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Teen Addiction Severity Index (T-ASI)

User Information

Acronym:

T-ASI

Author/Developer / Address:

Developer: The Adolescent Drug Abuse and Psychiatric Treatment Program
Division of Child and Adolescent Psychiatry
Western Psychiatric Institute and Clinic
2811 O'Hara Street
Pittsburgh, PA 15213
Editors: Yifrah Kaminer, M.D.
Oscar Bukstein, M.D.
Ralph Tarter, Ph.D.

Publication dates:

 Not specified.

Description / Type of Assessment:

Objective face-to-face structured interview combined with opportunity for assessor to offer comments, confidence ratings (indicating whether the information may be distorted), and severity ratings (indicating how severe the assessor believes is the need for treatment or counselling).

Primary use / Purpose:

To provide basic information on an adolescent prior to entry into inpatient care for substance use-related problems.

Domains measured / Life Areas / Problems Assessed:

Chemical use
School status
Employment/support
Family relationships
Peer/social relationships
Legal status (involvement with criminal justice program)
Psychiatric status
Contact list for additional information

Population:

 Adolescents.

Administration / Completion Time:

 30 - 45 minutes for a skilled and trained technician.

Scoring Procedures:

 Not specified.

Scoring Time:

 One minute (by computer). Five minutes (by hand).

Credentials/Training:

 Assessors will require training in interviewing troubled youth with substance use problems.

Source of Psychometrics:

 Western Psychiatric Institute. See address above.

Languages:

English. Theare are several languages version including Spanish and Portuguese (including reports on the favorable psychometric properties of the T-ASI in these two languages) as well as translations into Dutch, Finnish, Italian and Hebrew. The T-ASI is currenlty also being translated into German (in Austria) and possibly Arabic (in Egypt). For specific inquiries please see the attachment "T-ASI Global" for the names of contact person in the respective countries/languages.

Availability / Inquiries:

Western Psychiatric Institute. See address above.
Yifrah Kaminer, M.D.
263 Farmington Ave.
University of Connecticut Health Center
Farmington, CT 06030-2103
(860) 679-4344. (860) 679-4077 (fax). kaminer@psych.uchc.edu or www.uchu.edu

Price:

The T-ASI is not in the public domain, however the author grants permission for its use free of charge for research and for "Non for Profit Organizations". Interested parties are asked to contact the original author when using the T-ASI.

Practicability / usefulness:

The T-ASI can be used for different purposes in assessing substance abuse adolescents: a) to assess the problem severity of the interviewee, and b) for periodic repeated administrations to monitor and quantify change in problems commonly associated to substance abuse

 

Instrument
Teen Addiction Severity Index (T-ASI)
PDF
Download this attachment in PDF format
Spanish review T-ASI
Download this attachment in PDF format
T-ASI Global
Download this attachment in PDF format
Relevant Studies
Validation of the Teen Addiction Severity Index
Kaminer, Y.; Wagner, E.; Plummer, B.; Seifer, R. Validation of the Teen Addiction Severity Index. The American Journal of the Addictions, Vol. 2, 3, 250-254. 1993.

This study was designed to determine: 1) whether the T-ASI discriminated between hospitalised psychiatric patients with and without co-morbid psychoactive substance use disorders; 2) whether T-ASI scores were related to other indices of problem behaviour; and 3) whether there was any specifity in the ratings of different domains of the T-ASI when compared with other criteria. The results of the study provide support for the good psychometric properties of the T-ASI.

The Teen-Addiction Severity Index
Kaminer, Y.; Buckstein, O.; & Tarter, R.E. The Teen-Addiction Severity Index: Rationale and Reliability. The International Journal of the Addictions, 26(2), 219-226. 1991.

This paper discusses the rationale for the design of the T-ASI and presents a preliminary study indicating satisfactory interrater reliability of the rating scale.

