The Effect of Computer-Mediated Administration on Self-Disclosure of Problems on the Addiction Severity Index

Abstract

Objectives People tend to disclose more personal information when communication is mediated through the use of a computer. This study was conducted to examine the impact of this phenomenon on the way respondents answer questions during computer-mediated, self-administration of the Addiction Severity Index (ASI) called the Addiction Severity Index–Multimedia Version® (ASI-MV®). Methods A sample of 142 clients in substance abuse treatment was administered the ASI via an interviewer and the computerized ASI-MV®, three to five days apart in a counterbalanced order. Seven composite scores were compared between the two test administrations using paired t-tests. Post hoc analyses examined interviewer effects. Results Comparisons of composite scores for each of the domains between the face-to-face administered and computer-mediated, self-administered ASI revealed that significantly greater problem severity was reported by clients in five of the seven domains during administration of the computer-mediated, self-administered version compared to the trained interviewer version. Item analyses identified certain items as responsible for significant differences, especially those asking clients to rate need for treatment. All items that were significantly different between the two modes of administration revealed greater problem severity reported on the ASI-MV® as compared to the interview administered assessment. Post hoc analyses yielded significant interviewer effects on four of the five domains where differences were observed. Conclusions These data support a growing literature documenting a tendency for respondents to be more self-disclosing in a computer-mediated format over a face-to-face interview. Differences in interviewer skill in establishing rapport may account for these observations.

Eating Disorders, Addictions and Substance Use Disorders

“…Psychometric data support the reliability and validity of Form 90 if it is administered by interviewers who have been adequately trained (Sobell & Sobell, 2003). More recently, a computer-administered version of the interview has been found to be promising in terms of eliciting increased self-disclosure (Butler, Villapiano, & Malinow, 2009) and providing a more time-efficient assessment method that does not require staff training or administration. The ASI has considerable psychometric data supporting its reliability and validity (see review by Makela, 2004) and is widely used in both clinical and research settings.…”

Nonmedical Use of Prescription ADHD Stimulant Medications Among Adults in a Substance Abuse Treatment Population

“…On the other hand, self-reported information obtained via computer (the mode used by ASI-MV) may be more accurate than self-reports collected by an interviewer. A growing body of evidence suggests that respondents tend to endorse more sensitive or socially undesirable life circumstances on computer-administered surveys than they do to interviewers (Butler, Villapiano, & Malinow, 2009;Garb, 2007;Hewson, 2007;Joinson & Paine, 2007).…”

Evaluation of the Current Opioid Misuse Measure Among Substance Use Disorder Treatment Patients

“…The scores for alcohol and drug use composites range from 0 (no endorsement of any problems) to 1 (maximal endorsement of all problems). There is strong support for the psychometric properties of the ASI (Butler et al, 2009; Leonhard et al, 2000; McLellan et al, 1980). Individual items on the ASI asking about use of specific substances (e.g., heroin, cocaine) were also used.…”

“…SUD treatment settings often rely on the Addiction Severity Index (ASI) to assess recent opioid use. While this measure commonly used measure of substance use in assessing addiction severity (Butler et al, 2009; Leonhard et al, 2000; McLellan et al, 1980), it may have poor sensitivity for detecting nonmedical prescription opioid use. The ASI uses just one item to assess prescription opioid use and previous research indicates that it underestimates prescription opioid use among SUD treatment settings (Bohnert et al, 2013; Price et al, 2011).…”