The Substance Abuse Subtle Screening Inventory, also referred to as the SASSI, was created by Dr. Glenn A. Miller in 1985, revised in 1994 and is now in its third edition. The instrument is a screening questionnaire used on people who depend on substances. It is a brief self-report, easily administered psychological screening measure available in separate versions for adults and adolescents. It is said to detect substance use with high accuracy regardless of the respondent’s honesty and motivation (Feldstein & Milller, 2017).
The SASSI includes face valid and subtle items with no apparent relationship to substance use. The subtle items are included to identify some individuals with alcohol and other drug problems who are unwilling or unable to acknowledge substance misuse or symptoms associated with it. Support materials for the screening inventory are included user guides containing simple instructions for administering, scoring, interpretation, and manuals providing thorough information on development, consistency, and validity.
Description of Test
The SASSI is a simple, brief one-page paper-and-pencil questionnaire completed in 10 to 15 minutes. The SASSI is easy to administer to individuals or groups and can be objectively scored by hand and interpreted, based on objective decision rules, in a minute or two. Optical scanning equipment is available for mass scoring and interpretation. It does not require a high level of reading ability. The SASSI may be used by a variety of programs and professionals, including school counselors, student assistance programs, and employee assistance programs.
The SASSI went through rigorous scientific development for more than a decade before being first published in 1988. It included two new scales; the SASSI-2 published in 1994 and the SASSI-3, published in 1997 with a new scale and improved accuracy. Selected items on the SASSI were based on established research methods and statistical analysis.
Some queries on the questionnaire about client experiences related to alcohol and other drugs are answered on a 4-point scale which ranges from never to repeat. Some items that may appear unrelated to substance use (indirect or subtle items) are in a true/false format. The items make up ten to fourteen sub-scales, and the results are reported on a profile form discussed with the subject, separated according to gender.
The SASSI-3 can be evaluated or read in 15 minutes and it contains two sides, Side one, which has 67 items used to conquer dissimulation and side two which has 12 items specific to alcohol use and 14 items for other substance use (Laux & DuFresne, 2022).
Statistical and Normative Data
The SASSI-3 has an overall accuracy of 93% (K et al., 2021), which is not affected by age, gender, ethnicity, occupational status, socioeconomic status, marital status, educational level, drug of choice, and general level of functioning. The adolescent version of the SASSI has been available since the 90s. The version of the Adolescent SASSI (SASSI-A2) has a 95% overall accuracy (Miller, 2001). The SASSI-A2 is designed to screen individuals 12 to 18 years old. The client will review the profile of the SASSI results. A profile graph compares the scores to normal people (also called a normative sample). Feedback is then given regarding whether the individual has a high or low probability of having a substance dependence disorder. Individual scale scores may develop ideas or hypotheses for further evaluation, treatment, and research. The information is based on clinical experience with the inventory (Gray, B. Thomas., 2001).
The results may indicate symptoms (like inability to acknowledge personal weaknesses or focusing on others’ needs while unaware of one’s own needs). The results may suggest an approach with the client (increasing awareness or acknowledging and validating their feelings). The results may suggest a treatment plan to which the client may respond (for example, an education-focused program and self-help groups). Finally, the results may show appropriate treatment goals for the client. Providing feedback about SASSI results is to have a two-way sharing and understanding of descriptive and not judgmental.
Current Use of the Test
The SASSI-3 is the most commonly used commercial screening tool by master addictions counselors (Juhnke, Vacc, Curtis, Coll, & Paredes, 2003). Reports from publication manuals and subsequent psychometric research shows that the SASSI-3 reliability and validity estimates surpassed those created by instruments meant to measure the same constructs. It also showed that the SASSI-3 has a high sensitivity rate even across various levels of change in the population (Laux et al., 2012).
The SASSI is a good tool in assessing disorders brought by substance abuse. The tool is not designed to tell if someone is an addict; it aims to screen a person with a “high probability of having a substance dependence disorder.” We should remember that a skilled professional is the only one who can perform a thorough assessment. The assessment integrates other available information, such as self-report and family history. This comprehensive assessment is required to determine if an individual meets the accepted standards in the mental health professional’s handbook, Diagnostic and Statistical Manual of Mental Disorders, for a clinical diagnosis of a substance-related disorder.
Personal Evaluation
The Abuse Subtle Screening Inventory is a highly dependable tool for assessing individuals with the probability of having a substance dependence disorder. Having data on the severity of substance abuse helps better clinical interventions that could help improve quality of life. Since the SASSI is easy to use, process, and assess, psychologists can use this inventory screening tool during patient sessions to determine if a recommendation is warranted.
Conclusion
A suggestion that future research should focus on revising the subtle scales to produce a more valid instrument. As logically and empirically derived screening instruments have assets and limitations, a valid instrument that incorporates both is greatly needed. The SASSI-A2 is beneficial in that it is effective even with people unable to acknowledge their behaviors, it has two scales for measuring risk caused by the adolescent’s friends and family, and the adolescent’s attitude towards substance use and misuse (Iskuith, 2022).
References
Balkin, R. B., & Juhnke, G. A. (2018). Marriage, substance abuse, and suicide assessment. In Balkin, R.B., & Juhnke, G.A. (Eds.), Assessment in counseling: Practice and application (pp. 200-205). New York, NY: Oxford University Press.
Clements, R. (2012). Psychometric properties of the substance abuse subtle Screening inventory-3. Journal of Substance Abuse Treatment, 23(4), 419-423.
Iskuith, P. (2022). Adolescent Substance Abuse Subtle Screening Inventory | PAR. Web.
Laux, J. M., Piazza, N. J., Salyers, K., & Roseman, C. P. (2012). The substance abuse subtle screening inventory–3 and stages of change: A screening validity study. Journal of Addictions & Offender Counseling, 33(2), 82-92.
Lazowski, L.E., & Geary, B.B. (2019). Validation of the adult substance abuse Subtle Screening Inventory-4 (SASSI-4). European Journal of Psychological Assessment, 35(1), 86–97. Web.
Tiburcio, N.J., Baker, S.L., & Hanauer, M. (2019). Detecting “faking good” with the adolescent substance abuse Subtle Screening Inventory-SASSI-A3: A clinical response to alcohol & other drug use minimization among teens. Alcoholism Treatment Quarterly, 38(3), 356-363.