Abstract
The monitoring of alcohol use by patients undergoing treatment is vital to ensure good clinical care, and to provide data on the effectiveness of therapy. However, many treatment programs do not have systematic procedures for the regular assessment of a patient’s alcohol consumption during treatment and follow-up. Part of the difficulty is due to skepticism about the validity of alcoholics’ self-reports, as well as resource constraints that limit the use of objective measures of alcohol use, such as tests of liver functioning. Although the notion that alcoholics deny the extent of their drinking is widely held, recent studies have found that various populations of alcohol abusers may provide fairly accurate information about their drinking and alcohol-related problems. An important instance where self-reports tend to underestimate drinking is when the patient has a positive blood alcohol level while undergoing the assessment.
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References
American Psychiatric Association, 1980, Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Washington, D.C.
Amit, Z., Sutherland, E. A., and Weiner, A., 1977, Guide to Intelligent Drinking, Fitzhenry and Whiteside, Don Mills, Ontario.
Annis, H. M., 1979, Self-report reliability of skid-row alcoholics, Br. J. Psychiatry 134:459–465.
Armor, D. J., Polich, J. M., and Stambul, H. B., 1978, Alcoholism and Treatment, Wiley, New York.
Bailey, M. B., Haberman, P. W., and Scheinberg, J., 1966, Identifying alcoholics in population surveys: A report on reliability. Q. J. Stud. Alcohol 27:300–315.
Bean, K. L., and Karasievich, G. O., 1975, Psychological test results at three stages of inpatient alcoholism treatment, J. Stud. Alcohol 36:838–852.
Bernadt, M. W., Munford, J., Taylor, C., Smith, B., and Murray, R. M., 1982, Comparison of questionnaire and laboratory tests in the detection of excessive drinking and alcoholism, Lancet 1: 325–328.
Bridell, D. W., and Nathan, P. E., 1975, Behavior assessment and modification with alcoholics: current status and future trends, in: Progress in Behavior Modification, vol. 2 ( M. Hersen, R. M. Eisler, and P. M. Miller, eds.), pp. 1–51, Academic Press, New York.
Cahalan, D., 1970, Problem Drinkers, Jossey-Bass, San Francisco.
Campbell, D. T., and Fiske, D. W., 1959, Convergent and discriminant validation by the multitrait- multimethod matrix, Psychol. Bull. 56:81–105.
Chalmers, D. M., Rinsler, M. C., MacDermott, S., Spicer, C. C., and Levi, A. J., 1981, Biochemical and haematological indicators of excessive alcohol consumption, Gut 22: 992–996.
Chick, J., Krietman, N., and Plant, M., 1981, Mean cell volume and gamma-glutamyl transpeptidase as markers of drinking in working men, Lancet 1: 1249–1251.
Cooper, A. M., Sobell, M. B., Maisto, S. A., and Sobell, L. C., 1980, Criterion intervals for pretreatment drinking measures in treatment evaluation, J. Stud. Alcohol 41:1186–1195.
Cooper, A. M., Sobell, M. B., Sobell, L. C., and Maisto, S. A., 1981, Validity of alcoholics’ self-reports: Duration data, Int. J. Addict. 16: 401–406.
Cronbach, L. J., 1970, Essentials of Psychological Testing, Third edition, Harper and Row, New York.
Devenyi, M. D., Robinson, G. M., Kapur, B. M., and Roncari, D. A. K., 1981, High density lipoprotein cholesterol in male alcoholics with and without severe liver disease, Am. J. Med. 71:589–594.
Echardt, M. J., Ryback, R. S., Rawlings, R. R., and Graubard, B. I., 1981, Biochemical diagnosis of alcoholism, JAMA 246: 2707–2710.
Edwards, G., and Gross, M. M., 1976, Alcohol dependence: Provisional description of clinical syndrome, Br. Med. J. 1:1058–1061.
Edwards, G., Gross, M. M., Keller, J., Moser, J., and Room, R., 1977, Alcohol-Related Disabilities, World Health Organization Offset Publication Number 32, Geneva, Switzerland.
Fuller, R. K., Beebe, H. T., Littell, A. S., Houser, H. B., and Witschi, J. C., 1972, Drinking practices recorded by a diary method, Q. J. Stud. Alcohol 33:1106–1121.
Guze, S. B., and Goodwin, D. W., 1972, Consistency of drinking history and diagnosis of alcoholism, Q. J. Stud. Alcohol 33:111–116.
