Multi-center cross-cultural adaptation of the Addiction Severity Index, Sixth Edition (ASI6) for Brazil

LETTER TO THE EDITORS

Multi-center cross-cultural adaptation of the Addiction Severity Index, Sixth Edition (ASI6) for Brazil

Felix Kessler^I; John Cacciola^II; Sibele Faller^I; Maria Lucia Souza-Formigoni^III; Marcelo Cruz^IV; Sílvia Brasiliano^V; Flavio Pechansky^I

^ICentro de Pesquisa de Droga e Álcool, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil

^IIDepartment of Psychiatry, University of Pennsylvania, Filadélfia, USA

^IIIDeparament of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil

^IVInstituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil

^VInstituto de Psiquiatria, Escola de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil

^{Correspondence}

Dear Editors:

The first step in the assessment of alcohol and drug users is obtaining a detailed and reliable biopsychosocial diagnostic assessment, providing proper development of a therapeutic plan. Although such concept is clear for Brazilian professionals working with chemical dependence, there is a lack of research and clinical instruments approaching the wide range of problems found in alcohol and drug users.¹

In this context, the sixth version of the Addiction Severity Index (ASI6) was chosen to be adapted and validated in Brazil in a multi-center study. ASI has been translated into more than 20 languages,² showing total evidence of its reliability and validity.^3-5 It is a semi-structured interview, designed to obtain information about the profile of substance abuse and aspects of life related to use of alcohol and drugs in the following areas: medical, employment, legal aspects, social and family, and psychiatric. Interviewers usually take 45-90 minutes to apply the instrument.

The last version of the instrument (ASI6) was developed to enhance the content about problems related to substance abuse and to approach the main limitations present in its previous version (ASI5).²

Studies are being conducted in the USA to validate the sixth version of ASI, and the authors of the original scale participated actively in the development and adaptation of the Brazilian instrument for 2 years, through meetings in both countries and electronic mail. The translation and adaptation method consisted of the stages shown in Figure 1.

Figure 1 - Click to enlarge

Since ASI is a complex questionnaire requiring specific training, a training video and a manual for ASI6 were developed concomitantly with the process of instrument adaptation, in which guidance was provided about all items, besides detailed descriptions and explanations. The first Brazilian version of the ASI6, with manual and video, is available at the websites of the Brazilian Observatory of Information on Drugs (OBID, www.obid.senad.gov.br) and of the Research Center on Alcohol and Drugs (CPAD, www.cpad.org.br). Download is offered for free.

This is the first study conducted in Latin America with the aim of adapting and validating ASI6. It involved efforts by researchers from many Brazilian regions (South, Southeast and Northeast), also originating a partnership for other studies in this important area of public health. Adaptation of ASI6 will allow training of health professionals to obtain a better panorama of problems faced by drug users, aiming at therapeutic planning, as well as for follow-up of each case. In addition, it makes room for the development of other versions of that instrument in Brazil, such as ASI Lite, ASI follow-up and a computer version. There is an ongoing important initiative to test ASI6 in Brazil, in order to validate the instrument in a multi-center study in which the psychometric properties of this instrument (in samples of patients and outpatients users of alcohol and/or drugs in four Brazilian states) are being investigated.

References

Received August 29, 2007.

Accepted August 30, 2007.

Funding: This study was supported by the Brazilian Anti-Drug Agency (SENAD), GPPG-HCPA nº 05-460). Approved by the Ethic Committee.

• 1. Formigoni MLOS, Castel S. Escalas de avaliação de dependência de drogas: aspectos gerais. Rev Bras Psiquiatr. 1999;26(1):5-31.
• 2. Thomas McLellan A, Cacciola JC, Alterman AI, Rikoon SH, Carise D. The addiction severity index at 25: origins, contributions and transitions. Am J Addict. 2006;15(2):113-24.
• 3. Senoo E, Ogai Y, Haraguchi A, Kondo A, Ishibashi Y, Umeno M, et al. Reliability and validity of the Japanese version of the Addiction Severity Index (ASI-J). Nihon Arukoru Yakubutsu Igakkai Zasshi. 2006;41(4):368-79.
• 4. Scheurich A, Muller MJ, Wetzel H, Anghelescu I, Klawe C, Ruppe A, et al. Reliability and validity of the German version of the European Addiction Severity Index (EuropASI). J Stud Alcohol. 2000;61(6):916-9.
• 5. Gerevich J, Bácskai E, Kó J, Rózsa S. Reliability and validity of the Hungarian version of the European Addiction Severity Index. Psychopathology. 2005;38(6):301-9.

Correspondence

:

Felix Henrique Paim Kessler

Rua Itaqui, 89/103

CEP 90460-140, Porto Alegre, RS, Brazil

Publication Dates

• Publication in this collection
  31 Mar 2008
• Date of issue
  Dec 2007