Ibáñez-Martínez Núria, Stevens Matthew William Richard, Civit-Bel Núria, Moreno-Ferrer Noemí, Lopez-Ferré Sandra, Olivares-Casado Ana, Claramunt-Mendoza Juame, Holmwood Chris, Ali Robert
Departament de Justicia, Drets I Memoria. Direcció General d'Execució Penal a la Comunitat i de Justícia Juvenil, Barcelona, Spain.
School of Biomedicine (Pharmacology), The University of Adelaide, Adelaide, Australia.
Child Adolesc Psychiatry Ment Health. 2025 Jan 13;19(1):1. doi: 10.1186/s13034-024-00845-6.
Substance use among adolescents is strongly associated with adverse physical, mental health, and social outcomes. Prevention and early intervention can reduce the likelihood of future problems, but requires valid and reliable screening tools capable of assessing risk across a range of substances. This study assessed the validity, reliability, and clinical utility of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST-Y) for adolescents aged 15-17 years.
A sample of adolescent males (N = 101), aged 15-17 years, held in a juvenile detention facility on substance-related offences in Barcelona, Spain were eligible. Participants were administered a battery of standardized substance-use screening tools by a clinical psychologist, and underwent a diagnostic interview assessing DSM-IV-TR substance abuse and dependence by an addiction medicine specialist. Scores on the various assessments were compared to establish validity (concurrent with interview, convergent with other measures), reliability, and clinical utility of ASSIST-Y.
Majority of participants (n = 77) completed assessments. While tobacco was not assessed as part of the interview, concurrent validity in detecting substance abuse was established for all remaining substances. Concurrent validity for detecting dependence was established for alcohol, cannabis, cocaine, stimulants and sedatives. Fewer numbers in higher-risk groups for inhalants, opioids and hallucinogen use limited confirmation of validity for those substances. ASSIST-Y also demonstrated good convergent validity with the other screening tools for all substances, except hallucinogens. Reliability for each subscale was established, except for tobacco (too few items), sedatives, and hallucinogens. Finally, clinical utility indices were significant for most substances (except sedatives and opioids); whilst clinical utility indices were significant for ruling out cases of non-dependence (all substances).
As a screening tool, the purpose of ASSIST-Y is designed to help identify adolescents who may be at-risk of substance-related harm. While the instrument was found to be valid and reliable in identifying risky use across a variety of substances, further research is needed to validate the instrument in other population groups, and for other substances. Future research should investigate the effect of the linked brief intervention to reduce risk of harm, especially for non-specialist clinicians.
青少年物质使用与不良身体、心理健康及社会后果密切相关。预防和早期干预可降低未来出现问题的可能性，但需要有效且可靠的筛查工具来评估多种物质的风险。本研究评估了针对15至17岁青少年的酒精、吸烟与物质使用筛查测试（ASSIST - Y）的有效性、可靠性及临床实用性。
选取西班牙巴塞罗那一家青少年拘留所中因与物质相关犯罪而被关押的15至17岁青少年男性样本（N = 101）作为研究对象。由临床心理学家对参与者进行一系列标准化物质使用筛查工具测试，并由成瘾医学专家进行诊断访谈，以评估《精神疾病诊断与统计手册》第四版修订版（DSM - IV - TR）中物质滥用和依赖情况。比较各项评估的得分，以确定ASSIST - Y的有效性（与访谈结果一致、与其他测量方法趋同）、可靠性及临床实用性。
大多数参与者（n = 77）完成了评估。虽然访谈中未评估烟草使用情况，但对于其余所有物质，均确立了其在检测物质滥用方面的同时效度。对于酒精、大麻、可卡因、兴奋剂和镇静剂，确立了其在检测依赖方面的同时效度。吸入剂、阿片类药物和致幻剂使用的高风险组人数较少，限制了对这些物质效度的确认。除致幻剂外，ASSIST - Y与其他所有物质的筛查工具也显示出良好的趋同效度。除烟草（项目太少）、镇静剂和致幻剂外，各子量表的信度均已确立。最后，大多数物质的临床实用性指标具有显著性（镇静剂和阿片类药物除外）；而在排除非依赖病例方面，临床实用性指标对所有物质均具有显著性。
作为一种筛查工具，ASSIST - Y旨在帮助识别可能面临物质相关伤害风险的青少年。虽然该工具在识别多种物质的危险使用方面被发现有效且可靠，但仍需进一步研究以在其他人群组和其他物质中验证该工具。未来的研究应调查相关简短干预措施对降低伤害风险的效果，特别是对非专科临床医生而言。
