Using the Timeline Followback to determine time windows representative of annual alcohol consumption with problem drinkers.

When assessing individuals with alcohol use disorders, measurement of drinking can be a resource intensive activity, particularly because many research studies report data for intervals ranging from 6 to 12 months prior to the interview. This study examined whether data from shorter assessment intervals is sufficiently representative of longer intervals to warrant the use of shorter intervals for clinical and research purposes. Participants were 825 problem drinkers (33.1% female) who were recruited through media advertisements to participate in a community-based mail intervention in Toronto, Canada. Participants' Timeline Followback (TLFB) reports of drinking were used to investigate the representativeness of different time windows for estimating annual drinking behavior. The findings suggest that for aggregated reports of drinking and with large sample (e.g., surveys), a 1-month window can be used to estimate annual consumption. For individual cases (e.g., clinical use) and smaller samples, a 3-month window is recommended. These results suggest that shorter time windows, which are more time and resource efficient, can be used with little to no loss in the accuracy of the data.

Comparison of the quick drinking screen and the alcohol timeline followback with outpatient alcohol abusers.

OBJECTIVE: A recent study comparing the Quick Drinking Screen (QDS) with the Timeline Followback (TLFB) found that in a nonclinical population of problem drinkers both measures produced reliable summary measures of drinking. The current study was designed to replicate these findings with a clinical population of alcohol abusers. The data were collected over three years (2004-2006). METHOD: Participants were 124 alcohol abusers who voluntarily enrolled for outpatient treatment. Over half (52.4%) were female with an average age of almost 40 years. About a third were married, had completed university, and a quarter were unemployed and nonwhite. Participants reported having a drinking problem for an average of 8.3 years, and reported drinking on about 5 days per week, averaging six drinks per drinking day. On two different occasions, they responded to two different sets of questions about their alcohol use. The instruments were: (a) the Quick Drinking Screen (QDS), a summary drinking measure, administered by telephone prior to the assessment; and (2) the TLFB self-administered by computer at the assessment. RESULTS: As in a previous study, this study found that the QDS and the TLFB, two very different drinking measures, collected similar aggregate drinking data for four drinking variables in a clinical sample of alcohol abusers. CONCLUSIONS: When it is not necessary or not possible to gather detailed drinking data, the QDS produces reliable brief summary measures of drinking for problem drinkers. Generalization to nonclinical samples awaits further research.

Smokers' narrative accounts of quit attempts: AIDS and impediments to success.

In this study, the authors used cigarette smokers' narratives describing their quit attempts to understand factors related to the change process. Maintained quitters (MQs, n = 59) and temporary quitters (TQs, n = 47) wrote autobiographical narratives describing their most serious (TQs) or last (MQs) quit attempt. Two types of content analysis were used to analyze the reports: (a) dichotomous ratings of the presence or absence of an event and (b) computerized content analysis of event or word frequency. The valence (anti- or pro-smoking cessation) of change factors was also examined. MQs wrote significantly more affective statements than did TQs. When valence was examined, MQs made significantly more pro-smoking cessation social support, cognitive, and affective statements than TQs did, and TQs made significantly more anti-smoking cessation social support and affective statements than MQs did.

Comparison of a quick drinking screen with the timeline followback for individuals with alcohol problems.

OBJECTIVE: Two major strategies have typically been used to assess recent drinking: (1) Daily Estimation (DE) measures such as the Timeline Followback (TLFB) and (2) Quantity-Frequency (QF) summary measures. Although QF measures provide a quick and easy measure of consumption, they have been criticized as not being able to capture sporadic and unpatterned drinking (e.g., days that reflect important social and/or health risks). The TLFB, a psychometrically sound drinking assessment method, is able to capture all drinking, including sporadic heavy days and unpatterned drinking. In some situations, however, recall of daily drinking may not be possible or practical (e.g., limited time; no resources). This article compares results obtained by using a QF measure and a DE measure to assess problem drinkers' pretreatment drinking. METHOD: The current study, part of a large community mail intervention with 825 alcohol abusers, compared results from two drinking measures covering the same time interval that were administered on two different occasions approximately 2.5 weeks apart. Both measures, the Quick Drinking Screen (QDS; a QF summary measure that collected data by telephone) and the TLFB (a self-administered daily estimation measure), collected drinking data for the year prior to the interview. RESULTS: Although the QDS and the TLFB are very different drinking measures, remarkably similar aggregate drinking data were obtained for five drinking variables. CONCLUSIONS: When it is not necessary or possible to gather detailed drinking data, the QDS produces reliable brief summary measures of drinking, at least for not severely alcohol dependent individuals. Also, respondents do not appear to use a repetitive response pattern when completing the TLFB.

