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Center for Substance Abuse Treatment. Screening and Assessment for Alcohol and Other Drug Abuse Among Adults in the Criminal Justice System. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1994. (Treatment Improvement Protocol (TIP) Series, No. 7.)

  • This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

Cover of Screening and Assessment for Alcohol and Other Drug Abuse Among Adults in the Criminal Justice System

Screening and Assessment for Alcohol and Other Drug Abuse Among Adults in the Criminal Justice System.

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Appendix D—Supplementary Instruments Recommended for the Assessment of Life Domains and Problem Areas of Adult Clients1

Adult Assessment Instruments by Domain/Problem Area

Adult Assessment Instruments by Domain/Problem Area.

Table

Adult Assessment Instruments by Domain/Problem Area.

1. SUBSTANCE ABUSE ASSESSMENT, DIAGNOSIS, AND RELATED PROBLEMS

Michigan Alcoholism Screening Test (MAST) (Selzer, 1971). The MAST is a relatively simple, inexpensive, and widely used alcoholism screening instrument that was designed principally to provide a quantifiable, structured interview instrument for the detection of alcoholism. It has been widely used with many different subject groups. These include alcoholics, persons convicted of driving while intoxicated, other social or problem drinkers, drug abusers, psychiatric patients, and general medical patients. It consists of 25 face-valid questions that require a simple "yes" or "no" answer, which can be rapidly administered.

The original normative sample, used by Selzer (1971) to develop a scoring system with a cut-off score for diagnosing the subject as having an alcohol problem, consisted of 1) 41 white males admitted to the hospital for alcoholism; 2) 67 white male blue-collar employees; and 3) 36 white males visiting an allergy clinic. The age range was 19 to 73 years. The convergent validity of the MAST was assessed originally by searching the records of legal, social, and medical agencies and reviewing subjects' driving and criminal records. In the original study by Selzer (1971), of 128 diagnosed as problem drinkers, the MAST test missed only two. But Rounsaville and associates (1983) later reported that one-fourth of a group identified as alcohol dependent by the Research Diagnostic Criteria (RDC) indicated that they had no alcohol-related problems on the MAST. The accuracy of the screening of alcoholics by MAST has been found to be only "moderately satisfactory," according to Hedlund and Vieweg (1984). In a validation study, (Moore 1972), of 400 adult psychiatric inpatients, 78 percent agreement was found between the MAST and the psychiatrists' opinions on whether the patient was a "problem drinker" or "alcoholic." Its internal consistency and test-retest reliability appear to be satisfactory. Reported alpha coefficients from nine different studies ranged from .83 to .95. Zung (1982) reported test-retest reliability coefficients of .97 for 1-day retest interval, .86 for 2-day interval, and .85 for 3-day interval, when using a psychiatric population (N = 120). Skinner and Sheu (1982) obtained a test-retest reliability coefficient of .84 for an average 4.8 month retest interval, with a sample of 91 psychiatric patients. The time required to administer is approximately 7 minutes.

Test items are available from the source listed below (either without cost or at nominal cost).

Access:
Melvin L. Selzer, M.D.
6967 Paseo Laredo
La Jolla, CA 92037
(619) 299-4043

The Drug Abuse Screening Test (DAST) (Harvey A. Skinner, Ph.D.).

The Drug Abuse Screening Test (DAST) (Harvey A. Skinner, Ph.D.).

Table

The Drug Abuse Screening Test (DAST) (Harvey A. Skinner, Ph.D.).

Manson Evaluation (ME) Revised (Manson and Huba, 1987). This 72-item instrument has been administered to more than a quarter of a million individuals for use as a screening measure of alcohol abuse. It also measures anxiety, depression, depressive fluctuations, emotional sensitivity, resentfulness, aloneness, and quality of interpersonal relations. Five to 10 minutes are required for either individual or group administration. The test form is easy to use and has a unique AutoScore system, which makes it possible to score, profile, and interpret the test in just a minute or two. A Probability Index for Alcohol Abuse Proneness indicates the degree of likelihood that the subject is abuse prone. Scoring can be done by computers and interpretive reports generated.

A normative sample developed in 1985 consisted of 326 applicants (147 males and 179 females) for clerical, manual labor, and professional positions at a medium-size company in Los Angeles. The age range was from 16 to 60 years; mean age, 30 years (S.D., 9 years). The mean education was 14 years of school completed (S.D. = 2 years). No race/ethnic distribution is reported.

The Cronbach Alpha internal consistency reliability was .87 for this total sample. Validity was determined in a study in which each of the 71 items analyzed separately differentiated known alcoholics from known non-alcoholics to a statistically significant degree. Also, a cut-off score of 21 points for males and 26 points for females correctly diagnosed 79 percent of males and 84 percent of females as alcoholic.

Costs:

ME COSTS
Item No. Description Price
W-3
Kit, including 25 autoscore test profile forms for hand scoring and one manual


$ 55.00
W-3A
Autoscore test profile forms, price per pkg. of 25
1 pkg.
2 - 9 pkgs.
10 or more pkgs.


29.00
26.60
25.10
W-3B
Manual

27.50
W-56C
Mail-in computer-scored answer sheets
1 - 9 answer sheets, price each
10 or more answer sheets, price each


9.50
8.60

Disk for computerized administration, good for 25 uses (will also score the tests and complete an interpretive report)

125.00

Add 10% shipping and handling, plus applicable tax in California. Call for current prices and ordering information.

Access:
Western Psychological Services
12031 Wilshire Blvd.
Los Angeles, CA 90025
(310) 478-2061 or (800) 648-8857

The Chemical Dependency Assessment Profile (CDAP) (Harrell et al., 1991) is a 235-item, multiple-choice, and true-false self-report instrument, to assess alcohol and drug use and chemical dependency problems. The 11 dimensions measured include quantity/frequency of use, physiological symptoms, situational stressors, antisocial behaviors, interpersonal problems, affective dysfunction, attitude toward treatment, degree of life impact, and three "use expectancies" (i.e., the client's expectation that use of the substance a) reduces tension; b) facilitates socialization; or c) enhances mood. An example of a "use expectancy" item is, "I get aggressive or violent when using alcohol."

