Evidências de validade da versão brasileira do Addiction Severity Index 6 (ASI6) Light

Abstract

Introduction: Advances in research have increasingly contributed to increasing knowledge about psychoactive substance use disorders (SPAs). The evaluation of a substance user is quite complex, since, in addition to investigating the specific use of the drug, the global investigation of several areas of the individual's life that may be affected by this consumption becomes paramount. The Addiction Severity Index (ASI) is an instrument to evaluate information on various aspects of the life of people with problems related to alcohol and other drugs, such as medical problems, employment, legal, socio-family, psychiatric, alcohol and other drugs. Currently this instrument is in the sixth version, but remains with some problems in its use for research. Objectives: The objectives of this work involved two studies: 1) to develop a systematic review of the literature of the studies that evaluated the psychometric properties of ASI; 2) to evaluate new evidence of validity and reliability of the reduced Brazilian version of the Addiction Severity Index Light (ASI6 Light). Method: For the review, bibliometric data were collected and analysis of thematic categorical content was performed. The second study involved the ASI6 Light validation process, which was submitted to the analysis of validity evidences based on relations with external variables, evaluation of intravalid means differences, as well as calculation of Intraclass Correlation Coefficient (ICC) and the analysis of the independence of dimensions in ASI6 Light. Results: The results of the review showed that the fifth and sixth version of the ASI presented good psychometric properties, although some areas, such as the "familiar" area, presented some limitations regarding reliability and internal consistency. Most studies show a moderate correlation between ASI summary scores and other instruments, not being uniformly high. The analyzes supported the multidimensionality of ASI. In the second study, the results showed that, in general, evidence of validity based on relations with external variables was good. The correlation between DSM-5 and the "alcohol" and "drug" areas was high (r = 0.77, both). Regarding the reliability and reproducibility of ASI6 Light, intraclass correlation coefficients (ICC) ranged from 0.73 to 0.98. The ASI6 Light dimension independence analysis showed weak correlations among the six scores. The "alcohol" and "drug" areas presented good evidence of validity with DSM- 5. The ASI6 Light was presented as a stable and reproducible instrument. Discussion: Despite the limitations, the ASI has assisted clinicians and researchers, contributing to the elaboration of a therapeutic plan, determining the clinical priorities, as well as the management of these. The reduced version has become an easy-to-use and quick-toapply instrument containing the items that best assess the severity of substance problems and associated problems in the various areas.