Revisiting the Drinker Inventory of Consequences: An Extensive Evaluation of Psychometric Properties in Two Alcohol Clinical Trials


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Abstract

Alcohol-related consequences are linked directly to the diagnostic criteria for alcohol use disorder (AUD). However, alcohol consumption outcome variables (e.g., percent days abstinent, heavy drinking days) remain the dominant outcome in AUD treatment research. Two reasons AUD treatment researchers have not shifted to include alcohol-related consequences as a primary outcome may be that previous studies have failed to provide convincing evidence of (1) the psychometric properties of measures of alcohol-related consequences, and (2) whether consequences measures are sensitive to change following treatment. The present study directly addresses these two concerns via psychometric evaluation and sensitivity/specificity testing of the Drinker Inventory of Consequences (DrInC; Miller, Tonigan, & Longabaugh, 1995) in two of the largest multisite clinical trials ever conducted (COMBINE Study, Anton, et al., 2006; and Project MATCH, Project MATCH Research Group, 1997). Results indicated that the five subscales commonly used for the DrInC had poor construct validity and were noninvariant across time. A newly developed three-factor model consisting of mild, moderate, and severe consequences had excellent psychometrics, including good internal consistency reliability, construct validity, and measurement invariance over time. The three-factor model of the DrInC was also sensitive and specific for detecting consumption outcomes in both COMBINE and MATCH and had convergent validity with measures of consumption and wellbeing. In conclusion, the three-factor DrInC may be a useful tool for defining AUD treatment success in a clinically meaningful way that aligns with diagnostic criteria.

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