Performance of the pictorial representation of illness and self measure in individuals with alcohol dependence, alcohol abuse or at-risk drinking.
BACKGROUND
The impact of chronic illnesses is not only influenced by one's physical functioning but also by its subjective importance to the individual's life. However, it is often difficult to asses such an impact in an appropriate way. PRISM (pictorial representation of illness and self measure) measures the perception of illness and first data on its validity have been published. The aim of the present study was to prove the applicability of PRISM regarding alcohol-dependent patients. Therefore, a comparison was made between alcohol-dependent patients, alcohol abusers and at-risk drinkers.


METHODS
The sample consisted of 763 general practice patients, who scored above the cutoff in alcohol-related screening questionnaires. Of this sample, 330 were diagnosed as alcohol dependent, alcohol abusers (both according to DSM-IV) or at-risk drinkers. To prove the applicability, PRISM was put in context with the severity of alcohol dependence and the core constructs of the transtheoretical model of behavior change.


RESULTS
PRISM was related to the severity of the drinking problem: the severer the drinking problem, the shorter the distance between self and illness. High correlations with aspects of alcohol consumption - such as adverse consequences from drinking, temptation to drink, and self-efficacy to abstain - were found. Concerning stages of change according to the transtheoretical model of behavior change, data show a significant difference in the self-illness separation between patients in the stage of contemplation compared to those in the precontemplation or action stage.


CONCLUSIONS
The PRISM task is applicable to patients with alcohol use disorders. Within this group and in contrast to other chronic diseases, PRISM reveals a significant relationship not only to the severity of drinking, but also to the readiness to change one's drinking behavior.
Reinhardt
Susa
S
Department of Psychiatry and Psychotherapy, Research Group S:TEP (Substance Abuse: Treatment, Epidemiology and Prevention), University of Lübeck, Germany. Susa.Reinhardt@ukl.uni-luebeck.de
Bischof
Gallus
G
Grothues
Janina
J
John
Ulrich
U
Rumpf
Hans-Jürgen
HJ
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010775:Photic Stimulation; D011237:Predictive Value of Tests; D012307:Risk Factors; D012649:Self Concept; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires