Psychology of Addictive Behavior1990. Vol. 4, No. 2. 77-81

ISSN 0893-164X. Sanely ofPsychologists in Addictive Behaviors

Further Support for the CriterionValidity of the Alcohol Use Inventory

Carl E. IsenhartVeterans Administration Medical Center

Danville, Illinois

This project reports evidence for the criterion validity of the Alcohol Use Inventory(AUI; Wanberg, Horn, & Foster, 1977) by showing that the instrument accuratelyidentifies expected differences in a specific condition (alcohol severity) in two con-trasting groups of alcohol abusers. Two hundred male veterans admitted to an in-patient alcohol program were categorized as to whether or not they had a father whoabused alcohol. Veterans with a father who abused alcohol scored significantly higheron AUI scales measuring alcohol abuse severity and alcohol-related problems thanveterans with no such history. Differences in patterns of and benefits from alcoholuse were not found. These results are consistent with the AUI literature and providefurther evidence of the validity of the AUI.

A major advancement in the area of alcoholabuse assessment is the development of the Al-cohol Use Inventory (AUI; Horn, Wanberg, &Foster, 1986; Wanberg, Horn, & Foster, 1977).The AUI is based on the philosophy of usingmultidimensional concepts and measures to as-sess alcohol abuse (Wanberg & Horn, 1983). Psy-chometric reports (Skinner and Allen, 1983; Hornet al., 1986; Wanberg et al, 1977) have beensupportive of the instrument. Horn et al. (1986)provided evidence for the criterion validity ofthe AUI (i.e., the extent to which the instrumentaccurately identifies specific conditions or cri-teria). Using different levels of alcohol severityas the criterion, the authors reported threestudies demonstrating that the AUI accuratelydiscriminates between groups of patients withdifferent levels of alcohol severity and alcohol-related problems. In the first study, the AUI re-sulted in higher alcohol severity ratings and morealcohol-related problems in chronic-severe pa-

The author gratefully acknowledges the assistance ofPamela Marcuro for her help in reviewing articles forthis project. Appreciation is also expressed to RandyTaylor, Ph.D., Michael Clayton, Ph.D., and two anon-ymous reviewers for their comments on a draft of thisarticle.

Correspondence concerning this article should be ad-dressed to Carl Isenhart, Alcohol and Drug Rehabili-tation Unit, Veterans Administration Medical Center,Danville, IL 61832.

tients than inpatients who, in turn, had higherAUI severity ratings than outpatients. The sec-ond study found that readmitted patients hadhigher alcohol severity ratings than first-admit-ted patients. The third study demonstrated higherseverity ratings of people in AA than those whohad never attended AA (Horn et al., 1986).

The present study was conducted to furtherinvestigate the criterion validity of the AUI byusing two groups of alcohol abusers: those whoreported their fathers had significant alcohol-re-lated problems (Father Positive, FP), and thosewho reported their fathers did not have alcohol-related problems (Father Negative, FN). Theliterature clearly demonstrates that, when com-pared to individuals who do not have an alcohol-abusing parent or parents, people who had analcohol-abusing parent or parents (as a group)drink at an earlier age and experience more socialand personal problems (Penick, Read, Crowley,& Powell, 1978); have more alcoholic symptom-atology, less occupational stability, and more al-cohol-related physical symptomatology (Frances,Timm, & Bucky, 1980); display more symptomsof alcoholism (Alterman & Tarter, 1983); ex-perience more severe pathology (Schuckit, 1983);exhibit higher levels of alcohol use, more symp-toms of alcoholism, more incarcerations, andmore sociopathy (Beardslee, Son, & Vaillant,1986); and demonstrate more dependent prob-lems drinking and marital disruption (Parker &Harford, 1987, 1988).

77

78 CARL E. ISENHART

It is hypothesized that the FP group wouldscore higher than the FN group on scales mea-suring alcohol abuse and alcohol-related prob-lems. That is, criterion validity would be dem-onstrated if the AUI identifies different levels ofalcohol severity in these two groups.

Method

Subjects

The subjects were 200 male veterans (127 FNs and73 FPs) admitted to a cognitive-behavioral alcohol anddrug rehabilitation unit in a Midwestern Veterans Af-fairs Medical Center. Approximately 72% of the vet-erans abused alcohol only, whereas 28% had a con-current drug abuse problem. The average age of thesubjects was 44.2 (SD - 11.61). Table 1 displays otherrelevant demographic characteristics.

For two logistical reasons, the study was limited tomales with fathers who were alcohol abusers. First, thepercentage of veterans whose mothers or both parentsabused alcohol was less than 10%. Second, less than3% of the veterans in the program are female. It wasbelieved that the low incidence of these two groups ofveterans would not allow for an adequate number ofsubjects of which to collect and analyze data.

