Department of Psychology, Syracuse University, New York 13244, USA.
J Stud Alcohol Drugs. 2011 Jul;72(4):592-601. doi: 10.15288/jsad.2011.72.592.
The measurement of readiness to change has become common practice in alcohol and drug treatment of both adults and adolescents. Nevertheless, there is relatively little research on the validity of measures of readiness to change among treated adolescents. The purpose of this study was to compare three measures of readiness to change marijuana use commonly used in clinical research and practice with adolescents: the Readiness Ruler, the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES; Factors 1 and 2, Recognition and Taking Steps, respectively), and a staging algorithm.
The participants were 174 adolescents presenting for intensive outpatient alcohol and drug treatment who reported current marijuana use at the initial assessment. Evidence for concurrent validity was assessed by computing simple correlations among readiness measures, and correlations of each readiness measure with marijuana involvement (percentage of days abstinent in the last 30 days, problem severity score, and marijuana abuse and dependence symptom count [based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria]) at both the initial/baseline assessment and at a 6-month follow-up assessment. Evidence for predictive validity was based on the results of multilevel regression models of the readiness measures in predicting frequency of marijuana use, symptoms, and problems at 6 months from the initial readiness assessment and then in predicting marijuana use, symptoms, and problems at 12 months from the readiness assessment at 6 months.
The results showed evidence for good concurrent and predictive validity for the ruler, the staging algorithm, and Taking Steps but poor evidence for the validity of Recognition. The ruler emerged as the measure with the most clinical utility when brevity and ease of administration are taken into account.
Research and clinical implications of the findings are discussed.
在成人和青少年的酒精和药物治疗中，改变准备度的测量已经成为常见做法。然而，针对接受治疗的青少年改变准备度测量的有效性的研究相对较少。本研究的目的是比较三种常用于临床研究和实践中的青少年大麻使用改变准备度的测量方法：准备度量尺、改变阶段准备度和治疗意愿量表（SOCRATES；分别为因素 1 和 2，即识别和采取步骤），以及一个分期算法。
参与者为 174 名青少年，他们在最初评估时报告了目前的大麻使用情况，并在门诊酒精和药物强化治疗中就诊。通过计算准备度测量之间的简单相关性，以及每个准备度测量与大麻使用情况（过去 30 天内的禁欲天数、问题严重程度评分、大麻滥用和依赖症状数[基于精神障碍诊断和统计手册，第四版，标准]）在初始/基线评估和 6 个月随访评估中的相关性，评估了同时效度的证据。预测效度的证据基于从初始准备评估到 6 个月时的大麻使用频率、症状和问题的多水平回归模型的准备度测量结果，然后基于从 6 个月时的准备度评估到 12 个月时的大麻使用、症状和问题的多水平回归模型的准备度测量结果。
结果表明，度量尺、分期算法和采取步骤具有良好的同时和预测效度，但识别的效度证据较差。当考虑到简洁性和管理便利性时，度量尺成为最具临床实用性的测量方法。
讨论了研究和临床结果的意义。
