Adult Substance Use and Driving Survey-Revised (ASUDS-R) Psychometric Properties and Construct Validity

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1 T2007 Seattle, Washington Adult Substance Use and Driving Survey-Revised (ASUDS-R) Psychometric Properties and Construct Validity Kenneth W. Wanberg¹ and David S. Timken² ¹Center for Addictions Research and Evaluation (CARE), Arvada, CO. USA ²Center for Impaired Driving Research and Evaluation (CIDRE), Boulder, CO USA Introduction: The Adult Substance Use and Driving Survey-Revised (ASUDS-R) 11 is a differential screening instrument designed for DWI offenders. It is the evolution of the Adult Substance Use and Driving Survey (ASUDS) developed by the authors in This instrument was developed from the Adult Substance Use Survey (ASUS)8. The ASUDS-R has 16 primary scales and three supplemental disruption scales, with a total of 123 items. Each item has a five point response scale. The scales are: Alcohol Involvement ( Extent of alcohol use); Driving Risk (Extent of driving hazard and risk); Involvement 1 (Lifetime and last six month involvement in 10 major drug categories); AOD Use Benefits (Extent of use for social and psychological benefits); Disruption 1 (Extent of problems and negative consequences of AOD use); AOD Involvement Last Six-months (Extent of involvement and disruption from AOD use in past six-months); Mood Disruption Psychological Problems (Extent of psychological and emotional adjustment); Social Non-conforming (Past and present rebelliousness and antisocial attitudes and behaviors; Legal Non-conforming (Involvement in criminal thinking, associates and conduct); Legal Non-conforming Six-months (Last six months involvement in criminal thinking, associates and conduct); Global (Degree of problems in substance use, mood adjustment and community compliance); Defensive (Degree client is able to divulge personal and sensitive information); Motivation (Extent of motivation and readiness to change); Strengths (Extent of strengths in family, marriage, work, behavioral, emotional and cognitive self-control); Involvement 2 and Disruption 2 (Same as Involvement 1 and Disruption 1, but normed on non-dwi clients in intensive outpatient or residential programs); Behavioral Control Disruption (Behavioral control problems while under the influence); Psychological Disruption (Psychological symptoms associated with intoxication or withdrawal); Social Disruption (Degree of AOD disruption in normal and expected social roles). The tool was normed on over 1000 DWI offenders as well as over 600 alcohol dependent patients in residential and intensive outpatient programs. All major ethnic/racial groups and both genders, adolescents and the elderly were included in the sample. The ASUDS-R is available in both paper-pencil and automated versions and is in wide use in Colorado and a number of other jurisdictions. Procedures: The procedures involved the description of samples, determining means, standard deviations (SD) and internal consistency reliabilities (ICR) (Cronbachs Alpha). Intercorrelations of the scales were performed along with ICR, squared multiple correlations (SMR) and percent unique variance (PUV). Correlations with age, gender, ethnicity and marital status among others, were

2 performed. Correlates between ASUDS-R scales and independent criterion measures were also reviewed in order to provide evidence of criterion (construct) validity of the scales. Included, but not limited to, were level of supervision of DWI offenders, women offenders, general drug involvement, degree of drug disruption and symptoms. Also included were levels of supervision of DWI offenders. Several other scale correlations were used including prior diagnosis of substance abuse/dependence and driving related measures. Regression analysis was performed to help determine whether the ASUDS-R is useful for placing DWI offenders in education and/or treatment. 1, 4, 5, 6, 7, 8, 9, 15, 16 Analytical Results: The analytical results were largely favorable. Internal consistency reliabilities were within optimal range. Each scale was found to render a unique dimension, intercorrelations among scales showed a consistent positive manifold, consistency of measurement among different samples was strongly supported and robust correlations were found with external criterion tests and scales. Evidence was found to support the use of the ASUDS-R scales independently and in combination with collateral variables to provide service guidelines for DWI offenders. (see tables below)

3 Table 1: DESCRIPTION OF TWO SAMPLES: SAMPLE A=2340; SAMPLE B=1099 GENDER SAMPLE A SAMPLE B Male Female ETHNICITY SAMPLE A SAMPLE B Angle-White Hispanic African American Asian Other MARITAL STATUS SAMPLE A SAMPLE B Never married Married Divorced Separated Widowed AGE SAMPLE A SAMPLE B 15 through through through through through through through EDUCATION SAMPLE A SAMPLE B Six years or less completed Seven to nine years completed to 12 years completed to 15 years completed years or more EMPLOYMENT STATUS SAMPLE A SAMPLE B Employed full time Employed part time Unemployed

