Biomedical subjects

D R Gavin

Publications and source records attributed to D R Gavin.

5 recordsLinked to original sources

PubMed1999

Evaluation of the Yale-Brown Obsessive Compulsive Scale (YBOCS-hd) for heavy drinking with mild to moderately dependent alcohol abusers.

BACKGROUND: Many similarities have been noted between urges and desires to drink heavily and obsessive-compulsive disorders (OCD). Based on such similarities, Modell et al. (1992) developed the Yale-Brown Obsessive Compulsive Scale for heavy drinking (YBOCS-hd), a modified version of YBOCS, to assess obsessions and compulsions related to heavy drinking. Evaluation of the YBOCS-hd has been limited to more severely dependent alcohol abusers. METHODS: The present study used a self-administered version of the YBOCS-hd to evaluate (1) the severity of drinking-related obsessive compulsive symptoms with mild to moderately dependent alcohol abusers (problem drinkers), and (2) whether end-of-treatment changes in YBOCS-hd scores would be related to within-treatment functioning. RESULTS: Results indicated that problem drinkers have lower alcohol-related Obsessive and Compulsive subscale scores than did more severely dependent drinkers, but higher scores than did non-problem drinkers, supporting the construct validity of the YBOCS-hd. In addition, at the end of treatment, the YBOCS-hd scores of alcohol abusers who drank at low-risk levels during treatment were significantly lower than the scores of those who drank at high-risk levels. Lastly, exploratory factor analysis did not provide support for the two purported YBOCS-hd subscales (Obsessive, Compulsive). Instead, the analysis yielded a single general factor and a second factor that contained two questions measuring heavy drinking. CONCLUSIONS: Despite the fact that total YBOCS-hd scores covaried with drinking, neither the total YBOCS-hd pretreatment score nor the two subscale scores predicted functioning at the end of treatment. The present results call into question the utility of the YBOCS-hd, because a single item measuring the heaviness of drinking was as useful as the total YBOCS-hd and its two subscales in relating changes during treatment to end-of-treatment functioning for problem drinkers. However, although the YBOCS-hd does not predict changes in drinking, it may have value as an indirect measure of drinking in situations where direct measurement of alcohol consumption is undesirable (i.e., direct measurement might be reactive). Because the present findings are derived from problem drinkers, further research is needed to confirm the factor structure of the YBOCS-hd with clients who represent a broader range of alcohol problem severity.

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PubMed1998

Evaluation of the readiness to change questionnaire with problem drinkers in treatment.

Prochaska and DiClemente's (1982, 1983) readiness to change model proposes that people resolve health-related concerns by working through a qualitative progression of distinct motivational stages. The present study examined the responses of 66 (44 males, 22 females) mildly dependent outpatient alcohol abusers to the Readiness to Change Questionnaire, a scale developed to classify individuals according to their motivational stage. It has been suggested that the RTCQ may have applicability to problem drinkers in treatment. Reliability analyses conducted on the questionnaire's three subscales resulted in alpha coefficients of .30 for the Precontemplation subscale, .52 for the Contemplation subscale, and .76 for the Action subscale. The low internal reliability for the first two subscales does not support the use of this questionnaire in a treatment context at this time. Further studies are needed to refine the subscales. A psychometrically sound measure, once developed, would provide guidance in treatment matching.

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PubMed1990

Diagnostic validity of the MAST and the alcohol dependence scale in the assessment of DSM-III alcohol disorders.

The comparative validity of the Michigan Alcoholism Screening Test (MAST) and the Alcohol Dependence Scale (ADS) in screening for current DSM-III alcohol abuse/dependence disorders is evaluated. These scales were administered to 501 patients presenting for treatment of alcohol or drug problems. DSM-III alcohol disorders are diagnosed using the Diagnostic Interview Schedule. Receiver Operating Characteristic (ROC) analysis is used to determine optimum threshold scores for the MAST and ADS and to compare the screening ability of the two instruments. Optimum cut points for the MAST and the ADS are 12/13 and 8/9, respectively. The overall accuracy of classification for both instruments using these threshold scores is 88%. The areas under the ROC curves are .91 and .90 (SD = .02) and there are no significant differences between the MAST and the ADS in their ability to screen for alcohol abuse or dependence in this population. The MAST and the ADS correlate highly with each other (.79). The results reported in our study should be applicable to the revised DSM-III since a field trial found a high level of agreement on alcohol disorders between the diagnostic systems. Categorical versus dimensional approaches to the assessment of alcoholism are discussed.

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PubMed1989

Diagnostic validity of the drug abuse screening test in the assessment of DSM-III drug disorders.

Diagnostic validity of the DAST was assessed using a clinical sample of 501 drug/alcohol patients. Various DAST cut-points were validated against DSM-III drug abuse/dependence criteria, as assessed by the Diagnostic Interview Schedule. The DAST attained 85% overall accuracy in classifying patients according to DSM-III diagnosis. This accuracy was maintained between DAST score cut-points of 5/6 through 9/10. Receiver Operating Characteristic analysis indicated that 5/6 was the optimum threshold score. The DAST was also correlated with demographic variables, psychiatric history, and drug use. The results showed very good concurrent and discriminant validity. This study concluded that fairly accurate estimation of DSM-III drug criteria could be made using a brief self-administered questionnaire (DAST). However, caution must be expressed when generalizing these findings to other contexts (e.g. the justice system) where subjects may have stronger motivation to under-report drug involvement.

Adult↗

PubMedDate not supplied

Fostering self-change among problem drinkers: a proactive community intervention.

This paper describes the rationale and design for a recently implemented study involving a community-based intervention designed to foster self-change for individuals who otherwise would be unlikely to seek formal help or treatment for their alcohol problem. The study is based on research examining natural recovery processes with alcohol abusers and on clinical trials using a Guided Self-Change model of treatment with problem drinkers. Advertisements and mailed pamphlets are used to solicit individuals who wanted to change their drinking on their own using self-help materials. Respondents are screened and, if eligible, are randomly assigned to two conditions: Guided Self-Change (GSC) or Educational Materials Control (EMC) (projected N = 788): All subjects complete and mail in several brief assessment forms. Subjects in the GSC group receive advice and personalized feedback based on their assessment answers. Subjects in the EMC group receive educational pamphlets prepared for general medical and mental health settings. Subject characteristics and drinking-related history variables for the first 10% of the sample are presented. Subjects will be followed up at 12 months following the intervention.

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