This instrument probably develops as much detailed information related to substance use, abuse, and dependency as any of the others described in this manual; there are 90 items on alcohol use and problems alone. The questionnaire covers chemical use history, patterns of use, reinforcement dimension of use, perception of situational stressors, and attitudes about treatment, self-concept, and interpersonal relations.

Adequate internal consistency reliability coefficients, calculated separately for each of the 11 dimensions, ranged from .60 to .88. Test-retest reliability (after 6 to 9 days) was supported by correlations ranging from .77 to .96 separately for the 11 dimensions.

The degree of validity of the CDAP (i.e., the degree to which it measured what it is intended to measure) was determined by the degree to which the 11 CDAP scores were found to correlate with 1) MAST scores, and 2) a factor score of Alcohol Use Inventory (AUI). The correlations with the MAST ranged from .33 to .77. The correlations with the AUI ranged from .35 to .79. The best correlations were with the "Use Quantity/Frequency" and "Degree of Life Impact Dimensions" of the CDAP.

Normative data are available thus far on only 86 subjects, including 31 polydrug abusers, 27 alcohol abusers, and 28 social drinkers. In this sample, there were 52 males and 48 females, with mean age of 35.3 years (S.D. = 11.6), and mean years of education of 13.2 years (S.D. = 3.1). The race/ethnic distribution was 93 percent Caucasian, 4 percent Black, and 3 percent Hispanic. (A discriminant function classification analysis of the alcohol abuse group vs. polydrug abuse group yielded correct classification of 100 percent of the subjects.) This finding suggests that the normative data are useful, even for this small sample (Harrell et al., 1991).

The CDAP can be administered by computer, as well as in paper and pencil format, and a three- to eight-page computerized report can be generated. This report includes the subscale scores for the 11 dimensions.

Costs:

CDAP COSTS
Item No.Description Price

B-CD1-5B

IBM 5 1/4"
$295.00

B-CD1-3B

IBM 3 1/2"
295.00

B-CD1-MA

Macintosh
295.00

B-CD1P

Paper Version (16 pages, 20/pkg.)
22.00

Access:
Multi-Health Systems (MHS) Publishers
65 Overlea Blvd., Suite 218
Toronto, Ontario
M4H 1P1 Canada
(800) 456-3003
or
908 Niagara Falls Blvd.
North Tonawanda, NY 14120-2060

The Structured Clinical Interview for Diagnosis (SCID) (Spitzer et al., 1990), and The Revised Diagnostic Interview for Children and Adults (DICA-R) (Reich et al., 1990). These two psychiatric interview forms use the DSM-III-R diagnostic criteria for enabling the interviewer to either rule out or to establish a diagnosis of "drug abuse" or "drug dependence" and/or " alcohol abuse" or "alcohol dependence." The DSM-III-R criteria for substance abuse diagnoses are the same for adolescents as for adults. The SCID can be used for adolescents as well as for adults. The questions on the DICA-R are worded somewhat more appropriately for adolescents. These diagnoses can be made by the examiner asking a series of approximately 10 questions of a client. The DSM-III-R criteria for determining a diagnosis of "Psychoactive Substance Abuse" are:

  1. A maladaptive pattern of psychoactive substance use indicated by at least one of the following: 1) continued use despite knowledge of having a persistent or recurrent social, occupational, psychological, or physical problem that is caused or exacerbated by use of the psychoactive substance; 2) recurrent use in situations in which use is physically hazardous (e.g., driving while intoxicated).
  2. Some symptoms of the disturbance have persisted for a least 1 month, or have occurred repeatedly over a longer period of time.
  3. Never met the criteria for Psychoactive Substance Dependence for this substance.

The criteria required for establishing a DSM-III-R diagnosis of "dependency" are more severe than required for "abuse." Two of these criteria, for example, are: 1) "Characteristic Withdrawal Symptoms," and 2) "Marked Tolerance" (need for at least a 50% increase in the amounts of substance used to achieve intoxication or desired effect). (There are apparently no normative data available as yet, based on a general population sample, for either adolescents or adults.)

The interview time for determining the presence of a substance abuse/dependency diagnosis with the SCID is approximately 10 minutes.

The SCID only is available from:
American Psychiatric Press, Inc.
1400 K Street, N.W.,
Suite 1101
Washington, DC 20005
(800) 368-5777

A Starter Kit, Item 84S1, including a user's guide and 10 instruments, is priced at $10.

The DICA-R only is available from:
Dr. Wendy Reich
Washington University
Division of Child Psychiatry
4940 Childrens Place
St. Louis, MO 63110
(314) 454-2307

Kit is available for $50.

The SCID and the DICA-R are available from:
Multi-Health Systems (MHS) Publishers
65 Overlea Blvd., Suite 218
Toronto, Ontario
M4H 1P1 Canada
(800) 456-3003
or
908 Niagara Falls Blvd.
North Tonawanda, NY 14120-2060

MHS prices for the SCID and DICA-R are as follows:

Costs:

SCID Costs
Item No. Description Price
B-SC1P
SCID-P Starter Kit (User's Guide with 10 SCID-P forms)

$ 87.75
B-SC2P
SCID-P with Psychotic Screen Starter Kit (User's Guide with 10 SCID-P forms)


81.95
B-SC5P
SCID User's Guide

46.75
B-SC6P
SCID-P (10 forms/pkg.)

46.75
B-SC7P
SCID-P with Psychotic Screen (10 forms/pkg.)

40.95
B-DI3-5B
DICA-R IBM 5 1/4" Both Versions

825.00
B-DI3-3B
DICA-R IBM 3 1/2" Both Versions

825.00
B-DI1-5B
IBM 5 1/4" Parent Version

450.00
B-DI3-3B
IBM 3 1/2" Parent Version

450.00
B-DI2-5B
IBM 5 1/4" Child/Adolescent Version

450.00
B-DI2-3B
IBM 3 1/2" Child/Adolescent Version
450.00

The Quantitative Cocaine Inventory

The Quantitative Cocaine Inventory.

Table

The Quantitative Cocaine Inventory.

