Psychological Evaluation of Substance Use Disorder in Adolescents and Adults

RALPH E. TARTER

Psychological evaluation is directed at characterizing cognitive, emotional, and behavioral processes. The evaluation of substance use disorders thus focuses on multiple domains of psychological functioning. The instruments selectively reviewed in this chapter satisfy the following criteria: (1) the psychometric properties have been empirically established, (2) the measures have practical utility, and, (3) they are applicable to diverse populations.

It has been previously argued that the assessment of substance abuse should use comparable measures in clinical and research settings (Rounsaville, 1993). The ultimate usefulness of psychological measurement is to delineate the unique factors within the individual that predispose to substance use onset, sustain habitual consumption, and impede psychosocial adjustment. Moreover, a comprehensive evaluation should directly guide the selection of prevention and treatment strategies that are most likely to be successful. In the managed care environment, where there is an emphasis on cost containment and empirical documentation, it is invaluable to obtain as much information as possible that could expedite effective treatment.

Psychological evaluation must also accommodate contemporary understanding of the disorder. Hence, evaluation must encompass an approach that aligns with an appreciation of the multifactorial etiology of substance use disorder. A multivariate assessment protocol is therefore necessary to characterize the individual fully. Finally, it needs to be recognized that manifold psychologi cal disturbances presage, are concomitant to, and emerge as consequences of chronic substance use. A comprehensive psychological evaluation must therefore encompass the natural history of the disorder.

This chapter is divided into three sections. First, I discuss the scope and requirements of a psychological assessment. Next, the methods for conducting a psychological assessment are described. A presentation of a decision-tree format that links the results of psychometric evaluation to specific modes of treatment concludes the chapter.

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