Development of ASI Psychiatric Severity Cut-Off Scores To Identify Co-Occurring Psychiatric Disorders

Abstract

This study empirically evaluates the value of the psychiatric section of the Addiction Severity Index (ASI) as a screening instrument for non-substance use Axis-I psychiatric disorders. Data were from a diverse sample of 672 recently admitted patients to inpatient, residential, and outpatient substance abuse treatment. ASI psychiatric summary scale scores and SCID-III-R results were subjected to Receiver Operating Characteristics analyses to determine how well the ASI identified participants with/out a co-occurring psychiatric disorder. Diagnostic detection using the ASI psychiatric scales was good: ASI Interviewer Severity Ratings (ISRs) yielded 81% sensitivity and 53% specificity (C = 0.73); ASI Clinical Factors (CFs), 85% sensitivity and 55% specificity (C = 0.78); ASI Composite Scores (CSs), 80% sensitivity and 60% specificity (C = 0.76); ASI Evaluation Indices (EIs), 80% sensitivity and 60% specificity (C = 0.75). Separate analyses by gender generated very similar results. Clinical implications and applications as well as further research directions are discussed.