A measure of subjective substance use disorder awareness – Substance Use Awareness and Insight Scale (SAS). (1st February 2022)

• Record Type: Journal Article
• Authors: Kim, Julia; Kambari, Yasaman; Taggar, Anmol; Quilty, Lena C.; Selby, Peter; Caravaggio, Fernando; Ueno, Fumihiko; Torres, Edgardo; Song, Jianmeng; Pollock, Bruce G.; Graff-Guerrero, Ariel; Gerretsen, Philip
• Is Part Of: Drug and alcohol dependence. Volume 231(2022)
• Publication Date: 2022-02-01
• Subjects: Illness awareness -- Denial -- Problem awareness -- Addiction awareness -- Insight into illness -- Anosognosia -- Substance use disorder -- Cannabis -- Opioids -- Recreational drugs; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2021.109129
• Languages: English
• ISSNs: 0376-8716

Abstract

Abstract: Introduction: Impaired illness awareness or inability to recognize that one has a substance use disorder can be a barrier to treatment seeking and rehabilitation. A validated scale is needed to better understand the clinical impact of impaired substance use disorder awareness. This study aimed to examine the psychometric properties of the Substance Use Awareness and Insight Scale (SAS), a novel scale to assess impaired illness awareness in individuals with substance use disorder. Methods: We developed the SAS, a 7-item self-report measure to assess the theoretical constructs of illness awareness in substance use disorder (www.illnessawarenessscales.com ). Participants 18 years of age or older with a score of 8 or more on the Drug Use Disorders Identification Test (DUDIT) were included. Data were collected via Dynata, an online survey platform. Results: A total of 299 participants were included (mean (SD) age = 47.3-years (15.4), 54% women). The SAS demonstrated good convergent (r = 0.82, p < 0.001) and discriminant validity (r = −0.23, p < 0.001) with a measure of illness recognition and positive affect, respectively. SAS also demonstrated good internal consistency (Cronbach's alpha = 0.86) and one-month test-retest reliability (intra-class correlation = 0.87). An exploratory factor analysis suggested the retention of two components. Separate analyses of the SAS in individuals with cannabis, opioid, and other substance use showed similar results. Discussion: The results of this study provide initial support for the psychometric validation of the SAS in adults with substance use disorder. The SAS holds promise for use in research and clinical settings to assess the influence of impaired substance use disorder awareness on treatment outcomes. Highlights: Impaired illness awareness in substance use disorder may be a barrier to treatment seeking and rehabilitation. SAS is a novel, brief self-report scale that assesses addiction awareness in substance use disorder. SAS demonstrated good convergent and discriminant validity, internal consistency, and test-retest reliability. SAS may be applied in both clinical and research settings.