A brief measure for the assessment of coping self-efficacy among alcohol and other drug users.

AIMS: To develop a reliable and valid brief measure of coping self-efficacy for substance users to serve the needs of clinicians and researchers who desire a global measure of a client's confidence across high-risk situations. The eight-item global measure of self-efficacy was derived from the Drug-Taking Confidence Questionnaire (DTCQ), a 50-item self-report measure of situation-specific coping self-efficacy applicable to alcohol and other drug users. DESIGN: The questionnaire was administered by trained staff to clients at intake to treatment. Items were selected using stepwise regression. Reliability and construct validity were assessed using alpha and correlation coefficients. SETTING: An addiction treatment facility in Toronto, Ontario. PARTICIPANTS: Seven hundred and thirteen English-speaking adults presenting for treatment with an alcohol or other drug problem. The sample was comprised of alcohol (344), cocaine (253), heroin (53), cannabis (43), other drug (20) users. MEASUREMENTS: The DTCQ: perceived difficulty quitting, motivation to quit and confidence in quitting; depression score (SCL-90-R); and motivation scores (SOCRATES-revised). FINDINGS: An eight-item version (DTCQ-8) accounted for 95% of the variance in the total DTCQ-50 scores and correlated 0.97 with the total DTCQ-50 score. Reliability and validity for the DTCQ-8 as a global indicator of coping self-efficacy was confirmed. CONCLUSIONS: Clinically, the DTCQ-8 is useful for the assessment and monitoring of confidence levels during treatment. The DTCQ-8 is a promising research tool for inclusion in outcome evaluation batteries that require a brief, reliable and valid measure of coping self-efficacy.

Gender in relation to relapse crisis situations, coping, and outcome among treated alcoholics.

Relapse crisis situations resulting in successful coping (i.e., abstinence) and unsuccessful coping (i.e., relapse) were examined in 90 male and 35 female alcohol clients over the first 12 weeks following treatment discharge. More similarities than differences were observed between the genders in the relapse crisis situations encountered, the number and type of coping strategies used, and the drinking outcome results. A similar proportion of males and females successfully abstained in the first 12 weeks posttreatment; a combination of cognitive and behavioral coping was most frequently used by both genders, and negative emotional states constituted the most commonly reported relapse crisis situation. Survival of a relapse crisis was strongly associated with the number of coping strategies used by both men and women. There was a nonsignificant trend for females to relapse more frequently in negative affect situations (i.e., negative emotions, conflict with others) and males in the presence of other drinkers. Further studies employing larger sample sizes are needed to examine gender differences in the process of relapse.

Retention in substance abuse treatment. Role of psychiatric symptom severity.

The authors investigated the association between psychiatric symptom severity and subsequent treatment retention among substance abusers. The Symptom Check List-90-R was administered, after admission to an addiction treatment facility, to 308 male and 106 female clients with moderate-to-severe substance abuse problems. Mean scores on nine symptom and three summary scales were computed. Controlling for other sociodemographic and treatment variables, somatization was significantly associated with dropout from specialized outpatient and inpatient treatment programs. This study, however, suggests that psychopathologic symptom severity at admission has only limited utility in predicting subsequent treatment retention among substance abusers with overall moderate levels of psychological distress.

Development and validation of the drug-taking confidence questionnaire: a measure of coping self-efficacy.

The Drug-Taking Confidence Questionnaire (DTCQ; Annis & Martin, 1985) is a 50-item self-report questionnaire developed to assess situation-specific coping self-efficacy for use of a particular substance of abuse (e.g., cocaine, heroin, alcohol, cannabis, etc.). Results from exploratory and confirmatory factor analyses of the DTCQ on 713 clients seeking treatment at an addiction treatment facility provided strong evidence for the situation-specificity of efficacy beliefs. An 8-factor first-order model, based on the eight high-risk categories for relapse identified by G.A. Marlatt (Marlatt & Gordon, 1980) and a 3-factor second-order model (i.e., negative situations, positive situations, and temptation situations) provided the best fit to the data. All eight subscales of the DTCQ were shown to have good reliability (alphas .79 to .95). Extensive convergent and discriminant validity analyses for the DTCQ and its subscales in relation to ADS, DAST, OES, DRIE, SCQ, SCL-90R, BDI, HS, and SOCRATES substantiate that the DTCQ is a promising tool for further research and clinical application.

Measurement of antecedents to drug and alcohol use: psychometric properties of the Inventory of Drug-Taking Situations (IDTS).

The development, factor structure, and validity of the Inventory of Drug-Taking Situations (IDTS) is described. This 50-item self-report questionnaire, which is an extension of the Inventory of Drinking Situations (Annis, 1982. Inventory of drinking situations; Annis, Graham & Davis, 1987, Inventory of drinking situations (IDS): User's guide), is designed to assess the situational antecedents to use of a wide range of drugs of abuse. The IDTS consists of 8 subscales that measure a client's substance use in the 8 situations identified in the work of Marlatt (1978, Alcoholism: New directions in behavioral research and treatment): Unpleasant Emotions, Physical Discomfort, Pleasant Emotions, Testing Personal Control, Urges and Temptations to Use, Conflict with Others, Social Pressure to Use, and Pleasant Times with Others. Reliability, factor structure and validity of the IDTS were assessed on 699 clients admitted to the Addiction Research Foundation's treatment facility in Toronto. The IDTS was shown to have reliable subscales. The IDTS total score correlated with self-ratings of the severity of the clients' substance use problem, and with retrospective reports of frequency of use (drugs) and quantity of use (alcohol), years of usage, and severity of dependence. Confirmatory factor analysis was used to test the fit of the data to Marlatt's model of substance use situations, as well as to several alternative models. The goodness-of-fit indicators suggested that the best fit for the data was an 8-factor model corresponding to the 8 subscales based on the Marlatt categories. Evidence was presented that the 8 subscales can be further grouped into 3 second-order factors: (1) negative situations, (2) positive situations, and (3) temptation situations. The negative situation subscales of Unpleasant Emotions, Conflict with Others and Physical Discomfort were found to be correlated with the SCL-90R Depression scale. Interpersonal Sensitivity scale and Somatization scale respectively. The positive social situation subscales of Pleasant Times with Others and Social Pressure to Use were found to be negatively correlated with percentage of time using alone, and positively correlated with pressure from friends and family to use. On the States of Change Readiness and Treatment Eagerness Scales (SOCRATES), clients at the precontemplation stage of change had relatively flat, undifferentiated IDTS profiles (i.e. little scatter of subscale scores), whereas clients in the determination stage had the most differentiation in their IDTS subscale scores. Excellent comparability was found for alcohol clients between the IDS and the IDTS. Evidence was also presented for adequate comparability between the computer and paper and pencil administrative formats of the IDTS.