Global Appraisal Of Individual Needs Research Articles

Exploring predictors of substance use disorder treatment engagement with machine learning: The impact of social determinants of health in the therapeutic landscape

BackgroundImproved knowledge of factors that influence treatment engagement could help treatment providers and systems better engage patients. The present study used machine learning to explore associations between individual- and neighborhood-level factors, and SUD treatment engagement. MethodsThis was a secondary analysis of the Global Appraisal of Individual Needs (GAIN) dataset and United States Census Bureau data utilizing random forest machine learning and generalized linear mixed modelling. Our sample (N = 15,873) included all people entering SUD treatment at GAIN sites from 2006 to 2012. Predictors included an array of demographic, psychosocial, treatment-specific, and clinical measures, as well as environment-level measures for the neighborhood in which patients received treatment. ResultsGreater odds of treatment engagement were predicted by adolescent age and psychiatric comorbidity, and at the neighborhood-level, by low unemployment and high population density. Lower odds of treatment engagement were predicted by Black/African American race, and at the neighborhood-level by high rate of public assistance and high income inequality. Regardless of the degree of treatment engagement, individuals receiving treatment in areas with high unemployment, alcohol sale outlet concentration, and poverty had greater substance use and related problems at baseline. Although these differences reduced with treatment and over time, disparities remained. ConclusionsNeighborhood-level factors appear to play an important role in SUD treatment engagement. Regardless of whether individuals engage with treatment, greater loading on social determinants of health such as unemployment, alcohol sale outlet density, and poverty in the therapeutic landscape are associated with worse SUD treatment outcomes.

Youth not engaged in education, employment, or training: a discrete choice experiment of service preferences in Canada

BackgroundPrior research has showed the importance of providing integrated support services to prevent and reduce youth not in education, employment, or training (NEET) related challenges. There is limited evidence on NEET youth’s perspectives and preferences for employment, education, and training services. The objective of this study was to identify employment, education and training service preferences of NEET youth. We acknowledge the deficit-based lens associated with the term NEET and use ‘upcoming youth’ to refer to this population group.MethodsCanadian youth (14–29 years) who reported Upcoming status or at-risk of Upcoming status were recruited to the study. We used a discrete choice experiment (DCE) survey, which included ten attributes with three levels each indicating service characteristics. Sawtooth software was used to design and administer the DCE. Participants also provided demographic information and completed the Global Appraisal of Individual Needs–Short Screener. We analyzed the data using hierarchical Bayesian methods to determine service attribute importance and latent class analyses to identify groups of participants with similar service preferences.ResultsA total of n=503 youth participated in the study. 51% of participants were 24–29 years of age; 18.7% identified as having Upcoming status; 41.1% were from rural areas; and 36.0% of youth stated that they met basic needs with a little left. Participants strongly preferred services that promoted life skills, mentorship, basic income, and securing a work or educational placement. Three latent classes were identified and included: (i) job and educational services (38.9%), or services that include career counseling and securing a work or educational placement; (ii) mental health and wellness services (34.9%), or services that offer support for mental health and wellness in the workplace and free mental health and substance use services; and (iii) holistic skills building services (26.1%), or services that endorsed skills for school and job success, and life skills.ConclusionsThis study identified employment, education, and training service preferences among Upcoming youth. The findings indicate a need to create a service model that supports holistic skills building, mental health and wellness, and long-term school and job opportunities.

New Validity Evidence of the Global Appraisal of Individual Needs-Short Screener for Evaluating Internalizing/Externalizing Behaviors in Spanish Adolescents.

The Global Appraisal of Individual Needs (GAIN-SS) is a screening instrument evaluating internalizing/externalizing behaviors. This study examines the validity evidence of the GAIN-SS in Spanish adolescents and explores sex differences in its performance. Participants were 1,547 Spanish adolescents from the community (females = 48.2%, mean [SD] age = 15.20 [0.74]). A cross-sectional online assessment was used to evaluate past-month substance use and gambling involvement. Problems associated to these behaviors were assessed using the GAIN-SS, the South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA), and the Rutgers Alcohol Problem Index (RAPI). Factor analyses were conducted to examine the internal structure of the GAIN-SS. Results revealed four subscales accounting for 47.03% of the variance related to externalizing (EDScr), internalizing (IDScr), substance use disorders (SDScr), and crime/violence problems (CVScr). Concurrent validity was supported through significant correlations between the GAIN-SS subscales, alcohol-related problems, and gambling behavior, with the exception of the IDScr. Past-month gamblers or substance users evidenced higher scores in the CVScr. Females reported more internalizing symptoms, whereas males reported higher scores in CVScr. The GAIN-SS is a valid screener for substance use and gambling in Spanish adolescents. Sensitivity of the GAIN-SS to sex differences suggests that it may be useful to design gender-sensitive interventions.

