Inconsistencies in self-reported drug use by adolescents in substance abuse treatment: Implications for outcome and performance measurements

Abstract

This paper analyzes logical inconsistencies in adolescents' reporting of recent substance use to assess the potential effect of inaccurate reporting on measures of treatment outcomes and program performance. We used data from 1,463 clients at 10 adolescent treatment programs to assess the relationship between inconsistent reports and various factors that contribute to program assignment and treatment outcomes. Our results suggest that inconsistencies do not arise at random. Instead, inconsistencies were associated with program assignment and factors widely considered to influence treatment outcomes, including age at first use, living situation, race/ethnicity, and mental distress. We also found a positive relationship between the level of inconsistent reporting of drug use and self-reports of improvement over time on several well-established treatment outcome measures. Our study highlights the need for greater awareness of the potential impact of inaccuracies in the reporting of substance use on outcomes and performance measurement and for the development of methodologies to improve accuracy.

Inconsistent reports of risk behavior among Brazilian middle school students: National School Based Survey of Adolescent Health (PeNSE 2009/2012)

“…Consistent with previous analyses of other survey data, in both editions of the PeNSE survey, we found that the prevalence of inconsistency was higher for males 45,53,54,55 , delayed students 56 , and those who reported having experimented with drugs 26,44,56 .…”

Discrimination, drugs, and alcohol among Latina/os in Brooklyn, New York: Differences by gender

“…Self-reported substance use may be underreported. However, steps were taken to assure confidentiality of responses decreasing the likelihood of under-reporting (Harris, Griffin, McCaffrey, & Morral, 2008). Respondents were also given urine tests.…”

The reliability and validity of drug users' self reports of amphetamine use among primarily heroin and cocaine users

“…Alternatively, people may exaggerate their amphetamine use to meet eligibility requirements for a program, be seen as rebellious, or impress an interviewer (Harrell, 1997; Macleod, Hickman, & Smith, 2005). Other reasons for inaccurate self-report data include: misunderstanding questionnaire items, memory failure, embarrassment about the topic, and not recognizing the drug terminology used on the questionnaire (Cottler et al, 1994; Harris, Griffin, McCaffrey, & Morral, 2008; Hser, Anglin, & Chou, 1992; Oullett, Cagle, & Fisher, 1997). The myriad reasons why respondents may unintentionally or intentionally provide inaccurate information about their drug use result in bias, through systematic under- and over-reporting, and to increased variability, through increased random error.…”