2. MEDICAL PROBLEMS AND PHYSICAL HEALTH STATUS

General Health Rating Index (GHRI) (Davis and Ware, 1981; Ware, 1984; Ware, 1976). This 23-item self-administered questionnaire measures "perceptions of past, present, and future health status, as well as worry about health and personal views regarding susceptibility to illness." This questionnaire, which requires approximately 7 minutes to complete, differs from other instruments for evaluating health status in that it does not include items on specific illnesses, diseases, symptoms, or components of health. It appears to assess the physical and social role limitations due to poor health and/or acute physical and psychiatric symptoms. This instrument was used in the Rand Health Insurance Study (HIS) on a sample of 4,444 adults and children at six sites in four States. Norms for various age groups and for the two genders are available based on the general populations of these four States, including representation from various minority ethnic groups. The curve of the GHRI score distribution is roughly symmetrical in a general population.

The GHRI has demonstrated internal consistency reliability of .89 in a general population. Empirical evidence of validity is also favorable. Test-retest reliability coefficients, based on retesting at 2- to 6-week intervals, are "somewhat lower" than the internal consistency coefficients. Construct validity was established by a factor analysis, which confirmed the basis for the six subscales. Convergent validity for various ways to use the GHRI has been established by developing significant correlations of the GHRI summary scores with 35 different measures of health status. The summary score was also shown to discriminate between those with and without a chronic disease. Administration time is 10 minutes to complete.

A copy of the GHRI form and of the norms for scoring have been available thus far for no cost.

Access:
Dr. John E. Ware, Jr.
N.E.M.C.H.
750 Washington St.
Health Institute, Box 345
Boston, MA 02111
(617) 350-8098
(617) 350-8077 Fax

3. ACADEMIC SKILLS

The Wide Range Achievement Test Revised (WRAT-R) (Jastak and Wilkinson, 1984). This is a well-standardized test that is widely used with children, adolescents, and adults for a quick evaluation of reading, spelling, and arithmetic skills and performance. Two levels of the test are available: Level 1 (ages 5-11) and Level 2 (ages 12-adult). It is a time-limited test with approximately 5 to 10 minutes allowed for each of three sections. Reliability coefficients range from .90 to .97 for various ages. Validity is well related to external criteria, such as some longer tests of reading, spelling, and arithmetic skills. Norms based on a national, stratified sample (including varied ethnic and racial groups) are available for raw scores, grade equivalents, standard scores, and percentile ranks. The test is hand scorable.

Costs:

WRAT-R Costs
Description Price

Manual (Admin. & Scoring)
$25.00

Level 1 Test Forms (pkg. of 25)
15.00

Level 2 Test Forms (pkg. of 25)
15.00

Reading/Spelling Plastic Cards
10.00

Reading/Spelling Tape Cassette
25.00

Access:
Sarah Jastak, Ph.D.
Jastak Assessment Systems
P.O. Box 3410
Wilmington, DE 19804
(302) 652-4990

A revised edition of the WRAT-WRAT3- was released in September 1993. The WRAT3 features a new national stratified sample, new grade ratings, scaling and item analysis by the Rasch Method, and new test forms. Prices are as follows:

WRAT3 Costs
Item No. Description Price
R9SS
WRAT3 Starter Set (R91, R92B, R92T, R93, R95 & WR1)
$95.00
R91
Manual for Administration & Scoring
30.00
R92B
Blue Test Forms (25)
20.00
R92T
Tan Test Forms (25)
20.00
R93
Profile/Analysis Form (25)
10.00
R95
Plastic Cards for Reading Spelling
10.00
WR1
Wide Range Soft Attache Case
20.00

4. EMPLOYMENT

Index of Job Satisfaction (Brayfield and Rothe, 1951). This instrument provides a measure of how much the individual is pleased with the work in which he/she is currently employed. It is a brief test of 18 statements to which the individual responds on a 5-point scale ranging between "strongly agree" and "strongly disagree." Results with this instrument have been found to be reliable, (split half correlation of .87) as well as valid (correlation of .92 with the Hoppock Job Satisfaction scale). The scale also distinguishes between individuals placed on jobs appropriate to their training and interests from those in occupations not in line with their expressed interests. The time required to administer is 5-10 minutes.

Cost: Not available.

Access: Brayfield, A.H., and Rothe, H.F. (1951). Journal of Applied Psychology, 35, pp.307-311. Miller, D.C. (1991). Handbook of Research Design and Social Measurement, (5th ed.), Newbury Park, CA: Sage Publications, pp. 466-468.

Note on assessment of employment: Possibly standardized employment instruments are appropriate for use with substance-abusing clients. This task can also be accomplished in a less formal, but systematic, fashion by asking the client to review his/her educational-vocational training and employment history. The combination of this background information, the client's current employment status, and expressed attitudes toward work should enable the counselor to judge whether there is any relationship between the substance abuse and job experiences. It may also identify employment history links with other social and emotional problems. This is relevant to the type of rehabilitation or treatment program most appropriate for the client.

5. SOCIAL LIFE STYLE AND PROBLEMS

Social Life Feelings Scales (SLFS) (Schuessler, 1982). This instrument consists of 12 relatively independent scales. Each scale consists of 5 to 14 statements in which the individual is asked whether he/she agrees or disagrees. For each scale, there are norms to judge the social life feelings of the individual. The examiner need not administer all 12 scales, but merely select those perceived as appropriate for the person being assessed.

Some of the scales that seem most useful for evaluating a drug abuser's social adjustment are Doubt About Self-Determination; Doubt About Trustworthiness of People; Job Satisfaction/Career Concerns; People Cynicism (cynical about people's motives); Feeling Demoralized/Future Outlook.

5. Social Life Style and Problems

5. Social Life Style and Problems.

Table

5. Social Life Style and Problems.

Social Intelligence Test (Moss et al., 1990). This test, intended to evaluate the subject's social perceptions and sensitivity, consists of items to which the individual is asked to express an opinion. An examiner is required for administration. Six factors are measured: 1) judgement in social situations; 2) recognition of the mental state of another person; 3) the feelings that another person is experiencing; 4) accuracy when observing human behavior; 5) memory for names and faces; 6) sense of humor. Percentile norms are provided separately for high school, college, and adult populations, by means of which a client's social perceptions and sensitivity can be evaluated.