Mental Health and Oral Health in a Nationally Representative Cohort

Evidence connects mental illness to other adverse health conditions, including oral health. However, longitudinal associations between mental and oral health remain understudied. We aimed to examine mental health–oral health associations prospectively in a nationally representative US cohort. Data were from the Population Assessment of Tobacco and Health (PATH) Study. The Global Appraisal of Individual Needs–Short Screener measured 3 types of mental health symptoms: internalizing, externalizing, and substance use problems. Six self-reported oral health conditions related to periodontal disease were evaluated: self-rated oral health, bleeding gums, loose teeth, tooth extraction, gum disease, and bone loss around teeth. Cross-sectional analysis within PATH Study wave 4 (2016 to 2018, n = 30,746) compared the survey-weighted prevalence of the 6 oral health outcomes according to severity of mental health problems. Prospectively, oral health outcomes were assessed 2 y later (wave 5, 2018 to 2019) according to wave 4 (baseline) mental health problems (n = 26,168). Survey-weighted logistic regression models controlled for confounders (age, sex, tobacco use, etc.) with imputation for missing values. All 6 adverse oral health conditions were greater in prevalence among participants with severe internalizing problems. Multiple conditions were also associated with severe externalizing or substance use problems. Longitudinally associations attenuated, but multiple associations of meaningful magnitude persisted, most with internalizing problems. For example, the adjusted odds ratio was 1.27 (95% CI, 1.08 to 1.50) for bleeding gums and 1.37 (95% CI, 1.12 to 1.68) for tooth extraction when we compared severe versus none/low internalizing problems. Providers should expect higher levels of oral disease among patients with adverse mental health symptoms. Independent of externalizing and substance use problems, symptoms of internalizing problems (related to depression and/or anxiety) are plausible risk factors for future oral disease. Better integration and coordination of mental and oral health treatment and prevention are recommended.

Impact of the COVID-19 pandemic on alcohol or drug use symptoms and service need among youth: a cross-sectional sample from British Columbia, Canada

BackgroundConcerns about youth alcohol and drug use have risen since the declaration of the global COVID-19 pandemic due to the pandemic’s impact on known risk and protective factors for substance use. However, the pandemic’s immediate and long-term impact on youths’ substance use patterns has been less clear. Thus, this study sought to determine how the COVID-19 pandemic impacted alcohol or drug use and its risk and protective factors among youth accessing integrated youth services.MethodsWe conducted a repeated cross-sectional study of patient-reported outcomes data collected between May 2018 and February 2022 among youth (n = 6022) ages 10–24 accessing a provincial network of integrated youth services in Canada. The main exposure of interest was the COVID-19 pandemic (March 2020 – February 2022) compared with a pre-pandemic period (May 2018 – February 2020). As measured by the Global Appraisal of Individual Needs – Short Screener, outcomes included the average number of past month alcohol or drug use symptoms and past month likelihood of service need for alcohol/drug use (moderate/high vs. low need). Interrupted time series (ITS) examined change in average monthly alcohol/drug use symptoms between the pre- and pandemic periods. Stratified multivariable logistic regression investigated how the pandemic modified the effects of established risk/protective factors on likelihood of alcohol/drug use service need.ResultsFifty-percent of youth met the criteria for moderate/high likelihood of alcohol/drug use service need, with the odds being 2.39 times (95% confidence interval = 2.04, 2.80) greater during the pandemic compared to the pre-pandemic period. Results from the ITS indicated significant immediate effects of the pandemic on monthly substance use symptoms (p = 0.01). Significant risk/protective factors for service need included exposure to violence, engagement in meaningful activities, and self-rated physical and mental health; and the direction of their effects remained consistent across pandemic and pre-pandemic periods.ConclusionsThis study demonstrated that the COVID-19 pandemic corresponded with increased alcohol or drug use among youth accessing integrated services. This signals an urgent need for increased clinical capacity in existing youth services and policies that can respond to risk/protective factors for substance use earlier.

