborsky, Woody, & O'Brien, 1980; McLellan et al., 1985) was used to gather demographic data, and information on prior treatments for substance use disorders and problem severity levels during IOP, and drug use at each follow-up.”
Method
Psychosocial correlates in treatment seeking gamblers: Differences in early age onset gamblers vs later age onset gamblers.
Sharman, S., Murphy, R., Turner, J., & Roberts, A. (2019) · Addictive Behaviours · doi:10.1016/j.addbeh.2019.05.013 · Cited by 26
Sleep reductions associated with illicit opioid use and clinic-hour changes during opioid agonist treatment for opioid dependence: Measurement by electronic diary and actigraphy
Bertz, J. W., Epstein, D. H., Reamer, D., Kowalczyk, W. J., Phillips, K. A., Kennedy, A., Jobes, M. L., Ward, G., Plitnick, B., Figueiro, M. G., et al. (2019) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2019.08.011 · Cited by 31
Psychiatric needs of male prison inmates in Italy.
Piselli, M., Attademo, L., Garinella, R., Rella, A., Antinarelli, S., Tamantini, A., Quartesan, R., Stracci, F., & Abram, K. (2015) · International Journal of Law and Psychiatry · doi:10.1016/j.ijlp.2015.03.011 · Cited by 26
Alcohol and drug treatment involvement, 12-step attendance and abstinence: 9-year cross-lagged analysis of adults in an integrated health plan
Witbrodt, J., Ye, Y., Bond, J., Chi, F. W., Weisner, C., & Mertens, J. (2013) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2013.10.015 · Cited by 26
“The ASI has been shown a reliable and valid instrument (Mclellan et al., 1992; Mclellan et al., 1985).”
Method
Partner Violence and Health among HIV-Infected Jail Detainees
Meyer, J. P., Wickersham, J. A., Fu, J. J., Brown, S.-E., Sullivan, T. P., Springer, S., & Altice, F. (2013) · International Journal of Prisoner Health · doi:10.1108/ijph-03-2013-0011 · Cited by 26
Co-occurring amphetamine use and associated medical and psychiatric comorbidity among opioid-dependent adults: results from the Clinical Trials Network
Pilowsky, D., Wu, L.-T., Burchett, B. M., Blazer, D., Woody, G., & Ling, W. (2011) · Substance Abuse and Rehabilitation · doi:10.2147/sar.s20895 · Cited by 26
Relationship between Cigarette Use and Mood/Anxiety Disorders among Pregnant Methadone-Maintained Patients
Chisolm, M., Tuten, M., Brigham, E., Strain, E., & Jones, H. (2009) · American Journal on Addictions · doi:10.3109/10550490903077721 · Cited by 26
The efficacy of cue exposure with response prevention in extinguishing drug and alcohol cue reactivity
Havermans, R., Mulkens, S., Nederkoorn, C., & Jansen, A. (2007) · Behavioral Interventions · doi:10.1002/bin.219 · Cited by 26
“Upon admission patients are diagnosed by treatment staff (under supervision of the resident psychiatrist) as being either alcohol or drug dependent according to DSM-IV criteria using a structured interview based on the Addiction Severity Index (ASI; McLellan et al., 1985) assessing drug or alcohol use (e.”
Method
A comparison between low-magnitude voucher and buprenorphine medication contingencies in promoting abstinence from opioids and cocaine.
Gross, A., Marsch, L., Badger, G., & Bickel, W. (2006) · Experimental and clinical psychopharmacology · doi:10.1037/1064-1297.14.2.148 · Cited by 26
“Repeated measures ANOVAs were used for treatment comparisons corresponding to Addiction Severity Index (ASI; McLellan et al., 1985) composite scores collected at intake, at the end of the 8-week baseline phase prior to randomization, and at the end of the 12-week experimental phase.”
Opioid antagonist detoxification under anaesthesia versus traditional clonidine detoxification combined with an additional week of psychosocial support: a randomised clinical trial.
