Factors affecting agreement between severely mentally ill alcohol abusers' and collaterals' reports of alcohol and other substance abuse.

Abstract

This study examined subject-collateral reports of alcohol use among a sample of 167 dually diagnosed individuals seeking outpatient treatment at a community mental health clinic. All subjects met Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) criteria for a schizophrenia-spectrum or bipolar disorder and for alcohol abuse or dependence. Subjects were recruited within 2 weeks of treatment entry and completed measures of cognitive functioning, alcohol dependence severity, psychiatric symptoms, and quantity and frequency of substance use over the previous 60 days using the Timeline Follow-Back interview (L. C. Sobell & M. B. Sobell, 1996). They also provided a urine sample, which was screened for recent drug use. Collateral interviews were conducted by phone and included an assessment of the subject's alcohol and drug use over the same 60-day period. Collaterals also reported their confidence in the accuracy of their reports. Overall, the results indicated generally poor subjectcollateral agreement. However, subject-collateral agreement appeared better for those individuals (n = 97) with negative urine drug screens. The most consistent predictor of subject-collateral discrepancy scores was subjects' recent drug use. Recommendations for enhancing the validity of self-reports of substance use in a severely mentally ill population are discussed. Keywordsalcohol; bipolar; collaterals; self-report; schizophrenia Verbal self-report continues to be the primary method by which clinicians and researchers obtain measurements of a person's past substance use (Connors & Maisto, 2003). Collateral reports are viewed as an important second measure of an individual's drinking and drug use behavior. In a recent review of the subject-collateral (S-C) literature, Connors and Maisto (2003) concluded that "recent research supports the assertion that subjects provide accurate NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript reports about their drinking and associated consequences" (p. 21). This conclusion was drawn from research examining S-C agreement among various clinical (e.g., outpatient alcoholics) and non-clinical (e.g., general population) subject populations.Although information obtained from alcohol-dependent men and women tends to be reliable and valid, there can be considerable variability in accuracy depending on many factors (Babor & Del Boca, 1992). In an effort to provide a framework for understanding the optimal conditions for obtaining self-report information, Babor, Brown, and Del Boca (1990;Babor & Del Boca, 1992;Babor, Stephens, & Marlatt, 1987) proposed a conceptual model that specifies the major sources of unreliability and invalidity in the questionanswering process. In brief, within the social context of the interview, the respondent's selfreport is said to be influenced directly by a combination of task variables, respondent characteristics, motivation, and cognitive processes. A key benefit of this model is that it sugges...

Correlations and agreement between delta‐9‐tetrahydrocannabinol (THC) in blood plasma and timeline follow‐back (TLFB)‐assisted self‐reported use of cannabis of patients with cannabis use disorder and psychotic illness attending the CapOpus randomized clinical trial

“…Previous studies have reported sensitivity and specificity at 0.60 and 0.42 [10] and Spearman's correlation of approximately 0.4 [29], well below what we found in the present study. Other studies found kappas between 0.47 [11] and 0.9 [30], intraclass correlation (ICC) of 0.62 [31] and Yule's Y of 0.8 [32], being comparable or just below our correlation coefficients. In the cases where our study shows better agreement than previous studies, it is difficult to state whether this is due to the use of blood rather than urine, due to differences in sample populations or simply to statistical chance.…”

Collateral Reports in the College Setting: A Meta‐Analytic Integration

“…Ideally, the collateral has frequent contact with the participant, especially in drinking situations. Statistically significant positive correlations have been found between collateral estimates of participant self-reported substance use (Babor et al, 1987; O’Farrell and Maisto, 1987), although poor collateral and participant agreement has been found in those with comorbid mental disorders (Stasiewicz et al, 2008). As more research indicates that self-reported drinking is often accurate, the use of collaterals has been discouraged as a way to obtain accurate reports of participant alcohol use (Babor and Del Boca, 1992; Babor et al, 1987, 2000;Maisto et al, 1990).…”

Development and psychometric evaluation of the Bipolar Functional Status Questionnaire (BFSQ)

“…Psychometric validation of the BFSQ was based on its implementation in an outpatient study group of adults recently treated naturalistically for an acute manic, hypomanic/manic, or depressive episode; performance characteristics of the BFSQ within more treatment‐resistant, chronically ill, or inpatient populations were not evaluated. In addition, although the use and abuse of alcohol and other substances are known to strongly influence patient functioning, these issues were not addressed within the BFSQ, in part due to the phenomenologic complexity of comorbid substance abuse, as well as the potential for unreliable self‐reporting of alcohol or substance misuse in dual‐diagnosis patients (56). Finally, it is also possible that other factors exist that may be relevant to functional status and were not identified either by the advisory panel or through cognitive testing in the study population, although the observed high degree of construct validity with other outcome measures would suggest that the contribution of any such unidentified factors is likely small.…”