Construct, concurrent and predictive validity of the URICA: Data from two multi-site clinical trials
Construct, concurrent and predictive validity of the URICA: Data from two multi-site clinical trials
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DOI：
10.1016/j.drugalcdep.2008.12.003
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发表时间：
2009-04-01
影响因子：
4.2
通讯作者：
Carroll, Kathleen M.
中科院分区：
文献类型：
--
作者：
Field, Craig A.;Adinoff, Bryon;Carroll, Kathleen M.
背景：更好地理解如何衡量改变的动机以及它与药物和酒精依赖患者的行为改变之间的关系，将拓宽我们对动机在成瘾治疗中作用的理解。
方法：在美国国家药物滥用研究所临床试验网络中进行了两项多中心随机临床试验，将简短的动机干预与标准治疗进行比较。进入门诊治疗的原发性药物依赖和酒精依赖患者参与了动机强化治疗（n = 431）或动机性访谈（n = 423）的研究。对源自罗德岛大学改变评估（URICA）的两种改变动机综合测量指标——改变准备度（RTC）和承诺行动（CA）的结构效度、同时效度和预测效度进行了评估。
结果：验证性因素分析证实了URICA的先验因素结构。RTC在基线时与成瘾严重程度的测量指标显著相关（r = 0.12 - 0.52，p < 0.05）。尽管具有统计学意义（p < 0.01），但治疗结果与RTC之间的相关性较低（r = -0.15和0.18）。进一步的分析不支持动机对治疗保留或物质使用的调节或中介作用。
结论：在大量药物和酒精依赖患者样本中分别证实了URICA的结构效度。然而，综合分数预测效度的证据非常有限，并且两种测量指标对治疗结果均无调节或中介作用。因此，由URICA得出的动机综合分数所衡量的改变动机增强似乎并不影响治疗结果。由爱思唯尔爱尔兰有限公司出版。
Background: A better understanding of how to measure motivation to change and how it relates to behavior change in patients with drug and alcohol dependence would broaden our understanding of the role of motivation in addiction treatment.Methods: Two multi-site, randomized clinical trials comparing brief motivational interventions with standard care were conducted in the National Institute on Drug Abuse Clinical Trials Network. Patients with primary drug dependence and alcohol dependence entering Outpatient treatment participated in a study of either Motivational Enhancement Therapy (n = 431) or Motivational Interviewing (n = 423), The construct, concurrent, and predictive validity of two composite measures of motivation to change derived from the University of Rhode Island Change Assessment (URICA): Readiness to Change (RTC) and Committed Action (CA) were evaluated.Results: Confirmatory factor analysis confirmed the a priori factor structure of the URICA. RTC was significantly associated with measures of addiction severity at baseline (r = .12-.52, p < .05).Although statistically significant (p < .01), the correlations between treatment outcomes and RTC were low (r = - .15 and 18). Additional analyses did not support a moderating or mediating effect of motivation on treatment retention or substance use.Conclusions: The construct validity of the URICA was confirmed separately in a large sample of drug- and alcohol-dependent patients. However, evidence for the predictive validity of composite scores was very limited and there were no moderating or mediating effects of either measure on treatment outcome. Thus, increased motivation to change, as measured by the composite scores of motivation derived from the URICA, does not appear to influence treatment Outcome. Published by Elsevier Ireland Ltd.