Reliability and validity of the time-line follow-back interview among psychiatric outpatients: A preliminary report.

People with severe mental illness (SMI) have high rates of substance use disorders. The Transtheoretical Model (TTM) is a framework for understanding behavior change. There are five leading measures associated with the TTM -University of Rhode Island Change Assessment, Processes of Change Scale, Decisional Balance Scale, Abstinence Self-Efficacy Scale, and Temptation to Use Drugs Scale. While these measures have been found to be reliable and valid in primary substance abusers, it is unknown if these measures are relevant in people with co-occurring SMI and substance use disorders (SUD). We evaluated the psychometric properties of these measures in a sample (n=240) of people with co-occurring disorders. Participants met DSM-IV criteria for schizophrenia/schizoaffective disorder or non-psychotic affective disorder, and current cocaine dependence or cocaine dependence in remission. All subscales showed good reliability and validity in the total sample. Analyses within diagnostic groups showed good reliability and validity in most groups, with some falling off in the affective disorders and remitted cocaine dependence groups. Overall, findings support the use of these measures in people with co-occurring disorders. Keywordsserious mental illness; substance abuse; transtheoretical model; psychometrics Corresponding Author: Melissa Nidecker, Ph.D., Postdoctoral Fellow, VA Maryland Healthcare System, BT/MIRECC, 10 North Green Street, Baltimore, MD 21201, Phone: 410-605-7000 ext. 4734, Melissa.nidecker@va.gov. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript IntroductionSubstance abuse is a critical and devastating health problem in individuals with severe mental illness (SMI). Nearly 50% of all persons with SMI have met criteria for a lifetime substance use disorder (SUD; Barry, Fleming, & Grennley, 1995;Mueser, Yarnold, & Bellack, 1992). SUDs are especially harmful for people with SMI, who are already severely disadvantaged by impairments that are part of their mental illness. People with co-occurring SMI and SUDs show more medication noncompliance, symptom exacerbations, and re-hospitalizations than do people with SMI only, as well as poor social adjustment and an overall poorer prognosis (Drake, Mueser, Clark, & Wallach, 1996;Cournos, et al., 1991). Although treatment for people with co-occurring SMI and SUDs is complex, interventions for substance abuse that emphasize long-term, integrated treatment that is tailored to the special needs of people with SMI have been shown to b...

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“…Sobell, 1992, for a review). Carey (1997) has reported comparable results for psychiatric patients with psychotic disorders.…”

Section: Drugsupporting

confidence: 54%

Application of the Transtheoretical Model of change: Psychometric properties of leading measures in patients with co-occurring drug abuse and severe mental illness

Nidecker

DiClemente

Bennett

et al. 2008

Addictive Behaviors

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“…The TF has been used extensively in the study of drinking patterns (20)(21)(22)(23)(24) and has recently been used to study patterns of other drug use, for which reliability and validity has been examined and documented (25)(26)(27). However, to our knowledge, this is the first time the TF has been used to study patterns of illicit drug use longitudinally in a sample of college students.…”

Section: 6a Measures Of Drug Exposure Opportunity and Use Patternmentioning

confidence: 94%

Drug Exposure Opportunities and Use Patterns among College Students: Results of a Longitudinal Prospective Cohort Study

et al. 2008

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Underage drinking and drug use among college students are major public health concerns, yet few studies have examined these behaviors and their associated risk factors and consequences prospectively. This paper describes the sampling and recruitment methods of a longitudinal study of 1,253 college students at a large, mid-Atlantic university. Incoming first-year students were screened during the unique window between high school and college in order to oversample drug users for longitudinal follow-up. Intensive recruitment strategies yielded a 95% cumulative response rate in annual interviews and semi-annual surveys. We report preliminary results on exposure opportunity, lifetime prevalence, initiation, continuation, and cessation of substance use for alcohol, tobacco, and ten illicit and prescription drugs during the first two years of college. Findings suggest that while some substance use represents a continuation of patterns initiated in high school, exposure opportunity and initiation of substance use frequently occur in college. Implications for prevention and early intervention are discussed. Keywords NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript IntroductionUnderage drinking and illicit substance use among college students are major public health concerns. Annually, at least 1,400 deaths are attributable to alcohol use on college campuses (1). High-risk drinking among young adults is associated with sexual assault, destruction of property, academic problems, accidental injury, and several adverse health consequences (2-5). Binge drinking and illicit drug use often co-occur (2,6-10), but in contrast to longitudinal studies of alcohol consumption (11), surprisingly few longitudinal prospective studies have examined patterns, correlates, and consequences of illicit drug use among college students. Little information is available on the patterns of initiation and cessation during college-that is, it is not known how often drug use is initiated after coming to college versus continuing a pattern that began in high school, and how often a pattern of regular drug use resolves among college students. Moreover, a majority of the conceptual models used to explain the onset and course of early drug use were developed from studying samples of adolescents, many of whom were deviant and disadvantaged (12)(13)(14)(15)(16)(17). Although the application of these models to samples of educated, academically-achieving youths might be appropriate, other risk factors and consequences might be needed to fully describe the natural history and course of drug use and other health risk behaviors during this unique developmental window. For example, an important potential outcome of drug use among college students might be diminished expectations regarding career goals or difficulty establishing autonomy.This paper describes results from the College Life Study (CLS), funded by the National Institute on Drug Abuse in October 2003 to address critical gaps in our knowledge base concerning the longi...

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“…1997;Gossop et al, 1995). In previous research with SMI individuals (e.g., Gonzalez et al, 2007), the SDS has had good internal consistency.…”

Section: Methodsmentioning

confidence: 99%

“…The TLFB was used to assess subjects' daily alcohol and drug use over the previous 60 days, as reported by both subjects and their collaterals. The TLFB has been found to be a reliable and valid method for use with psychiatric outpatients (Carey, 1997). It also has been administered to collaterals in several studies (e.g., Fals-Stewart et al, 2000;Stasiewicz et al, 1997;Stasiewicz & Stalker, 1999).…”

Section: Methodsmentioning

confidence: 99%

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

Stasiewicz¹,

Vincent²,

Bradizza³

et al. 2008

Psychology of Addictive Behaviors

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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...

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Reliability and validity of the time-line follow-back interview among psychiatric outpatients: A preliminary report.

Cited by 150 publications

References 33 publications

Application of the Transtheoretical Model of change: Psychometric properties of leading measures in patients with co-occurring drug abuse and severe mental illness

Application of the Transtheoretical Model of change: Psychometric properties of leading measures in patients with co-occurring drug abuse and severe mental illness

Drug Exposure Opportunities and Use Patterns among College Students: Results of a Longitudinal Prospective Cohort Study

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

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