Patient-spouse agreement on the drinking behaviors of alcoholics

Because investigators have expressed concern about the validity of alcoholism self-report measures, attention has been focused on the use of spouse or other collateral ratings of patient drinking behaviors. Previous studies have shown that spouse ratings of alcoholics on the Self-Administered Alcoholism Screening Test (SAAST) were reliable and a valid means of screening for alcoholism. In the current study, our objectives were to attempt to replicate the earlier findings in a new and larger sample and to determine whether the various content dimensions of the SAAST show similar patient-spouse agreement. The SAAST results of 240 patient-collateral pairs showed that the mean percentage agreement over the 35 items of the SAAST was 76.5%. Patient-spouse agreement ranged from 84.7% on the component "family alcohol problems" to 68.5% on "loss of control." When patients were classified as alcoholic or nonalcoholic on the basis of spouse ratings on the SAAST, correct classification occurred 98% of the time. Correct conjoint classification by both patient and spouse occurred 95.4% of the time. Thus, we found a high level of agreement between patient and spouse on the SAAST ratings and confirmed that spouse SAAST ratings of drinking behavior of patients provide a reliable diagnosis of alcoholism.