Substance specific dependence scales
scale characteristics and quality framework scores
Dependence is a key element of addiction. There is a lack of consensus on how to measure dependence and in particular how much emphasis should be given to the presence of withdrawal syndromes which are different from one substance to another. Universal dependence scales usually take account of how people respond to withdrawal rather than withdrawal itself and have the benefit that comparisons can be made across all substances. There may be particular reasons for choosing a substance specific measure, nonetheless, consideration should be given as to the suitability of a universal scale.
SADQ :: Severity of Alcohol Dependence Questionnaire designed to screen for drinking triggers prior to a controlled drinking intervention
The Severity of Alcohol Dependence Questionnaire, SADQ, was designed as a 'pure' measure of the alcohol dependence syndrome. It focuses exclusively on the most readily quantifiable elements namely the experience of withdrawal symptoms the morning after a heavy drinking day. A shorter version for use in the community SADQ-C was developed which made significant changes to wording. There are a total of 20 items, four items in each of the five sections used: Q1-4 physical withdrawal symptoms (PHYS), Q5-8 affective withdrawal symptoms (AFF), Q9-12 withdrawal relief drinking (NEED), Q13-16 quantity and frequency of alcohol consumption (ALC) and Q17-20 rapidity of reinstatement of withdrawal symptoms following a period of abstinence (POSTAB). The SADQ is the first in a family of scales: others are The Severity of Opiate Dependence Questionnaire, SODQ, and The Severity of Amphetamine Dependence Questionnaire, SAmDQ. Timeframe :: A heavy drinking period in the previous 6 months. Scoring :: Each item is rated upon a four point frequency scale: for Q1-16 0= 'almost never' 1= 'sometimes' 2= 'often' 3= 'nearly always' and Q17-20 0= 'not at all' 1= 'slightly' 2= 'moderately' 3= 'quiet a lot'. Thus the range of the total score is from 0 to 60. Completion time :: <5minute. Cut-off score :: Suggested cut-off scores for dependence are: mild 0-15, moderate 16-30 and severe >30.
ADS :: Alcohol Dependence Scale designed for research especially with a focus on dependence
The ADS was derived from the Alcohol Use Inventory via component analysis in an effort to develop a scale more closely related to an underlying dimensional continuum. One of the main objectives of the ADS was to emphasise a dimensional approach to the syndrome that marks the progression of alcohol use from involvement to impaired control. The ADS is a 25-item multiple-choice questionnaire. Although there seems to be an underlying dependence measure there have also been suggestions for subscales. Timeframe :: The last 12 months. Scoring :: Dichotomous items are scored 0, 1; three-choice items are scored 0, 1, 2; and four-choice items are scored 0, 1, 2, 3. In each case, the higher the value the greater the dependence. Total scores range from 0 to 47. Completion time :: Not specified. Cut-off score :: Scores 1–13 reflect a low level of alcohol dependence, marked by psychological rather than physical dependence; 14–21 reflect moderate levels of alcohol dependence, marked by psychosocial problems related to drinking and psychological dependence with signs of physical dependence; 22–30 reflect substantial levels of alcohol dependence, with physical dependence likely and physical and psychosocial problems probable; 31–47 reflect severe alcohol dependence, with physical dependence and physical disorders likely.
The ADS was developed by the Addiction Research Foundation, which is now part of the Center for Addiction and Mental Health, Toronto. Licence fees apply without which reproducing the scale is not permitted.
FTND :: Fagerstrom Test of Nicotine Dependence designed for routine practice and research
Licence: FTND is copyright of Taylor and Francis Ltd., but may be reproduced without permission
The most widely used smoking dependence scales are the Fagerström Tolerance Questionnaire, FTQ, and its improved version, the Fagerström Test for Nicotine Dependence, FTND. The FTND was developed mainly because the FTQ had significant psychometric disadvantages, such as unacceptable internal consistency, poor criterion validity and a multifactorial structure. The FTND was initially developed to determine whether or not nicotine replacement therapy is needed to treat withdrawal symptoms. The instrument consists of six of the original FTQ items with revised scoring for two questions. It is easily understood and rapidly applied. Q1 time to first smoke Q2 salience Q3 importance of first cigarette Q4 amount Q5 early morning smoking Q6 salience. Timeframe :: Not specified - 'now' is implied. Scoring :: Q1 and Q4 scored 0-4; other items scored 0-1. Completion time :: Very brief. Cut-off score :: Suggested cut-offs for nicotine dependence are: very low (0 to 2 points); low (3 to 4 points); moderate (5 points); high (6 to 7 points); and very high (8 to 10 points).