Guze, S. B., Tuason, V. B., Stewart, M. A., and Picken, B., 1963, The drinking history: A comparison of reports by subjects and their relatives, Q. J. Stud. Alcohol 24:249–260.
Halstead, W., 1947, Brain and Intelligence, University of Chicago Press, Chicago.
Harford, T. C., Dorman, N., and Feinhandler, S. J., 1976, Alcohol consumption in bars: Validation of self-reports against observed behavior, Drink. Drug Pract. Surv. 11:13–15.
Harmer, M. H., 1978, TNM Classification of Malignant Tumors, International Union against Cancer, Geneva, Switzerland.
Hart, L. S., and Stueland, D., 1979, An application of the multidimensional model of alcoholism to program effectiveness, J. Stud. Alcohol 49:645–655.
Holt, S., 1981, Observations on the relation between alcohol absorption and the rate of gastric emptying, Can. Med. Assoc. J. 124:267–278.
Holt, S., Skinner, H. A., and Israel, Y., 1981, Early identification of alcohol abuse: Clinical and laboratory indicators, Can. Med. Assoc. J. 124:1279–1295.
Iber, F. L., and Miller, P. A., 1981, Alcohol among stable cirrhotic patients in a liver clinic, Hepatology 2: 692.
Jalazo, J., Steer, R. A., and Fine, E. W., 1978, Use of breathanalyzer scores in the evaluation of persons arrested for driving while intoxicated, J. Stud. Alcohol 39:1304–1307.
Kalant, H., 1971, Absorption, diffusion, distribution, and elimination of ethanol: Effects on biological membranes, in: The Biology of Alcoholism, ( B. Kissin and H. Begleiter, eds.), pp. 1–63, Plenum Press, New York.
Kapur, B. M., and Israel, Y., 1983, A dipstick methodology for rapid determination of alcohol in body fluids (abst.), Clin. Chem. 29:1178.
Kazdin, A. E., 1974, Self-monitoring and behavior change, in: Self Control: Power to the Person ( N. J. Mahoney and C. E. Thorsen, eds.), pp. 218 - 246, Brooks-Cole, Monterey, California.
Kennedy, R. W., and Gilbert, G. S., 1978, A self-control program for drinking antecedents: The role of self-monitoring and control orientation, J. Clin. Psychol. 34:238–243.
Lishman, W. A., 1981, Cerebral disorder in alcoholism: Syndromes of impairment, Brain 104:1–20.
Maisto, S. A., Sobell, L. C., and Sobell, M. B., 1979a, Comparison of alcoholics’ self reports of drinking behavior with reports of collateral informants, J. Consult. Clin. Psychol. 47: 106–112.
Maisto, S. A., Sobell, M. B., Cooper, A. M., and Sobell, L. C., 19796, Test-retest reliability of retrospective self-reports in three populations of alcohol abusers, J. Behav. Assess. 1:315–326.
Maisto, S. A., Sobell, M. B., and Sobell, L. C., 1982a, Reliability of self-reports of low ethanol consumption by problem drinkers over 18 months of follow-up, Drug Alcohol Depend. 9: 273–278.
Maisto, S. A., Sobell, M. B., Cooper, A. M., and Sobell, L. C., 19826, Comparison of two drinking techniques to obtain retrospective reports of drinking behavior from alcohol abusers, Addict. Behav. 7:33–38.
McColl, K. E. L., Whiting, B., More, M. W., and Goldberg, A., 1979, Correlation of ethanol concentrations in blood and saliva, Clin. Sci. 56:283–286.
McCrady, B. S., Paolino, T. J., and Longabaugh, R., 1978, Correspondence between reports of problem drinkers and spouses on drinking behavior and impairment, J. Stud. Alcohol 39:1252–1257.
Midanik, L., 1982a, The validity of self-reported alcohol consumption and alcohol problems: A literature review, Br. J. Addict. 77:357–382.
Midanik, L., 19826, Overreports of recent alcohol consumption in a clinical population: A validity study, Drug Alcohol Depend. 9:101–110.
Miller, P. M., 1975, A behavioral intervention program for chronic public drunkenness offenders, Arch. Gen. Psychiatry 32:593–596.
Miller, P. M., Hershen, M., Eisler, R. M., and Watts, J. G., 1974, Contingent reinforcement of lowered blood alcohol levels in an outpatient chronic alcoholic, Behav. Res. Ther. 12:261–263.
