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 updated April 6, 2004

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CIDI - Substance Abuse Module (SAM)

Description

The CIDI-Substance Abuse Module (SAM) is an expanded and more detailed version of the substance use sections of the Composite International Diagnostic Interview (CIDI), with an added section on caffeine use. Like its parent instrument (the CIDI), the SAM is fully structured and can be administered by non-clinician or clinician interviewers after appropriate training. The SAM can be used as a stand-alone instrument or as a substitute for the substance use disorder sections of the CIDI. The interview questions serve the diagnostic criteria of DSM-III, DSM-III-R, DSM-IV and ICD-10 psychoactive substance use disorders. The interview is generally arranged with diagnostic criterion labels on the left, questions in the center, and answer codes on the right. There are four diagnostic sections in the SAM. A different letter in each section precedes question numbers. Section A contains demographic questions, Section B is for tobacco, Section C is for alcohol, Section D is for drugs, and Section E covers caffeine. The substances covered in Section D include: amphetamines and other stimulants, cannabinoids, cocaine, PCP and other hallucinogens, inhalants, heroin and other opiates, barbiturates and other sedatives and tranquilizers. Club drugs are now included in the SAM.

The SAM includes questions about the onset and recency of specific symptoms, as well as the specific withdrawal symptoms and physical, social, and psychological consequences for each category of substances used by the respondent. In addition, the SAM can be used to ascertain whether criteria have been met for a diagnosis. Information is obtained about the severity and course of each disorder. This includes the quantity and frequency of both the heaviest use and use in the past 12 months, age at first and last use, age at first and most recent symptoms, age that criteria were first and most recently met, and age(s) at remission(s). The SAM also assesses the respondent’s impairment and treatment seeking. Finally, because of the significant associations between disorder and demographic characteristics, the SAM elicits information about parental absence during childhood, marital status, parenthood, educational achievement, and employment, in addition to the general demographic items.

The newest version is now computerized which facilitates the administration of the SAM. Requirements for the computerized SAM are given on the price list below.

Training

Training usually requires 3 to 5 days. Clinicians generally require less practice than do lay interviewers. Each trainee needs a copy of the specifications and several hard copies of the interview for practice. Quality Control Assistants should be trained along with the interviewers so that they become fully familiar with the interview and instructions for administering it.

Respondents

The SAM is designed for respondents who are 15 years of age or older. It is written in language appropriate for persons with significantly different educational backgrounds and intelligence. It is simple enough that respondents with a 6th grade education can respond meaningfully to the questions, yet it does not patronize those with higher levels of education. Respondents with severe mental retardation or severe organic brain syndrome will not be able to give meaningful answers.

Duration of Interviews

The SAM is designed for use as a single session assessment. Administration of the SAM averages 45 minutes, if all systems and drugs are being queried. The time can be reduced if not all systems and drugs are included. It is recommended that the respondent be given the opportunity to take a 5-10 minute break during long interviews. The length of time for interruptions or breaks should not be included in the total interview time, so interviewers should subtract the total number of minutes used for breaks from the ending time.

History of the SAM

Originally, the SAM was developed between 1986 and 1989 at the request and with the assistance of the World Health Organization (WHO) Task Force on Psychiatric Assessment and the former Alcohol Drug and Mental Health Administration (ADAMHA). Users of the CIDI were interested in developing an assessment that was more comprehensive and detailed than the alcohol, drug, and tobacco use sections of the CIDI. After good to excellent reliability was established, the SAM became an official supplemental module of the CIDI, to be used when more detail about substance use is required. It has been used extensively by investigators in the field of substance abuse and dependence research, and was the instrument chosen for the DSM-IV Substance Use Disorders Field Trials.

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Assessments

Diagnostic Interview Schedule (DIS)

Composite International Diagnostic Interview (CIDI)

¬ CIDI - Substance Abuse Module (SAM)

Schedules for Clinical Assessment in Neuropsychiatry (SCAN)

© 2004 Washington University in St. Louis