The Case for Cognitive Interviewing in Survey Item Validation: A Useful Approach for Improving the Measurement and Assessment of Substance Use Disorders

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To accurately identify substance use disorders, we must be confident of our ability to define and measure the construct itself. To date, research has demonstrated that the ways in which substance use disorder criteria are operationalized or assessed can significantly affect the information we obtain from these diagnoses. For example, differing operationalizations of the same construct, such as impaired control over substance use, can result in markedly different estimates of prevalence. This points to the need for approaches that aim to improve the validity of diagnostic assessments during the measure development phase. We performed a scoping review of the cognitive interviewing literature, a technique that aims to provide a systematic way of identifying and reducing measurement error associated with the structure and content of assessment items. Along with this, we apply cognitive interviewing to items assessing alcohol tolerance. We argue that cognitive interviewing is well suited for reducing measurement error in substance use disorder assessment items. Incorporating cognitive interviewing into the item generation stage of measure development for substance use disorder assessments is a worthwhile endeavor for improving validity.