Subject-Collateral Reports of Drinking in Inpatient Alcoholics with Comorbid Mental Disorders

Verbal self-report continues to be the primary method by which clinicians and researchers obtain measurements of a person's past drinking. In addition, collateral reports are an important second measure of an individual's drinking behavior. Although there is considerable confidence in the use of collateral reports as a measure of drinking in individuals with only a diagnosis of alcohol abuse or dependence, information about subject-collateral reports for alcoholics with a comorbid mental disorder is lacking. Given both that symptoms of mental illness can negatively impact cognitive processes relevant to the recall of information, and that such symptoms can be influenced by alcohol consumption, it is important to be confident in the reports of alcohol use in dually diagnosed individuals. This study examined subject-collateral reports of alcohol use in two groups of inpatient alcoholics: those meeting DSM-Ill-R criteria for an alcohol use disorder and a current mental disorder (n= 91) and those meeting criteria for an alcohol use disorder only (n= 93). Overall, the results show that the self-reports of alcoholics with comorbid mental disorders are generally valid. In addition, subject-collateral agreement was found to be similar for both groups, with no consistent tendency to overreport or underreport alcohol or drug use in either group. Importantly, psychological symptom severity and cognitive functioning were not related to subject-collateral agreement. However, less frequent contact between subject and collateral had a more negative impact on subject-collateral agreement for the dual diagnosis group, compared with the alcohol-only group. Recommendations for enhancing the accuracy of self-reports of drinking in a dual diagnosis population are discussed.