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Spectrum project

SCI-SUBS
STRUCTURED CLINICAL INTERVIEW
FOR SUBSTANCE USE SPECTRUM
Version 1.0
October 31, 2004
Cassano GB, Sbrana A, Frank E, Dell’Osso L, Shear MK, Maser JD, Endicott
J, Mauri M, Grochocinski VJ, Gonnelli C, Impagnatiello P, Pacciardi B
Acknowledgements: The development of this instrument was supported by a grant from Pfizer-Roering INTRODUCTION: SUBSTANCE USE SPECTRUM
Thank you for coming in to talk with me today. The interview we are going to do is focused on experiences that you may or may not have had in your life. We would like to know whether you have had these experiences at any time, even if it was a long time ago. There are six sections of the interview and it will take half an hour to complete it. Do you have any questions before we start? DOMAIN I. SUBSTANCE USE
Most people have tried things like coffee, tea, cigarettes, alcohol or chocolate. I would like to ask you about your experience with them. Did you ever drink a lot of coffee, tea or cola? If yes, did you start before the age of 15? Did you ever smoke or chew a lot of tobacco? If yes, did you start before the age of 15? If yes, did you start before the age of 15? If yes, did you start before the age of 15?
A. Medications

Are you the type of person who seeks medication whenever you experience a physical symptom or some kind of stress? Have you ever used the following drugs more than other people and/or without a medical
prescription?

diet pills (such as amphetamine, Xenical, Didrex, Adderal, Desoxyne, Redux, Dexedrine, Tenuate, Pondimin, Adipex-p)? steroids (such as Android, Halotestin, Andro L.A., Delatest, Depotest)? DOMAIN I. SUBSTANCE USE (continued)
Have you ever used the following drugs more than other people and/or without a medical
prescription?

Nose sprays (such as Astelin, Beclovent, Rhinocort, Intal, Decadron, Pain killers (such as Tylenol, Codaphen, Precocet, Proval, Ascriptin, Codeine, Advil, Excedrin, Orudis, Aleve, Talwin)? Cough medicines (such as Benylin, Sudafed Cough, Bromphen Tranquillizers (such as Librium, Tranxene T-TAB, Xanax, Valium)? Sleeping pills (such as Atarax, Halcion, Ambien, Sonata, Pro-Som, Allergy reliefs (such as Zyrtec, Unisom, Hismanal, Periactin, Barbiturates (such as Mebral, Nembutal)? B. Recreational Drugs

NOTE to interviewer: if the patient says ‘yes,’ then ask if they just tried it, used it occasionally, or used
regularly/often.

Now I want to ask you whether you have ever tried…
…ecstasy or other amphetamines (such as speed, …inhalants (such as glue, nail-polish, poppers)? …opioids (such as heroin, morphine, methadone, …other substances to get high or come down off a DOMAIN II. SUBSTANCE SENSITIVITY
After using caffeine, tobacco, alcohol, drugs or medications, did you ever…
…have a different reaction than other people? …have a change in your mood or behavior? …have an allergic or other bad reaction?
Did you ever notice that your use of caffeine, alcohol, cigarettes, medications or any of the drugs
mentioned so far…

Have you ever found yourself thinking about caffeine, alcohol, cigarettes, medications or any of
the other drugs mentioned above…

…as if they were an important part of your life? …as if your life would be unbearable without them? DOMAIN II. SUBSTANCE SENSITIVITY (continued)
Did you ever use prescribed medications…
…for reasons other than they were intended? …looking for an effect different from the one intended? …at a higher dose than that prescribed in order to get high? …by combining them in order to get high? Did you ever inject any of the drugs or medications we talked about…
DOMAIN III. USE OF SUBSTANCES OR DRUGS AS SELF-MEDICATION

A. Mood/Anxiety

Did you ever use caffeine, tobacco, alcohol, drugs or medications without the advice of your
doctor in order to…

.improve your mood (for example, to feel less irritable, angry, or sad)? …relieve tension, anxiety, or any kind of discomfort or to escape from your …help make important or difficult decisions? …feel capable of doing things successfully? …achieve or maintain a sense of euphoria? DOMAIN III. USE OF SUBSTANCES OR DRUGS AS SELF-MEDICATION (continued)

Did you ever use caffeine, tobacco, alcohol, drugs or medications without the advice of your
doctor in order to…

…feel better after something bad happened? …tolerate persistent pain or other physical symptoms? thoughts, urges or images that bother you? …control repetitive behaviors that bother you?
B. Improving performance

Did you ever use caffeine, tobacco, alcohol, steroids, drugs or medications without the advice of
your doctor in order to…

…improve your ability to speak in public? …feel more comfortable in the situations we have just described? DOMAIN III. USE OF SUBSTANCES OR DRUGS AS SELF-MEDICATION (continued)