Shorter and proximal Timeline Followback windows are representative of longer posttreatment functioning.

Very little research has been conducted on what time window provides a representative picture of daily drinking. With respect to pretreatment drinking, one study that used the Timeline Followback (TLFB) with problem drinkers found that a 3-month window is generally representative of annual pretreatment drinking. The objective of the present study was to determine the shortest representative time window for reports of annual posttreatment drinking. A second objective was to determine which of two time windows, 90 days from the end of treatment or 90 days prior to the end of follow-up, was the most representative proxy for annual posttreatment drinking. TLFB reports from 467 problem drinkers who participated in a randomized controlled trial of a mail-based intervention were used in the present analysis. The results show that a 3-month posttreatment window (i.e., first 90 days after the intervention) is sufficiently representative (r = .94) of annual posttreatment drinking for problem drinkers (i.e., less severely dependent alcohol abusers). In addition, although there were no clinically significant differences in drinking behavior between the two 90-day posttreatment windows, the use of proximal windows (i.e., closer to the end of treatment) would minimize participant attrition. In addition, a 3-month versus 12-month TLFB follow-up time frame resulted in a much higher percentage of participants completing the full TLFB (89% vs. 71%). Further research is needed to determine if these findings will generalize to more severely dependent alcohol abusers.

Psychometric properties of the Drug Use Disorders Identification Test (DUDIT) with substance abusers in outpatient and residential treatment.

The psychometric properties of the Drug Use Disorders Identification Test (DUDIT), an 11-item self-report questionnaire developed to screen individuals for drug problems, are evaluated. The measure, developed in Sweden and evaluated there with individuals with severe drug problems, has not been evaluated with less severe substance abusers or with clinical populations in the United States. Participants included 35 drug abusers in an outpatient substance abuse treatment program, 79 drug abusers in a residential substance abuse treatment program, and 39 alcohol abusers from both treatment settings who did not report a drug abuse problem. The DUDIT was found to be a psychometrically sound drug abuse screening measure with high convergent validity (r=.85) when compared with the Drug Abuse Screening Test (DAST-10), and to have a Cronbach's alpha of .94. In addition, a single component accounted for 64.91% of total variance, and the DUDIT had sensitivity and specificity scores of .90 and .85, respectively, when using the optimal cut-off score of 8. Additionally, the DUDIT showed good discriminant validity as it significantly differentiated drug from alcohol abusers. These findings support the DUDIT as a reliable and valid drug abuse screening instrument that measures a unidimensional construct. Further research is warranted with additional clinical populations.

Rates of apparently abnormal MMPI-2 profiles in the normal population.

MMPI-2 standardization data were re-sampled using Monte Carlo simulations to estimate the base rate of apparently abnormal scores expected by chance in the normal population when multiple scales are interpreted. 36.8% of normal adults are likely to obtain a score that would otherwise be considered clinically significant at 65T on one or more of the 10 Clinical scales. The normal incidence of at least one apparently abnormal score was 38.3% on the Content and 55.1% on the Supplementary scales. When the Clinical, Supplementary, and Content scales and subscales are interpreted together, at least three seemingly meaningful scores will be found in 47.4% of perfectly normal individuals, and five or more scales that appear to be clinically significant can be expected in 30.1% of cases that are actually unremarkable. These results imply that the number of MMPI-2 scales that can be meaningfully interpreted in clinical practice is limited, and that high T-scores are necessary for an adequate level of confidence even when interpretation is appropriately limited to the Clinical scales.