The Addiction Severity Index (ASI)

A psychological assessment is defined as “the gathering and integration of psychology-related data for the purpose of making a psychological evaluation that is accomplished through the use of tools such as tests, interviews, case studies, behavioral observation, and specially designed apparatuses and measurement procedures” (Cohen, Swerdlik, &Sturman, 2013). Although examiners strive toward the assessment being good enough to be useful, they sometimes have to make decisions about what type of error is acceptable. There are many psychological assessments that have been used in the study of addictions, but we will take a look at the Addiction Severity Index.

The Addiction Severity Index (ASI) is a clinical and research instrument given structured

in the form of an interview that measures problem severity before and after treatment (Haraguchi et al., 2009). For purposes of this study, we will be discussing the ASI Japan Version also known as the ASI-J which, like all Addiction Severity Index’s, measures the severity of several problems including severity of drug dependence and experiences of child abuse (Ogai et al., 2015). The ASI-J measures severities in seven functional areas in people with substance abuse disorders which include all of the following: medical, employment and/or support, alcohol use, drug use, legal, family and social relationships, and psychiatrics (Haraguchi et al., 2009). The interview takes a look at problems that participants have experienced within the last 30 days in each of the seven areas and throughout their lifetime; it also looks at how much they have been bothered by these problems and how important it is for treatment for the problem (Ogai et al., 2015).
To rate the severity of problems, the ASI provides two types of scores: the composite score (CS) and the severity rating (SR) (Haraguchi et al., 2009).

The composite score is objective and calculated through a weighted formula designed to provide an equal contribution from each item while the severity rating is subjective and indicates the need for additional treatment in specific areas (Haraguchi et al., 2009). The SR ranges from 0 to 9 points and the CS ranges from 0 to 1 with anything higher than the normal 9 SR or 1 CS indicating greater problem severities (Haraguchi et al., 2009). Although some problems still exist, the ASI has been reported to have nearly achieved both reliability and validity (Haraguchi et al.,

2009).
When examining the results of psychological assessments, examiners must take many factors into consideration to determine the predictive validity and reliability of the test which means they must make decisions about what type of error is acceptable. In determining this predictive validity, examiners must look at hit rates. Hit rates are the proportion of people accurately identified by the test as exhibiting a particular trait (Cohen, Swerdlik, &Sturman, 2013). When using the ASI-J, the hits would be those substance abuse users who are correctly classified as having severities. Miss rates are the proportion of people who are incorrectly classified as having, or not having, a particular characteristic (Cohen, Swerdlik, &Sturman, 2013). In the ASI-J, the misses would be those substance abuse users who the assessment failed to identify as having or not having severities.
Miss rates may be subdivided into two categories: false negatives and false positives. A false negative is a miss in which the test predicted the testtaker did not exhibit the particular characteristic being measured when in actuality they did (Cohen, Swerdlik, &Sturman, 2013). This would be the case if the results from the assessment of one of the substance abuse users indicate that they had no severities when in fact they did have severities in one or more of the seven functional areas. A false positive is a miss in which the test predicted the testtaker did exhibit the particular characteristic being measured when in fact they did not (Cohen, Swerdlik, &Sturman, 2013). This would be the case if the results from the assessment of one of the substance abuse users indicate that they had severities when in fact they did not have severities in any of the seven functional areas.
The ASI-J is based on self-reported information which is often not 100% truthful when dealing with substance abuse users because they tend to report what they think the examiner wants to hear, and hide those facts that could potentially validate their usage.

Because of this misinformation, the examiner can take all the necessary precautions, yet still end up with errors beyond their control. I do think the fact that the ASI-J is given pre and post treatment can help to validate some of the information that the substance abuse users may have falsified in the beginning when they were under the influence of drugs and/or alcohol. Once the information from the pre and post tests are compared, it will allow the examiner to better determine hits, misses, false positives, and false negatives. Information gathered from results of the ASI-J is often used as prediction tools in treatment responses and outcomes and relapses; therefore, testing errors can lead to inaccurate prediction results which could lead to false positives and negatives. The ASI-J has also been proven useful as a comparison tool in clarifying similarities and differences between substance abuse users, so valid and reliable results are important (Haraguchi et al.,

2009).
In psychological assessments, the decision of what is acceptable and unacceptable is the decision of the examiner, which means that because of the different conditions of criteria in assessments there will be a great variance by examiner as to what is acceptable and what is unacceptable (Cohen, Swerdlik, &Sturman, 2013). When administering the assessment, it is important that examiners fully understand all parts of the assessment, rules/regulations, and be able to help the testtaker with anything they may misunderstand to help avoid errors in testing. Examiners must know which errors are acceptable and unacceptable when interpreting the results of the assessments because it can cause the test to be invalid and unreliable in use. When employing psychological assessments, it is important for examiners to be mindful and cautious of the criteria they select as it will help determine the number or ratio of true and false negatives and positives in the results.