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Measuring harm from drinking in Sweden: Self-reports from drinkers in the general population
Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

There are several traditions of conceptualizing and measuring harm from drinking. Two main approaches are considered in the introduction – the psychiatric epidemiology and the social survey research traditions. The present thesis adopts the latter, although, as discussed, on the empirical level there is no sharp borderline between the two perspectives, as there is not between personal (i.e. physical and psychological) and social harm from drinking as such. But while methods for studying personal harm are fairly well developed, social harm, i.e. adverse consequences of alcohol that involve social interaction, has received less attention. One of the aims of the thesis has been to explore different dimensions of harm from drinking, identify different harm areas and develop and apply area-specific measures using general population survey data.

Two papers examine psychometric properties of a widely used screening instrument, the AUDIT (Alcohol Use Disorder Identification Test). While the first paper is concerned with the validity of the AUDIT, testing it against different criteria, the second paper focuses on the test-retest reliability of the instrument. In the third paper, a number of summary measures of different areas of alcohol-related harm are constructed using factor analysis. These measures are then, in the last paper, applied to estimate prevalence and risk of alcohol-related harm in the Swedish general population. The analyses are based on data from a national survey on drinking problems in Sweden collected in 2001-2002.

It is concluded that the AUDIT screens well for both impaired self-control and social harm from drinking (as well as for high volume drinking), but performs less well when screening for health problems. The test-retest reliability of the AUDIT is relatively high. In the other two papers, constructing new summary measures and applying them to estimate prevalence of harm, it is concluded that, except for being young, no particular sociodemographic risk groups can be identified for different areas of harm from the same level and pattern of drinking. To what extent this reflects reality or is an effect of the methods we use and kind of population we reach in surveys is discussed.

Place, publisher, year, edition, pages
Stockholm: Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD) , 2006. , 143 p.
Keyword [en]
Key words: AUDIT measure, validity, reliability, harm from drinking, social problems, summary measures, predictors of alcohol-related harm, general population surveys.
National Category
Sociology
Identifiers
URN: urn:nbn:se:su:diva-995ISBN: 91-7155-247-2 (print)OAI: oai:DiVA.org:su-995DiVA: diva2:200816
Public defence
2006-05-22, Högbomsalen, Geovetenskapens hus, Svante Arrhenius väg 8 C, Stockholm, 13:00
Opponent
Supervisors
Available from: 2006-04-28 Created: 2006-04-28Bibliographically approved
List of papers
1. Alcohol use disorder identification test (AUDIT): What does it screen?: Performance of the AUDIT against four different criteria in the general population sample
Open this publication in new window or tab >>Alcohol use disorder identification test (AUDIT): What does it screen?: Performance of the AUDIT against four different criteria in the general population sample
2006 (English)In: Substance Use & Misuse, ISSN 1082-6084, E-ISSN 1532-2491, Vol. 41, no 14, 1881-1899 p.Article in journal (Refereed) Published
Abstract [en]

The purpose of this article was to examine the kinds of alcohol use disorder the AUDIT most accurately screens for since the literature is inconsistent in the use of the AUDIT. Sometimes it is viewed as a measure of hazardous or harmful drinking and sometimes as a measure of dependence. The performance of its subsets (consumption items, AUDIT-C; and problem items, AUDIT-P) and of the full AUDIT (AUDIT-10) was tested against four criteria: high-volume drinking, alcohol-related social problems, alcohol-related health problems, and alcohol dependence. A general population sample of 600 Swedish subjects was interviewed during the winter 2000–01. The results document that, at the recommended cutoff score of 8+, the AUDIT-10 performed well against all four criteria, even if less well against the alcohol-related health problems. The AUDIT-C also performed well against all the problem criteria, showing high areas under the ROC curve, even though significantly lower than the full scale. When measuring high-volume drinking, the AUDIT-C outperformed the full instrument. Scoring at least 1 on the AUDIT-P improved sensitivity of the instrument when screening for social problems and dependence and made it a satisfactory measure of health problems. It is suggested that, when using the full AUDIT to screen for problems more severe than high-volume drinking, the criterion of scoring at least 1 on the AUDIT-P should be applied in combination with a cutoff score on the AUDIT-C.

