Department of Emergency Medicine, Alpert Medical School, Brown University, Providence, Rhode Island, USA
J Stud Alcohol Drugs. 2013 Sep;74(5):770-6. doi: 10.15288/jsad.2013.74.770.
Standardized measures of self-reported alcohol use are the predominant method by which change in alcohol use following interventions is evaluated. This study examined whether the invariance of the test-retest pretreatment Alcohol Use Disorders Identification Test (AUDIT) was affected by the treatment experience. In this study, the intervening exposure was to motivational interviewing (MI) versus community service (CS), the treatment-as-usual control group.
Analyses were conducted on a subsample of court-referred 16- to 21-year-olds recruited into a randomized controlled trial examining the effects of MI on alcohol use and police charges for risky driving and/or drinking. Youths were randomized to CS or MI. A subsample of 478 participants, who at baseline completed the AUDIT in reference to alcohol use for the 6 months before their conviction, later repeated the AUDIT at treatment completion, in reference to the same 6-month baseline period.
At completion of treatment, participants receiving CS had a significant decrease in baseline AUDIT scores, whereas those in MI reported no significant change. The difference between the two groups was significant (p = .02). Also, of those who reported no drinking before treatment, after receiving MI, 33.5% changed their response and acknowledged pretreatment drinking, compared with only 8.3% in CS.
These results suggest that treatment received may differentially affect a standardized measure of self-reported risky drinking. This effect may be attributable to the treatment experience and/or the experience of the control group. Possible explanations for the effect are explored, including more honesty because of a trusting therapeutic alliance and a response shift bias. Differential change in self-report might affect treatment outcome assessment. Depending on the treatment contrasts, research that relies on pre- to post-treatment changes in self-report may be underestimating treatment effects.
自我报告的饮酒量的标准化测量是评估干预后饮酒量变化的主要方法。本研究检验了治疗经验是否会影响酒精使用障碍识别测试（AUDIT）的重测前后不变性。在这项研究中，干预暴露是接受动机性访谈（MI）或社区服务（CS），作为常规治疗对照组。
对参加一项随机对照试验的被法庭传唤的 16 至 21 岁青少年的子样本进行了分析，该试验旨在研究 MI 对饮酒量的影响以及因危险驾驶和/或饮酒而被警察指控的情况。青少年被随机分配到 CS 或 MI。一个 478 名参与者的子样本，他们在基线时完成了 AUDIT，以参考他们被定罪前的 6 个月的饮酒情况，后来在治疗结束时再次重复 AUDIT，以参考相同的 6 个月基线期。
在治疗结束时，接受 CS 的参与者的基线 AUDIT 分数显著下降，而接受 MI 的参与者则没有显著变化。两组之间的差异具有统计学意义（p=0.02）。此外，在那些报告治疗前没有饮酒的人中，接受 MI 后，33.5%的人改变了他们的回答，承认了治疗前的饮酒，而 CS 组只有 8.3%的人改变了回答。
这些结果表明，所接受的治疗可能会对自我报告的危险饮酒的标准化测量产生不同的影响。这种影响可能归因于治疗经历和/或对照组的经历。探讨了可能的解释，包括由于信任的治疗联盟而更加诚实，以及反应转移偏差。自我报告的差异变化可能会影响治疗结果评估。根据治疗对比，依赖治疗前到治疗后的自我报告变化的研究可能低估了治疗效果。