Administration time is 50 minutes. A hand key is available for scoring. Pkg. of 25 is $12.00.

Access:
The Center for Psychological Service
1511 K Street, N.W., Suite 430
Washington, DC 20005
(202) 347-4069

6. FAMILY AND MARITAL RELATIONSHIPS AND PROBLEMS

The Family Environment Scale (FES) (Moos and Moos, 1981), is a "whole family" assessment, an instrument that measures the family environment or climate. This 90-item questionnaire includes 10 subscales, each composed of nine items, and these subscales compose three primary domains: 1) personal growth (independence, achievement orientation, intellectual-cultural orientation, active recreational orientation, moral-religious emphasis); 2) family interaction and relationships (cohesion, expressiveness, conflict); 3) system; maintenance dimensions (organization, control).

Three different test booklets are available: 1) the Real Form, which measures an individual's perception of the family as it is; 2) the Ideal Form, which asks the individual how the family should be; and 3) the Expected Form, which asks the individual to predict family behavior in new situations. Administrative time of the test ranges from 15-20 minutes.

Norms are available, based on 285 families of various sizes, and including adequate numbers of African-American and Mexican-American families, but low SES families are underrepresented in this original normative sample. As reported by Moos (1990), "...the FES subscales generally show adequate internal consistency, reliability, and stability over time when applied in samples that are diverse; the items also have good content and face validity. An extensive body of research supports the construct, concurrent, and predictive validity of the FES." The internal consistency reliability coefficients, based on 814 subjects, are acceptable, ranging from .64 to .79 for the 10 subscales. The test-retest reliability coefficients, based on 47 subjects, with an 8-week interval between testings, are acceptable, ranging from .73 to .86 for the 10 subscales. Discriminant validity was established by the fact that the inter-correlations between the 10 subscales scores, for the 814 subjects, range from .01 to .38, and the average inter-correlation was .20.

Costs:

FES Costs
Description Price

1 pkg. of 25 Form I Test Booklets
$17.00

1 pkg. of 25 Form R Test Booklets
16.00

1 pkg. of 25 Form E Test Booklets
17.00

1 pkg. of 25 Answer Sheets
6.00

1 pkg. of 25 Profiles
5.00

Scoring Key
8.00

Manual (1986)
13.00

User's Guide
10.00

Access:
Consulting Psychologist's Press, Inc.
P.O. Box 10096, 3803 E Bayshore Road
Palo Alto, CA 94303
(415) 969-8901

The Family Assessment Measure (FAM-III) (Skinner et al., 1983), which was developed to provide quantitative indices of family strengths and weaknesses, is a 134-item self-report instrument that can be completed by a parent and child with adequate reading ability in approximately 45 minutes. The most recent version, FAM-III, consists of three scales, each of which provides a different perspective on the family: 1) a 50-item "General Scale" examines overall family health; 2) a 42-item "Dyadic Relationships Scale" measures how each family member views independently the dyadic relationships of each family dyad; and 3) a "Self-Scale" (42 items), which reports the family member's perception of his/her functioning in the family. FAM-III also has seven subscales to assess dimensions of family functioning and status: Task Accomplishment; Role Performance; Communication; Affective Expression; Involvement; Control; and Values and Norms (which include specific cultural influences and values handed down from earlier generations).

The FAM-III also includes subscales that measure the response biases ("Denial/Defensiveness") of the individual family member completing the form "Social Desirability."

Norms based on 247 normal adults and 65 normal adolescents, as well as on clinical families, are available by writing to Dr. Harvey Skinner (see address below).

The statistical analyses to determine reliability and validity involved 475 families (933 adults and 502 children). Internal consistency reliability coefficients were very adequate: General Scale (.93), Dyadic Scale (.95), and Self-Rating Scale (.89). Intercorrelations between the content subscales were moderately high (.55 to .79) suggesting "that a general factor of family health or pathology underlies the content subscales" (Skinner, 1978).

Discriminant validity was supported by the power of FAM-III to differentiate 133 "problem families" (defined as having one or more members receiving professional help for psychiatric, emotional, alcohol, drug, or school problems) from 342 nonproblem families. The problem families reported more dysfunction, to a significant degree, in the areas of Role Performance and Involvement (interest in each other). Only a moderate level of agreement between spouses was found in the rating of family functioning: 1) a median correlation of .36 for the profiles of the subscale scores of 74 normal couples, and 2) a median correlation of .51 for the profiles of the subscale scores of 43 clinical couples. Reliability, as measured by internal consistency estimates, is reported to be excellent. Studies on its validity are incomplete. Only the Role Performance and Involvement dimensions have been shown thus far to differentiate problem families from nonproblem families.

Inquiries:
Harvey A. Skinner
Addiction Research Foundation
33 Russell St.
Toronto, Ontario, Canada M5S-251
(416) 595-6000

Access:
Multi-Health Systems (MHS) Publishers
65 Overlea Blvd., Suite 218
Toronto, Ontario
M4H-1P1 Canada
(800) 456-3003

or

908 Niagara Falls Blvd.
North Tonawanda, NY 14120-2060

Costs:

FAM-III COSTS
Item No. Description Price
B-FA1P
FAM-III Starter Kit (includes 10 of each test booklet, 50 General Scale answer sheets, 75 Dyadic Relationship Scale answer sheets, 50 Self-Rating Scale answer sheets, 25 General Scale Profile sheets, 50 Dyadic Relationship/Self-Rating Scale Profile sheets, 1 Administration & Interpretation Guide)
$95.00
B-FA4P
FAM-III General Scale Test Booklets - reusable (10/pkg.)
7.00
B-FA5P
FAM-III Dyadic Relationship Test Booklets - reusable (10/pkg.)
7.00
B-FA6P
FAM-III Self-Rating Scale Test Booklets - reusable (10/pkg.)
7.00
B-FA7P
FAM-III General Scale Answer Sheets (25/pkg.)
10.00
B-FA8P
FAM-III Dyadic Relationship Scale Answer Sheets (25/pkg.)
10.00
B-FA9P
FAM-III Self-Rating Scale Answer Sheets (25/pkg.)
10.00
B-FA10P
FAM-III General Scale Profile Sheets (25/pkg.)
4.00
B-FA11P
FAM-III Dyadic Relationship/Self-Rating Scale Profile Sheets (25/pkg.)
4.00
B-FA3P
FAM-III Administration & Interpretation Guide
10.00
B-FA2P
FAM-III Specimen Set (includes 1 of each test booklet, 5 General Scale answer sheets, 10 Dyadic Relationship Scale answer sheets, 5 Self-Rating Scale answer sheets, 2 General Scale Profile sheets, 5 Dyadic Relationship/Self-Rating Scale Profile sheets, 1 Administration & Interpretation Guide)
20.00

