The eleven-item Alcohol, Smoking and Substance Involvement Screening Test (ASSIST-11): Cross-cultural psychometric evaluation across 42 countries

Lee, Chih-Ting;Lin, Chung-Ying;Koós, Mónika;Nagy, Léna;Kraus, Shane W.;Demetrovics, Zsolt;Potenza, Marc N.;Ballester-Arnal, Rafael;Batthyány, Dominik;Bergeron, Sophie;Billieux, Joël;Burkauskas, Julius;Cárdenas-López, Georgina;Carvalho, Joana;Castro-Calvo, Jesús;Chen, Lijun;Ciocca, Giacomo;Corazza, Ornella;Csako, Rita I.;Fernandez, David P.;Fernandez, Elaine F.;Fujiwara, Hironobu;Fuss, Johannes;Gabrhelík, Roman;Gewirtz-Meydan, Ateret;Gjoneska, Biljana;Gola, Mateusz;Grubbs, Joshua B.;Hashim, Hashim T.;Islam, Md. Saiful;Ismail, Mustafa;Jiménez-Martínez, Martha;Jurin, Tanja;Kalina, Ondrej;Klein, Verena;Költő, András;Lee, Sang-Kyu;Lewczuk, Karol;Lochner, Christine;López-Alvarado, Silvia;Lukavská, Kateřina;Mayta-Tristán, Percy;Milea, Ionut;Miller, Dan J.;Orosová, Oľga;Orosz, Gábor;Sungkyunkwan University’s Research Team, ;Ponce, Fernando P.;Quintana, Gonzalo R.;Garzola, Gabriel C.Quintero;Ramos-Diaz, Jano;Rigaud, Kévin;Rousseau, Ann;Scanavino, Marco De Tubino;Schulmeyer, Marion K.;Sharan, Pratap;Shibata, Mami;Shoib, Sheikh;Sigre-Leirós, Vera;Sniewski, Luke;Spasovski, Ognen;Steibliene, Vesta;Stein, Dan J.;Strizek, Julian;Ünsal, Berk C.;Vaillancourt-Morel, Marie-Pier;Van Hout, Marie Claire;Bőthe, Beáta

Daniel Miller

Abstract

The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is an instrument to screen substance-use-related health risks. However, little is known whether the ASSIST could be further shortened while remaining psychometrically sound across different countries, languages, gender identities, and sexual-orientation-based groups. The study aimed to validate a shortened 11-item ASSIST (ASSIST-11). Using the International Sex Survey data, 82,243 participants (M age = 32.39 years) across 42 countries and 26 languages completed questions from the ASSIST-11 regarding gender identity, sexual orientation, and other information. Confirmatory factor analysis (CFA) and multigroup CFA (MGCFA) evaluated the ASSIST-11's structure and tested measurement invariance across groups. Cronbach's α and McDonald's ω were used to examine the internal consistency. Cohen's d and independent t-tests were used to examine known-group validity. The ASSIST-11 was unidimensional across countries, languages, age groups, gender identities (i.e., men, women, and gender-diverse individuals), and sexual orientations (i.e., heterosexual and sexual minority individuals). Cronbach's α was 0.63 and McDonald's ω was 0.68 for the ASSIST-11. Known-group validity was supported by Cohen's d (range between 0.23 and 0.40) with significant differences (p-values<0.001). The ASSIST-11 is a modified instrument with a unidimensional factor structure across different languages, age groups, countries, gender identities, and sexual orientations. The low internal consistency of the ASSIST-11 might be acceptable as it assesses a broad concept (i.e., use of several different substances). Healthcare providers and researchers may use the ASSIST-11 to quickly assess substance-use information from general populations and evaluate the need to follow up with more detailed questions about substance use.

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Journal of Psychiatric Research

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165

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1879-1379

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Elsevier

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DOI

10.1016/j.jpsychires.2023.06.033