Estimating the Effects of a Complex, Multidimensional Moderator: An Example of Latent Class Moderation to Examine Differential Intervention Effects of Substance Use Services.

Improvements in substance use disorder recovery may be achieved by recognizing that effective interventions do not work equally well for all individuals. Heterogeneity of intervention effects is traditionally examined as a function of a single variable, such as gender or baseline severity. However, responsiveness to an intervention is likely a result of multiple, intersecting factors. Latent class moderation enables the examination of heterogeneity in intervention effects across subgroups characterized by profiles of characteristics. This study analyzed data from adolescents (aged 13 to 18years old) who needed treatment for cannabis use (n = 14,854) and participated in the Global Appraisal of Individual Needs to evaluate differential effects of substance use services on cannabis use outcomes. We demonstrate an adjusted three-step approach using weights that account for measurement error; sample codes in Mplus and Latent Gold are provided and data are publicly available. Indicators of the latent class moderator comprised six contextual (e.g., recovery environment risk) and individual (e.g., internal mental distress) risk factors. The latent class moderator comprised four subgroups: low risk (21.1%), social risk (21.1%), environmental risk (12.5%), and mixed risk (45.2%). Limited moderation of associations between level of care and any past 90-day cannabis use were observed. In predicting number of cannabis use-days, compared to individuals with low risk, those with environmental risk showed improved outcomes from intensive outpatient care whereas individuals with social risk and mixed risk showed improved outcomes from residential care (all compared to early intervention/outpatient care). Latent class moderation holds potential to elucidate heterogeneity in intervention effectiveness that otherwise may go undetected.

Comparing the effectiveness of three substance use interventions for youth with and without homelessness experiences prior to treatment.

Many adolescents and young adults receiving substance use treatment have experienced or are at risk for homelessness. It is unknown whether specific treatment approaches are more or less effective for youth experiencing homelessness (YEH) compared to stably housed youth. The present study compared the effectiveness of the Adolescent Community Reinforcement Approach, Motivational Enhancement Therapy combined with Cognitive-Behavioral Therapy (MET/CBT), and Treatment as Usual (TAU) for these two groups. Further subgroup differences were investigated by age, sex, and sexual and gender minority status. YEH (n = 855) and a matched sample of stably housed youth (n = 855) were drawn from the Global Appraisal of Individual Needs, a nationwide substance use treatment data set. Multiple-group latent change score modeling was used to examine change in substance use frequency and related problems at baseline, 3-, 6-, and 12-month follow-ups. Results indicated significant declines in substance use frequency and problems during treatment for all intervention groups. The TAU group showed the greatest declines in substance use problems during treatment and the greatest declines in frequency post-treatment. Compared to stably housed youth, YEH entered treatment with greater substance use and problems, and had greater declines in substance use in the MET/CBT group only. Other differences were found by age and sex. Overall, all three substance use interventions appear to be effective in reducing substance use and related problems. TAU and MET/CBT may be particularly effective for YEH in treatment settings. Implications for future research and practice are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Internalizing problems are associated with initiation and past 30-Day use of flavored tobacco products

ObjectiveTobacco use remains disproportionately common among adults with internalizing problems. The rising prevalence of flavored tobacco use among this population may be a contributing factor. Using data from Wave 4 of the Population Assessment of Tobacco and Health Study, this study examined differences across adult ever tobacco users by severity of internalizing problems, in initiation of tobacco use with a flavored product and past 30-day (current) flavored tobacco use (n = 27,425).Severity of internalizing problems was measured using the Global Appraisal of Individual Needs–Short Screener Internalizing Disorder Screener. Tobacco use variables included initiation with or current use of a flavored product, assessed separately for each product. Weighted chi-square tests and multivariable modified Poisson regression models were used to examine the associations between severity of internalizing problems and each outcome. ResultsControlling for covariates, ever users with severe internalizing problems were more likely to have initiated with flavors for cigarettes (adjusted prevalence ratio [aPR]: 1.16, 95% confidence interval [CI]: 1.09,1.24), cigarillos (aPR: 1.09, 95% CI: 1.03, 1.16), electronic nicotine products (aPR: 1.08, 95% CI: 1.03, 1.13) and smokeless tobacco (aPR: 1.15, 95% CI: 1.04, 1.27), relative to those with low internalizing problems. Ever users with severe internalizing problems were more likely to currently use a flavored tobacco product for cigarettes (aPR: 1.15, 95% CI: 1.07, 1.24) and cigarillos (aPR: 1.15, 95% CI: 1.04, 1.28). ConclusionsFlavored tobacco use seems disproportionately common among tobacco users with severe internalizing problems, across a variety of measures.