Family Satisfaction Scale (Olson et al., 1982). This brief instrument consists of 14 items, each of which is a 5-point rating scale measuring the degree of satisfaction to 14 different aspects of family life. The theoretical model on which this instrument was constructed results in two underlying factors: family cohesion and family adaptability. The focus of the items is on the subject's degree of satisfaction with the amount of the cohesion dimension and the amount of adaptability dimension perceived in the family.

The norms for this scale were derived from the scores obtained in it by 412 adolescents who participated in a national survey of families that were "primarily Caucasian and Lutheran." The standardization sample was 433 university students. Cronbach Alpha coefficients of reliability of .82 and .86 were obtained for the cohesion and adaptability subscale, respectively. The total scale yielded a Cronbach Alpha of .90.

Access:
See Family Inventories Project (FIP) Price Schedule, below.

The Family Crisis-Oriented Personal Evaluation Scales (F-COPES) (McCubbin et al., 1982) is a brief 29-item, 5 subscales inventory that measures two types of family coping mechanisms: internal ("the ways in which the family handles difficulties and problems that arise between family members"); and external ("the ways in which the family handles problems and demands which come from the social environment"). The five subscales are: Acquiring Social Support; Reframing (defined as "...the family's capability to redefine stressful events in order to make them more manageable"); Seeking Spiritual Support; Mobilizing the Family to Acquire and Accept Help; and Passive Appraisal. These five scales were derived by a factor analysis of the 49 items of a pilot instrument.

The prefix for all items is, "When we face problems or difficulties in our family, we respond by [-item-]." The F-COPES can be readily completed by most subjects over 12 years of age. Norms are available separately for males and females, and for adolescents and adults. A normative sample (N = 2.692), consisting of 1,140 couples and 412 adolescents, was derived from 31 States. This sample was predominantly Lutheran and Caucasian.

Cronbach's Alpha coefficients of reliability ranged from .63 for the Passive Appraisal scale to .83 for the Acquiring Social Support scale, (based on a sample of 2,582 subjects). The test-retest (over a 4- to 5-week period) reliability coefficients ranged from .61 for the Reframing scale to .95 for the Seeking Spiritual Support scale.

The administration time is 1520 minutes to complete. A manual entitled Family Inventories: Inventories Used in a National Survey of Families Across the Family Life Cycle is available (see FIP Price Schedule, on the next page). The forms required for administering the F-COPES (as well as the ENRICH and the Parent-Adolescent Communicating instruments) are presented in the NIDA manual and may be photocopied with the permission of Dr. Olson.

The Enrich Inventory (Fournier et al., 1983). This 125-item instrument to which the individual responds on a 5-point scale ranging between "strongly disagree" and "strongly agree," probes various aspects of a couple's relationship, such as communication, satisfaction with the relationship, roles, leisure activities and interests, financial management, and personality issues. There are 10 items to measure each of 11 content categories: Idealistic Distortion; Marital Satisfaction; Personality Issues; Communication; Conflict Resolution; Financial Management; Leisure Activities; Sexual Relationship; Children and Marriage; Family and Friends; Equalitarian Roles; and Religious Orientation. Also included are 15 items on "Idealistic Distortion," a revision of the Edmond's Social Desirability Scale. The manual presents the definitions and concepts for each of the 11 content categories, and clarifies the meaning of the individual scores.

Separate norms for males and females are available for ENRICH, based on 672 couples (1,344 individuals), referred from Lutheran churches in Minnesota. Test-retest reliability coefficients, which are adequate, range between .77 and .92. It is reported (Fournier et al., 1983) that validity was demonstrated by findings. Significant correlations have been found between ENRICH scores and scores of previously established marital satisfaction tests such as the Locke-Wallace Marital Adjustment Scale. The administration time is 30-45 minutes.

Dyadic Adjustment Scale (DAS) for marital and couple adjustment (Spanier, 1976). The DAS consists of 37 statements to which the individual responds. Some of the scales have five points, others have six points, and a few have seven points. Each item deals with the quality of how members of a couple relate to each other; they deal with such factors as agreement, affection, dyadic satisfaction, and cohesion. The instrument was carefully developed and has been widely used both for research and in clinical practice. Reliability coefficients for internal consistency range between .76 and .96, which are quite favorable. The scales validly discriminate between married and divorced samples, as well as between distressed and non-distressed groups of individuals. Construct validity is reported as .86 and .88, which is unusually high.

The Dyadic Adjustment Scale is a self-report measure of relationship adjustment. A comprehensive manual describes the development and clinical uses of this scale. Extensive research with over 1,000 published studies has supported the use of this measure in determining the degree of relationship dissatisfaction couples are experiencing.

A total score below 100 points is indicative of a relationship distress. Four factored subscales are scored that include: Dyadic Satisfaction; Dyadic Cohesion; Dyadic Consensus; Affectional Expression.

The DAS can be administered using either QuikScoreTM profile forms or directly on the computer. Brief interpretive statements are also output from the computer version. Each person's responses can be saved for future reference or research purposes. The computer program allows for 50 administrations.

