Brown J, Kranzler H R, Del Boca F K
Alcohol Research Centre, University of Connecticut School of Medicine, Farmington 06032.
Br J Addict. 1992 Jul;87(7):1013-24. doi: 10.1111/j.1360-0443.1992.tb03118.x.
The reliability and validity of self-report data regarding substance abuse has often been questioned. To determine how best to enhance the veracity of self-report, three factors which might affect self-report veracity were examined: alcohol status at time of interview; level of cognitive functioning; and method of self-report data collection. Subjects were 234 admissions to an inpatient substance abuse treatment unit. Self-report data were collected via both personal interview on the day of admission and and questionnaire within the first week of stay. Self-reports concerned use of alcohol, cocaine, and marijuana in the days preceding admission. Test-retest reliability for the questionnaire data produced reliability coefficients of 0.88, 0.91, and 0.88, for alcohol, cocaine, and marijuana, respectively. Variation in inter-test interval had virtually no effect upon reliability coefficients. Interview data were compared to toxicologic analyses of blood and urine samples collected on admission. Overall, this comparison showed self-reports to be valid, with a 97% agreement between verbal report and laboratory data for alcohol, 93% for cocaine, and 84% for marijuana. The comparison of interview data with questionnaire responses also showed self-reports to be valid: 90% agreement for alcohol, 93% for cocaine, and 81% for marijuana. Level of cognitive function did not influence the validity of self-reports for any of the three substances. Recent consumption of alcohol also had no statistically significant effect on the validity of self-reported marijuana use, regardless of the operational form of validity tested. However, BAC-negative subjects produced a significantly greater validity coefficient for self-reported cocaine use (kappa = 0.87) than did BAC-positive patients (kappa = 0.43), when interview data were compared with toxicologic measures. A similar finding was not uncovered when interview and questionnaire data were compared. An interaction between admission alcohol status and cognitive function was uncovered for cocaine self-reports when interview data was compared with toxicologic measures. The rate of agreement for alcohol-negative subjects is quite high for both cognitively impaired and unimpaired subjects (M = 93% and M = 94%, respectively) as well as for alcohol-positive, cognitively unimpaired subjects (M = 94%), but not for alcohol-positive, cognitively impaired subjects (M = 67%). Results are discussed in terms of threats to the validity of self-report and strategies for the optimization of response accuracy.
关于药物滥用的自我报告数据的可靠性和有效性一直备受质疑。为了确定如何最好地提高自我报告的准确性，研究了可能影响自我报告准确性的三个因素：访谈时的酒精状态；认知功能水平；以及自我报告数据的收集方法。研究对象为234名入住住院药物滥用治疗单元的患者。自我报告数据通过入院当天的个人访谈以及住院第一周内的问卷调查收集。自我报告涉及入院前几天酒精、可卡因和大麻的使用情况。问卷调查数据的重测信度显示，酒精、可卡因和大麻的信度系数分别为0.88、0.91和0.88。测试间隔的变化对信度系数几乎没有影响。将访谈数据与入院时采集的血液和尿液样本的毒理学分析结果进行了比较。总体而言，这种比较表明自我报告是有效的，酒精的口头报告与实验室数据之间的一致性为97%，可卡因为93%，大麻为84%。访谈数据与问卷调查结果的比较也表明自我报告是有效的：酒精为90%，可卡因为93%，大麻为81%。认知功能水平对这三种物质中任何一种的自我报告有效性均无影响。无论所测试的有效性操作形式如何，近期饮酒对自我报告的大麻使用有效性也没有统计学上的显著影响。然而，当将访谈数据与毒理学测量结果进行比较时，血液酒精浓度（BAC）呈阴性的受试者自我报告可卡因使用的有效性系数（kappa = 0.87）显著高于BAC呈阳性的患者（kappa = 0.43）。当比较访谈数据和问卷调查数据时，未发现类似结果。当将访谈数据与毒理学测量结果进行比较时，发现可卡因自我报告中存在入院时酒精状态与认知功能之间的交互作用。对于酒精呈阴性的受试者，无论认知功能是否受损，一致性率都相当高（分别为M = 93%和M = 94%），对于酒精呈阳性且认知功能未受损的受试者也是如此（M = 94%），但对于酒精呈阳性且认知功能受损的受试者则不然（M = 67%）。将根据对自我报告有效性的威胁以及优化回答准确性的策略来讨论研究结果。