Sex differences in factors predicting post-treatment opioid use.

Several reports have documented risk factors for opioid use following treatment discharge, yet few have assessed sex differences, and no study has assessed risk using contemporary machine learning approaches. The goal of the present paper was to inform treatments for opioid use disorder (OUD) by exploring individual factors for each sex that are most strongly associated with opioid use following treatment. Secondary analysis of Global Appraisal of Individual Needs (GAIN) database with follow-ups at 3, 6 and 12months post-OUD treatment discharge, exploring demographic, psychological and behavioral variables that predict post-treatment opioid use. One hundred and thity-seven treatment sites across the United States. Adolescents (26.9%), young adults (40.8%) and adults (32.3%) in treatment for OUD. The sample (n=1,126) was 54.9% male, 66.1% white, 20% Hispanic, 9.8% multi-race/ethnicity, 2.8% African American and 1.3% other. Primary outcome was latency to opioid use over 1year following treatment admission. For women, regularized Cox regression indicated that greater withdrawal symptoms [hazard ratio (HR)=1.31], younger age (HR=0.88), prior substance use disorder (SUD) treatment (HR=1.11) and treatment resistance (HR=1.11) presented the largest hazard for post-treatment opioid use, while a random survival forest identified and ranked substance use problems [variable importance (VI)=0.007], criminal justice involvement (VI=0.006), younger age (VI=0.005) and greater withdrawal symptoms (VI=0.004) as the greatest risk factors. For men, Cox regression indicated greater conduct disorder symptoms (HR=1.34), younger age (HR=0.76) and multiple SUDs (HR=1.27) were most strongly associated with post-treatment opioid use, while a random survival forests ranked younger age (VI=0.023), greater conduct disorder symptoms (VI=0.010), having multiple substance use disorders (VI=0.010) and criminal justice involvement (VI=0.006) as the greatest risk factors. Risk factors for relapse to opioid use following opioid use disorder treatment appear to be, for women, greater substance use problems and withdrawal symptoms and, for men, younger age and histories of conduct disorder and multiple substance use disorder.

Rasch Analysis of the Global Appraisal of Individual Needs in the City of São Paulo

Approximately 5% of the global population used an illicit drug in 2013. Regarding licit drugs, alcohol is responsible for the occurrence of approximately 200 diseases, among them depression. In addition to health impairments, alcohol is also implicated in many acts of violence. This study aimed to measure the properties of the Rasch model of the Portuguese version of the Global Appraisal of Individual Needs-Short Screener based on evidence obtained during care for users of alcohol and other drugs. To collect the data, 128 interviews were held at the Psychosocial Care Center for Alcohol and Other Drugs in the state capital, during which the scale was applied. The Rasch model revealed that the subscales of the instrument were appropriate, with all items having mean infit and outfit values from 0.5 to 1.5, considered optimal for measurement. There was no evidence of differential performance for gender. Substance use and crime and violence items presented redundancy for severity measures. Given the need for validated instruments for use in Brazil, it is encouraging that the Portuguese version of the scale was valid for the Rasch model. The results are consistent with studies using the other American, Brazilian, and Canadian versions of the instrument.

Associations Between Time Spent Using Social Media and Internalizing and Externalizing Problems Among US Youth