Access:
Multi-Health Systems, Inc.
65 Overlea Blvd., Suite 218
Toronto, Ontario, M4H 1P1, Canada
(800) 456-3003
or
908 Niagara Falls Blvd.
North Tonawanda, NY 14120-2060

Costs:

Family Inventories Project (FIP) Price Schedule
Price Include Manuals and Scales
I. Family Inventories Manual (10 inventories)
  1. FACES II
  2. Family Satisfaction
  3. Parent-Adolescent Communication
  4. ENRICH
    1. Marital Satisfaction
    2. Marital Communication
    3. Marital Conflict Resolution
  1. Family Strengths
  2. Quality of Life
  3. FILE
  4. A-FILE
  5. F-COPES
$65.00

II. Individual Family Inventories
FACES II (For Research Projects)
FACES III (For Clinical Work)
Family Satisfaction
ENRICH Couple Research Scales (Satisfaction, Communication, Conflict Resolution)
Parent-Adolescent Communication
CRS-Clinical Rating Scale


30.00
30.00
10.00

10.00
10.00
5.00
III. Marital Scales
PAIR (For Research Projects)
ENRICH (For Clinical Work) - Please contact:
Dr. David H. Olson
PREPARE/ENRICH, Inc.
P.O. Box 190
Minneapolis, MN 55440
(612) 331-1731

30.00
Mailing cost for materials:
All orders must be prepaid by check or purchase order.
Make checks payable to: University of Minnesota

U.S.
International
U.S. Express

5.00
10.00
15.00

Order from:
Family Inventories Project
Family Social Science
University of Minnesota
290 McNeal Hall
St. Paul, MN 55108


(612) 625-7250
(612) 625-4227 Fax

Costs for Dyadic Adjustment Scale:

DAS Costs
Item No. Description Price
B-DA1P
DAS Complete Kit (includes Manual and 20 QuikScoreTM forms)
$40.00
B-DA2P
DAS QuikScoreTM Forms (hand-scorable) (20 forms - 10 couples/pkg.)
25.00
B-DA3P
Dyadic Adjustment Scale Manual
19.00
B-DA1-5B
IBM 5 1/4" (50 uses)
125.00
B-DA1-3B
IBM 3 1/2" (50 uses)
125.00
B-DA1-AP
Apple II
125.00

7. PSYCHOLOGICAL/PSYCHIATRIC PROBLEMS (MENTAL HEALTH STATUS; DIAGNOSIS)

Symptom Check List (SCL-90) (Derogatis et al., 1976). The SCL-90-R is designed to measure nine psychopathology dimensions. These are: depression, anxiety, somatization, obsessive-compulsive, and paranoid ideation. It also provides three global indices. It is a 90-item self-report symptom inventory that requires the patient to respond to each item in terms of a 5-point scale of distress, from "not-at-all" to "extremely." It requires 20 minutes for patient completion, plus 2-5 minutes of administrative introduction. A factor analytic study has confirmed the clinical dimensions reported (Derogatis and Cleary, 1977). Validity studies have been conducted (Derogatis et al., 1976; Boleloucky and Horvath, 1974), and high levels of both internal consistency and test-retest reliability reported (Derogatis, 1977; Edwards et al., 1978).

Symptom Check List (SCL-90)

Symptom Check List (SCL-90).

Table

Symptom Check List (SCL-90).

DSM-III-R Diagnosis of "Antisocial Personality Disorder." The criteria required for establishing a lifetime diagnosis of Antisocial Personality Disorder in an adolescent or adult at least 18 years of age are: 1) evidence of Conduct Disorder with onset before age 15, and 2) a pattern of irresponsible and antisocial behavior since age of 15, as indicated by at least 4 of 10 possible types of behavior (e.g., (a) "repeatedly destroying property, harassing others, stealing, pursuing an illegal occupation, whether arrested or not"; or (b) "lacks remorse, feels justified in having hurt, mistreated, or stolen from another").

The sources for the DICA-R and SCID instruments are listed above (see A. Substance Use/Abuse Assessment).

The Maudsley Neuroticism Scale of the Maudsley Personality Inventory (MPI) (Eysenck, 1959) is one of the most extensively used and researched personality assessment instruments available. However, a limitation of this Neuroticism scale is that it is suitable only for the assessment of milder forms of psychopathology, and not suitable for assessment of major affective or psychotic disorders. Although it is brief, requiring 10 to 15 minutes to administer, the Maudsley is sufficiently reliable for individual use. The value of the MPI is derived in part from the years of intensive research and theory building on the dimensions of personality. Two relatively independent "Super Factors," "extroversion-introversion" and "neuroticism," were found to account for a large part of the variance in "personality." The Neuroticism scale is the one more specifically recommended for assessment of drug abuse clients.

Normative data for the MPI are available for several different types of populations, including: 1) 714 male and 350 female American "normals" (college students); 2) 1,931 British male and female employees (primarily blue-collar workers); 3) 468 male and female psychiatric patients, as well as for a population of criminals. (The other demographic characteristics of these normative samples have not been provided.) Although there are no norms available specifically for adolescent subjects, the items of the inventory are appropriate for adolescents.

Socioeconomic level was found to have a negligible relationship to the neuroticism scores. Split-half and Kuder Richardson reliability coefficients were derived for numerous samples for the Neuroticism scale, and were found to range from .75 to .87, and from .85 to .90, respectively. Test-retest reliabilities were reported at .83 and .81. Convergent or concurrent validity of the Neuroticism scale was established by studies; each showed high correlations > .01) with other scales purported to measure neuroticism; for example, a correlation of .76 was found for a sample of 254 college students with the scores of the Taylor Manifest Anxiety Scale, and the following significant correlations: 1) .42, with Cattell's Neuroticism (NSQ) factor scale; and 2) .70 with Cattell's Anxiety (SAF) factor scale.

Costs:

MNS Costs
Description Price

Pkg. of 100 Forms
$27.25

Manual
2.90

Set of Hand-Scoring Keys
7.00

Access:
EDITS: Educational and Industrial Testing Service
Box 7234
San Diego, CA 92107
H.J. Eysenck, The Maudsley Personality Inventory, London: University of London Press, 1959.

Beck Depression Inventory (BDI) (Beck and Ward, 1972). This instrument is widely used for assessing the degree of depression of psychiatric patients, and the possible existence of depression in other populations. Depression symptoms are very common in alcohol and drug abuse patients. The BDI is sensitive to measuring change in these patients as they respond to treatment. The instrument is quite brief, consisting of 21 multiple choice items. For each item, the respondents indicate which of four multiple-choice statements best indicate how they have been feeling over the past week.

