Volume_6_Issue_2_Digest

3 TPC Digest These results elicit deliberation about whether substance use disorder counselors would be better served by a SUD screening instrument that over- or under-predicts SUD diagnoses. An over-predictive instrument could waste counselors’ time by forcing them to conduct full-diagnostic interviews with clients who don’t need it, and clients might be unnecessarily inconvenienced by this process. Alternatively, counselors using a scoring method that under-predicts would have fewer clients unnecessarily inconvenienced and spend less time assessing persons who do not need SUD treatment. The unfortunate trade-off is that persons with a SUD that might benefit from assessment and treatment would otherwise be sent home without an appropriate recommendation. Counselors would benefit from a screening instrument with high sensitivity and specificity. When that goal cannot be achieved, counselors and agencies may want to consider which of these two is more important. John M. Laux is a Professor at The University of Toledo. Robin M. DuFresne is a practicing clinical counselor at the Zepf Center in Toledo, Ohio. Allison K. Arnekrans is an Assistant Professor at Central Michigan University. Sylvia Lindinger- Sternart is an Assistant Professor at the University of Great Falls. Christopher P. Roseman is an Associate Professor at The University of Toledo. Amy Wertenberger is a doctoral candidate at The University of Toledo. Stephanie Calmes is a professional counselor at Harbor Behavioral Health in Toledo, Ohio. Darren W. Love is the Treatment Program Manager at Court Diagnostic and Treatment Center in Toledo, Ohio. Andrew M. Burck is an Assistant Professor at Marshall University. Jim Schultz is a mental health counselor at Harbor Behavioral Health in Toledo, Ohio. Correspondence may be addressed to John M. Laux, MS 119, 2801 W. Bancroft St., Toledo, Ohio, 43606, John.Laux@utoledo.edu . Read full article and references: Laux, J. M., DuFresne, R. M., Arnekrans, A. K., Lindinger-Sternart, S., Roseman, C. P., Wertenberger, A., . . . Schultz, J. (2016). Assessing the accuracy of the Substance Abuse Subtle Screening Inventory-3 using DSM-5 criteria. The Professional Counselor , 6, 121–133. doi : 10.15241/jl.6.2.121 3 TPC Digest T he Substance Abuse Subtle Screening Inventory-3 (SASSI-3; Miller & Lazowski, 1999) is a substance use screen that does a better job at identifying alcohol use disorders than other screens. Also, the SASSI-3 allows users the added benefit of screening for drugs use other than alcohol. The SASSI-3 includes seven subscales to help arrive at a decision. It is the substance use screen most frequently used by Master Addictions Counselors certified by the National Board for Certified Counselors. However, the SASSI-3 was standardized using DSM-IV substance dependence criteria. The DSM-5 merged the criteria formerly associated with abuse and dependence onto one substance use disorder (SUD) continuum and added one new criterion—craving. Due to these changes, we wanted to examine how well the SASSI-3 could accurately assess SUDs using these new DSM-5 criteria. To find this out, we conducted diagnostic interviews and administered SASSI-3s to 241 people who were either clients at one of two SUD treatment centers or university students. We found that the SASSI-3s did not positively identify as many people as having a SUD as did the counselors. Those people that the SASSI-3 missed are called “false negatives.” We wondered why the instrument produced so many false negative decisions. We thought that this might be because the instrument requires too high of a score in order to recommend a diagnosis. To test this idea, we lowered the cut scores to see if we could improve the SASSI-3 and clinician agreement rate. One of the SASSI-3’s scales performed well and did not need adjusting. Two other scales’ agreement with counselors improved when their cut scores were lowered. The final two scales could not be improved by adjusting their cut scores. By adjusting down the two scales, the SASSI-3’s overall agreement with the counselors’ diagnoses improved.