Does subtle screening for substance abuse work? A review of the Substance Abuse Subtle Screening Inventory (SASSI)

Sarah Feldstein Ewing, William R. Miller

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Aim: Through a complex combination of direct (face-valid) and indirect (subtle) subscales, the Substance Abuse Subtle Screening Inventory (SASSI) is purported to detect substance use disorders with a high degree of validity regardless of respondent honesty or motivation. This review evaluates empirical evidence regarding the reliability and validity of this widely used screening instrument. Methods: Source documents were 36 peer-reviewed reports yielding data regarding the SASSI's internal consistency, test-retest reliability, psychometric structure, convergent and divergent validity and criterion (predictive) validity. Results: The total N of the studies reviewed equaled 22 110. Internal consistency is high for the overall SASSI and for its direct but not its indirect (subtle) subscales, suggesting that the instrument taps a single face-valid construct. SASSI classifications converged with those from other direct screening instruments, and were also correlated with ethnicity, general distress and social deviance. Studies found test-retest reliability lower than that reported in the test manuals. Sensitivity was found to be similar to that for public domain screening instruments, but on specificity the SASSI appears to yield a high rate of false positives. Conclusion: No empirical evidence was found for the SASSI's claimed unique advantage in detecting substance use disorders through its indirect (subtle) scales to circumvent respondent denial or dishonesty. Recommendations for screening and for future research with the SASSI are offered.

Original languageEnglish (US)
Pages (from-to)41-50
Number of pages10
JournalAddiction
Volume102
Issue number1
DOIs
StatePublished - Jan 2007
Externally publishedYes

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Substance-Related Disorders
Equipment and Supplies
Reproducibility of Results
Public Sector
Psychometrics
Motivation

Keywords

  • Adolescent
  • Adult
  • SASSI
  • Screening
  • Substance abuse

ASJC Scopus subject areas

  • Medicine (miscellaneous)

Cite this

Does subtle screening for substance abuse work? A review of the Substance Abuse Subtle Screening Inventory (SASSI). / Feldstein Ewing, Sarah; Miller, William R.

In: Addiction, Vol. 102, No. 1, 01.2007, p. 41-50.

Research output: Contribution to journalArticle

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