The BDI was originally standardized on 598 psychiatric patients, but has since been applied to other populations. An internal consistency coefficient of .95 was found with a sample of 101 male alcoholics. A 1-month test-retest reliability coefficient of .82 was reported for a group of 27 alcoholics. A split-half reliability correlation of .86 was also reported. Concurrent validity correlations ranging between .55 and .196 have been reported between BDI scores and independent clinical judgments (Beck et al., 1988).

The test is self-administered or it can be read to the patient. The administration time is approximately 10 minutes.

Costs:

BDI Costs

Description
Price

Kit, including instruction manual and 25 record forms
$43.00

Access:
The Psychological Corporation
555 Academic Court
San Antonio, TX 78204-2498
(800) 228-0752

IPAT Depression Scale (Krug and Laughlin, 1976). This is a brief, 40-item questionnaire that requires about 10 minutes to administer and is quite easy to score. It is standardized on over 1,000 individually diagnosed patients and on 1,900 non-patients. It is intended for adults of most educational levels. Satisfactory internal consistency reliability of .93, and validity that distinguished effectively between relevant groups, are reported. Also reported was a correlation of .32 with the MMPI Depression Scale, which is not so encouraging.

Costs:

IPAT Costs
Description Price

Depression Scale Testing Kit (contains manual, test booklet, and scoring key)
$12.95

Depression Scale Manual
9.75

Test Booklets, pkg./25
8.80

Scoring Key
3.45

Access:
IPAT
1801 Woodfield Drive
Savoy, IL 61874
(217) 352-4739

The Structured Clinical Interview for DSM-III-R (SCID) (Spitzer et al., 1990). This is a semi-structured interview designed specifically to determine the diagnoses of all of the 50 major DSM-III-R psychiatric diagnoses in Axis I, and the 12 types of personality disorder in Axis II. Axis I includes the substance abuse/dependence disorders. The DSM-III-R criteria for each disorder are presented alongside the interview questions. A User's Guide includes illustrative case vignettes to demonstrate how the SCID can be used. Although inter-rater reliabilities are in the process of being established, research with the SCID at the Center for Cognitive Therapy at the University of Pennsylvania Medical School (Luborsky, L., personal communication, 1991) indicates that satisfactory levels of inter-rater agreement can be achieved (Riskind et al., 1987). The SCID takes approximately 75 minutes to administer by a trained interviewer. A training program, which is several days in duration, is required for someone with clinical experience, preferably a psychiatrist, psychologist, or psychiatric social worker.

Costs:

SCID DSM-III-R Costs
Description Price

User's Guide with 10 SCID "full patient" forms
$75.00

10 SCID-II forms (Personality Disorders)
19.95

Access:
The American Psychiatric Press, Inc.
1400 K Street, N.W., Suite 1101
Washington, DC 20005
(202) 682-6262
(800) 368-5777

The Mini-SCID (Spitzer et al., 1992) is a computerized, shortened version of the SCID, for a quick method of screening for many of the major adult Axis I psychiatric disorders, such as mood disorders and anxiety disorders, in addition to substance use disorders. The Mini-SCID can be completed by the client in 25 minutes, after a brief tutorial introduces the client to the keyboard, and allows a choice between responding by using simple highlighted menu bars, or by pressing the letter to indicate choice of response.

The Mini-SCID provides three different report options: complete summary of patient responses; concise summary of possible diagnoses that you should consider; and an expanded version of the concise summary that includes additional diagnostic tips, which are your "next steps" in the diagnostic process.

Costs:

MINI-SCID Costs

Description
Price

IBM 5 1/4" or 3 1/2"
$295.00

Access:
Multi-Health System, Inc.
65 Overlea Blvd., Suite 218
Toronto, Ontario, M4H 1P1 Canada
(800) 456-3003
(416) 424-1736 Fax

or

908 Niagara Falls Blvd.
North Tonawanda, NY 14120-2060

8. ILLEGAL BEHAVIOR

Law Encounter Severity Scale (LESS) (Witherspoon et al., 1973). The 38-item interview aims to assess the severity of an individual's encounter with the law enforcement system. Types of criminal offenses are surveyed, along with their frequency, severity, and consequences. Results from the interview can range from no encounter with illegal behavior, to felonies that may lead to imprisonment for life. Since each point on a 5-point scale of severity of illegal behavior is clearly defined in detail, the severity of each offense can be scored. The normative data were based on the post-release illegal behavior of 142 male felons in Alabama. Three judges independently ranked the illegal and law encounter behavior for severity of the type of offense, based on a 5-point scale of severity, and agreed in 90 percent of the cases. (The demographic characteristics of the normative sample are not reported.)

The time required to administer is 20 minutes.

Costs:

LESS

Description
Price

Instruction manual and 25 test forms
$25.00

Access:
John McKee
The Behavior Science Press
3710 Resource Drive
Tuscaloosa, AL 35401
(205) 758-2885

SUPPLEMENT FOR ASSESSING COCAINE-CRACK USE AND RELATED BEHAVIORS (Cocaine Use and Craving Scales)

Some of the assessment instruments recommended here, such as the Addiction Severity Index (ASI), were developed before the advent of the cocaine epidemic of recent years, and thus do not collect sufficient information regarding cocaine use. For example, they do not distinguish between smoking "crack," freebasing, IV use, and snorting cocaine. These methods of use have various serious consequences. Accordingly, the administration of a brief supplementary instrument is recommended for this specific purpose. Measures of cocaine use and cocaine craving have been developed by Gawin and Kleber (1984). These measures were more recently adapted by Carroll and associates (1991).

The cocaine use instrument provides questions regarding the amount, method, and frequency of the patient's cocaine use throughout his/her cocaine-using career. For example, for 1 month ago, 3 months ago, and 6 months ago, the patient is asked how many grams of cocaine were used per week, the number of days used per week, and the usual method of administration. This instrument also includes questions regarding the areas of the patient's life being disturbed by cocaine use.

The cocaine craving scale is a brief, 64-item self-report form that assesses the intensity of the patient's current desire for cocaine on a 20-point scale ranging form "0" = "none at all" to "20 = "more than ever." The quality of the cocaine high experienced by the patient and the amount of control over his or her urge for cocaine are also assessed.

The articles by Carroll and associates (1991) and Gawin and Kleber (1984) may facilitate the effort to obtain copies of the two brief instruments.

