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Protocol OverviewBrowse » Domains » Alcohol, Tobacco and Other Substances » Substances - Lifetime Abuse and Dependence » Substances - Lifetime Abuse and Dependence Note: Some Protocols contain images. You may click the thumbnails to preview the full image. To print Protocols with full size images, please add those Protocols to your Toolkit and Generate a Report.
Substances - Lifetime Abuse and Dependence #031401
Protocol Release Date
  February 6, 2009 Protocol Name From Source
The Expert Review Panel has not reviewed this measure yet. Description of Protocol
Measurement of respondent’s signs of substance abuse and dependence. These responses correspond with criteria from the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV). There are two questions within each of which are multiple parts. Specific Instructions
These series of questions are only asked if a respondent had affirmatively answered one of the drug category questions in the Substances - Lifetime Use measure. Interviewer will query the respondent with each section (marijuana and other drugs). Protocol
The Working Group acknowledges the following questions may gather sensitive information relating to the use of substances and/or illegal conduct. If the information is released it might be damaging to an individual’s employability, lead to social stigmatization, or other consequences. For information on obtaining a Certificate of Confidentiality, which helps researchers protect the privacy of human research participants, please go to the National Human Genome Research Institute’s Institutional Review Board. Please note that the specific Semi-Structured Assessment for the Genetics of Alcoholism II (SSAGA II) questions used for assessing an abuse or dependence diagnosis with the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria are included in this protocol. Questions from the SSAGA II marijuana and drug sections that are not used to assess the DSM-IV criteria have been excluded. The variable names are included in brackets at the end of the question text. These variable names are used in the coding algorithm for the abuse and dependence diagnosis. If the respondent answered "Yes" to any of the drug categories asked in the Substances - Lifetime Use measure, they are then asked the next series of questions. This protocol includes the survey questions, a scoring sheet used to create the DSM-IV diagnosis, and SAS coding algorithm to determine the diagnosis. The SSAGA II divides the substances section into two parts: a marijuana section and a drugs section. Each section refers to a "Tally Sheet." The Tally Sheets are shown below at the end of the questions. Marijuana IF RESPONDENT HAS NEVER USED MARIJUANA (ASSESSED WITH THE Substances - Lifetime Use MEASURE), THEN SKIP TO THE DRUGS SECTION BELOW. 1. Did you ever use marijuana at least 21 times in a single year? [F1B] [ ] 1 NO [ ] 5 YES [ ] 9 DON’T KNOW / REFUSED IF Question 1=1 THEN SKIP TO THE DRUGS SECTION BELOW. 2. Has there ever been a period of a month or more when a great deal of your time was spent using marijuana, getting marijuana, or getting over its effects? [F5] [ ] 1 NO [ ] 5 YES (MARK TALLY SHEET A) [ ] 9 DON’T KNOW / REFUSED 3. Because of your marijuana use, did you ever experience any of the following: CODE IN COLUMN 1.
FOR EACH 5 CODED IN COL. I, ASK Question 3.6. 3.6. Did you continue to use marijuana after you knew it caused this? CODE IN COLUMN 2. (IF YES FOR COL. 2, ITEMS 1, 2, 3, or 5, MARK TALLY SHEET A) 4. Have you often wanted to stop or cut down on marijuana? [F7] [ ] 1 NO [ ] 5 YES [ ] 9 DON’T KNOW / REFUSED 4.1. Have you ever tried to stop or cut down on marijuana but found you couldn’t? [F7A] IF NEVER TRIED TO STOP/CUT DOWN, CODE NO. [ ] 1 NO, COULD STOP [ ] 5 YES, COULD NOT STOP [ ] 9 DON’T KNOW / REFUSED IF NO, COULD STOP (OR NEVER TRIED), SKIP TO Question 5. OTHERS CONTINUE. 4.2. Were you unable to stop or cut down 3 or more times? [F7B] [ ] 1 NO [ ] 5 YES (MARK TALLY SHEET A) [ ] 9 DON’T KNOW / REFUSED 5. Have you often used marijuana more frequently or in larger amounts than you intended to? [F8] [ ] 1 NO [ ] 5 YES (MARK TALLY SHEET A) [ ] 9 DON’T KNOW / REFUSED 6. Did you ever need larger amounts of marijuana to get an effect, or did you ever find that you could no longer get high on the amount you used to use? [F9] [ ] 1 NO [ ] 5 YES (MARK TALLY SHEET A) [ ] 9 DON’T KNOW / REFUSED 7. When you stopped, cut down, or went without marijuana, did you ever experience any of these following problems for most of the day for 2 days or longer? Did you..... CODE IN COLUMN 1.
