Abstract

The study objective was to develop a revision of the Substance Abuse Subtle Screening Inventory for Adolescents (SASSI-A2) to include new subtle and symptom-related identifiers of SUD in adolescents and new items to identify nonmedical use of prescription medications. Interview items, scales, decision rules, and enhanced question stems were also updated, to make the language more contemporary and understandable to present-day teens. This validation project was conducted to evaluate the instrument’s psychometric properties and screening accuracy against a criterion of DSM-5 diagnosis for SUD. The responses of 1,065 participants were used to develop and examine various aspects of the Adolescent SASSI-A3. Clinical professionals from substance use treatment programs, criminal justice, and social service programs throughout the United States who used the SASSI Online screening tool submitted 515 completed administrations along with their independent DSM-5 diagnosis. The remaining 550 respondents constituted the normative sample collected via Knowledge Panel^®, a probability-based web panel designed to be representative of the United States. Cross validation sample findings demonstrated SASSI-A3 sensitivity of 98%, specificity of 85%, and AUC 94%. Items added to identify adolescents who abused opioids or sedatives showed perfect sensitivity (100%), high specificity (98%), and high AUC (95%).

Keywords: Substance use disorders; DSM-5; Subtle screening; SASSI; Adolescent alcohol and drug screening, Prescription drug abuse