Assessing motivation for change: Preliminary development and evaluation of a scale measuring the costs and benefits of changing alcohol or drug use.

Cunningham, John A.; Sobell, Linda C.; Gavin, Douglas R.; Sobell, Mark B.; Breslin, F. Curtis

doi:10.1037/0893-164x.11.2.107

Cited by 66 publications

(59 citation statements)

References 23 publications

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“…The two subscales, costs of quitting and benefits of quitting, are supported by factor analysis and are internally consistent (alphas = .90 and .92, respectively) (Cunningham et al, 1997 Folstein et al, 1975) provide evidence of validity. Patients scoring 23 or less (the standard cutoff score for dementia) were generally excluded from the study.…”

Section: Alcohol and Drug Consequences Questionnaire (Adcq) (Cunninghmentioning

confidence: 88%

“…The lowest response option is 0 ("probably will not happen to me"); other options reflect that the consequence "probably will happen to me and it is "not important" (1) to "extremely important" (5). Because the response format proved confusing to pilot participants, we administered the ADCQ orally and asked two questions: (a) Was the specified consequence likely to occur (yes or no); if not, we entered a "0" and proceeded to the next item; (b) If yes, we then asked how important that consequence was to them in their decision to "cut down or stop using" their primary substance, using the 1-5 response options.The two subscales, costs of quitting and benefits of quitting, are supported by factor analysis and are internally consistent (alphas = .90 and .92, respectively) (Cunningham et al, 1997 Folstein et al, 1975) provide evidence of validity. Patients scoring 23 or less (the standard cutoff score for dementia) were generally excluded from the study.…”

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confidence: 88%

“…We expanded the assessment of readiness-to-change variables to include the following self-report measures: (a) the Recognition, Ambivalence, and Taking Steps subscales from the SOCRATES, (b) pros and cons of continuing to use substances (from the Decisional Balance Scale; King & DiClemente, 1993), and (c) pros and cons of quitting (from the Alcohol and Drug Consequences Questionnaire; Cunningham, Sobell, Gavin, Sobell, & Breslin, 1997). Psychometric evaluation of these theoretically related constructs may provide tools to enhance our understanding of the generalizability of models of change to different populations of substance users.…”

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confidence: 99%

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Measuring readiness-to-change substance misuse among psychiatric outpatients: I. Reliability and validity of self-report measures.

et al. 2001

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Objective-The high rates of comorbid substance use disorders among persons living with severe and persistent mental illness (SPMI) have increased interest in assessing and enhancing motivation to change substance misuse in this population. This study provides evidence for the psychometric adequacy of three self-report measures of readiness-to-change.Method-The sample consisted of 84 persons (65% men) with co-occurring substance abuse or dependence and an SPMI. After a psychiatric assessment, participants completed three measures of readiness-to-change, which yielded seven subscales: (1) the Stages of Change Readiness and Treatment Eagerness Scale (ambivalence about change, recognition of substance-related problems, taking steps), (2) Decisional Balance Scale (pros of using, cons of using) and (3) the Alcohol and Drug Consequences Questionnaire (costs of quitting, benefits of quitting).Results-All of the subscales were stable over time, and 6 of the 7 subscales demonstrated excellent internal consistency. Reliability indices were comparable when analyses were repeated on subsets of participants defined by diagnosis, cognitive function, positive symptoms and negative symptoms. A pattern of theoretically meaningful intercorrelations provided convergent evidence of validity, and a general lack of relationships with demographic variables and indices of psychiatric status provided discriminant evidence of validity. These findings support efforts to quantify readiness-to-change substance misuse among persons with an SPMI.Substance use disorders are highly prevalent among persons with schizophrenia and other major mental illnesses. Persons with major (Axis I) mental disorders have three times the risk of drug or alcohol diagnoses compared to the rest of the population (Regier et al., 1990). Persons with schizophrenia represent a particularly high risk group for problems related to substance use. Among all persons with a diagnosis of schizophrenia, 47% meet lifetime criteria for a substance use disorder (Regier et al., 1990). This prevalence rate is often higher in samples of schizophrenic patients in treatment (Mueser et al., 1990;Test, Wallisch, Allness, & Ripp, 1989).A diagnosis of substance abuse or dependence impairs both the process and outcome of mental health treatment. Symptom exacerbation and psychiatric admissions have both been linked to acute drug use in outpatients with a severe and persistent mental illness (SPMI), such as schizophrenia (Haywood et al., 1995;Shaner et al., 1995). Individuals enrolled in outpatient treatment and "dually diagnosed" with psychiatric and substance use disorders exhibit poor (Keck, McElroy, Strakowski, Bourne, & West, 1997;Owen, Fischer, Booth, & Cuffel, 1996;Pristach & Smith, 1990), report more severe psychiatric symptoms (Carey, Carey, & Meisler, 1991), and involve themselves minimally in structured treatment programs Lehman, Herron, Schwartz, & Myers, 1993;Richardson, Craig, & Haugland, 1985). This pattern of poor treatment compliance and exacerbated symptoms leads ...