Measures

Alcohol Use Inventory (A VI). The AUI (Wanberg etal., 1977) is a 147-item questionnaire that measures16 primary factors, four secondary factors, and onebroad measure of general alcoholism. The primary scalesassess the individual's alcohol use pattern (e.g., gre-garious vs. isolated drinking), benefits from alcohol use(e.g., mood change), and negative consequences (e.g.,delirium and hangover). The secondary scales assessthe extent that alcohol enhances the individual's per-formance, and the extent that the individual's drinkingis obsessive, compulsive, and sustained. Other sec-ondary scales provide estimates of alcohol-related dis-ruption experienced by the individual (two scales) andthe amount of anxiety and concern the individual ex-periences about his or her alcohol abuse.

Wanberg et al. (1977) reported internal consistencyreliability coefficients ranging from .38 to .93, test-retest reliability coefficients ranging from .54 to .94over a 1-week period, and interscale correlation coef-ficients for the primary scales ranging from .00 to .62.Skinner and Allen (1983) reported internal consistencyreliability coefficients ranging from .48 to .92 and cor-relation coefficients with the Michigan AlcoholismScreening Test (MAST; Selzer, 1971) ranging from .01to .72. They found minimal correlations with a mea-sure of defensive responding (r — —.03 to —.30), but

they found significant negative correlations between ameasure of social desirability and all but three of theAUI scales (r = - . 0 2 to - .50) . That is, respondentstended to create an overly positive or negative view ofthemselves when responding to items related to severealcohol abuse. As a result, Skinner and Allen (1983)suggested administering a social desirability scale alongwith the AUI. In that way, the AUI profiles of indi-viduals who have high or low social desirability scorescan be interpreted with special care.

Procedures

Every participant admitted to the program routinelyreceived a psychological evaluation that consisted ofcompleting a test battery that included the AUI. Also,each participant completed a "Family History Ques-tionnaire." This questionnaire asked the individual toindicate whether his father, mother, brothers), sis-ter(s), step-father, step-mother, maternal grandfatheror grandmother, or paternal grandfather or grand-mother "has or had an alcohol abuse problem to theextent that it has resulted in medical, legal, family, job,or emotional problems for that individual." Nobodywas admitted to the unit and therefore did not partic-ipate in this study if there were any signs of intoxica-tion, impending withdrawal, severe cognitive impair-ment, an active psychiatric disorder, or an acute medicalcondition. The AUI test data and the Family HistoryQuestionnaire results were retrospectively collectedfrom the records of veterans who had been admittedto the program.

Results

Table 1 displays the demographics of the twogroups. Analysis shows that the FP group wassignificantly younger (40.14) than the FN group(46.51; t = 3.86, p < .001). Further examinationof Table 1 reveals no other significant demo-graphic differences between these groups. Be-cause of the significant age difference, an analysisof covariance was performed using age as thecovariate. Because of the increased probabilityof making Type I errors when conducting mul-tiple comparisons, the level of significance wasset at .0025 (.05/20) as suggested by Hays (1981).

Table 2 displays the results of this analysis.There were no significant differences betweenthese groups on scales measuring benefits fromor patterns of alcohol use. However, there weresignificant differences on three primary scalesmeasuring negative consequences associated withalcohol abuse. The FP group scored significantlyhigher on the following scales: Loss of Control

VALIDITY OF THE ALCOHOL USE INVENTORY 79

Table 1Demographic Characteristics and Comparisonof the FN and FP Groups

Table 2Mean Scores (and Standard Deviations) of theFP and FN Groups for Each of the A VI Scales

Demographic

FP FN

Total 73) 127) Statistic

Age

RaceWhiteBlackOther

Marital statusSingleMarriedSeparatedDivorcedWidowed

EducationCollege13-15 yearsHigh school9-11 years<9 years

44.2 40.1

16336

1

323426

1026

1253

1081413

OccupationProfessional 1Administrative 15Clerks/techs 23Skilled labor 87Semi/unskilled 74

60130

138

1337

2

22539

43

063

3331

46.5 x" = 0.3860*

X2 = 0.583910323

1

• 4.77519261365

4

1028691010

19

205443

X2 = 6.037

*p < .001.

(a history of causing harm to self and/or others,experiencing blackouts and passing out, or stag-gering or stumbling when drinking), Role Mal-adaptation (a history of unemployment or dif-ficulties at work, residential instability, legalproblems, or incarcerations), and Hangover (ahistory of shakes, nausea and vomiting, tachy-cardia, convulsions, or chills while sobering up).There was also a significant difference on onesecondary scale (Deterioration-1), suggesting thatthe FP group experiences a greater level of al-cohol-related deterioration and disruption thanthe FN group. Finally, the FP group scored sig-nificantly higher than the FN group on the ter-tiary scale (General Alcoholism) measuring theextent to which a person may be experiencingsymptoms consistent with problematic drinking.

The General and Deterioration-1 scales con-sist of, but are not limited to, items from theprimary scales, including the Loss of Control,Role Maladaptation, and Hangover scales.