4 Table 2: Psychometric Properties of the (ASUDS-R) Scales for SAMPLE A: Number of questions in scale (ITEMS), Number of Subjects (N), Means, Standard Deviation (SD), Internal Consistency Reliabilities (ICR) (Cronbach's, 1951, Alpha) for total sample (Total N=2340, however N for calculating scale statistics will vary because of missing data) BASIC SCALES ITEMS N Mean SD ICR 1. ALCOHOL INVOLVEMENT DRIVING RISK INVOLVEMENT AOD USE BENEFITS DISRUPTION AOD SIX MONTHS MOOD ADJUSTMENT SOCIAL NON-CONFORMING LEGAL NON-CONFORMING LEGAL NON-CONFORMING 6 MO GLOBAL AOD-PSYCHOSOCIAL PROB DEFENSIVENESS MOTIVATION STRENGTHS Table 3: Psychometric Properties of the (ASUDS-R) Scales for SAMPLE B: Number of questions in scale (ITEMS), Number of Subjects (N), Means, Standard Deviation (SD), Internal Consistency Reliabilities (ICR) (Cronbach's, 1951, Alpha) for total sample (Total N=1099, however N for calculating scale statistics will vary because of missing data) BASIC SCALES ITEMS N Mean SD ICR 1. ALCOHOL INVOLVEMENT DRIVING RISK INVOLVEMENT AOD USE BENEFITS 10 ND ND ND ND 5. DISRUPTION AOD SIX MONTHS MOOD ADJUSTMENT SOCIAL NON-CONFORMING LEGAL NON-CONFORMING 9 ND ND ND ND 10. LEGAL NON-CONFORMING 6 MO. 9 ND ND ND ND 11. GLOBAL AOD-PSYCHOSOCIAL PROB DEFENSIVENESS MOTIVATION STRENGTHS 11 ND ND ND ND

5 Table 4: SAMPLE A: Intercorrelations among 10 of the Original Scales of the ASUDS-R and Internal Consistency Reliabilities (ICR), Squared Multiple Correlations (SMR) and Percent Unique Variance (PUV) for Each Scale SCALE ALCOHOL 2. DRIVING RISK INVOLVEMENT DISRUPTION AOD 6 MO MOOD ADJST SOCIAL NON-C DEFENSIVE MOTIVATION GLOBAL ICR SMR PUV Table 5: SAMPLE B: Intercorrelations among 10 of the Original Scales of the ASUDS-R and Internal Consistency Reliabilities (ICR), Squared Multiple Correlations (SMR) and Percent Unique Variance (PUV) for Each Scale SCALE ALCOHOL 2. DRIVING RISK INVOLVEMENT DISRUPTION AOD 6 MO MOOD ADJST SOCIAL NON-C DEFENSIVE MOTIVATION GLOBAL ICR SMR PUV

6 Table 6: Perspective Validity: Correlations of ASUDS-R Scales with Perspective Validity Measures: Sex (male=1, female=2); AF-AM, African American=2, other=1; AN-AM, Anglo-American=2, other=1; HISP, Hispanic origin=2, other=1; NEV- MA, never married=2, other=1; MARR, married=2, other=1). SCALES AGE SEX AF-AM AN-AM HISP NEV-MA MARR 1. ALCOHOL.13** -.06* **.06** DRIVING RISK -.10** -.05* ** -.15**.10**.10** 3. AOD INVOLVE.07** ** -.12** *AOD BENEFITS.13.16** AOD DISRUPT.07** ** -.10** AOD 6 MONTHS * 7. MOOD ADJUST.07**.10** ** -.06* SOCIAL NON-C -.13** -.16** * -.10** 9.*LEGAL NON-C.14** *LEGAL NC 6 MO GLOBAL ** -.10** DEFENSIVE **.13** MOTIVATION **.07* *STRENGTHS **.20** Correlations.14 to.18: p <.01 Correlations >.18: p <.001 Table 7: Comparison of Male and Female Offenders across the Adult Substance Use Scales (ASUS) and on Level of Supervision - Revised (LSI-R) on the Crime, Mental Health and Total LSI-R Scales for 10 Judicial Samples 12 ASUS SCALE NAME ASUS: INVOLVEMENT NS NS NS NS F2 NS NS NS M1 NS ASUS: DISRUPTION F1 F2 F2 F2 F1 F1 NS F1 NS F2 ASUS: ANTISOCIAL M1 M1 M1 M1 M1 M1 M1 M1 M1 M1 ASUS: PSYCH PROB F1 F1 F1 F1 F1 F1 F1 F1 F1 F1 ASUS: DEFENSIVE M1 M1 M1 M1 M1 M1 M1 M2 M1 M1 ASUS: MOTIVATION NS NS NS NS NS NS NS ASUS: GLOBAL NS NS NS NS F1 F1 NS F1 NS F2 NS = Statistically non-significant F1 = Females score higher with probability <.009 F2 = Females score higher with probability <.05 M1 = Males score higher with probability <.009 M2 = Males score higher with probability <.05

