The use of the RCQ-D in patients with poly drug abuse

Abstract

Aim: The transtheoretical model is often used in substance abuse treatment planning. For polydrug abusing patients, operationalizing the stages of change is more difficult, as their readiness to change may differ depending on the substances. It was the aim of this study to investigate if the same structure of the Dutch Readiness to Change Questionnaire (RCQ-D) in a group of alcohol abusers could be found in an inpatient group of polydrug abusers for all substances. Design: For each substance, the structure of RCQ-D was tested using factor-analysis. Internal consistency was evaluated with Cronbach's alpha. Mean scores were calculated to evaluate conformity with stage assignment. Around 305 polydrug abusers completed 1248 RCQ-D during their first week of stay. Findings: The RCQ-D had a different, but interpretable structure from the expected one. A two-factor structure was found for alcohol, nicotine and opiates, a three-factor structure for benzodiazepines, cannabis, methadone and cocaine. The underlying construct, based on the transtheoretical model, seemed to fit for alcohol and nicotine. There were some problems of stage allocation for benzodiazepines, cannabis and methadone. But, people in action could be distinguished from those not in action. More serious problems of allocation were found for opiates and cocaine. Conclusions: RCQ-D can be used to measure polydrug abusers' thinking and use-behaviour separately by substance. The validity of RCQ-D to assign stages in case of opiates and cocaine is unclear

Motivation for Treatment and Motivation for Change in Substance-Dependent Patients with Co-Occurring Psychiatric Disorders

“…Furthermore, we found that motivation for changing substance use differs for the various substances. In line with previous research (Raes et al 2010), we conclude that it is important to assess motivation for change for each substance separately.…”

“…In cocaine-dependent patients, all three factors of the RCQ-D loaded on the same factor, whereas in the other categories a 2-factor solution was found. Previously, Raes et al (2010) found similar results, with the factor structure in cocaine-dependent patients being of a different nature than that for other substance categories.…”

“…This shows that patients indicated rather strong motivation to change their illegal drug use and, to a somewhat lesser extent, their alcohol use, but they were far less motivated to change smoking behavior. These findings were in support of discriminating between substances when assessing motivation for change (Raes et al 2010). These results partly contradicted, however, previous findings by Abellanas and McLellan (1993), who found almost identical profiles for motivation for change among a sample of patients in methadone maintenance treatment for opioid, cocaine, and nicotine use.…”

“…The reliability of each scale was found to be satisfactory (Cronbach's α for PREC = 0.68, CON = 0.70, ACT = 0.81 in the RCQ-D). In our study, we adapted the RCQ-D, which was originally developed for use in alcohol-dependent patients, to a population of polydrug users (Raes et al 2010). Patients filled out a RCQ-D for each substance separately, resulting in substance-specific motivation to change.…”

Readiness-to-change as a moderator of a web-based brief intervention for marijuana among students identified by health center screening

“…Because previous work has shown both two and three factor solutions for the RTCQ (Crackau et al, 2010; Raes et al, 2010), we first conducted a principal component analysis (PCA) of the 12 items using orthogonal (varimax) rotation forcing three and two component structures. Determination of the scale component structure was based on Kaiser's rule (i.e., eigenvalue > 1), item component loading > .4, item factorial complexity of one, and interpretability.…”