FP FN

Primary scalesSocial benefit

Mental benefit

Gregariousdrinking

Obsessive drink-ing

Sustained drink-ing

Guilt and worry

Mood change

Help before

Loss of controlRole maladapta-

tionDelirium

Hangover

Drug abuse

Quantity

Secondary scalesSelf-enhancement

Obsessive/sus-tained

Anxious concern

Deterioration-1

Deterioration-2

Tertiary scaleGeneral alco-

holism

5.55(2.54)1.63

(1.58)5.08

(2.68)3.59

(2.36)6.84

(3.01)5.85

(2.29)5.63

(2.21)3.08

(2.23)9.15

(3.77)6.67

(2.91)3.89

(3.36)5.74

(2.60)2.25

(2.12)6.03

(2.59)

8.49(4.08)10.16(4.30)14.59(5.05)

21.16(8.20)8.44

(2.49)

5.00(2.67)1.47

(1.56)4.76

(2.52)2.92

(2.39)6.93

(3.37)5.03

(2.71)5.10

(2-39)2.94

(2.23)7.00

(4.13)5.34

(2.83)2.91

(3.19)4.29

(3.14)1.29

(1.79)5.28

(2.90)

7.52(3.83)9.47

(4.62)12.54(5.69)16.99(9.38)7.31

(3.69)

1.088

0.017

0.014

3.661

0.504

3.383

1.272

1.273

10.56

9.893

5.800

10.53

2.756

2.988

0.482

0.415

4.055

10.09

3.854

.2986

.8641

.8721

.0540

.4855

.0639

.2597

.2594

.0018*

.0023*

.0161

.0018*

.0944

.0816

.4954

.5277

.0427

.0021*

.0481

36.45 29.17(12.29) (15.24)

10.76 .0016*

*p < .0025.Note. A 0 score on two scales. Using Alcohol to CopeWith Marital Conflict and Alcohol Use Resulting inMarital Conflict, has two interpretations: first, the per-son does not use alcohol to cope with marital conflictand/or alcohol use does not result in marital conflicts;or second, the person did not answer the scales's itemsbecause the respondent was not married or was not ina "marriage-type" situation for 6 months. Because ofthis "dual interpretation" of a 0 score, these scales werenot included in the data analysis to prevent any mis-interpretation.

80 CARL E. ISENHART

Therefore, the differences on the General andDeterioration-1 scales are expected given the sig-nificant differences between the groups on thethree primary scales.

Although not statistically significantly differ-ent at the alpha level used here, there were note-worthy differences between the two groups onother scales that are consistent with the hypoth-esis being tested in this study. For example, theFP group scored higher on the following scales:Delirium (a history of visual, auditory, or tactilehallucinations; frightening and unusual sensa-tions; and clouded thinking), Anxious Concern(feelings of worry, tension, depression, guilt, andshame surrounding alcohol abuse; and concernthat alcohol abuse is becoming worse), and De-terioration-2 (a measure of alcohol-related de-terioration that is a more indirect and subtlemeasure than Deterioration-1).

Discussion

This project used two contrasting groups todemonstrate criterion validity for the AUI. Con-sistent with the literature, the AUI scales reflect-ed more severe alcohol-related life-style prob-lems in the FP group than in the FN group.Specifically, the FP group was found to havehigher levels of alcohol-related loss of behavioralcontrol, greater social role maladaptation, andmore severe hangovers than the FN group. Also,there were indications that the FP group expe-rienced more severe alcohol-related delirium andhigher levels of anxiety surrounding their alcoholconsumption than the FN group. Overall, the FPgroup was found to have more alcohol-relateddeterioration and more indicators of problematicdrinking than the FN group. The lack of differ-ences on the scales measuring benefits from andpatterns of alcohol abuse are consistent with Hornet al.'s (1977) observation that severity is unre-lated to benefits and patterns. That is, more orless severe drinkers may drink for similar ben-efits and in similar patterns.

In addition to having higher severity ratings,the FP group was also significantly younger thanthe FN group. This finding suggests that, becauseof the severity of their alcohol-related problems,the FP group may become involved with an in-patient program at an earlier age than the FNgroup. Although this was not a hypothesis of thisstudy, this age difference is consistent with the

literature and supports findings that individualsraised by an alcohol-abusing parent(s) maythemselves develop an alcohol problem at ayounger age than individuals not raised by analcohol-abusing parent(s).

There are limitations to this study. First, thepopulation was all male, predominantly white,and from lower SES levels. Also, only the father'sdrinking history was considered. It is possiblethat other demographic groups would yield dif-ferent results (see Horn et al., 1986, for a dis-cussion on the scoring patterns of different racialgroups and females). Also, consideration of themother's drinking history separately and in ad-dition to the father's drinking history may pro-duce different results. Despite these consider-ations, however, these results are consistent withthe AUI literature and further support the valid-ity of this instrument.

References

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Beardslee, W. R., Son, L., & Vaillant, G. E. (1986).Exposure to parental alcoholism during childhoodand outcome in adulthood: A prospective longitu-dinal study. British Journal of Psychiatry, 149, 584-591.

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Hays, W. L. (1981). Statistics (3rd ed.). New York:CBS College Publishing.

Horn, J. L., Wanberg, H. W., & Foster, F. M. (1986).The alcohol use inventory (AUI). Minneapolis, MN:National Computer Systems, Inc.

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