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Lee CT, Lin CY, Koós M, Nagy L, Kraus SW, Demetrovics Z, Potenza MN, 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 RI, Fernandez DP, Fernandez EF, Fujiwara H, Fuss J, Gabrhelík R, Gewirtz-Meydan A, Gjoneska B, Gola M, Grubbs JB, Hashim HT, Islam MS, Ismail M, Jiménez-Martínez M, Jurin T, Kalina O, Klein V, Költő A, Lee SK, Lewczuk K, Lochner C, López-Alvarado S, Lukavská K, Mayta-Tristán P, Milea I, Miller DJ, Orosová O, Orosz G, Ponce FP, Quintana GR, Garzola GCQ, Ramos-Diaz J, Rigaud K, Rousseau A, Scanavino MDT, Schulmeyer MK, Sharan P, Shibata M, Shoib S, Sigre-Leirós V, Sniewski L, Spasovski O, Steibliene V, Stein DJ, Strizek J, Ünsal BC, Vaillancourt-Morel MP, Van Hout MC, Bőthe B. The eleven-item Alcohol, Smoking and Substance Involvement Screening Test (ASSIST-11): Cross-cultural psychometric evaluation across 42 countries. J Psychiatr Res 2023; 165:16-27. [PMID: 37453212 DOI: 10.1016/j.jpsychires.2023.06.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 06/22/2023] [Accepted: 06/25/2023] [Indexed: 07/18/2023]
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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Affiliation(s)
- Chih-Ting Lee
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Mónika Koós
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Léna Nagy
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
| | - Marc N Potenza
- Yale University School of Medicine, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA
| | - Rafael Ballester-Arnal
- Departmento de Psicología Básica, Clínica y Psicobiología, University Jaume I of Castellón, Spain
| | - Dominik Batthyány
- Institute for Behavioural Addictions, Sigmund Freud University Vienna, Austria
| | - Sophie Bergeron
- Département de Psychologie, Université de Montréal, Montréal, Canada
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Center for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
| | - Julius Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Lithuania
| | - Georgina Cárdenas-López
- Virtual Teaching and Cyberpsychology Laboratory, School of Psychology, National Autonomous University of Mexico, Mexico
| | - Joana Carvalho
- William James Center for Research, Departamento de Educação e Psicologia, Universidade de Aveiro, Aveiro, Portugal; CPUP: Center for Psychology at Porto University
| | - Jesús Castro-Calvo
- Department of Personality, Assessment, and Psychological Treatments, University of Valencia, Spain
| | - Lijun Chen
- Department of Psychology, College of Humanity and Social Science, Fuzhou University, China
| | - Giacomo Ciocca
- Section of Sexual Psychopathology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Ornella Corazza
- Department of Clinical, Pharmaceutical and Biological Sciences, University of Hertfordshire, United Kingdom; Department of Psychology and Cognitive Science, University of Trento, Italy
| | - Rita I Csako
- Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
| | | | | | - Hironobu Fujiwara
- Department of Neuropsychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Decentralized Big Data Team, RIKEN Center for Advanced Intelligence Project, Tokyo, Japan
| | - Johannes Fuss
- Institute of Forensic Psychiatry and Sex Research, Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Roman Gabrhelík
- Charles University, Department of Addictology, Prague, Czech Republic; General University Hospital in Prague, Department of Addictology, Czech Republic
| | | | | | - Mateusz Gola
- Institute of Psychology, Polish Academy of Sciences, Poland; Institute for Neural Computations, University of California San Diego, USA
| | | | | | - Md Saiful Islam
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh; Centre for Advanced Research Excellence in Public Health, Savar, Dhaka, 1342, Bangladesh
| | | | - Martha Jiménez-Martínez
- Universidad Pedagógca y Tecnológica de Colombia, Colombia; Grupo de Investigación Biomédica y de Patología, Colombia
| | - Tanja Jurin
- Department of Psychology, Humanities and Social Sciences, University of Zagreb, Croatia
| | - Ondrej Kalina
- Department of Educational Psychology and Psychology of Health, Pavol Jozef Safarik University in Kosice, Slovakia
| | - Verena Klein
- School of Psychology, University of Southampton, United Kingdom
| | - András Költő
- Health Promotion Research Centre, University of Galway, Ireland
| | - Sang-Kyu Lee
- Department of Psychiatry, Hallym University Chuncheon Sacred Heart Hospital, South Korea; Chuncheon Addiction Management Center, South Korea
| | - Karol Lewczuk
- Institute of Psychology, Cardinal Stefan Wyszynski University, Warsaw, Poland
| | - Christine Lochner
- SAMRC Unit on Risk & Resilience in Mental Disorders, Stellenbosch University, South Africa
| | | | - Kateřina Lukavská
- Charles University, Department of Addictology, Prague, Czech Republic; Charles University, Department of Psychology, Prague, Czech Republic
| | | | | | | | - Oľga Orosová
- Pavol Jozef Safarik University in Kosice, Department of Educational Psychology and Psychology of Health, Slovakia
| | | | | | - Gonzalo R Quintana
- Departamento de Psicología y Filosofía, Universidad de Tarapacá, Arica, Arica y Parinacota, Chile
| | | | | | | | - Ann Rousseau
- Leuven School for Mass Communication, KU Leuven, Leuven, Belgium
| | - Marco De Tubino Scanavino
- Department of Psychiatry, Universidade de São Paulo, Brazil; Experimental Pathophisiology Post Graduation Program, Universidade de São Paulo, Brazil
| | | | - Pratap Sharan
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Mami Shibata
- Department of Neuropsychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Sheikh Shoib
- Department of Psychology, Shardha University, India
| | - Vera Sigre-Leirós
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Institute of Legal Psychiatry, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
| | | | | | - Vesta Steibliene
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Lithuania
| | - Dan J Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town, South Africa
| | | | - Berk C Ünsal
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | | | | | - Beáta Bőthe
- Département de Psychologie, Université de Montréal, Montréal, Canada
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