Multiple addictive behaviors in young adults: Student norms for the Shorter PROMIS Questionnaire

Abstract

The Shorter PROMIS Questionnaire (SPQ; Christo, Jones, Haylett, Stephenson, Lefever & Lefever, 2003) is a multidimensional self report that measures 16 addictive behaviors. This study examined the psychometric properties of the SPQ and collected normative data from 948 students at two Canadian universities. Factor analysis confirmed the existence of two categories of addictive behavior, which Haylett and her colleagues (2004) labelled hedonistic and nurturant. The hedonistic categories included behaviors such as the use of prescription drugs, gambling, caffeine, illegal drugs, alcohol, tobacco and compulsive sex. The nurturant group included behaviors such as compulsive helping, work, relationships, shopping, disordered eating and exercise. Men (N = 250) scored higher than women on dominant relationships, exercise, gambling, illegal drugs, alcohol, tobacco and sex. Women (N = 698) scored higher on compulsive shopping, food binging and starving. These results suggest that the SPQ may be a useful index of multiple addictive behaviors in college-age people.

Introduction

Comorbidity of addictive behaviors is an important consideration for researchers and clinicians but there are practical and ethical restraints on the amount and type of information that can be collected from research participants. Structured interviews are inefficient in many research settings (e.g. Topp, Hando, Dillon, Roche, & Solowij, 1999) and, although brief self reports can be used to measure the use of alcohol (e.g. Stockwell, Murphy, & Hodgson, 1983), illicit drugs (e.g. Gossop et al., 1995), gambling (e.g. Lesieur & Blume, 1988), and disordered eating (e.g. Garner, Olmstead, & Polivy, 1983), the co-administration of many scales can be cumbersome. Some researchers have used simple de novo questionnaires intended to assess multiple addictions, but these instruments are likely to omit important details and their psychometric reliability and validity are not established (e.g. Cook, 1989, Greenberg et al., 1999). Research focusing on multiple addictive behaviors might be facilitated by the availability of a multidimensional self report questionnaire. In this study, we assessed the psychometric properties of the Shorter PROMIS Questionnaire (SPQ; Christo et al., 2003) as a tool for correlational research in university settings.

The SPQ was originally developed after an archival study of the co-occurrence of addictive behaviors among patients at a substance dependence recovery facility (Stephenson, Maggi, Lefever & Morojele, 1995). The psychometric properties of the SPQ and its 16 subscales were tested and norms for adults were established (Christo et al., 2003). Because the SPQ simultaneously measures a wide array of behaviors, it appears to be an ideal tool to test the notion that some of the addictive behaviors might have common etiology. Using factor analysis, Haylett, Stephenson, and Lefever (2004) identified two broad categories of addictive behaviors that are measured by the SPQ, which they termed hedonistic and nurturant. The hedonistic behaviors included the use of alcohol, tobacco, illegal and prescription drugs; gambling, compulsive sex, and dominance or submission in intimate relationships. The nurturant cluster included compulsive working and shopping, disordered eating and exercise, and compulsively helping others in a dominant or submissive role. The SPQ seems ideally suited to studies of the comorbidity of substance use and other compulsive behaviors.

A full understanding of addictive behavior is hindered by the fact that many social scientists have limited access to clinical populations and many conduct research using university students as research subjects. Although, according to the most recent American estimate, people between the ages of 18 and 25 have the highest incidence of drug use (Substance Abuse and Mental Health Services Administration, 2008), students have lower rates of drug abuse than non-students. In that survey of 67,870 households, 68.3% of the 18–25 age group reported use of alcohol in the past month, 41.8% reported binge drinking, and 14.7% had heavy alcohol use. Furthermore, 19.7% were current users of illegal drugs and cigarette smoking was reported by 32.7% of people aged 18–20 and by 38.5% of people aged 21–25. In Canada, drug and alcohol abuse is common among university students (Barrett, Darredeau & Pihl, 2006) and often co-occurs with pathological gambling (Rush, Bassani, Urbanoski & Castel, 2008) and disordered eating (Piran & Gadalla, 2007). University students are a potentially rich source of information about the etiology and sequelae of addictive behaviors.

Although the SPQ has been used to estimate the prevalence of addictive behaviors in high school students (Pallanti, Bernardi & Quercoli, 2006), its validity and psychometric properties in a non-clinical young adult population have not been evaluated. The present study was designed to test the SPQ's internal reliability and factor structure, as well as provide a set of comparative student data. Although no sample collected in a university setting can accurately represent the general populace, norms and prevalence estimates may generalize to other student populations.