Miller, W. R., and Munoz, R. F., 1976, How to Control your Drinking, Prentice-Hall, Englewood Cliffs, New Jersey.
Miller, W. R., Crawford, V. L., and Taylor, C. A., 1979, Significant others as corroborative sources for problem drinkers, Addict. Behav. 4:67–70.
Morgan, M. Y., Colman, J. C., and Sherlock, S., 1981, The use of a combination of peripheral markers for diagnosing alcoholism and monitoring for continued abuse, Br. J. Alcohol Alcoholism 16:167–177.
Nelson, R. O., 1977, Assessment and therapeutic functions of self-monitoring, in: Progress in Behavior Modification, ( M. Hersen, R. M. Eisler, and P. M. Miller, eds.), pp. 264–308, Academic Press, New York.
O’Farrell, T. J., and Connors, G. J., 1982, Obtaining driver’s license records for use in evaluating alcoholism treatment, J. Stud. Alcohol 43: 1046–1052.
Orrego, H., Blendis, L. M., Blake, J. E., Kapur, B. M., and Israel, Y., 1979, Reliability of assessment of alcohol intake based on personal interviews in a liver clinic, Lancet, 2: 1354–1356.
Papoz, L., Warnet, J. M., Pequignot, G., Eschwege, E., Claude, J. I., and Schwartz, D., 1981, Alcohol consumption in a healthy population: Relationship to gamma-glutamyl transferase activity and mean corpuscular volume, JAMA 245:1748–1751.
Pernanen, K., 1974, Validity of survey data on alcohol use, in: Research Advances in Alcohol and Drug Problems, vol. I ( R. J. Gibbons, Y. Israel, H. Kalant, R. E. Popham, W. Schmidt, R.G. Smart, eds.), pp. 355–374, Wiley, New York.
Phillips, M., 1982, Sweat-patch test for alcohol consumption: Rapid assay with an electrochemical detector, Alcohol. Clin. Exp. Res. 6:532–534.
Phillips, M., and McAloon, M. H., 1980, A sweat-patch test for alcohol consumption: Evaluation in continuous and episodic drinkers, Alcohol. Clin. Exp. Res. 4:391–395.
Polich, M. J., 1981, Epidemiology of alcohol abuse in military and civilian populations, Am. J. Public Health 111 1125–1132.
Polich, M. J., 1982, The validity of self-reports in alcoholism research, Addict. Behav. 7:123–132.
Pomerleau, O., and Adkins, D., 1980, Evaluating behavioral and traditional treatment for problem drinkers, in: Evaluating Alcohol and Drug Abuse Treatment Effectiveness ( L. C. Sobell, M. B. Sobell, and E. Ward, eds.), pp. 93–128, Pergamon Press, New York.
Popham, R. E., and Schmidt, W., 1981, Words and deeds: The validity of the self-report data on alcohol consumption, J. Stud. Alcohol 42:355–368.
Rankin, J. G., 1975, Alcohol, Drugs and Brain Damage, Addiction Research Foundation, Toronto.
Rohan, W. P., 1976, Quantitative dimensions of alcohol use for hospitalized problem drinkers, Dis. Nerv. Syst. 37:154–159.
Ryback, R. S., Eckardt, M. J.; Felsher, B., and Rawlings, R. R., 1982a, Biochemical and he-matologic correlates of alcoholism and liver disease, JAMA 248: 2261–2265.
Ryback, R. S., Eckardt, M. J., Rawlings, R. R., and Rosenthal, L. S., 1982b, Quadratic discriminant analysis as an aid to interpretive reporting of clinical laboratory tests, JAMA 248: 2342–2345.
Sanchez-Craig, M., and Annis, H. M., 1981, Gamma-glutamyl transpeptidase and high density lipoproteins cholesterol in male problem drinkers: Advantages of a composite index for predicting alcohol consumption, Alcohol. Clin. Exp. Res. 5:540–544.
Sanchez-Craig, M., and Annis, H. M., 1982, Self-monitoring and recall measures of alcohol consumption: Convergent validity with biochemical indices of liver function, Br. J. Alcohol Alcoholism 17:117–121.
Sellers, E. M., and Kalant, H., 1976, Alcohol intoxication and withdrawal, N. Engl. J. Med. 294:757–762.
Skinner, H. A., 1981, Assessment of alcohol problems: basic principles, critical issues and future trends, in: Research Advances in Alcohol and Drug Problems, Vol. 6, ( Y. Israel, F. B. Glaser, H. Kalant, R. E. Popham, W. Schmidt, and R. G. Smart, eds.), pp. 319–369, Plenum Press, New York.
