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syndrome with specific reference to opiates is described. There follows a description of two instruments designed to measure substance dependence as a psychological phenomenon, the first requiring adaptation of the wording for use with different drug using groups; the second requires no such adaptation.
3.4.1 The Severity of Alcohol Dependence Questionnaire (SADQ) and the community version, the SADQ-C
The Severity of Alcohol Dependence Questionnaire was first reported in 1979 (Stockwell et al. 1979) as a thirty-three item self-completion scale consisting of five sections measuring physical withdrawal, affective withdrawal, withdrawal relief, typical daily consumption and a section entitled “The morning after two days heavy drinking following at least four weeks abstinence” (p. 87). Its validation is based upon the scores of 104 respondents who were in-patients and out-patients at two alcohol treatment units, 91 of whom were breathalysed and given a structured interview about their drinking habits. A rating of alcohol dependence was made on the basis of the case notes of 72 of the respondents by a single experienced clinician. Eighty-two per cent of these were matched concordantly with severity ratings by the SADQ.
After extracting items which yielded the lowest loadings on the principal component as analysed for each section separately, factor analysis of the pooled items of sections 1, 2, 3 and 5 (excluding the section on consumption) yielded a single main factor which accounted for 53% of the variance. The scores for the five subscales correlated between 0.69 and 0.80 with the total SADQ scores. The authors maintained that “the correlations are sufficiently high and uniform to justify summing the scores from all five sections to yield the final measure” (p. 84). This seems to assume that heavy consumption of alcohol is an element of dependence rather than one that is strongly correlated with it.
Furthermore, since there were no items testing the salience of drink seeking behaviour, the narrowing of drinking repertoire or some of the subjective awareness of the compulsion to drink elements such as impaired control and difficulty in abstaining, the scale cannot be said to measure the dependence syndrome as described by Edwards and Gross (1976) nor can it be used as evidence of the unitary nature of this syndrome. Having claimed that the SADQ “was designed to cover central features of the alcohol dependence syndrome most amenable to measurement...” (Stockwell et al. 1979 p. 80), the authors then go on to say that:
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