Drug and Alcohol Dependence 80 (2006) 349–360 Addiction severity assessment tool: Development of a self-report measure for clients in substance abuse treatment  Stephen F. Butler a,* , Simon H. Budman a , Michael D. McGee b , Michael Sean Davis a , Rebecca Cornelli a , Leslie C. Morey c a Inflexxion Inc., 320 Needham St., Suite 100, Newton, MA 02464-1594, USA b St. Joseph Hospital, Nashua NH 03060, USA c Texas A&M University, College Station, TX 77843, USA Received 11 May 2004; received in revised form 27 April 2005; accepted 6 May 2005 Abstract This article describes the development and reliability and validity testing of the Addiction Severity Assessment Tool (ASAT), a brief, 27-item multidimensional self-report measure of problem severity in daily functioning, relational functioning, dysphoric states, dependence severity, recovery skill/self-efficacy, and existential factors for adult substance abuse clients. Items generated for an Alpha version were conceptually and empirically evaluated. A Beta version underwent further empirical evaluation and item selection. Cross validation of the final version examined internal consistency, test-retest reliability, factor structure, and convergent/discriminant and known groups validity. Sensitivity to change was evaluated in a 3-month outcome study. Clients were recruited from inpatient, outpatient and residential substance abuse treatment centers, and a sample of 238 nonpatients were also recruited from community groups. The Beta version was tested with 201 clients, and cross validation involved 242 clients. Well-known standardized, self-report and interview-based comparison measures were used to test convergent/discriminant validity of the ASAT. Reliability coefficients for the six ASAT domains were acceptable. Reasonable convergent/discriminant and known groups, construct validity were demonstrated, along with sensitivity to change of the domain scale scores. The ASAT appears to comprise a useful new tool for assessing clinical outcomes of adult clients in substance abuse treatment. © 2005 Elsevier Ireland Ltd. All rights reserved. Keywords: Drug and alcohol assessment; Self-report; Problem severity; Brief assessment; Addiction 1. Introduction The ASAT is a self-report measure of problem severity in adult substance abuse clients that is easy to administer and score, multidimensional, and psychometrically sound. This manuscript describes the creation, testing, and cross- validation of the measure. The ASAT contains 27 items and is rated on a four-point scale from “not at all true” to “very true,” addressing the following subscales: daily functioning, relational functioning, dysphoric states, dependence severity,  Supplemental materials for this article can be found by accessing the online version of this paper at http://dx.doi.org by entering doi:10.1016/ j.drugalcdep.2005.05.005. Please see Appendix A for more information. * Corresponding author. Tel.: +1 617 332 6028; fax: +1 603 672 3162. URL: sfbutler@inflexxion.com (S.F. Butler). recovery skill/self-efficacy, and existential factors. increasing scores denote increasing severity. Development of the ASAT was stimulated by the need in clinical substance abuse settings for a brief, easy to use, validated, self-report, and multidimensional assessment that provides information relevant for treatment planning and out- come measurement (Sederer et al., 1996). Given the realities of most clinical settings, outcome studies typically require a single self-report assessment tool. In addition to being reliable and valid, such a tool must be easily and quickly administered and scored and must tap outcome in the mul- tidimensional areas of symptoms and functioning relevant to substance abuse populations. Comparable measures for mental health and medical populations include the BASIS- 32 (Eisen et al., 1986; Eisen, 2000) and the Short-Form-36 (SF-36; Ware et al., 1993). These short, multidimensional 0376-8716/$ – see front matter © 2005 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.drugalcdep.2005.05.005