SUBJECT-COLLATERAL REPORTS OF DRINKING IN INPATIENT ALCOHOLICS WITH COMORBID MENTAL-DISORDERS

Verbal self-report continues to be the primary method by which clinici ans and researchers obtain measurements of a person's past drinking. I n addition, collateral reports are an important second measure of an i ndividual's drinking behavior. Although there is considerable confiden ce in the use of collateral reports as a measure of drinking in indivi duals with only a diagnosis of alcohol abuse or dependence, informatio n about subject-collateral reports for alcoholics with a comorbid ment al disorder is lacking. Given both that symptoms of mental illness can negatively impact cognitive processes relevant to the recall of infor mation, and that such symptoms can be influenced by alcohol consumptio n, it is important to be confident in the reports of alcohol use in du ally diagnosed individuals. This study examined subject-collateral rep orts of alcohol use in two groups of inpatient alcoholics: those meeti ng DSM-III-R criteria for an alcohol use disorder and a current mental disorder (n = 91) and those meeting criteria for an alcohol use disor der only (n = 93). Overall, the results show that the self-reports of alcoholics with comorbid mental disorders are generally valid. In addi tion, subject-collateral agreement was found to be similar for both gr oups, with no consistent tendency to overreport or underreport alcohol or drug use in either group. Importantly, psychological symptom sever ity and cognitive functioning were not related to subject-collateral a greement, However, less frequent contact between subject and collatera l had a more negative impact on subject-collateral agreement for the d ual diagnosis group, compared with the alcohol-only group. Recommendat ions for enhancing the accuracy of self-reports of drinking in a dual diagnosis population are discussed.