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Addictive Behaviors

(PS1-A23) The Development and Validation of the Compulsive Substance Use Scale

Friday, November 17, 2023
8:30 AM – 9:30 AM PST
Location: Regency Ballroom, Level 7
Compulsivity reflects an important subtype of substance use disorders (SUDs), but there has been variability in how compulsivity is defined and measured. To date, substance use compulsivity has been frequently measured in relation to scales drawn from the obsessive-compulsive disorder (OCD) literature, despite significant differences in conceptualizations of the development and maintenance of OCD and SUDs. This current study was designed to (1) develop a new measure to better understand substance use compulsivity and validate this scale in a community sample of individuals with a range of alcohol use severity, and (2) evaluate the association between problematic alcohol use and this new measure of compulsivity. A preliminary set of 46 items were generated for evaluation of the novel Compulsive Substance Use Scale (CSUS). Each item was rated on a 7-point Likert scale reflecting the degree to which subjects “strongly disagree” to “strongly agree” with the statements of substance use characteristics over the past week. The CSUS items were generated to reflect three conceptual aspects of substance use compulsivity: craving, disregarding negative consequences, and automaticity. A total of 253 alcohol drinkers, with a range of severity were recruited online using Amazon’s Mechanical Turk platform and answered surveys on compulsivity, frequency of alcohol use, craving, and negative consequences of alcohol use. In addition to the CSUS items, participants completed alternative measures of substance use compulsivity, such as the Obsessive-Compulsive Drinking Scale, the Brief Assessment Tool for Compulsivity-Associated Problems, and the Alcohol Craving Questionnaire Short Form Reviewed. The sample was 54% male with an average age of 35 years. This sample reflected a range in severity of alcohol use, with 57% (n=144) of the sample meeting criteria for problematic alcohol use (5 or more days of binge drinking in the past month). We performed an exploratory factor analysis (EFA) for the CSUS, beginning with 46 items. The result was a one-factor solution with 18 items, using a conservative cutoff for goemen rotated item loadings ( >0.7). The measure includes 9 craving items, 6 disregarding negative consequences items, and 3 automaticity items. The internal consistency for the measure was excellent (α=.96). Additionally, a good EFA model fit was found for the one factor (CFI=.81). The CSUS was also highly correlated with other measures of compulsivity and a greater number of heavy drinking days. The current study provides support for the utility of a new measure of compulsivity that is composed of items that closely hew to the clinical concept of substance use compulsivity.