Page 110 - PhD GT

proposed replacing all reference to intention in loss of control items with:
“....a more direct item, such as, ‘Have you felt an irresistible compulsion to continue drinking once you start?’”
(Chick 1980a p. 185)
Many of the instruments designed to measure loss of control or impaired control have avoided the question of intention to drink to a limit by asking simply whether the subject is able to stop drinking when they want to or once they have started, for example the Alcohol Dependence Scale (ADS) (Skinner and Allen 1982), the Michigan Alcoholism Screening Test (MAST) (Selzer 1971), the Composite International Diagnostic Interview-Substance Abuse Module (CIDI-SAM) (Cottler et al. 1989). Some scales, like the Impaired Control Scale (Heather et al. 1993) described below, have included items referring to intention as well as items referring simply to an inability to stop once started. These authors have built into the scale questions regarding attempts to control in order to address the question of whether or not there was prior intention.
5.3 Source of the definition: Objective or subjective measure?
A further issue in the definition of loss of control refers to the source of such definition. Both Chick (1980b) and subsequently Kahler et al. (1995) distinguished public, or “objective” loss of control from “subjective loss of control” where public loss of control was deemed to be objective by virtue of being defined by some universal rules or social norms of behaviour (passing out in public) and subjective loss of control referred to the breaking of a self-imposed limit, namely drinking more than one intended to, without defining the parameters of that intention. Given the obvious difficulties with a measure that is defined by some external rules of behaviour and the cultural relativity that must be attached to such definition and given that the whole idea of alcohol dependence refers to an altered relationship between the individual and alcohol, there would appear to be no problem with confining items to the measurement of subjective loss of control.
5.4 The timing of impaired control: is 'inability to abstain' a separate construct?
Further questions on the definition of impaired control refer to the timing of the phenomenon. Some writers have used the term to refer to between session loss of control, more
98