IF NO 5’S CODED IN Question 7, parts 1-7, SKIP TO Question 8. OTHERS CONTINUE. 7.8. Have you ever used marijuana to keep from having any of these problems (or to make them go away)? [F10A] [ ] 1 NO [ ] 5 YES [ ] 9 DON’T KNOW / REFUSED IF Question 7.1 is NO, SKIP TO Question 8. OTHERS CONTINUE. 7.9. Did this happen 3 or more times? [F10B] [ ] 1 NO [ ] 5 YES (MARK TALLY SHEET A) [ ] 9 DON’T KNOW / REFUSED IF ONLY ONE 5 CODED IN COL. 1, SKIP TO Question 8. OTHERS CONTINUE. 7.10. Did these problems ever occur together? [F10C] ] 1 NO [ ] 5 YES (MARK TALLY SHEET A) [ ] 9 DON’T KNOW / REFUSED 8. Have you given up or greatly reduced important activities like sports, work, or associating with friends or relatives while using marijuana? [F17] [ ] 1 NO [ ] 5 YES [ ] 9 DON’T KNOW / REFUSED IF NO TO QUESTION 8, THEN END PROTOCOL. IF YES, THEN CONTINUE TO QUESTION 8.1. 8.1. Has this happened 3 or more times, or did it last a month or longer? [F17A] [ ] 1 NO [ ] 5 YES (MARK TALLY SHEET A) [ ] 9 DON’T KNOW / REFUSED Drugs Note to the interviewer: This section allows for coding a total of five classes of drugs: cocaine, stimulants, sedatives, opiates, and the class of drugs used most from those remaining (i.e., PCP, hallucinogens, solvents, combination drugs, or drugs that don’t fit in any other category). The specific name or type of drug that will be coded in this fifth column should be recorded. If the respondent reports using equal amounts of drugs in more than one of these "other" classes, the interviewer should ask about the class of drugs that caused the most problems. 9. (HAND RESPONDENT CARD G) Have you ever used any of these drugs to feel good or high, or to feel more active or alert? Or did you use any prescription drugs when they were not prescribed, or more than prescribed?
IF ALL NO, END PROTOCOL. ALL OTHERS CONTINUE TO Question 10. FOR EACH DRUG CODED 5 (YES). 10. How many times in your life have you used (DRUG)?
IF NO DRUG IS USED 11 OR MORE TIMES, END PROTOCOL. IF THE RESPONDENT USED COCAINE, STIMULANTS, SEDATIVES, AND/OR OPIATES 11 OR MORE TIMES, CONTINUE WITH Question 11. IF THE RESPONDENT USED OTHER DRUGS (PCP, HALLUCINOGENS, SOLVENTS, OR COMBINATION DRUGS) 11 OR MORE TIMES, CONTINUE WITH ONE USED MOST AND CODE IN COL. 5. strong>IF "OTHER" COLUMN USED, RECORD THE DRUG: ______________________. 11. Was there ever a period of a month or more when a great deal of your time was spent using (DRUG), getting (DRUG), or getting over its effects? (IF YES, MARK TALLY SHEET B)
12.1. Have you often wanted to stop or cut down on (DRUG)? (IF YES, MARK TALLY SHEET B)
12.2. Have you ever tried to stop or cut down on (DRUG) but found that you couldn’t?
IF NO (COULD STOP), SKIP TO Question 13. OTHERS CONTINUE. 12.3. Were you unable to stop or cut down 3 or more times? (IF YES, MARK TALLY SHEET B)
13. Did you ever need larger amounts of (DRUG) to get an effect or find that you could no longer get high on the amount you used to use? (If YES, MARK TALLY SHEET B)
14.1. Have you ever given up or greatly reduced important activities while using (DRUG), like sports, work, or associating with friends or relatives?
14.2. IF YES: Did this happen 3 or more times or for a month or more? (IF YES, MARK TALLY SHEET B)
15. Have you often used (DRUG) more days or in larger amounts than you intended to? (IF YES, MARK TALLY SHEET B)
16. People who stop, cut down, or go without drugs after using drugs steadily for some time may not feel well. These feelings are more intense and can last longer than the usual hangover. When you stopped, cut down, or went without (DRUG), did you ever experience any of the following problems for most of the day for 2 days or longer? (NO=1, YES=5, DON’T KNOW/REFUSED=9) ASK Questions ONE COLUMN AT A TIME. IF BOX IS GREYED OUT, QUESTION IS NOT APPLICABLE TO DRUG CATEGORY.
