Summary
The literature on the validity of self-reported alcohol consumption and alcohol problems was reviewed. Studies done in this area were analyzed by type of sample, by specific behaviour which was validated and by criterion chosen as the standard to which the behaviour would be compared. Despite the usual conclusion of validity studies that self-reports are basically valid, variation exists depending upon what is being validated and how its accuracy is measured. Recent reports of consumption are validated more easily than drinking patterns measured in drinking practices surveys (as evidenced by coverage rates of surveys to sales statistics ranging from 40-60%). In addition, collateral reports by significant others do not necessarily yield better information on consumption. In the area of alcohol problems, only a few, highly‘visible’problems can realistically be validated. Thus, the reporting of drinking driving arrests can be better validated than tremors or other physical manifestations. It is concluded that more emphasis should be placed on developing new ways to validate alcohol consumption and alcohol problems so that researchers can continue to refine their data collection techniques in order to maintain confidence in their findings.

The validity of self-reported alcohol consumption and alcohol problems: a literature review.

Verbal report procedures, such as interviews, tests and questionnaires, have become the dominant method to obtain clinical data on alcohol abuse and its modification through treatment. The extent to which this method provides reliable and valid information for research purposes, and how its accuracy and usefulness can be enhanced, is examined. A review of methodological studies in the alcohol literature shows that although the information obtained from alcoholics and heavy drinkers tends to be reliable and valid, there can be considerable variability in accuracy, depending on the sensitivity of the information sought, the specificity of the validation criteria, the personal characteristics of the respondents and the demand characteristics of the task. It is suggested that the question of whether verbal report procedures are valid or invalid is less important than the issue of how they can be improved to the point that confidence can be placed in their findings. To facilitate this process, methodological t...

Verbal report methods in clinical research on alcoholism: response bias and its minimization.

Using data from The Collaborative Study on the Genetics of Alcoholism, we compare direct interview diagnoses of alcohol dependence to those obtained by history from family members. Using a requirement of three or more positive implications by history, the specificity, sensitivity, and positive predictive values are 98%, 39%, and 45%, respectively. A logistic analysis found the gender of the relative and alcoholism in the informant to be significant, but not the gender of the informant. The partial odds ratio of a diagnosis at interview associated with a positive family history diagnosis was 13.6. The relationship between the informant and relative was significant, with negative reports from an offspring or mate more influential than a negative report from a parent or second-degree relative. We derived a recursive equation to combine a variable number of family history reports, wherein the probabilities associated with a single report are computed from the logistic analysis. This permits the use of family history information both as a proxy for an uninterviewed relative, as well as a second source of information to be used in the analysis of genetic family data.

Comparison of direct interview and family history diagnoses of alcohol dependence

In 1979 we set out together on a journey. We decided to try to read every study that had ever been published (in languages we could understand) on the effectiveness of different approaches to treating alcohol problems. We had no idea what lay in store for us.

The Effectiveness of Alcoholism Treatment

Alcohol and drug problems affect not only those using these substances but also family members of the substance user. In this review evidence of the negative impacts substance misuse may have upon families are examined, following which family-focused interventions are reviewed. Several family-focused interventions have been developed. They can be broadly grouped into three types: (1) working with family members to promote the entry and engagement of substance misusers into treatment; (2) joint involvement of family members and substance misusing relatives in the treatment of the latter; and (3) interventions responding to the needs of the family members in their own right. The evidence base for each of the three types is reviewed. Despite methodological weaknesses in this area, a number of conclusions can be advanced that support wider use of family focused interventions in routine practice. Future research needs to focus on (1) pragmatic trials that are more representative of routine clinical settings; (2) cost-effectiveness analyses, in terms of treatment costs and the impact of interventions on costs to society; (3) explore treatment process; and (4) make use of qualitative methods. In addition, there is a need to define more clearly the conceptual underpinnings of the family intervention under study.

Family interventions in the treatment of alcohol and drug problems

Correlations between patients' and spouses' reports of drinking were modest when relatively precise measures of drinking were used but stronger when more global measures were used.

Correspondence between reports of problem drinkers and spouses on drinking behavior and impairment

This paper reports on a four-year follow-up of alcoholics treated in joint-hospitalization, couples-therapy and individual-therapy programs. The rationale for the baseline study, its experimental design, the treatment procedures used and 6-month outcomes have been reported previously (1-3) and are briefly summarized below. The project was based on the rationale that the spouse of an alcoholic is intimately involved in maintaining the drinking problem and is also seriously affected by it (4). Thus, intensive involvement of the spouse, through joint hospital admission in the initial phase of treatment and continued couples therapy after hospital discharge, was seen as a way to have maximum impact on dysfunetional marital interactions, with a resultant change in the drinking problem.

Joint hospitalization and couples therapy for alcoholism; a four-year follow-up.

The spouses of hospitalized alcoholics scored within the normal range on Lanyon's Psychological Screening Inventory; on two of three scales their scores were not significantly different from those of a normative sample.

R Longabaugh

Papers

Correspondence between reports of problem drinkers and spouses on drinking behavior and impairment

Joint hospitalization and couples therapy for alcoholism; a four-year follow-up.

Psychological disturbances in spouses of alcoholics. An empirical assessment.