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the present study where comparisons in dependence on alcohol and heroin were made.
3.4.7. The Leeds Dependence Questionnaire (LDQ)
The Leeds Dependence Questionnaire was developed in a clinical setting for the purpose of measuring dependence as part of a package of outcome measures that would be suitable for routine use (Raistrick et al. 1994). It is based in the purely psychological view of dependence as a set of behaviours and thoughts. The authors listed ten markers of dependence covering each of the elements of the phenomenon which were derived from interviews with users of a variety of drugs who were attending an addiction agency for treatment of drug and alcohol related problems. These markers were: i) a preoccupation of thoughts about the substance; ii) the salience of drinking or drug seeking; iii) a subjective awareness of the need to use the substance; iv) planning of daily activities around the procurement and use of the substance; v) maximisation of the effect of the substance; vi) stereotyping of the substance using behaviour, or narrowing of the drug or alcohol using repertoire; vii) perceived compulsion to continue use once started; viii) pursuit of the effect of the substance; ix) the maintenance of a constant state; x) a global belief in the need for drugs. From the interviews, operational definitions were given to the markers and these were then construed in question form (see Appendix 1). The order of the questions in the scale corresponds with the order of the markers described above.
A number of questions derived from the SADD (Raistrick et al. 1983), an instrument designed to measure alcohol dependence and described in section 3.4.1 of this chapter, were retained with slight modifications to allow for drugs other than alcohol and these were the ones measuring preoccupation of thoughts with the substance, planning of daily activities, impaired control and difficulty in abstaining. The inclusion of the behavioural items which referred to pursuit of the effect, maximisation of the effect and maintenance of a constant state was based upon the observation that positive reinforcement plays as central a role as negative reinforcement in the development and maintenance of dependent behaviour.
The ten items formed a Likert scale (described in McIver and Carmines 1981) with four frequency response choices which were scored 0-1-2-3 in the same direction with higher scores indicating a greater degree of dependence. Instructions given to respondents described the scale as being designed to assess the importance of alcohol and other drugs in their life; they were then asked to think about the main substance that they used, to think about the past week and to tick the response closest to the way that they felt.
The Leeds Dependence Questionnaire was validated for use in clinical samples of primary 70