Recent important substance-related losses predict readiness to change scores among people with co-occurring psychiatric disorders.

The transtheoretical model posits that contemplating change in substance abuse involves weighing the costs of substance use against the benefits. One of the common aversive consequences of substance misuse is personal loss. Indeed, higher total number of losses of unspecified recency and importance have predicted greater motivation to change substance use patterns. A sample of 110 participants with co-occurring Axis I psychiatric and substance use disorders completed a questionnaire measuring recent important substance-related losses (LOSS-QR) and the Brief Readiness to Change questionnaire (RTC). The LOSS-QR yielded scores for frequency, importance, and association of substance misuse with recent losses. Total recent important substance-related loss scores were positively and significantly correlated with total RTC. Hierarchical regression analyses found that identifying losses as substance related and important accounted for significant amounts of variance in total RTC, and identifying losses as substance related predicted precontemplation and contemplation scores. As hypothesized by the transtheoretical model, awareness of substance-related losses seems to be important for people with comorbid psychiatric disorders contemplating behavior change.