Keyword
alcohol use disorders alcohol-related problems AUDIT consumption dependency
National Category
Social Sciences
Identifiers
urn:nbn:se:su:diva-25926 (URN)10.1080/10826080601025532 (DOI)
Note
Part of urn:nbn:se:su:diva-995Available from: 2006-04-28 Created: 2006-04-28 Last updated: 2017-12-13Bibliographically approved
2. Test-retest reliability of the Alcohol Use Disorder Identification Test in a general population sample
Open this publication in new window or tab >>Test-retest reliability of the Alcohol Use Disorder Identification Test in a general population sample
2003 In: Alcoholism: Clinical and Experimental Research, ISSN 0145-6008, Vol. 27, no 9, 1428-1435 p.Article in journal (Refereed) Published
Identifiers
urn:nbn:se:su:diva-25927 (URN)
Note
Part of urn:nbn:se:su:diva-995Available from: 2006-04-28 Created: 2006-04-28Bibliographically approved
3. Social problems from drinking in the Swedish general population: Measurement and reliability
Open this publication in new window or tab >>Social problems from drinking in the Swedish general population: Measurement and reliability
2007 (English)In: Journal of Substance Use, ISSN 1465-9891, E-ISSN 1475-9942, Vol. 12, no 2, 103-118 p.Article in journal (Refereed) Published
Abstract [en]

Aims:

The paper constructs and tests summary measures for different areas of alcohol-related

problems, using general population data. The main emphasis is on the rather unexplored area of

measuring social harm from drinking.

Methods:

The data analysed is a Swedish national survey on drinking behaviour and related

consequences, collected in 2002 by means of telephone interviews with 5469 adult Swedes. In total,

38 items on both personal and social problems by respondents attributed to their drinking were

subjected to factor analysis in order to identify different problem areas for which summary measures

could be constructed. The psychometric properties of the measures were then tested.

Results:

In line with others’ findings, the problem items tended to load on a single factor. After

Varimax rotation, 11 factors were built, only in part fitting a logical conceptual pattern. In the light

both of the dimensions identified in the factor analysis and of face validity, measures of five areas of

alcohol-related problems were constructed: impaired self-control, chronic health problems, public

disorder, interpersonal problems and alcohol-related social problems. The last measure is a summary

scale including both items covered by public disorder and interpersonal problems scales, as well as a

few other items. In terms of internal consistency and test–retest reliability (analysing a smaller sample

from a test–retest pilot study), the five measures showed satisfactory psychometric properties.

Conclusions:

In the light of others’ findings, the measures developed here seem to be more consistent

and reliable than a number of other scales. In order to establish comparability, it seems reasonable to

develop and test similar measures across different drinking cultures and, perhaps, modify them

thereafter.

Place, publisher, year, edition, pages
Informa healthcare, 2007
Keyword
Dimensionality of harm from drinking, social consequences, summary measures, general
National Category
Social Sciences
Identifiers
urn:nbn:se:su:diva-25928 (URN)10.1080/14659890601156838 (DOI)
Note
Part of urn:nbn:se:su:diva-995Available from: 2006-04-28 Created: 2006-04-28 Last updated: 2017-12-13Bibliographically approved
4. Predicting alcohol-related harm by sociodemographic background: High prevalence versus high risk
Open this publication in new window or tab >>Predicting alcohol-related harm by sociodemographic background: High prevalence versus high risk
2005 In: Contemporary Drug Problems, ISSN 0091-4509, Vol. 32, no 4, 547-588 p.Article in journal (Refereed) Published
Identifiers
urn:nbn:se:su:diva-25929 (URN)
Note
Part of urn:nbn:se:su:diva-995Available from: 2006-04-28 Created: 2006-04-28Bibliographically approved

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