Comparison of Assessment Tools
Julia Ray
Capella University
Abstract
Julia selected substance abuse assessment tools for this report. She will be comparing two of the eight substance abuse assessment tools used in the mental health counseling field, the Substance Abuse Subtle Screening Inventory - Adolescent Version and the Adolescent Drinking Index. The comparison will compare the tools based on key test measurement concepts of reliability and validity. There will be a description of the results interpreted concerning both test based on standard statistical methods and procedures including scales of measurement, measures of central tendency, indices of variability, shapes and types of distributions, and correlations as they apply to each assessment tool. Finally, there will be a discussion on which assessment tool is the stronger assessment instrument using measurement concepts based upon the literature gathered.
Comparison of Assessment Tools Substance abuse assessment tests are an important tool in the counseling field since many psychological issues occur as the result of drugs and or alcohol. Drugs and alcohol are often used by the client to self-medicate which in turn compounds their psychological issues. Substance abuse assessments can be subjective or objective, meaning they may or may not result in a standardized score. Drug and alcohol addiction is a touchy subject for most; therefore, it is beneficial to build a rapport with the client prior to testing to ensure a more accurate result of the assessment. Otherwise, clients may not report their addiction and or abuse to the counselor which makes treatment extremely difficult. A drug and alcohol assessment is a tool used mostly by substance abuse counselors to determine the treatment needed to treat the individual. There are many types of substance abuse assessments which include the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Addiction Acknowledgment Scale, Composite International Diagnostic Interview Substance Abuse Module, Michigan Alcoholism Screening Test, National Institute on Drug Abuse Screening Tool, Drug Abuse Screening Test, Substance Abuse Subtle Screening Inventory-3, and the Alcohol Use Disorders Identification Test which are all developed for adults. For this report, Julia will be comparing the Substance Abuse Subtle Screening Inventory -3 and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Addiction Acknowledgment Scale. Substance Abuse Subtle Screening Inventory-3 Miller (2012) states that the SASSI-3 is used to evaluate the severity of substance abuse which includes alcohol as well as drugs. The SASSI-3 is a psychometric assessment instrument designed to make inferences concerning substance dependence disorder. The SASSI-3 has two sides of a number of items for the respondent to answer. One side has fourteen face valid items which are obviously worded in which to be related to substance dependence. These fourteen items are divided into alcohol related items and items related to other drugs. The opposite side contains sixty-seven items which are supposed to be indirectly related to substance dependence. The face valid items have a four point rating scale of frequency with the other items consisting of a true/false format. The responses on the SASSI-3 cover four certain time frames in the respondent’s lifetime; entire life, past six months, six months before, or six months since. The paper-pencil version can usually be completed with fifteen minutes and the administrator can objectively score the assessment within up to two minutes. The computerized versions as well as the optical scanning versions and audiotaped version are available for individuals with reading complications.
SASSI-3 and Reliability and Validity
Miller (2012) is none to kind on the interpretation of the SASSI-3 as well as the developers. The counselor who scores the SASSI-3 must interpret the score with a reference to a decision rule stipulating cutoffs for each of the subscales. If the counselor exceeds any of the rules interpretation can lead to a high probability of substance dependence disorder. On the other end of the spectrum, a score below the cutoff on all rules infers to a low probability of substance abuse disorder. The developers of the SASSI-3 caution administrators of the assessment on further interpretation of the individual subscale scores which is not shown with any empirical research. These interpretations are best viewed as a hypothesis and certain ideas for assessment of the individual. Meaning that the SASSI-3 is not shown to be a reliable assessment for diagnosing substance abuse disorder (Miller, 2012).
It stands to reason if the SASSI-3 is an unreliable assessment tool, then it would also be invalid. However, Miller (2012) reports that the validity of this assessment tool is comparable to other similar assessments. The SASSI-3 is worded in such a way as to make the respondent comfortable in responding more truthful than if faced with direct questioning of their addiction and or abuse. The SASSI-3 uses a random answer pattern to check for answers that are not randomly chosen to ensure validity. The random answer pattern also checks to make sure the respondent understands the question instead of just marking an answer to the questions (Miller, 2012).
SASSI-3 and Statistical Information
Accuracy rates for the SASSI-3 is at 80% stance of inferring that respondents have a level of substance abuse; however, interpretation should be done with caution. Caucasians are more likely to test higher than any other ethnic population, so it is necessary to be cautious when using the SASSI-3 with populations in which will result in a high proportion of substance abuse which increases the criterion validity. On the other end of the spectrum, using the SASSI-3 with populations who are less likely to suffer from substance abuse creates a lower base rate producing a lower criterion validity estimates. When using the manual for the SASSI-3 the data presented in the manual lowers the error by 70% in predicting criteria for substance abuse dependence while the error rate is lower within different populations. The SASSI-3 manual does not provide any normative data for population groups not directly connected with psychopathology treatment (Miller, 2012).