Social media use may be a risk factor for mental health problems in adolescents. However, few longitudinal studies have investigated this association, and none have quantified the proportion of mental health problems among adolescents attributable to social media use. To assess whether time spent using social media per day is prospectively associated with internalizing and externalizing problems among adolescents. This longitudinal cohort study of 6595 participants from waves 1 (September 12, 2013, to December 14, 2014), 2 (October 23, 2014, to October 30, 2015), and 3 (October 18, 2015, to October 23, 2016) of the Population Assessment of Tobacco and Health study, a nationally representative cohort study of US adolescents, assessed US adolescents via household interviews using audio computer-assisted self-interviewing. Data analysis was performed from January 14, 2019, to May 22, 2019. Self-reported time spent on social media during a typical day (none, ≤30 minutes, >30 minutes to ≤3 hours, >3 hours to ≤6 hours, and >6 hours) during wave 2. Self-reported past-year internalizing problems alone, externalizing problems alone, and comorbid internalizing and externalizing problems during wave 3 using the Global Appraisal of Individual Needs-Short Screener. A total of 6595 adolescents (aged 12-15 years during wave 1; 3400 [51.3%] male) were studied. In unadjusted analyses, spending more than 30 minutes of time on social media, compared with no use, was associated with increased risk of internalizing problems alone (≤30 minutes: relative risk ratio [RRR], 1.30; 95% CI, 0.94-1.78; >30 minutes to ≤3 hours: RRR, 1.89; 95% CI, 1.36-2.64; >3 to ≤6 hours: RRR, 2.47; 95% CI, 1.74-3.49; >6 hours: RRR, 2.83; 95% CI, 1.88-4.26) and comorbid internalizing and externalizing problems (≤30 minutes: RRR, 1.39; 95% CI, 1.06-1.82; >30 minutes to ≤3 hours: RRR, 2.34; 95% CI, 1.83-3.00; >3 to ≤6 hours: RRR, 3.15; 95% CI, 2.43-4.09; >6 hours: RRR, 4.29; 95% CI, 3.22-5.73); associations with externalizing problems were inconsistent. In adjusted analyses, use of social media for more than 3 hours per day compared with no use remained significantly associated with internalizing problems alone (>3 to ≤6 hours: RRR, 1.60; 95% CI, 1.11-2.31; >6 hours: RRR, 1.78; 95% CI, 1.15-2.77) and comorbid internalizing and externalizing problems (>3 to ≤6 hours: RRR, 2.01; 95% CI, 1.51-2.66; >6 hours: RRR, 2.44; 95% CI, 1.73-3.43) but not externalizing problems alone. Adolescents who spend more than 3 hours per day using social media may be at heightened risk for mental health problems, particularly internalizing problems. Future research should determine whether setting limits on daily social media use, increasing media literacy, and redesigning social media platforms are effective means of reducing the burden of mental health problems in this population.

Brief interventions for young adults who use drugs: The moderating effects of resilience and trauma

Among participants in an intervention clinical trial (N = 602), we examined resilience as a moderator of substance use outcomes by intervention condition and between participants with and without severe traumatic stress (STS). Eligibility included men and women ages 18–39 with recent multidrug use; drug treatment enrollees were excluded. Outcome measures were past 90-day frequencies of substance use and abstinence. Putative moderators were measured using the Resilience Research Centre's Adult Resilience Measure (RRC-ARM) and the Traumatic Stress Scale from the Global Appraisal of Individual Needs (GAIN). Analyses employed hierarchical linear models. High resilience predicted better substance use outcomes, and the ordering of intervention effects for high resilience participants was stepwise by intervention condition intensity. Participants with low resilience scores had poorer outcomes, and those outcomes were largely unaffected by intervention condition. Participants without STS experienced the interventions similarly to the overall sample. Regardless of the level of resilience, however, participants with STS did not benefit from the interventions. The findings point to the importance of screening for both resilience and traumatic stress prior to intervention to maximize the impact of brief interventions for substance users, and also to link those needing more intensive approaches to additional services and professional care.

Bottoming out experiences: factor analyses and moderating effects of gender and race

The Bottoming Out Experience (BOE) is thought to be the accumulation of negative experiences for those with Substance Use Disorders (SUDs). This study aimed to bridge research and the narrative utilized in 12-step programs by quantifying the construct of the BOE. To do this, we examined the factor structure of the BOE using negative experiences that have been associated with change for individuals at the intake level. We also tested for variances in factor loadings of the BOE between gender and ethnicity to understand moderating effects. Archival data from the Center from Substance Abuse Treatment (CSAT) was used, specifically data from the Global Appraisal of Individual Needs (GAIN). We hypothesized that identified negative experiences would load into a unidimensional model. Hypothesis one was rejected, due to exploratory factor analysis results. Thus, we created five subfactors (F1: mental distress and trauma; F2: stress; F3: substance use levels; F4: risky behaviors, and F5: financial problems) and confirmed the model with the second half of the dataset. Hypothesis two stated that differences would exist within the models based on both gender and ethnicity, and this hypothesis was supported. The overarching BOE model remained the same for all gender and ethnic groups, but factor loadings within the models differed based on both gender and ethnicity. Although previous theory supported the idea of the BOE, no research had been conducted on the multivariate relationships between these negative experiences. The BOE model and the gender and ethnic differences have significant implications for SUD treatment.

