The ecological and incremental validity of the SASSI-3 subtle scales in the prediction of substance abuse in homeless individuals seeking housing.

摘要

This study examined the ecological validity of the Substance Abuse Subtle Screening Inventory, Third Edition (SASSI-3) and the incremental validity of the subtle scales as a measure in predicting substance abuse. Archival records of a large community sample of 846 homeless adults who completed the SASSI-3 as a requirement to obtain housing and rehabilitative services at no cost were investigated. This population was demographically diverse with many reasons for homelessness.;Past research has related the validity of the SASSI to an already established diagnosis through either another instrument, biological indicators such as urinalysis, or a clinical interview. This study is unique in that the validity of the SASSI-3 was tested using behaviors indicative of substance abuse.;Logistic regression analyses were performed with the SASSI-3 subscale scores as the predictor variables and behavioral indicators of substance abuse as the criterion measure. The data analyses revealed surprising results. Not only did the SASSI-3 subtle scales fail to provide incremental validity over the face valid scales in this population, but the face valid scales alone failed to identify the clients who would abuse substances and lose their housing. There was some support for the Face Valid Alcohol (FVA) scale in some of the analyses.;Additionally, four decision rules that are algorithms using the subtle scales (rules 6-9) were tested to determine if these rules provide incremental validity over the decision rules that are based on the face-valid scales alone in predicting subsequent substance use. Rule 9, which is based on an algorithm of scores from the Face Valid Alcohol (FVA), Face Valid Other Drugs (FVOD), Subtle Attributes (SAT), Defensiveness (DEF), and Supplemental Addiction Measures (SAM) scales was the only decision rule to show significance in predicting substance abuse.;In a chi-square analysis, the SASSI-3 face valid scales were able to provide concurrent validity with self report of symptoms consistent with a diagnosis of substance abuse in an interview. However, there were a large number of false negatives.;The results of this study suggest that the SASSI-3 lacks validity in its ability to accurately identify individuals in the homeless population who exhibit behavioral indicators of substance abuse.