Foundations of Addictions Counseling, 3/E David Capuzzi & Mark D. Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Chapter 6 Assessment and Diagnosis of Addictions Updated by Melinda Haley, Walden University

Mental Health and Substance Abuse Disorders Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved 7.98 million Americans meet criteria for both mental health and substance abuse disorder High comorbidity means all counselors encounter addictions Vital to detect and diagnose

Standardized Assessments Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Assist clinical judgment Provide data relative to a “normative” population (vs. client’s family or friends) Normative data are objective Questions prevent denying or minimizing by the client Provides a method of screening Aids in treatment planning

Philosophical Underpinning of Instrument Construction Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Two methods or a combination used to construct instruments Logical Direct inquiry about amount, frequency, duration, consequences Criterion-keyed No direct relationship with substance abuse Statistically discriminates the target traits Circumvents defensiveness

Screening, Assessment, and Diagnosis Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Screen Indicates whether a problem may exist Assessment Confirm or rule out Diagnosis Standardized and prescribed criteria (DSM)

Evaluating Substance Abuse Screens and Assessments Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Sensitivity and specificity Reliability Consistency of measurement Validity Accuracy Measures what we want it to measure

Cost Efficiency Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Screens range in cost Public domain to several hundred dollars Labor costs Administering, scoring interpreting results Are the results sensitive and specific?

Classes of Substance Use Disorders in the DSM-5 Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Alcohol Caffeine Cannabis Hallucinogens Inhalants Opioids Sedatives, hypnotics, or anxiolytics Stimulants Tobacco Polysubstance Other

Diagnosis of Dependence by DSM-5 Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved With or without physiological dependence Three or more of the following: Using over a longer period Desire and/or attempts to cut down or quit The exertion of significant time Craving Continued use despite negative consequences Continued use despite hazardous situations Tolerance Withdrawal

Diagnosis of Abuse by DSM-5 Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved These symptoms are categorized as a pathological pattern: (Criteria 1-4), Pathological pattern (Criteria 5-7), social impairment (Criteria 8-9), risky use (Criteria 10-11) pharmacological

Diagnosis of Abuse by DSM-5Models Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Substance use disorders can be diagnosed from mild to severe dependent on the number of criteria endorsed. In addition, clinicians must determine if the person meets criteria for tolerance or withdrawal.

Self-Administered, Stand-Alone Screening Instruments Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Substance Abuse Subtle Screening Inventory (SASSI) Current version is SASSI-3 17 Minutes to complete, score and interpret The Michigan Alcoholism Screening Test (MAST) Alcohol use True/False questions 10 to 15 minutes to complete

The CAGE Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Designed for primary care physicians Alcohol abuse only Best for advanced stages CAGE: Ever felt the need to Cut down Annoyed by criticism? Felt Guilty? Morning drink or Eye opener?

Alcohol Use Disorders Identification Test (AUDIT) Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Administration and scoring takes 3 Minutes Substance abuse screens Fast alcohol screening test (FAST) AUDIT-C AUDIT-3

Alcohol Use Inventory (AUI) Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved 228 Items, minutes Assessments include Perceived benefits measurements Socialim Mentalim Mangmood Maricope Styles of drinking Gregarus Compulsv Sustained

Personality Assessment Instruments with Substance Abuse Scales Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Minnesota Multiphasic Personality Inventory-2 (MMPI) 567 True/False 3 Scales McAndrew Alcoholism Scale-Revised Addiction Potential Scale Addiction Acknowledgment Scale

Personality Assessment Inventory (PAI) Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Adult personality Psychopathology assessment 344 Items, 22 scales Alcohol Problems Scale (ALC) Drug Problems Scale (DRG)

Millon Clinical Multiaxial Inventory-III (MCMI-III) Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved For adults Personality disorders, clinical syndromes 24 Scales, complete in 25 Minutes MCMI-III Drug Dependence (T) 14 Items Exercise caution when interpreting MCMI-III: Alcohol Dependence (B) 15 Items, many indirect

Counselor Initiated Comprehensive Substance Abuse Assessment Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Diagnostic Interviews The Addiction Severity Index (ASI) Public domain – Free 17 Languages Standard Assessment Tool Alcohol and other addictions Oral, computerized, internet, and automated phone 60 Minutes

Instruments Designed to Assess Alcohol Misuse During Pregnancy Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved T-Ace Specifically designed for pregnant women 4 questions, 1 minute Tweak 5 Items Counselor or self-administered Best used in emergency and primary care

Useful Web Sites Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved National Institute on Alcohol Abuse and Alcoholism The Addiction Research Institute of the Center for Social Work Research at the University of Texas at Austin ntListing.html ntListing.html