SUPPLEMENT FOR ASSESSING AIDS RISK BEHAVIOR

The instruments recommended here, other than the DATOS and DATAR instruments, do not include an assessment of AIDS risk behavior. Since applicants for drug abuse treatment who are IV users of drugs or who engage in certain types of sexual behavior are particularly at risk for the HIV infection, and subsequently for AIDS, administration of an AIDS Risk Behavior questionnaire is recommended as a supplement to one of the comprehensive drug-problem screening instruments.

It is therefore recommended that those programs that do not plan to use the DATOS or DATAR instruments as their comprehensive intake screening procedure should use the "AIDS Risk Behavior" section of the DATOS Pre-treatment Interview Form, or the "AIDS Risk Assessment" section of the DATAR, as a supplement to whatever comprehensive instrument they elect to use. This section of the DATOS includes 17 questions (items) for male clients and 13 questions (items) for female clients. The DATAR section includes a total of 41 items. The information required for gaining access to these two instruments can be found in the earlier section of this brochure, which describes the whole DATOS instrument.

For those clients for whom it appears, based on this brief survey of their risk behavior, that they may in fact be at risk for HIV infection, it is further recommended that a more thorough study of their risk behavior be conducted. The instrument that has been developed by NIDA for this later purpose for the National AIDS Research Project, is the Risk Behavior Assessment Questionnaire (RBA). The RBA sections are "Sexual Activity," "Sex for Money/Drugs," "Sex-Related Diseases," "Health Status," and "IV and Needle Use Behavior."

Access:
NIDA
Community Research Branch
5600 Fishers Lane
Rockville, MD 20857
(301) 443-6720

Endnote

References

  1. Beck, A.T., Steer, R.A., Garbin, M.G. (1988). Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clinical Psychology Review .
  2. Boleloucky, A., and Horvath, M. (1974). SCL-90 rating scale: first experience with the Czech version in health male scientific workers. Archives of Nerv. Sup., . [PubMed: 4416042]
  3. Brodman, K., Erdman, A., Lorge, I., and Wolff, H. (1949). The Cornell Medical Index: an adjunct to medical interview. Journal of American Medical Association .
  4. Carroll, K.M., Rounsaville, M.D., and Gawin, F.H. (1991). A comparative trial of psychotherapies for ambulatory cocaine abusers: relapse prevention and interpersonal psychotherapy. American Journal of Drug and Alcohol Abuse . [PubMed: 1928019]
  5. Derogatis, L.R. (1977) SCL-90 Administration: Scoring and Procedures Manual. .
  6. Derogatis, L.R., and Cleary, P. (1977). Confirmation of the dimensional structure of the SCL-90: a study in construct validation. Journal of Clinical Psychology, .
  7. Fournier, D.G., Olson, D.H., and Druckman, J.M. (1983) Assessing marital and premarital relationships: the PREPARE-ENRICH Inventories. In E.F. Filsinger (Ed.) Marital and Family Assessment. .
  8. Gawin, F.H., and Kleber, H.D. (1984). Cocaine abuse treatment. Archives of General Psychiatry, . [PubMed: 6431939]
  9. Krug, S.E., and Laughlin, J.E. (1976) IPAT Depression Scale. .
  10. Manson, M.P., and Huba, G.J. (1987) The Manson Evaluation Manual .
  11. McCubbin, H., Larson, A., and Olsen, D.H. (1982) (F-Copes) Family coping strategies. In D.H. Olsen, H.I. McCubbin, H. Barnes, A. Larson, M. Muxen, and M. Wilson (eds.) Family Inventories: Inventories Used in a National Survey of Families Across the Family Life Cycle .
  12. Moore, R.A. (1972). The diagnosis of alcoholism in a psychiatric hospital: a trial of the Alcohol Screening Test (MAST) American Journal of Psychiatry . [PubMed: 5025276]
  13. Moss, F.A., Hung, T., and Omwake, K. (1990). Social Intelligence Test. Montreal: Institute of Psychological Research, Inc.
  14. Reich, W., Welner, Z., Taibleson, C., and Kram, L. (1990) The DICA-R Training Manual. St. Louis, MO: Washington University School of Medicine.
  15. Ridley, T.D., and Kordinak, S.T. (1988). Reliability and validity of the Quantitative Inventory of Alcohol Disorders (QIAD) and the veracity of self-report by alcoholics. American Journal of Drug and Alcohol Abuse, . 14(2), pp.263-292 [PubMed: 3177342]
  16. Selzer, M.L. (1971). The Michigan Alcoholism Screening Test: the quest for a new diagnostic instrument. American Journal of Psychiatry , 127(12), pp. 1653-1658 [PubMed: 5565851]
  17. Spitzer, R.L., Williams, J.B., Gibbon, M., and First, M.B. (1992). Structured Clinical Interview for DSM-III-R: The Mini-SCID. Washington, D.C.: The American Psychiatric Press.
  18. Ware, J. (1984). General Health Rating Index. In Wenger, N.K., Mattson, M.E., Furberg, D.C., & Elinson, J. (eds.), Assessment of Quality of Life in Clinical Trials of Cardiovascular Disease. New York: Le Jacq Publishing, Inc., pp.184-188.
  19. Ware, J.E., Jr. (1976). Scales for measuring general health perceptions. Health Services Research, . 11(4), pp. 396-415 [PMC free article: PMC1071941] [PubMed: 1030696]
  20. Witherspoon, A.D., deValera, E.K., and Jenkins, W.O. (1973). The Law Encounter Severity Scale (LESS): A criterion for criminal behavior and recidivism. Rehabilitation Research Foundation, Grant No. 21-01-73-38, Manpower Administration. Tuscaloosa, AL: Behavior Science Press.
  21. Zung, B.J. (1982). Evaluation of the Michigan Alcoholism Screening Test (MAST) in assessing lifetime and recent problems. Journal of Clinical Psychology, . 38, pp. 425-439 [PubMed: 7068887]

Footnotes

1

This appendix is a revision and update of Assessment Instruments for Drug Abusing Adolescents and Adults, published by the National Institute on Drug Abuse. The original NIDA manual is available through the National Clearinghouse for Alcohol and Drugs Information (NCADI) (800) 729-6686.

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