Abstract
BackgroundThere is significant interest in the value of motivational approaches that enhance participant readiness to change, but less is known about clients’ self-reports of problematic behavior when participating in such interventions.MethodsWe examined whether participants in a motivationally-based intervention for DUI offenders changed their reports of substance use at postintervention (when reporting on the same 30 days that they reported on at preintervention). Specifically, Study 1 (N = 8,387) tested whether participants in PRIME For Life (PFL) changed their reports about baseline substance levels when asked at postintervention versus at preintervention. Study 2 (N = 192) compared changes in self-reported baseline drinking between PFL and intervention as usual (IAU) participants.ResultsMany participants in Study 1 did not change their reports about how much they used substances during the 30-day period before baseline. Among those who did, the most common change was an increase in reported amounts of baseline drug use, and typical and peak alcohol use. This sample also showed changes in reports of their baseline pattern of high-risk-use (consistent versus occasional). At postintervention, participants who were younger, single, or endorsing more indicators of alcohol dependence were more likely to later report greater frequency of baseline drug use, and greater peak and typical number of baseline drinks. Gender, education, and race were also associated with reporting inconsistency on some behaviors. In Study 2, PFL participants showed greater increases in reports of peak alcohol use compared to IAU, but both conditions showed similar increases for drugs and typical alcohol use.ConclusionsIn both research and clinical settings, a segment of participants may initially report less substance use than they do when asked later about the same baseline period. These preliminary findings suggest clinicians and researchers may find postintervention evaluations yield reports of greater baseline alcohol or drug use for some people. For some behaviors, this may occur more often in interventions that target client motivation. Future research should attempt to identify which reports – preintervention vs. postintervention – better reflect actual baseline substance use.
Highlights
There is significant interest in the value of motivational approaches that enhance participant readiness to change, but less is known about clients’ self-reports of problematic behavior when participating in such interventions
While relevant across many behaviors, this concern applies to drug and alcohol abuse, its treatment, and research evaluation of intervention programs [5]
There have been efforts to address the effects of social desirability as a way to increase client disclosure about possible use and consequences, though it appears that indirect methods (e.g., Substance Abuse Subtle Screening Inventory – SASSI [7]) are no more effective than direct inquiries (e.g., Alcohol Use Disorders Identification Test – AUDIT [8]) [9,10]
Summary
There is significant interest in the value of motivational approaches that enhance participant readiness to change, but less is known about clients’ self-reports of problematic behavior when participating in such interventions. In clinical and program evaluation settings, self-report remains the most widely used approach for assessing socially sensitive behaviors [1,2,3]. Questions exist about the willingness of respondents to endorse socially undesirable behavior in self-reports [2,4]. While relevant across many behaviors, this concern applies to drug and alcohol abuse, its treatment, and research evaluation of intervention programs [5]. Del Boca and Darkes [6] describe three broad domains that can affect self-reports of alcohol and drug use: social context, respondent characteristics, and task attributes. Social context includes general considerations such as societal views and subcultural norms about substance use, as well as more specific issues such as the setting in which an assessment occurs.
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