Comparison of three substance abuse screening instruments: MAST, CDAP, and SASSI

Substance Abuse Assessment

There are a variety of assessment or diagnostic instruments which can determine substance abuse. It is interesting to compare and contrast the Michigan Alcoholism Screening Test (MAST), Chemical Dependency Assessment Profile (CDAP), and the Substance Abuse Subtle Screening Inventory (SASSI).

Michigan Alcoholism Screening

The Michigan Alcoholism Screening Test (Mast) is a "binary-choice, 25-item test which is considered the most widely used test of its type for adults (Hodgson, 2002)."

This can be attributed to the time it takes to administer the test, which is approximately 5 minutes, and how easy it is to score. The MAST consists of a "questionnaire that requires a 'yes' or 'no' response and addresses drinking patterns, social, occupational, and medical aspects of drinking, and previous attempts at treatment. The three primary questions in the survey instrument are: 1) Have you ever attended a meeting of Alcoholics Anonymous?; 2) Have you ever gone to anyone for help about your drinking?; and 3) Have you ever been in a hospital because of drinking? (Blevins, 1996)."

The test was administered to felony offenders on probation and did not include drug use in order to get the respondents to answer more openly. "Quantitative analysis of the scores was conducted, and the Statistical Analysis System software was used to interpret the data collected (Blevins, 1996)." The test scores reveled if any of the participants were nonalcoholic, while determining those who could be alcoholic. Anyone with a MAST score of 5 or more were considered to be "problem drinkers (Blevins, 1996)."

The MAST can be administered either orally or with pencil and paper, and "has been productively used in a variety of settings with varied populations (www.niaaa.nih.gov/publications/mast.htm)." Besides the 25 items and formats by which the test can be administered, other issues for the test include the fact that the MAST can be "administered by practitioner or self, and there is no training required for administration (www.niaaa.nih.gov/publications/mast.htm)." The target population for the test is adults, and there are currently 4 additional versions available. The test is "score by staff and there are no norms available (www.niaaa.nih.gov/publications/mast.htm)."

In terms of psychometrics, the "reliability studies which have been conducted are test-retest and internal consistency, while the measures of validity derived are content and criterion (predictive, concurrent, 'postdictive') (www.niaaa.nih.gov/publications/mast.htm)." The applicability of research shows the MAST is helpful in determining "extent of lifetime alcohol-related consequences (www.niaaa.nih.gov/publications/mast.htm)." There is currently no copyright for the test, it costs $40 per copy and there is no usage fee.

Substance Abuse Subtle Screening Inventory

The Substance Abuse Subtle Screening Inventory (SASSI) has been used since 1988 as a "valued part of assessment packages in a variety of settings including criminal justice, employee assistance, educational, mental health, medical and vocational (www.sassi.com/sassi/index.shtml)."

The SASSI is a "short, one page self-report screening tool for chemical dependency. The SASSI's resistance to efforts at faking may well be its most important attribute. It is especially effective in identifying early stage CD individuals who are either in denial or deliberately trying to conceal their chemical dependency pattern (www.niaaa.nih.gov/publications/sassi-text.htm)." The report analysis from SASSI can create theories that "clinicians may find useful in understanding clients and planning their treatment (www.sassi.com/sassi/index.shtml)."

The test is mainly targeted at the "adult population and adolescents aged 12-19 in both inpatient and outpatient settings (www.niaaa.nih.gov/publications/sassi-text.htm)." The test can be "objectively scored and plotted by support staff and has objective decision rules to classify individuals as chemically dependent (CD) on nonchemically dependent (non-CD). In addition to its validity as a screening tool in classifying individuals as CD or non-CD, the configuration also adds clinical insights into the client's defensiveness and other characteristics (www.niaaa.nih.gov/publications/sassi-text.htm)."

The SASSI has "78 items with 8 subscales and can be administered with paper and pencil, self-administered on the computer or optically scanned (www.niaaa.nih.gov/publications/sassi-text.htm)." The test takes only 10-15 minutes to take, and is administered by staff members who are not required to have specialized training to give the test. The test is scored by the administrator, and the process generally takes one minute. The test can also be scored by interpretation or with a computer.

In terms of psychometrics, the "reliability studies which have been done are test-retest, and the measures of validity derived are criterion (www.niaaa.nih.gov/publications/sassi-text.htm)."

The test is not only effective in the "detection of early stage CD clients who might not otherwise be identified due to their high levels of denial and defensiveness, but the current decision rules and subscale configurations can be utilized clinically in measuring client response to treatment and likelihood of relapse. Additionally, revised decision rules for DWI offenders are presently under development that will indicate the appropriate level of treatment intervention based on SASSI subscales scores combined with external criteria such as blood alcohol level and number of prior arrests (www.niaaa.nih.gov/publications/sassi-text.htm)."

In terms of application for research, the SASSI is an extremely "useful instrument due to its brevity, ease of administration and scoring, and availability of computer format for data storage and analysis (www.niaaa.nih.gov/publications/sassi-text.htm)."

The accuracy rate for the Adult SASSA-3, which "identifies substance dependence is 93%, and the rate for the Adolescent SASSI-A2, which identifies substance use disorders, and both substance dependence and substance abuse is 94% (www.sassi.com/sassi/index.shtml)."

The test cost $75 for either the adult or adolescent starter kits, and $110 for a combination of each. The SASSI is copyrighted by both "Glenn Miller and the Psychological Screening Inventory, as well as Richard I. Lanyon, Ph.D. (www.niaaa.nih.gov/publications/sassi-text.htm)."

Conclusion

Drug and alcohol abuse is a serious problem in the United States today. By comparing the different aspects of the MAST, CDAP and SASSI, clinicians are able to administer the proper test to determine clients who may have a substance abuse problem.