C. Social disinhibition

Did you ever use caffeine, tobacco, steroids, alcohol, drugs or medications without the advice of
your doctor in order to…

…increase your self-confidence when talking with other people? …increase your self-confidence in sex? …increase your confidence in particular situations such as artistic …feel at ease in romantic relationships? …be able to participate at parties, in group games, or in group sports? …talk or not be shy with people that you don’t know very well? …get over fear of being judged by others? …get over fear of being considered stupid or foolish? …avoid appearing nervous, for example, by blushing, shaking, sweating? …reduce the fear of fainting in public or in situations you believe to be …avoid feeling uncomfortable when just thinking about the above D. Weight control
In order to control your weight, did you ever take substances…

…such as amphetamines, ecstasy, cocaine, diet pills or other …such as thyroid hormones, steroids, diuretics, laxatives or enemas? …along with intense physical exercise? DOMAIN III. USE OF SUBSTANCES OR DRUGS AS SELF-MEDICATION (continued)
E. Body image
Did you ever take drugs because you felt…

…dissatisfied with your physical appearance? Did you ever…
…try to improve your physique by taking steroids? …take steroids without considering the health consequences? …continue taking steroids despite negative effects such as excessive hair growth, loss of sexual interest, rage reactions, or prostate or other medical F. Other conditions
Did you ever use alcohol, drugs or medications in order to…

…take part in magical or secret ceremonies? …expand your mind or enhance your spirituality? …reach a higher level of self-awareness? DOMAIN IV: SENSATION SEEKING

Now I would like to ask you about the kinds of things you like to do.

Are you the type of person or have others told you that you…
…enjoy doing something dangerous like driving fast on a dangerous …find exciting what others find dangerous? …think you can do anything without regard for rules or regulations? …follow your instinct without really thinking about what you are doing? …break the rules if you think you are able to do it without consequences? …like trying new ways of doing things? DOMAIN V: ATTENTION DEFICIT
Are you the type of person who tends to be restless, always on the go, not Were you like that as a child (jumping, running, etc.)? Are you the type of person who often interrupts other people’s Are you the type of person who has difficulty paying attention at work or DOMAIN VI: SYMPTOMS OF SUBSTANCE USE DISORDER

NOTE to the interviewer: If the patient has never used any substances (that is, alcohol, caffeine,
tobacco, marijuana, psychostimulants, hallucinogens, opioids, inhalants or other drugs or medications
without the advice of a doctor), score all the items in this domain NO and conclude the interview.

A. Abuse
If you have ever used any of the following substances, that is, alcohol, caffeine, tobacco,
marijuana, psychostimulants, hallucinogens, opioids, inhalants or other drugs or medications
without the advice of a doctor, because of their use, did you ever notice or did anyone ever tell
you that…

…your work performance, including housework, was poor? …you should quit taking drugs because you were a danger to yourself or …you were at risk of having (or continue to have) legal problems?
B. Addiction
During the times when you most heavily used alcohol, caffeine, cigarettes, drugs or medications,
did you ever…

…have difficulty quitting or reducing their use? …have withdrawal symptoms or other problems after reducing or …feel that you could not control their use? Did you ever notice or did anyone ever tell you that you used alcohol, caffeine, tobacco, drugs or
medications…

…even though it caused you health problems? …even though it caused trouble with your family or your social life? …even though it caused problems at work or school? …for longer periods or in greater quantities than you planned to? DOMAIN VI: SYMPTOMS OF SUBSTANCE USE DISORDER (continued)
Have you ever…
…made attempts to stop or greatly reduce your use of substances? …spent a lot of time trying to obtain substances or recovering from their effects (for example, visiting many doctors or driving long distances)? C. Tolerance
Taking drugs or medications without the advice of your doctor, did you ever notice that…

…the amount you were taking no longer gave you the effect you wanted? …you need higher or more frequent doses to get the effect that you
D. Withdrawal

Did you ever notice or did anyone ever tell you that…

…you have withdrawal symptoms or that you felt bad after stopping or reducing the use of caffeine, tobacco or chocolate? …you have withdrawal symptoms or that you felt bad after stopping or reducing the use of alcohol, medications or other drugs? …you need to use alcohol, medications or drugs to avoid or reduce withdrawal symptoms (for example, insomnia, nausea, sweating, vomiting, tremors, muscle pain, agitation)? …you need to use alcohol, medications or drugs to avoid or reduce bad feelings such as anxiety, depression, irritability?
E. Intoxication

Did you ever notice or did anyone ever tell you that when you used substances…
…your behavior was improper, strange, or out of character? …you had disturbing or strange thoughts? …you could not concentrate or you used poor judgment?

Source: http://www.spectrum-project.org/questionnaires/pdfs/SCI-SUBS%207-7-05.pdf

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