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Section: Alcohol and Drug Consequences Questionnaire (Adcq) (Cunninghmentioning

confidence: 88%

mentioning

confidence: 88%

mentioning

confidence: 99%

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Measuring readiness-to-change substance misuse among psychiatric outpatients: I. Reliability and validity of self-report measures.

et al. 2001

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“…Unfortunately, instruments for assessing dimensions of substance abuse other than quantity/frequency tend to cover only a single class of substances. Hence, many widely-used assessments of craving (Anton and Drobes, 1998), drug-related expectancies (Galen and Henderson, 1999;Solomon and Annis, 1989), and motivation to change (Cunningham et al, 1997;McConnaughy et al, 1983) have been developed and validated separately for individual classes of substances.…”

Section: Dealing With Assessment Burdenmentioning

confidence: 99%

Single versus multiple drug focus in substance abuse clinical trials research

Rounsaville

Petry

Carroll

2003

Drug and Alcohol Dependence

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Complex patterns of multiple substance use pose clinical and methodological challenges for substance abuse clinical trials research. To increase measurement precision and internal validity, the modal approach has been to target both treatment interventions and outcome assessment to a single class of abused substance. This strategy warrants reconsideration because it entails limitations in recruitment feasibility and generalization of study findings. This report reviews pros and cons of single versus multiple targeted drugs, suggests guidelines for choosing between these strategies and outlines methods for broadening the scope of substance abuse clinical trails to take abuse of multiple substances into account. We recommend that investigators consider moving away from a single drug focus in three ways. First, include systematic assessment of a wide range of psychoactive substance use throughout the trial and evaluate the impact of study treatments on use of all classes of drugs. Second, except where contraindicated, include patients who use and abuse multiple classes of substances even in trials evaluating treatment of a single targeted drug. Third, consider inclusion of polysubstance abusers or those who primarily abuse multiple classes of substances in the same clinical trial. Although many treatment efficacy questions can best be answered by single focus studies, we recommend that such designs be adopted only after less restrictive designs are first considered.

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“…Items were taken from the Alcohol and Drug Consequences Questionnaire (Cunningham et al, 1997) and the Decisional Balance for Immoderate Drinking Scale (Migneault et al, 1999). All responses were on a 5-point Likert scale, anchored by not important and extremely important.…”

Section: Potential Mediators (A) Drinking To Cope With Stressmentioning

confidence: 99%

Testing Cross-Sectional and Prospective Mediators of Internalized Heterosexism on Heavy Drinking, Alcohol Problems, and Psychological Distress Among Heavy Drinking Men Who Have Sex With Men

Kuerbis

Mereish

Hayes

et al. 2017

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: Minority stress theory is one of the primary theories used to understand substance use among lesbian, gay, and bisexual populations. This study tested whether drinking to cope with stress (DTC), loneliness, and gay community participation (GCP) mediated the relationship between one type of minority stress (i.e., internalized heterosexism) and behavioral health outcomes. Method: Using secondary data analysis and the PROCESS procedure, relationships between internalized heterosexism, the mediators (DTC, loneliness, and GCP), and outcomes (heavy drinking, alcohol problems, and psychological distress) were explored, both cross-sectionally and in a lagged manner, among both treatment-seeking and non-treatment-seeking problem drinking men who have sex with men. Problem drinkers (N = 187) were assessed, provided brief normative feedback about their drinking, given the choice to receive brief alcohol use disorder treatment or change on their own, and then followed for 9 months. Results: Cross-sectional findings revealed that internalized heterosexism was significantly associated with heavy drinking, alcohol problems, and psychological distress. DTC emerged as a significant mediator of internalized heterosexism for all the health outcomes. Loneliness and GCP were significant mediators of internalized heterosexism for alcohol problems and psychological distress. Multiple mediation models reveal that all three mediators significantly contribute to internalized heterosexism's effect on health outcomes. Lagged analyses did not yield any significant indirect effects. Conclusions: DTC, loneliness, and GCP all play an integral, mediational role in the relationship between internalized heterosexism and alcohol problems and psychological distress. Findings underscore the necessity of addressing internalized heterosexism in psychosocial interventions along with coping skills training, emphasizing culturally relevant social support and loneliness. (J. Stud. Alcohol Drugs, 78, 113-123, 2017)

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Assessing motivation for change: Preliminary development and evaluation of a scale measuring the costs and benefits of changing alcohol or drug use.

Cited by 66 publications

References 23 publications

Measuring readiness-to-change substance misuse among psychiatric outpatients: I. Reliability and validity of self-report measures.

Measuring readiness-to-change substance misuse among psychiatric outpatients: I. Reliability and validity of self-report measures.

Single versus multiple drug focus in substance abuse clinical trials research

Testing Cross-Sectional and Prospective Mediators of Internalized Heterosexism on Heavy Drinking, Alcohol Problems, and Psychological Distress Among Heavy Drinking Men Who Have Sex With Men

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