Validation of the revised Problems Assessment for Substance Using Psychiatric Patients

This study assessed the factor structure, internal consistency, test–retest reliability, and construct validity of the Problems Assessment for Substance Using Psychiatric Patients (PASUPP; Carey, Roberts, Kivlahan, Carey, & Neal, 2004) with a sample of 278 men and women seeking outpatient dual-diagnosis treatment. All participants were diagnosed with a current AUD and schizophrenia and/or bipolar disorder. Initial confirmatory factor analysis did not support the 1-factor model for the 50-item measure found by Carey and colleagues. Instead, exploratory factor analysis yielded a shorter (27-item) scale with four distinct, yet related factors (Physical Problems, Aggression, Social and Financial Consequences, and Psychological Problems). The factor-based scales had good internal consistency (α = .77–.81) and 1-week test–retest reliability (r = .67–.73). The revised PASUPP (PASUPP-R) was associated with measures of psychiatric symptoms/adjustment, substance use/dependence, and another measure of substance use problems, providing evidence for convergent validity. Subgroup comparisons suggested few demographic differences on the PASUPP-R, but differential patterns of problems endorsement emerged as a function of mental health and substance use diagnosis. Overall, this study provides preliminary evidence for the psychometric soundness of the PASUPP-R as a measure of problems experienced by persons with co-occurring psychiatric and substance use disorders.

Research Highlights
► Developed a revised measure of problems among substance using psychiatric patients.
► Using EFA, identified four distinct, yet related factors (e.g., Aggression).
► Scales had good internal consistency and test–retest reliability.
► Initial assessment of convergent and discriminant validity of new measure.