7 Table 8: ASUDS-R Scales: SAMPLE A (pre-sentenced, N=2286); SAMPLE B (post-sentenced, N=1088) compared across ASUDS-R Scales evaluated at post-sentencing ASUDS SCALE DESCRIPTION COLORADO MASSACHUSETTS Mean SD Mean SD t Value 1. ALCOHOL INVOLVE * 2. DRIVING RISK * 3. ADO Involvement * 5. AOD DISRUPTION * 6. AOD 6 MONTHS * 7. MOOD DISRUPT * 8. SOCIAL NON-CON * 11. GLOBAL DISRUPT * 12. DEFENSIVE * 13. MOTIVATION Age at Evaluation * Gender (Female=1) P <.0001 Table 9: Correlations of ASUDS-R Scales with Criterion Scales Measuring Substance Use Involvement and Problems: MF (Mortimer- Filkins); SSI (Simple Screening Inventory); ADS (Alcohol Dependence Scale); DAST (Drug Abuse Screening Test); LSI-D (Level of Supervision Inventory-Drug Scale); LSD-C (Level of Supervision Inventory-Criminal) (DWI=impaired driving samples and N-DWI=judicial samples mostly non-dwi) 11, 8, 10, 3 SCALES MF N=358 DWI SSI N=589 N-DWI ADS N=673 N-DWI DAST N=673 N-DWI LSI-D N=1385 N-DWI LSI-C N=1385 N-DWI 1. ALCOHOL.41* DRIVING.23* AOD INVOLVE.33*.43*.43*.62*.61*.32* 4. AOD BENEFITS.32*.59* AOD DISRUPT.36*.55*.63*.65*.59*.28* 6. AOD 6 MONTHS.29*.39* *.37* 7. MOOD ADJUST.39*.43*.26*.31*.31*.19* 8. SOCIAL NON-C.44*.36*.41*.32*.45*.50* 9. LEGAL NON-C.41*.44* LEGAL NC 6 MO.25*.33* GLOBAL.49*.56*.60*.68*.63*.36* 12. DEFENSIVE -.31* -.44* -.29* -.27* -.31* -.21* 13. MOTIVATION.32*.56* *.35* 14. STRENGTHS * * p <.001

8 Table 10: Correlations of ASUDS-R Scales with Prior Diagnosis of Substance Abuse/dependence (PRIOR DX); Substance Abuse DSM-IV diagnosis (SA DSM-IV); or Substance Dependence DSM-IV diagnosis (SD DSM-IV) SCALES PRIOR DX N=739 DWI SAMPLE SA DSM-IV N=984 DWI SAMPLE SD DSM-IV N=982 DWI SAMPLE 1. ALCOHOL INVOLVEMENT.42*.38*.50* 2. DRIVING RISK.18*.20*.23* 3. AOD INVOLVEMENT.38*.37*.43* 4. AOD USE BENEFITS *.50* 5. AOD DISRUPTION.50*.40*.50* 6. AOD 6 MONTHS INVOLVE.26*.25*.35* 7. MOOD ADJUSTMENT.37*.28*.42* 8. SOCIAL NON-CONFORMITY.32*.42*.47* 9. LEGAL NON-CONFORMITY *.49* 10. LEGAL NC 6 MONTH *.29* 11. GLOBAL DISRUPTION.49*.51*.62* 12. DEFENSIVE -.34* -.29* -.39* 13. MOTIVATION.42*.38*.44* 14. STRENGTHS * p <.001