The supporting materials for the SASSI-3 does contain data to verify the appropriateness of making distinctions between the clinical scale profiles. Similarly, the instrument does not confirm the factor structure of the SASSI-3. Temporal stability of the SASSI-3 is also limited. The manual reports that only forty of the respondents who participated in substance abuse treatment populations retested at a high reliability rate in a two-week interval. It is also reported that at the two-week and four-week intervals the binary diagnosis of substance abuse resulted in a lower reliability rate. In addition, the SASSI-3 scores are vulnerable to instructions for fake good or bad. Finally, the SASSI-3 does not provide data to indicate the function compared to other measures of substance abuse. While the SASSI-3 is remarkable at the development of the questionnaire items, it does not score high on reliability and the validity is skeptical (Miller, 2012).
Minnesota Multiphasic Personality Inventory-2 Addiction Acknowledgment Scale
The Minnesota Multiphasic Personality Inventory-2 Addiction Acknowledgment Scale (MMPI-2 AAS) is an assessment tool used to identify substance abuse individuals. The study surrounding the review consisted of both women and men who were of Caucasian and African-American ethnicities with a higher number of women than men and a higher number of Caucasian than African-American. The MMPI-2 AAS is designed to be used with a population of adults eighteen and older. The MMPI-2 AAS contains 567 items which takes between one to two hours to complete depending on the respondent’s reading level even though it is designed at a sixth-grade reading level. There is an abbreviated form of the MMPI-2 AAS which uses the first 370 items of the long form of the MMPI-2 AAS. The abbreviated form is used when the full version cannot be completed due to an illness, time pressure, or another circumstance that does not allow for full version completion. The abbreviated form scores are not as extensive as the scores available with the full version. The original form of the MMPI-2 AAS is the third most widely used assessment in the psychology field. It is also important to note that the study in review was performed with an outpatient mental health setting (Stein, Graham, Ben-Porath, & McNulty, 1999).

MMPI-2 AAS and Reliability and Validity
It is noted in the review that the MMPI-2 AAS has become an extremely reliable assessment to use when assessing substance abuse. Since the MMPI-2 has been widely used and is considered to be the third in assessment ranking usage, the MMPI-2 has become a reliable assessment in which the administrator can use. The only issue with the MMPI-2 AAS is that its validity relies upon the validity of the MMPI-2 portion of the assessment and not combined or solely on the AAS portion. The administrator must review the score of the MMPI-2 scores outside the interpretation of the AAS section of the assessment which makes the AAS portion dependent on the valid score of the MMP-2 (Stein, Graham, Ben-Porath, & McNulty, 1999).
MMPI-2 AAS and Statistics
Overall, the hit rates for accuracy analyses were higher at the adjusted base rates which reflected the base rate of substance abuse in the total sample groups. Women rated at 49% while mean rated at 74% with an adjusted base rate of 16% for women and 27% for men which may be more realistic estimates of these rates of substance abuse within the outpatient setting. Women had a T-score cutoff of 65 at optimal classification accuracy while the men’s optimal T-score cutoff was at 60. However, women had a poor positive predictive power at both cutoffs while the men’s cutoff of 65 was acceptable. Elevated scores on any of the scales within an outpatient mental health setting indicate further data gathering regarding the possibility of substance abuse (Stein, Graham, Ben-Porath, & McNulty, 1999).
The MMPI-2 AAS is limited on it interpretability. However, it is important that the examiner reviews the scores on the validity scales of the MMPI-2 prior to interpreting the AAS section of the assessment. If the respondent is of the defensive mind while taking the assessment it is more likely the test will result in artificially low scores on the AAS as well as other content scales. While higher scores on the AAS may suggest substance abuse, the lower the score does not rule out substance abuse (Stein, Graham, Ben-Porath, & McNulty, 1999).
In conclusion, both the SASSI-3 and MMPI-2 AAS are useful in assessing the probability of substance abuse. However, the SASSI-3 seems to prove a little more unreliable than the MMPI-2 AAS. The MMPI-2 AAS ranks much higher in usage as well as reliability and validity than the SASSI-3. It is the assumption, that the MMPI-2 AAS would be more effective in identifying substance abuse than the SASSI-3.

References
Miller, G. (2012). Substance Abuse Subtle Screening Inventory-3 (The). Retrieved March 12,
2014 from http://ezproxy.library.capella.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=mmt&AN=TIP07002479&site=ehost-live&scope=site
Stein, L. A. R., Graham, J. R., Ben-Porath, Y. S., McNulty, J. L. (1999). Using the MMPI-2 to
Detect Substance Abuse in an Outpatient Mental Health Setting. Retrieved March 12, 2014 from http://www.360translations.com/educ533/using_the_mmpi.htm#AG-998014464-13