Favrat, B., Zimmermann, G., Zullino, D., Krenz, S., Dorogy, F., Muller, J., Zwahlen, A., Broers, B., & Besson, J. (2006) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2005.06.003 · Cited by 26
Conversion and validation of the Teen-Addiction Severity Index (T-ASI) for Internet and automated-telephone self-report administration.
Brodey, B., Rosen, C., Winters, K., Brodey, I. S., Sheetz, B. M., Steinfeld, R., & Kaminer, Y. (2005) · Psychology of Addictive Behaviors · doi:10.1037/0893-164x.19.1.54 · Cited by 26
“Although the assessment of adult substance abuse problems has a well-tested vehicle in the Addiction Severity Index (ASI; McLellan et al., 1992; McLellan et al., 1985; McLellan, Luborsky, Woody, & O’Brien, 1980), no equivalent “gold-standard” instrument presently exists for adolescent substance abuse assessment.”
BackgroundInfluential
Gambling Behavior in Adolescent Substance Abuse
Kaminer, Y., Burleson, J., & Jadamec, A. (2002) · Substance Abuse · doi:10.1080/08897070209511489 · Cited by 26
Suggested specifications for a standardized Addiction Severity Index database.
Carise, D., McLellan, A., Cacciola, J., Love, M., Cook, T., Bovasso, G. B., & Lâm, V. (2001) · Journal of Substance Abuse Treatment · doi:10.1016/s0740-5472(01)00161-1 · Cited by 26
Self-citation
CORRELATES OF EMPLOYMENT: A COHORT STUDY
Sterling, R. C., Gottheil, E., Glassman, S. D., Weinstein, S. P., Serota, R., & Lundy, A. C. (2001) · The American Journal of Drug and Alcohol Abuse · doi:10.1081/ada-100103123 · Cited by 26
“Other follow-up data reported on in this study were drawn from the ASI (11).”
MethodInfluential
Randomized comparison of intensive outpatient vs. individual therapy for cocaine abusers.
Weinstein, S. P., Gottheil, E., & Sterling, R. C. (1997) · Journal of Addictive Diseases · doi:10.1300/j069v16n02_04 · Cited by 26
Ethnocultural variations in service use among veterans suffering from PTSD.
Rosenheck, R., & Fontana, A. (1996) · American Psychological Association eBooks · doi:10.1037/10555-019 · Cited by 26
Longitudinal Substance Use and Biopsychosocial Outcomes Following Therapeutic Community Treatment for Substance Dependence
Staiger, P., Liknaitzky, P., Lake, A., & Gruenert, S. M. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9010118 · Cited by 25
“89 with trained clinicians assessing severity of addiction problems [41].”
Background
Healthcare Empowerment and HIV Viral Control: Mediating Roles of Adherence and Retention in Care
Wilson, T. E., Kay, E. S., Turan, B., Johnson, M. O., Kempf, M.-C., Turan, J. M., Cohen, M. H., Adimora, A. A., Pereyra, M. R., Golub, E. T., et al. (2018) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2018.02.012 · Cited by 25
Effects of Prenatal Alcohol Exposure in a Prospective Sample of Young Adults: Mental Health, Substance Use, and Difficulties with the Legal System
Lynch, M. E., Kable, J., & Coles, C. (2017) · Neurotoxicology and Teratology · doi:10.1016/j.ntt.2017.10.001 · Cited by 25
“Wechsler Abbreviated Scale of Intelligence (WASI).”
Influential
Effects of Prereactivation Propranolol on Cocaine Craving Elicited by Imagery Script/Cue Sets in Opioid-dependent Polydrug Users
Jobes, M. L., Aharonovich, E., Epstein, D. H., Phillips, K. A., Reamer, D., Anderson, M. R., & Preston, K. L. (2015) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000000169 · Cited by 28
“Screening included physical examination, standard laboratory tests, and the Addiction Severity Index (McLellan et al., 1985).”