Internal Consistency and Convergent Validity of the Portuguese Versions of the Global Appraisal of Individual Needs-Initial and Short Screener: Validity of the Portuguese GAIN-I and SS.

The goal of this article is to present evidence on the internal consistency and convergent validity of the Brazilian Portuguese versions of the Global Appraisal of Individual Needs–“Initial” and “Short Screener” versions.MethodsOne hundred sixty-eight individuals from an inpatient service and/or a community-based outpatient service located in São Paulo were interviewed using the Brazilian Portuguese versions of the instruments. The internal consistency of the instruments scales was computed, along with evidence for the convergent validity between corresponding subscales of the Initial and Short Screener instruments.ResultsCronbach’s alpha values for both instruments’ total scale scores were greater than .7. The Short Screener scales showed strong-to-moderate correlations with corresponding subscales of the Initial. The General Individual Severity Scale from the Initial and Total Disorder Screener from the Short Screener have convergent validity with each other (ρ = 0.801).ConclusionsThe Brazilian Portuguese instrument scales showed evidence for internal consistency and convergent validity performing similarly to the American English versions.

Test Review: Global Appraisal of Individual Needs–Short Screener (GAIN-SS)

Test Review: <i>Global Appraisal of Individual Needs–Short Screener (GAIN-SS)</i>

An independent replication of the Adolescent-Community Reinforcement Approach with justice-involved youth.

Substance use disorders among youth remain a serious public health problem. Although research has overwhelmingly supported the use of evidenced-based interventions, one of the primary limitations of the current evidence base is that for the vast majority of treatments, the developers of the treatments are also the ones conducting research on them, raising the possibility of allegiance bias. The present study was an independently conducted randomized controlled trial (n = 126) comparing an evidenced-based treatment for adolescent substance use, Adolescent-Community Reinforcement Approach (A-CRA), and assertive continuing care (ACC), to services as usual (SAU) provided by a juvenile probation department. Latent growth curve modeling was used to compare the treatments on change in substance use assessed by the Global Appraisal of Individual Needs (GAIN) at baseline and 3, 6, and 12 months following treatment entry. All youth evidenced a substantial reduction in substance use frequency and substance-related problems following treatment; however, youth treated with A-CRA/ACC evidenced a substantially greater decrease in substance-related problems. Results are consistent with studies conducted by A-CRA/ACC model developers supporting the effectiveness of the clinical approach and, because the outcomes resulted from an independent replication, are encouraging for the transportation potential of A-CRA/ACC.

Drug use, mental health and problems related to crime and violence: cross-sectional study.

Objective: to investigate the correlation between disorders related to the use of alcohol and other drugs and symptoms of mental disorders, problems related to crime and violence and to age and gender. Methods: cross-sectional descriptive study carried out with 128 users of a Psychosocial Care Center for Alcohol and other Drugs, in the city of São Paulo, interviewed by means of the instrument entitled Global Appraisal of Individual Needs - Short Screener. Univariate and multiple linear regression models were used to verify the correlation between the variables. Results: using univariate regression models, internalizing and externalizing symptoms and problems related to crime/violence proved significant and were included in the multiple model, in which only the internalizing symptoms and problems related to crime and violence remained significant. Conclusions: there is a correlation between the severity of problems related to alcohol use and severity of mental health symptoms and crime and violence in the study sample. The results emphasize the need for an interdisciplinary and intersectional character of attention to users of alcohol and other drugs, since they live in a socially vulnerable environment.

Rasch model of the GAIN substance problem scale among inpatient and outpatient clients in the city of São Paulo, Brazil

IntroductionThis study used the Rasch model to evaluate the psychometric properties of the Portuguese version of the Substance Problem Scale (SPS) of the “Global Appraisal of Individual Needs - Initial” for use in Brazil. The SPS measures alcohol and drug problem severity within a DSM-IV-TR framework. The goal of the Rasch analysis was to assess scale dimensionality, item severity, and differential item functioning (DIF). MethodsData was collected from 40 inpatients and 70 outpatients in São Paulo, Brazil. The Rasch model fit and DIF by gender and level of care were examined. ResultsThe SPS fit the Rasch model, with no items distorting the measure. Only three of the sixteen items performed differently between men and women and three performed differently by level of care. ConclusionsThe results were compatible with those from Rasch analyses of the American English and Canadian English versions of the scale. The Portuguese version of the SPS is, thus, valid for use in Brazil, both with men and women in inpatient and outpatient programs.