9 Table 11: Correlations of ASUDS-R Scales with Prior Treatment (PTX), Prior outpatient treatment (POPTX) and prior inpatient treatment (PITTX): For Impaired Driving Sample (DWI) and Judicial Samples Mainly Non-DWI (N-DWI) SCALES PTX N=979 DWI PTX N=739 DWI POPTX N=589 N-DWI POPTX N=665 DWI PINTX N=665 DWI PINTX N=291 DWI 1. ALCOHOL.28*.38* DRIVING AOD INVOLVE.24*.37* *.39*.36* 4. AOD BENEFITS.25* * AOD DISRUPT.30*.49*.28*.36*.49*.53* 6. AOD 6 MONTHS * MOOD ADJUST * *.40*.44* 8. SOCIAL NON-C.33*.30*.13.26*.21* LEGAL NON-C.39* LEGAL NC 6 MO GLOBAL.40*.48*.28*.39*.48*.49* 12. DEFENSIVE * * -.26* 13. MOTIVATION.29*.44* *.25* STRENGTHS = p <.01 * p <.001 Table 12: Relationship of Arrest BAC and Prior DWIs, Prior treatment (PRIOR TX), Prior Diagnosis (PRIOR DX), Diagnosis of Substance Abuse (DSM-IV ABUSE) and Diagnosis of Substance Dependence (DSM-IV DEPENDENCE) SAMPLES PRIOR DWIs PRIOR TX PRIOR DX DSM-IV ABUSE DSM-IV DEPENDENCE N=651.13* * N= *.14* N= *.14* * P <.001

10 Table 13: `Model 2: Comparing ASUDS-R PLUS DWI Variables Weighted Placement with Evaluator's Final Placement DESCRIPTION OF PLACEMENT SERVICES PERCENT PLACED BY ASUDS-R AND COLLATERALS N=2223 PERCENT PLACED BY EVALUATOR N= Level I Education Level II Education Level II Ed. plus weekly outpatient Level II Ed., weekly OP plus enhanced treatment Discussion and Summary Findings: The ASUDS-R is designed to gain the client's self-report of his or her perception of important areas of life functioning, including AOD use and abuse, mental health concerns, attitudes and behaviors that run counter to the expectations of society and the community, and motivation and readiness for treatment services, and self-perceived strengths. The current document presents many of the construct validation that has been done on the scales of this instrument. The most salient findings are as follows: The internal consistency reliabilities of the ASUDS-R are within optimal range. This is an important component of the construct validity of measurement scales. Although the scales are correlated, each represents independent measurements of critical conditions, situations and patterns important in the understanding, assessment, and determination of service needs of DWI offenders. Each scale renders a unique dimension to this assessment process. Consistent with other studies of AOD samples, the intercorrelations among the ASUDS-R scales show a consistent positive manifold indicating that there is a common factor of lifeadjustment problems among DWI offenders. DWI clients who are defensive consistently score lower across the ASUDS-R scales. This finding is consistent across all of the correlations between defensiveness and other measures of life-adjustment problems, e.g., AOD problems, mental health problems, antisocial attitudes and behaviors. This provides strong indication of consistency validity of the ASUDS-R scales. Consistent with the literature, younger age DWI offenders are at higher risk for AOD involvement and risk-taking behaviors and older DWI offenders higher risk for mental health problems. A finding consistent in the literature is that women report higher levels of mental health and mood adjustment problems and men report higher levels of antisocial attitudes and behaviors. This is a consistent finding across numerous large samples of judicial clients. The relationship of gender to the ASUDS-R scales is consistent across large samples of