The T-ASI was developed to fill the need for a reliable, valid and standardized instrument for the evaluation of adolescents who abuse chemicals. It designs modifies the reliable, valid and commonly used adult psychiatric scales for the evaluation of psychiatric symptomatology in children and adolescents. The T-ASI represents a modification of the Addiction Severity Index (ASI - McLellan et al., 1980, 1985). The medical scale of the ASI was omitted and two other domains were added to the T-ASI: school status and social-peer relationships.

The purpose if this study was to analyse interrater reliability of the T-ASI among adolescents substance abusers. The sample comprises 25 consecutive admission of 13 - to 18-year-old adolescents to a substance abuse treatment program. Pearson r correlations were computed between scores of two different raters. The degree of agreement between them was very high, with the average correlation across scales being 0.78. The only scale which did not attain significance was for familiar relationships.

The authors conclude that the T-ASI may have clinical utility in treatment settings, the Family Relationships Scale needs to be refined and that further research about the T-ASI is required.

Psychotherapies for Adolescent Substance Abusers
Kaminer, Y.; Burleson, J.A.; Blitz, C.; Sussman, J.; Rounsaville, B.J. Psychotherapies for Adolescent Substance Abusers. A pilot Study. Journal of Nervous and Mental Disease, 186: 684-690. 1998.

In this study, the T-ASI was used as an evaluation instrument to monitor changes over time of severity of substance use and related problems in dually diagnosed adolescents substance abusers. Thirty-two dually diagnosed adolescents substance abusers were randomised into two 12-week manual guided outpatient group psychotherapies. The T-ASI demonstrated ability to describe changes over time in severity of substance abuse, family, school and peer relationships, legal problems and psychiatric severity. Also, the T-ASI was a useful instrument to compare outcomes achieved by the two treatment modalities.

Screening and Assessing Adolescent Substance Use Disorders in Clinical Populations

Ken C. Winters, PH.D., and Yifrah Kaminer, M.D., M.B.A. J. Am. Acad. Child Adolesc. Psychiatry, 47:7, July 2008.

When faced in a clinical setting with an adolescent suspected of or known to have a substance abuse problem, it is important to integrate the assessment process with treatment decisions. The initial phase involves efficient identification of substance use and related problems, psychiatric comorbidity, and psychosocial maladjustment. This objective can be achieved by the use of screening instruments as a brief first step for the assessment of drug use before moving, if necessary, to the second step of comprehensive assessment of problem severity once it becomes clear that the adolescent may meet criteria for a substance use disorder (SUD). The result of this assessment is a diagnostic summary that identifies the adolescent treatment needs. Finally, an integrative treatment plan is developed to target multidimensional areas of dysfunction, which includes psychiatric comorbidity, as well as potential problems in the school, family, peer, and legal domains. With 6.0% and 5.4% of youths ages 12 to 17 years clas  fied as needing treatment for alcohol use and illicit drug use, respectively, and with substance use during adolescence appearing to lead to a much greaterrate of a current SUD compared to rates if drug use occurs later in life, these are important public health issues. Reports on performance of pediatricians who customarily see youths for periodic checkups and address their medical needs have not been encouraging. Less than half of the pediatricians surveyed reported screening adolescents for use of tobacco, alcohol, and other drugs, and less than one fourth acknowledged feeling comfortable conducting a comprehensive assessment or offering or making referral for treatment. The reasons for these troubling figures have been summarized as follows: insufficient time, lack of training to manage positive screens, need to triage competing medical problems, lack of treatment resources, unfamiliarity with screening tools, and tenacious parents (who may not readily leave the room). There are no similar reports addre  ing how prepared child and adolescent psychiatrists (CAPs) are to follow the task at hand. Based on our own clinical and teaching experience, the quantity and quality of training devoted to the screening and assessment of youth substance use, abuse, and dependence in medical schools and psychiatric residency/fellowship training are often insufficient. Little, if any, training is given on how to screen and assess for substance involvement and related problems and on what tools are available to assist with this process. Therefore, the objectives of this column are, first, to introduce several established screeners and comprehensive assessments, and, second, to make recommendations as to standards of training and professional proficiency.

Page last updated: Monday, 21 September 2009