CONTINUE ASKING ONE COLUMN AT A TIME. FOR EACH DRUG COLUMN: IF ALL CODED 1, GO TO NEXT DRUG COLUMN. IF ONLY ONE CODED 5, SKIP TO Question 17.2. IF TWO OR MORE 5’S CODED, CONTINUE. 17.1. Was there ever a time when 2 or more of these problems occurred together because of stopping, cutting down on, or going without (DRUG)? REVIEW SYMPTOMS AS NEEDED. (IF YES, MARK TALLY SHEET B)
17.2. Have you ever used (DRUG) to keep from having any of these problems (or to make them go away)? IF NO, SKIP TO NEXT DRUG. IF NO DRUG, SKIP TO Question 18.1.
17.3. Did you do that 3 or more times? (IF YES, MARK TALLY SHEET B)
18.1. Did using (DRUG) cause you to have any other problems like an overdose?
18.2. IF YES: Did this happen 3 or more times? (overdose that required medical treatment) (IF YES, MARK TALLY SHEET B)
18.3. Did using (DRUG) cause you to have any other problems like hepatitis?
18.4. IF YES: Did you continue to use (DRUG) knowing it caused hepatitis? (IF YES, MARK TALLY SHEET B)
18.5. Did using (DRUG) cause you to have any other serious health problems? (IF YES, MARK TALLY SHEET B) SPECIFY: __________________________________
18.6. IF YES: Did you continue to use (DRUG) knowing it caused health problems? (IF YES, MARK TALLY SHEET B)
19. Has your use of (DRUG) ever caused you emotional or psychological problems like:
IF ALL ARE CODED 1, END PROTOCOL. OTHERS CONTINUE. 19.6. Did you continue to use (DRUG) after you knew it caused any of these problems? REVIEW SYMPTOMS AS NEEDED. (IF YES, MARK TALLY SHEET B)
MARIJUANA TALLY SHEET A - DSM-IV CRITERIA This Tally Sheet is used for assessing an abuse and dependence diagnosis. The question numbers are listed in black in the left hand column. The corresponding variable name is listed below the question number in blue. The Tally Sheet is used by the interviewer to keep track of which criteria are positively endorsed by the subject. This tool is used to tally the multiple indicators of each criterion in the SSAGA. When a criterion question is rated positively by the interviewer, a tick mark/check is made on the Tally Sheet by that particular question. If at least one indicator is achieved in the left hand column, then the Box field is also checked, indicating that a DMS-IV substance use disorder criteria have been met.
DRUG TALLY SHEET B - DSM-IV CRITERIA This Tally Sheet is used for assessing an abuse and dependence diagnosis. The question numbers are listed in black in the left hand column. The corresponding variable name is listed below the question number in blue. The Tally Sheet is used by the interviewer to keep track of which criteria are positively endorsed by the subject. This tool is used to tally the multiple indicators of each criterion in the SSAGA. When a criterion question is rated positively by the interviewer, a tick mark/check is made on the Tally Sheet by that particular question. If at least one indicator is achieved in the left hand column, then the Box field is also checked, indicating that a DMS-IV substance use disorder criteria have been met.
;) Card G  Interviewer Instructions The following section can be used to train an interviewer administering this protocol. This information provides context for the questions. Marijuana The Marijuana section of the SSAGA-II is fully diagnostic for the DSM-IV criteria. Marijuana has been separated from the general Drug section because use of marijuana is relatively common (according to DSM-III-R, Cannabis is the most widely used illicit psychoactive substance in the United States) and because there are thought to be fewer negative withdrawal, physical, and emotional effects from marijuana, when compared with other drugs such as cocaine, stimulants, and sedatives. Marijuana is usually smoked, but it can be ingested orally as well. It is often used in combination with other substances such as alcohol and cocaine. Symptoms associated with marijuana use include tachycardia, increased appetite, paranoid ideation, panic attack, listlessness and dysphoric effects following cessation of use. Maladaptive behavioral effects include impaired judgement and interference with social or occupational functioning. With cannabis abuse, use is episodic and the person exhibits symptoms of maladaptive behavior, such as driving while under its influence. This section parallels in form and content the Alcohol and Drug sections since all come under the umbrella term of psychoactive substance use. The threshold for entry into this section -- use of marijuana 21 times or more within a single year -- differs from that of the Drug section. This threshold was selected because occasional recreational use is not uncommon in many subsamples of the population. If an individual denies ever having used marijuana then s/he will immediately skip to the next section. If R1 has used marijuana/hashish but never at least 21 times within a single year, R will skip to the Drug section. Question by question specifications:
Substances This is a fully diagnostic section that assesses Drug Abuse and Drug Dependence, using the DSM-IV diagnostic system. The Drug section is similar in form and content to the Tobacco, Alcohol, and Marijuana sections. The questions throughout the section are asked about each class of drug, not each specific drug. The section allows for coding a total of five classes of drugs: cocaine, stimulants, sedatives, opiates, and the class of drugs used most from those remaining (i.e., PCP, hallucinogens, solvents, combination drugs, or drugs that don’t fit in any other category). The specific name or type of drug that will be coded in this fifth column should be noted. If R reports using equal amounts of drugs in more than one of these "other" classes, the interviewer should ask about the class of drugs that caused the most problems. Generally, questions in the Drug section are asked in rows -- meaning that if more than one drug class is being coded, the interviewer asks the question for each coded drug class before moving on to the next question. So, for example: IVR2: "Have you ever wanted to cut down or tried to cut down on cocaine but found that you couldn’t?" IVR: "Did this happen with stimulants?" IVR: "Did this happen with opiates?" (Some respondents may need the stem question repeated more often.) Exceptions to this general pattern include questions 8, 10, and questions that have follow-up "IF YES, ASK:" subquestions. These exceptions should be coded by column, i.e., the questions and subquestions are completed for one drug class before continuing on to the next column. Question by question specifications:
1 R is an abbreviation for Respondent 2 IVR is an abbreviation for Interviewer Marijuana and Other Substances Diagnostic Algorithm - DSM-IV The SAS code for calculating an abuse and dependence diagnosis, based on DSM-IV criteria, can be found at the Collaborative Study on the Genetics of Alcoholism (COGA) website. Variables
Selection Rationale
The Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA), expressly developed for COGA (Collaborative Study on the Genetics of Alcoholism), is a polydiagnostic psychiatric interview that covers the major psychiatric disorders. SSAGA II (revised 1997) covers the major psychiatric disorders in DSM-IV and provides complete diagnoses in DSM-IV, the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; DSM-III-R), and the International Statistical Classification of Diseases and Related Problems (10th rev.; ICD-10). Unique features of the SSAGA compared to other structured research interviews include attention to making diagnoses according to several criteria systems, the addition of nondiagnostic items for phenotyping of alcoholism, and attention to comorbidity of alcohol/substance diagnoses in relation to other non-substance abuse disorders. Source
Semi-Structured Assessment for the Genetics of Alcoholism II (SSAGA II) (questions F1B, F5, F6, F6A, F7, F7A, F7B, F8, F9, F10, F10B, F10C, F17, F17A, G1, G1A, G6, G7, G7A, G7B, G8, G9, G9A, G10, G11, G11B, G11E, G11E2, G12A, G12A2, G12B, G12B1, G12C, G12C1, G18, G18A). The SSAGA was expressly developed for the Collaborative Study on the Genetics of Alcoholism (COGA), which is supported by the National Institutes of Health (NIH) Grant U10AA08401 from the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Life Stage
Adult Language
English Participant
≥18 years of age Personnel and Training Required
Interviewer must be trained and found to be competent to conduct personal interviews with individuals from the general population. The interviewer should be trained to prompt respondents further if a "don’t know" response is provided. Equipment Needs
The Semi-Structured Assessment for the Genetics of Alcoholism II (SSAGA II) instrument was developed to be administered by paper-and-pencil and computer formats. Standards
General References
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author. Bucholz, K. K., Cadoret, R., Cloninger, C. R., Dinwiddie, S. H., Hesselbrock, V. M., Nurnberger, J. I., Jr., Reich, T., Schmidt, I., & Schuckit, M. A. (1994). A new semi-structured psychiatric interview for use in genetic linkage studies: A report on the reliability of the SSAGA. Journal of Studies on Alcohol, 55, 149-158. Bucholz, K. K., Hesselbrock, V. M., Shayka, J. J., Nurnberger, J. I., Jr., Schuckit, M. A., Schmidt, I., & Reich, T. (1995). Reliability of individual diagnostic criterion items for psychoactive substance dependence and the impact on diagnosis. Journal of Studies on Alcohol, 56, 500-505. Hesselbrock, M., Easton, C., Bucholz, K. K., Schuckit, M., & Hesselbrock, V. (1999). A validity study of the SSAGA - A comparison with the SCAN. Addiction, 94(9), 1361-1370. Companion SSAGA instruments for use with children, ages 7-12 years (C-SSAGA-C), adolescents, ages 13-17 years (C-SSAGA-A), and for interviewing parents about their children (C-SSAGA-P) are also available. Please refer to the Collaborative Study on the Genetics of Alcoholism (CSGA) website for information. Mode of Administration
Interviewer-administered questionnaire Derived Variables
None Requirements
Process and Review
The Expert Review Panel has not reviewed this measure yet. Please cite use of the PhenX Toolkit as: http://www.phenxtoolkit.org - April 11, 2017, Ver 21.0 |
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Release: April 11, 2017, Ver 21.0
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