Psychometric Properties of the Arabic Version of the Addiction Severity Index (ASI-5): A Cross-Cultural Validation Study in Egypt and Saudi Arabia.

Background: The Addiction Severity Index (ASI) is a globally recognized tool for assessing substance use disorder (SUD) severity. Despite its widespread use, no validated Arabic version exists. This study aimed to validate the Arabic ASI-5 in Egypt and Saudi Arabia and evaluate its psychometric properties.

Methods: : A cross-sectional study recruited 400 participants (200 per country) from inpatient/outpatient SUD treatment centers. The ASI-5 underwent forward-backward translation, pilot testing, and cultural adaptation. Internal consistency (Cronbach's α), test-retest reliability (Spearman's ρ), and inter-observer reliability were assessed. Convergent and discriminant validity were evaluated using adjusted Spearman's correlations.

Results: The Arabic ASI-5 demonstrated acceptable internal consistency (α = 0.61-0.82), with medical (α = 0.78) and psychiatric (α = 0.82) domains showing the highest reliability. Lower consistency in drug (α = 0.62) and legal (α = 0.61) domains reflected cultural and methodological factors. Test-retest (ρ = 0.55-0.98) and inter-observer reliability (ρ = 0.78-0.99) were strong. Convergent validity was robust for medical and psychiatric domains (r = 0.70-0.85).

Conclusion: The Arabic ASI-5 is a reliable tool for assessing SUD severity in Arabic-speaking populations. Further refinement of drug and legal domains is recommended to enhance cultural relevance.