Performance of the Pictorial Representation of Illness and Self Measure in Individuals with Alcohol Dependence, Alcohol Abuse or At-Risk Drinking

Abstract

Background: The impact of chronic illnesses is not only influenced by one’s physical functioning but also by its subjective importance to the individual’s life. However, it is often difficult to asses such an impact in an appropriate way. PRISM (pictorial representation of illness and self measure) measures the perception of illness and first data on its validity have been published. The aim of the present study was to prove the applicability of PRISM regarding alcohol-dependent patients. Therefore, a comparison was made between alcohol-dependent patients, alcohol abusers and at-risk drinkers. Method: The sample consisted of 763 general practice patients, who scored above the cutoff in alcohol-related screening questionnaires. Of this sample, 330 were diagnosed as alcohol dependent, alcohol abusers (both according to DSM-IV) or at-risk drinkers. To prove the applicability, PRISM was put in context with the severity of alcohol dependence and the core constructs of the transtheoretical model of behavior change. Results: PRISM was related to the severity of the drinking problem: the severer the drinking problem, the shorter the distance between self and illness. High correlations with aspects of alcohol consumption – such as adverse consequences from drinking, temptation to drink, and self-efficacy to abstain – were found. Concerning stages of change according to the transtheoretical model of behavior change, data show a significant difference in the self-illness separation between patients in the stage of contemplation compared to those in the precontemplation or action stage. Conclusions: The PRISM task is applicable to patients with alcohol use disorders. Within this group and in contrast to other chronic diseases, PRISM reveals a significant relationship not only to the severity of drinking, but also to the readiness to change one’s drinking behavior.

Pictorial Representation of Illness and Self Measure Revised II (PRISM-RII) – a novel method to assess perceived burden of illness in diabetes patients

“…Support for this hypothesis further comes from the comments of the patients, who frequently referred to (the success of) their own coping efforts (e.g., "I make sure my diabetes does not become too big an issue in my life"). In a previous study among individuals with problematic alcohol use, Reinhardt et al [ 13 ] also found SIS to discriminate between different levels of readiness to change, which also reflects coping efforts. SIS was partly predicted by age, indicating older people on average having higher SIS scores.…”

“…Nevertheless, studies in patients with rheumatoid arthritis [ 6 ], chronic obstructive pulmonary disease [ 7 ], systemic lupus erythematosus [ 8 ], psoriasis [ 9 ], vitiligo [ 10 ], and chronic pain [ 11 ] have provided evidence suggesting that PRISM measures aspects of suffering, and a validation study with over 700 patients from different disease groups showed PRISM to have good test-retest reliability, and to be sensitive to therapeutic change [ 12 ]. In addition, the PRISM has been found useful in differentiating alcohol-related disorders [ 13 ], and in assessing post-traumatic growth in bereaved parents [ 14 ]. Because the measure is generic, it allows for comparison of suffering not only across different diseases, but even including problems of a different nature.…”

Graphic representation of the burden of suffering in dizziness patients

“…In terms of interpretation, two SIS ranges were distinguished (a mark within the self-circle, and a mark outside the self-circle) [ 26 ]. Previous studies have identified no disadvantages of the paper and pencil versus the original version, which uses a disc instead of a pencil mark [ 23 , 43 , 44 ]. The test and its instructions are shown in Figure 1 .…”

The Startle Reflex in Alcohol-Dependent Patients: Changes after Cognitive-Behavioral Therapy and Predictive Validity for Drinking Behavior

“…It is assumed that the regular association of these cues with the ingestion of alcohol leads to conditioned reactions [1, 2], motivating reward or relief craving and instigating drug intake [3]. In addition, the occurrence of these conditioned reactions may be interpreted by the individual as sign of intrusiveness and uncontrollability of the illness [4] and thus contribute to low self-efficacy. This stresses the necessity of interventions aiming at reducing conditioned reactions (i.e.…”