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Viability of the World Health Organization quality of life measure to assess changes in quality of life following treatment for alcohol use disorder

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Quality of life is an outcome often examined in treatment research contexts such as biomedical trials, but has been studied less often in alcohol use disorder (AUD) treatment. The importance of considering QoL in substance use treatment research has recently been voiced, and measures of QoL have been administered in large AUD treatment trials. Yet, the viability of popular QoL measures has never been evaluated in AUD treatment samples. Accordingly, the present manuscript describes a psychometric examination of and prospective changes in the World Health Organization Quality of Life measure (WHOQOL-BREF) in a large sample (N = 1383) of patients with AUD recruited for the COMBINE Study.


Specifically, we examined the construct validity (via confirmatory factor analyses), measurement invariance across time, internal consistency reliability, convergent validity, and effect sizes of post-treatment changes in the WHOQOL-BREF.


Confirmatory factor analyses of the WHOQOL-BREF provided acceptable fit to the current data and this model was invariant across time. Internal consistency reliability was excellent (α > .9) for the full WHOQOL-BREF for each timepoint; the WHOQOL-BREF had good convergent validity, and medium effect size improvements were found in the full COMBINE sample across time.


These findings suggest that the WHOQOL-BREF is an appropriate measure to use in samples with AUD, that the WHOQOL-BREF scores may be examined over time (e.g., from pre- to post-treatment), and the WHOQOL-BREF may be used to assess improvements in quality of life in AUD research.

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 This research was supported by grants from the National Institute on Alcohol Abuse and Alcoholism (NIAAA; R01-AA022328, PI: Witkiewitz; F31-AA024959, PI: Kirouac; K01-AA023233, PI: Pearson).

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Correspondence to Megan Kirouac.

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This research was conducted via secondary data analyses and the multi-site parent study involving human subjects research underwent informed consent procedures approved by the host universities.

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My co-authors and I do not have any conflicts of interest that could inappropriately influence, or be perceived to influence, our work.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Kirouac, M., Stein, E.R., Pearson, M.R. et al. Viability of the World Health Organization quality of life measure to assess changes in quality of life following treatment for alcohol use disorder. Qual Life Res 26, 2987–2997 (2017).

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