Skinner, H. A., 1982, Alcohol abuse: Strategy for early detection and brief intervention, workshop sponsored by the Association for Medical Education and Research in Substance Abuse and by the World Health Organization, November 15–16, 1982, Berkeley, California.
Skinner, H. A., and Allen, B. A., 1982, Alcohol dependence syndrome: measurement and validation, J. Abnorm. Psychol. 91:199–209.
Skinner, H. A., and Allen, B. A., 1983, Does the computer make a difference? Computerized versus face-to-face versus self-report assessment of alcohol, drug and tobacco use, J. Consult, Clin. Psychol. 51:267–275.
Skinner, H. A., 1983, Screening for alcohol dependence with drinking-driver offenders, unpublished manuscript.
Skinner, H. A., and Horn, J. L., 1984, Guidelines for Using the Alcohol Dependence Scale (ADS), Addiction Research Foundation, Toronto.
Skinner, H. A., and Sheu, W. J., 1982, Reliability of alcohol use indices: Lifetime drinking history and MAST, J. Stud. Alcohol 42:1157–1170.
Sobell, L. C., and Sobell, M. B., 1973, A self-feedback technique to monitoring drinking behavior in alcoholics, Behav. Res. Ther. 11:237–238.
Sobell, L. C., and Sobell, M. B., 1975, Outpatient alcoholics give valid self-reports, J. Nerv. Ment. Dis. 161:32–42.
Sobell, L. C., and Sobell, M. B., 1978, Validity of self-reports in three populations of alcoholics, J. Consult. Clin. Psychol. 46:901–907.
Sobell, L. C., and Sobell, M. B., 1980, Convergent validity: An approach to increasing confidence in treatment outcome conclusions with alcohol and drug abusers, in Evaluating Alcohol and Drug Abuse Treatment Effectiveness, ( L. C. Sobell, M. B. Sobell, and E. Ward, eds.), pp. 177–183, Pergamon Press, New York.
Sobell, L. C., and Sobell, M. B., 1981, Effects of three interview factors on the validity of alcohol abusers’ self-reports, Am. J. Drug Alcohol Abuse 8: 225–237.
Sobell, M. B., Sobell, L. C., and Vanderspek, R., 1979a, Relationships among clinical judgment, self-report, and breath analysis measures of intoxication in alcoholics, J. Consult. Clin. Psychol. 47:204–206.
Sobell, L. C., Maisto, S. A., Sobell, M. B., and Cooper, A. M., 19796, Reliability of alcohol abuser’s self-reports of drinking behavior, Behav. Res. Therapy 17:157–160.
Sobell, L. C., Cellucci, T., Nirenberg, T. D., and Sobell, M. B., 1982, Do quantity-frequency data underestimate drinking-related health risks ? Am. J. Public Health 72: 823–828.
Stockwell, T., Murphy, D., and Hodgson, R., 1983, The severity of alcohol dependence questionnaire: Its use, reliability and validity, Br. J. Addict. 78:145–155.
Uchalik, D. C., 1979, A comparison of questionnaire and self-monitored reports of alcohol intake in a nonalcoholic population, Addict. Behav. 4:409–413.
Wechsler, D., 1955, Manual for the Wechsler Adult Intelligence Scale, Psychological Corporation, New York.
Wiggins, J. S., 1973, “Personality and Prediction: Principles of Personality Assessment,” Addison- Wesley, Reading, Massachusetts.
Wilkinson, D. A., and Carlen, P. L., 1981, Chronic organic brain syndromes associated with alcoholism, in: Research Advances in Alcohol and Drug Problems, Vol. 6 ( Y. Israel, F. B. Glaser, H. Kalant, R. E. Popham, W. Schmidt, and R. G. Smart, eds.), pp. 107–145, Plenum Press, New York.
Wilkinson, D. A., and Sanchez-Craig, M., 1981, Relevance of cognitive dysfunction to treatment objectives: Should alcohol-related cognitive deficits influence the way we think about treatment, Addict. Behav. 6:253–260.
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Skinner, H.A. (1984). Assessing Alcohol Use by Patients in Treatment. In: Smart, R.G., et al. Research Advances in Alcohol and Drug Problems. Research Advances in Alcohol and Drug Problems, vol 8. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2719-6_6
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DOI: https://doi.org/10.1007/978-1-4613-2719-6_6
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