Method
Addiction Severity Index Scores and Urine Drug Screens at Baseline as Predictors of Graduation From Drug Court
Shah, S., DeMatteo, D., Keesler, M. E., Davis, J., Heilbrun, K., & Festinger, D. (2015) · doi:10.1177/0011128713496007 · Cited by 25
The Prevalence of Posttraumatic Stress Disorder Symptoms among Addiction Treatment Patients with Cocaine Use Disorders
Saunders, E. C., Lambert-Harris, C. A., McGovern, M. P., Meier, A., & Xie, H. (2015) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2014.977501 · Cited by 24
Children of treated substance-abusing mothers: A 10-year prospective study
Hser, Y.-I., Evans, E., Li, L., Metchik-Gaddis, A., & Messina, N. P. (2013) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104513486999 · Cited by 23
“The ASI is the most commonly used instrument in the substance abuse field with demonstrated psychometric validity and reliability for assessing clients’ problem severity in diverse populations (McLellan et al., 1985, 1992).”
Method
Predictors of Retention of Women Offenders in a Community‐Based Residential Substance Abuse Treatment Program
Adams, S. M., Peden, A., Hall, L., Rayens, M., Staten, R. R., & Leukefeld, C. (2011) · Journal of Addictions Nursing · doi:10.3109/10884602.2011.585719 · Cited by 25
Racial Differences in Retention in Residential Substance Abuse Treatment: The Impact on African American Men
Cooper, R., Macmaster, S. A., & Rasch, R. F. R. (2010) · Research on Social Work Practice · doi:10.1177/1049731509338936 · Cited by 25
“The ASI has been reported to be valid and reliable with a variety of different populations (Alterman, 2001; Appleby, 1997; Leonhard, 2000; McClellan et al., 1985; Zanis, 1994).”
Background
Effect of reinforcement probability and prize size on cocaine and heroin abstinence in prize-based contingency management.
Ghitza, U. E., Epstein, D., Schmittner, J., Vahabzadeh, M., Lin, J.-L., & Preston, K. (2008) · Journal of Applied Behavior Analysis · doi:10.1901/jaba.2008.41-539 · Cited by 25
“cluded medical, psychiatric, and drug use histories; physical examination; standard laboratory screens; and a battery of assessment instruments, including the Addiction Severity Index (ASI; McLellan et al., 1985) and Diagnostic Interview Schedule (DIS-IV; Robins, Cottler, Bucholz, & Compton, 1995).”
Method
Prescription Drug Use, Health Services Utilization, and Health Problems in Rural Appalachian Kentucky
Leukefeld, C., McDonald, H. S., Mateyoke-Scrivner, A., Roberto, H., Walker, R., Webster, M., & Garrity, T. F. (2005) · Journal of Drug Issues · doi:10.1177/002204260503500312 · Cited by 25
The validity of the Self-Efficacy List for Drug Users (SELD).
Oene, G. H. D. W.-V., Breteler, M., Schippers, G., & Schrijvers, A. (2000) · Addictive Behaviours · doi:10.1016/s0306-4603(99)00028-3 · Cited by 25
Predictors of HIV-related risk behaviors among heterosexuals in alcoholism treatment.
Woods, W. J., Avins, A. L., Lindan, C., Hudes, E., Boscarino, J. A., & Clark, W. (1996) · Journal of Studies on Alcohol · doi:10.15288/jsa.1996.57.486 · Cited by 25
Need for Care and Life Satisfaction in Adult Substance Use Disorder Patients With and Without Attention Deficit Hyperactivity Disorder (ADHD) or Autism Spectrum Disorder (ASD)
Kronenberg, L. M., Goossens, P. J. J., van Etten, D. M., van Achterberg, T., & van den Brink, W. (2014) · Perspectives In Psychiatric Care · doi:10.1111/ppc.12056 · Cited by 32

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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