11 judicial clients. These findings provide strong support for the consistency of measurement across different samples - validity consistency and invariance. As predicted, the ASUDS-R scales clearly discriminate between two DWI samples that differ as to status in the judicial system - pre-sentencing and post-sentencing. Across all scales measuring AOD and psychosocial problems, post-sentenced DWI offenders score significantly higher than pre-sentenced offenders; they score higher on motivation for services and change; and they score lower on defensiveness. Most likely, the source of variance for this difference is that post-sentenced DWI offenders are less defensive; and they do have higher levels of AOD and psychosocial problems. ASUDS-R scales have strong and robust correlations with external criterion tests and scales that measure AOD involvement and disruption and other psychosocial problems measured by the ASUDS-R. ASUDS-R scales measuring substance use involvement and disruption have strong correlations with variables measuring prior AOD diagnosis and DSM-IV diagnoses of Substance Abuse and Substance Dependence indicating predictive validity of these scales. ASUDS-R scales measuring substance use involvement and disruption have strong correlations with variables measuring prior AOD treatment indicating predictive validity of these scales. The ASUDS-R scales of ALCOHOL had consistent, though lower, positive statistically significant correlations with the DWI variables of BAC and prior DWI arrests/convictions. Positive, though not consistent, associations were found between AOD DISRUPTION, GLOBAL, AOD BENEFITS, and AOD INVOLVEMENT and the DWI variables. This suggests that BAC and prior DWIs may not be strong predictors of recidivism. Low, but statistically positive correlations were found between BAC and prior DWIs. The significant associations between BAC and the ASUDS-R scales, and significant associations between BAC and AOD diagnosis suggest that individuals with high arrest BACs are at greater risk of having more severe AOD problems and have a higher probability of having prior AOD treatment, at least in two of the three samples. Although BAC is an important variable in helping to determine placement, it should not be the only variable upon which placement should be determined. Studies relating ASUDS-R generated placement guidelines to actual placement decision made by DWI evaluators provides a sound basis for using the ASUDS-R scales independently in combination with collateral variables (e.g., arrest BAC, prior AOD treatment, prior DWI arrests/convictions) to provide service place guidelines for DWI offenders.

12

13 Conclusion: Self-report instruments, as represented by the ASUDS-R, are an essential and necessary component of the differential screening process. The raison d'etre of any self-report screening instrument is to provide guidelines for decision making. However, any viable assessment must integrate the findings from self-report with the findings of other-report data, using the convergent validation model. Assessment conclusions and placement decisions of DWI offenders should utilize all sources of information and always consider the current perceptions, agenda and needs of the client as well as the agenda and sanctioning expectations of the community as these are expressed through the legal system. Collateral data, official records, other clinical information and placement criteria such as those developed by the American Society of Addiction Medicine (1996) 2 should be used in conjunction with the ASUDS-R scales and the above defined collateral variables in making service referral decisions. References: 1. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th edition). Washington, DC: Author. 2. American Society of Addiction Medicine (2001). American Society of Addiction Medicine Patient Placement Criteria for the Treatment of Substance-related Disorders-Revised (ASAM PPC-2-R) (2 nd edition). Chevy Chase, MD: Author 3. Andrews, D. A., & Bonta, J. (1995). The Level of Supervision Inventory - Revised. Toronto: Multi-Health Systems. 4. Bowers, J. W., & Courtright, J. A. (1984). Communication research methods. Dallas, TX: Scott, Foresman and Company. 5. Campbell, D. T., & Fiske, D. W. (1959). Convergent and discriminant validation by the multitrait-multimethod matrix. Psychological Bulletin, 56, Cattell, R. B. (1957). Personality and motivation structure and measurement. New York: World Book. 7. Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16, CSAT: Center for Substance Abuse Treatment (1994). Simple screening instruments for outreach for alcohol and other drug abuse and infectious diseases. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service. 9. Ghiselli, E. E. (1964). Theory of psychological measurement. New York: McGraw-Hill Book

14 Company. 10. Horn, J. L., Skinner, H. A., Wanberg, K. W., & Foster, F. M. (1984). The Alcohol Dependence Scale -ADS (Alcohol Use Questionnaire). Toronto, Canada: Addiction Research Foundation. 11. Mortimer, I. R. G., Filkins, L. D., Lower, J. S., et al. (1971). Court procedures for identifying problem drinkers: Report on Phase I. DOT HS Washington, DC: Department of Transportation. 12. Skinner, H. A. (1982). The Drug Abuse Screening Test. Addictive Behaviors, 7, Wanberg, K.W. (1997). The Adult Substance Use Survey (ASUS). Arvada, CO Center for Addictions Research and Evaluation. 13. Wanberg, K. W., & Horn, J. L. (1983). Assessment of alcohol use with multidimensional concepts and measures. American Psychologist, 38, Wanberg, K. W., & Horn, J. L. (1987). The assessment of multiple conditions in persons with alcohol problems. In W. M. Cox (Ed.), Treatment and prevention of alcohol problems (27-56). New York: Academic Press. 15. Wanberg, K. W., & Timken, D. (1998). The Adult Substance Use and Driving Survey (ASUDS). Arvada, CO: Center for Addictions Research and Evaluation. 16. Wanberg, K. W., & Timken, D. (2006). The Adult Substance Use and Driving Survey - Revised (ASUDS-R). Arvada, CO: Center for Addictions Research and Evaluation.

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