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

Lee C.-T.; Lin C.-Y.; Koós M.; Nagy L.; Kraus S.W.; Demetrovics Z.; Potenza M.N.; Ballester-Arnal R.; Batthyány D.; Bergeron S.; Billieux J.; Burkauskas J.; Cárdenas-López G.; Carvalho J.; Castro-Calvo J.; Chen L.; Ciocca G.; Corazza O.; Csako R.I.; Fernandez D.P.; Fernandez E.F.; Fujiwara H.; Fuss J.; Gabrhelík R.; Gewirtz-Meydan A.; Gjoneska B.; Gola M.; Grubbs J.B.; Hashim H.T.; Islam M.S.; Ismail M.; Jiménez-Martínez M.; Jurin T.; Kalina O.; Klein V.; Költő A.; Lee S.-K.; Lewczuk K.; Lochner C.; López-Alvarado S.; Lukavská K.; Mayta-Tristán P.; Milea I.; Miller D.J.; Orosová O.; Orosz G.; Ponce F.P.; Quintana G.R.; Garzola G.C.Q.; Ramos-Diaz J.; Rigaud K.; Rousseau A.; Scanavino M.D.T.; Schulmeyer M.K.; Sharan P.; Shibata M.; Shoib S.; Sigre-Leirós V.; Sniewski L.; Spasovski O.; Steibliene V.; Stein D.J.; Strizek J.; Ünsal B.C.; Vaillancourt-Morel M.-P.; Van Hout M.C.; Bőthe B. · Journal of Psychiatric Research (2023) · DOI: 10.1016/j.jpsychires.2023.06.033

Resumen

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.

Instituciones: Universidad Científica del Sur; Universidad Privada del Norte