The utility of the Substance Abuse Subtle Screening Inventory-3 for use with individuals with brain injury

The utility of the Substance Abuse Subtle Screening Inventory (SASSI-3) for the use with individuals with traumatic brain injuries (TBI) was investigated. The SASSI-3 was administered to 78 subjects prior to discharge from inpatient rehabilitation. The SASSI-3 diagnosis of chemical dependency was compared with the diagnosis of staff psychologists. Lower accuracy, sensitivity, and specificity were found in SASSI-3 diagnosis for the subjects with brain injury, as compared to a normative sample of persons with disabilities participating in a vocational rehabilitation programme. When a diagnosis of 'dependence or abuse' was used, accuracy of the SASSI-3 increased. Comparison of diagnosis based on SASSI-3 versus Blood Alcohol Level (BAL) at the time of injury showed comparable accuracy; however, BAL was found to have higher specificity. For dependence or abuse, BAL continued to be more specific than the SASSI-3; however, the SASSI-3 was more sensitive. Based on these findings, a clinical approach to screening using both BAL and the SASSI-3 is discussed.