Validation of the global appraisal of individual needs’ general individual severity scale and its subscales against the Rasch measurement model

s / Drug and Alcohol Dependence 140 (2014) e2–e85 e37 examined. The study was conducted using a laboratory model of risk taking to examine these differences in a controlled setting. Methods: The sample included 233 adolescents (42% Black) assessed longitudinally across 4 years (between 9 and 16 years old). To evaluate risk taking, we utilized the well-validated BARTY laboratory risk task (Lejuez et al., 2007). Parental monitoring was measured using an abbreviated version of the Stattin and Kerr (2000) questionnaire. Exposure to threats was assessed through a 21-item scale consisting of self-reported neighborhood, home, and school threats ( ’s across 4 years = .86–.89). Results: Hierarchical Linear Modeling analyses indicated that relative to White, Black adolescents engaged in lower risk taking over time (ˇ =−6.69; SE=1.62; p 1.33 for both Infit MNSQ and Outfit MNSQ. The criterion-related validity of all scales was consistent with hypotheses. Based on differential test functioning analysis, the full GISS scores had different meanings depending on age and gender of the respondents. Conclusions: This study supported the use of the four GISS subscales for their target constructs. As suggested by the DSF results, we urge caution in relying only on the GISS total score since variability in how one arrived at a total varied by age and gender. Financial support: NIDA grant no. R37 DA011323 and SAMHSA contract no. 270-12-0397. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.122 Validation of the gain self-help involvement scale using the Rasch measurement model Karen M. Conrad1,2, K.J. Conrad3, L. Passetti 3, R.R. Funk3, Michael L. Dennis3 1 Program Metrics, Oak Park, IL, United States 2 University of Illinois at Chicago, Chicago, IL, United States 3 Chestnut Health Systems, Normal, IL, United States Aims: Self-help groups are increasingly recognized as an integral part of managing long term recovery from substance use disorders. The aims of this poster are to evaluate the psychometric properties of the original 21-item Self-Help Involvement Scale (SHIS) and of a short-form version based on traditionalmeasures of internal consistency (e.g., Cronbach’s alpha) and the more conservative Rasch measurement model (aka 1 parameter item response theory [IRT]). Methods: Data were collected using the Global Appraisal of Individual Needs during 2009–2010 from 801 clients in substance abuse treatment who completed the SHIS at 90-days post intake. The sample was predominantly over 18 years of age (71.4%) and male (54%). Over half were Caucasian (54%). Alcohol was reported as a primary drug by slightly over 20%,Marijuana andOpioidswere each reportedby18%, Cocainewas reportedby11%, Amphetamines was the least reported primary drug at about 8%. About a quarter were grouped into the other drug category rather than one of five primarydrugs listed.Winsteps softwarewasused toplacebothpersons and items on a common, linear, interval “ruler” that enabled examination of: person and item reliability; itemhierarchy; itemfit statistics; unidimensionality; and item invariance across primary drug of choice. Results: Both the original and short-form SHIS were internally consistent and met the requirements of the Rasch measurement model except for two items thatmisfit possibly due tomethod variance given that these two items had a different rating scale than the remaining items. Item invariance across drugs was observed for 10 items of the full 21-item version. This finding guided selection of items for the short-form version because of our interest in using the measure across primary drug types. Conclusions: Having available psychometrically sound, full and short-formmeasures of self-help involvement for use across drugs and treatment types strengthens our ability to discern treatment effects. Financial support: SAMHSA/CSAT Contract No. 270-12-0397. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.123

Measuring the impact of substance abuse on student academic achievement and academic growth

This research presents data linking the impact of substance disorder to academic achievement, using data gathered at a recovery high school. Recovery schools provide recovery supports and a high-quality education to students with substance use disorders. The Global Appraisal of Individual Needs – Short Screener and the Northwest Evaluation Association Measures of Academic Progress were administered, and paired observations (Testing 1 (T1) vs. Testing 2 (T2)) were categorized based on information from the Global Appraisal of Individual Needs – Short Screen, as increased, decreased, or no change in substance disorder. Results confirm the impact of substance disorder on academic growth, with T1–T2 pairings in which substance disorder increased resulting in a decrease in academic growth, and T1–T2 pairings in which substance disorder decreased resulting in an increase in academic growth. The impact of no change in substance disorder from T1 to T2 varied by the time frame of the substance use, either in the pa...