TPC-Journal-V6-Issue2

The Professional Counselor /Volume 6, Issue 2 126 participants diagnosed with an SUD, 85 participants (45.2%) had an alcohol use disorder. Of these 85, 33 (38.8%) had a mild alcohol SUD, 13 (15.3%) were moderate, and 39 (45.9%) were severe. One hundred thirty-three participants (55.2%) were positive for an SUD other than alcohol. Of these 133, 10 (7.5%) had a mild disorder, 8 (6.0%) were moderate, and 115 (86.5%) were severe. Cohen’s kappa (κ) statistic was calculated to determine the agreement between the DSM-5 diagnosis (i.e., met criteria or not) and the SASSI-3 overall score and each of the SASSI-3’s decision rules. Table 2 presents the results of these analyses as well as the number of SASSI-3 true positive, true negative, false positive and false negative classifications. The overall SASSI-3’s agreement with the counselors’ diagnostic decisions was fair (κ = .423, p = .060). The SASSI-3 results concurred with counselors’ diagnostic interviews on 182 cases and disagreed on 59 cases. The SASSI-3’s sensitivity (true positives) and specificity (true negatives) rates were .75 and .77, respectively. Table 2 Agreement Between Counselors’ Diagnoses and SASSI-3 Individual and Total Decision Rule s Rule True Positive True Negative False Positive False Negative Kappa 1 1 31 (12.9%) 151 (62.7%) 5 (2.1%) 54 (22.4%) 0.383*** 2 2 105 (43.6%) 105 (43.6%) 3 (1.2%) 28 (11.6%) 0.745***** 3 91 (37.8%) 47 (19.5%) 6 (2.5%) 97 (40.2%) 0.229*** 4 32 (13.3%) 53 (22.0%) 0 (0%) 156 (64.7%) 0.083** 5 38 (15.8%) 53 (22.0%) 0 (0%) 150 (62.2%) 0.100** 6 62 (25.7%) 50 (20.7%) 3 (1.2%) 126 (52.3%) 0.149** 7 107 (44.4%) 48 (19.9%) 5 (2.1%) 81 (34.0%) 0.313*** 8 4 (1.7%) 52 (21.6%) 1 (0.4%) 184 (76.3%) 0.001* 9 59 (24.5%) 46 (19.1%) 7 (2.9%) 129 (53.5%) 0.100** SASSI-3 141 (58.5%) 41 (17.0%) 12 (5.0%) 47 (19.5%) 0.423**** Note . 1 = Rule 1 kappa tested against positive for alcohol use disorder only. 2 = Rule 2 kappa tested against all substance use disorders but alcohol use. All other kappa values are calculated for each Decision Rule’s agreement a clinical diagnosis of any substance use disorder. * = less than chance agreement, ** = slight agreement, *** = fair agreement, **** = moderate agreement and ***** = substantial agreement (Landis & Koch, 1977). A closer examination of the kappa data indicates that the SASSI-3 and its subscales’ areas of weakness were the false negative rates. That is, the SASSI-3 failed to identify persons as likely substance dependent that the counselors judged as substance dependent (i.e., met criteria or not). Based on the kappa data, the SASSI-3 overall score incorrectly categorized 47 (19.5%) of the sample