A Measure to Assess Illness Awareness in Problem Gambling: Gambling Awareness and Insight Scale (GAS)

Individual differences and predictors of general awareness in problem gambling

In Canada, up to 3% of individuals have or are at risk of gambling disorder. Among these individuals, a lack of awareness of their problem gambling is a common barrier to treatment and negatively affects treatment adherence. A secondary analysis was conducted on data from 1346 individuals (mean age = 43.4, SD = 14.4; 54.3 % male) with problem gambling who did and did not perceive having a problem with their gambling as assessed by the fifth item of the Problem Gambling Severity Index, "In the past twelve months, how often have you felt that you might have a problem with gambling?" Additionally, we investigated predictors of increased general awareness at 12-month follow-up. At baseline, individuals who perceived a problem with their gambling experienced more gambling-related harms (OR = 1.714), had greater total gambling losses (OR = 1.067), were more likely to have a family history of problem gambling (OR = 2.143), experienced a greater loss of control (OR = 1.313) and more often gambled alone than with others (OR = 0.879), accounting for 26.6 % of the variance in general awareness. Baseline problem awareness was positively associated with attempts to cut down or control gambling at follow-up (χ²=11.350,p<.001), but negatively associated with remission (χ²=18.392,p<.001). Increases in awareness were related to an increase in the number of gambling-related harms, gambling involvement, impaired control, and lower educational attainment, explaining 35.5% of the variance in increased general awareness. The results indicate that experiencing more gambling-related harms increases the salience and awareness of problem gambling, and that awareness is also associated with an individual's gambling context, their loss of control, and their level of gambling involvement. The findings highlight the importance of gambling harms as they pertain to general awareness and suggest that improving the recognition of gambling harms could be beneficial for the prevention and intervention of gambling disorder.

A measure of subjective substance use disorder awareness - Substance Use Awareness and Insight Scale (SAS)

INTRODUCTION

Impaired illness awareness or inability to recognize that one has a substance use disorder can be a barrier to treatment seeking and rehabilitation. A validated scale is needed to better understand the clinical impact of impaired substance use disorder awareness. This study aimed to examine the psychometric properties of the Substance Use Awareness and Insight Scale (SAS), a novel scale to assess impaired illness awareness in individuals with substance use disorder.

METHODS

We developed the SAS, a 7-item self-report measure to assess the theoretical constructs of illness awareness in substance use disorder (www.illnessawarenessscales.com). Participants 18 years of age or older with a score of 8 or more on the Drug Use Disorders Identification Test (DUDIT) were included. Data were collected via Dynata, an online survey platform.

RESULTS

A total of 299 participants were included (mean (SD) age = 47.3-years (15.4), 54% women). The SAS demonstrated good convergent (r = 0.82, p < 0.001) and discriminant validity (r = -0.23, p < 0.001) with a measure of illness recognition and positive affect, respectively. SAS also demonstrated good internal consistency (Cronbach's alpha = 0.86) and one-month test-retest reliability (intra-class correlation = 0.87). An exploratory factor analysis suggested the retention of two components. Separate analyses of the SAS in individuals with cannabis, opioid, and other substance use showed similar results.

DISCUSSION

The results of this study provide initial support for the psychometric validation of the SAS in adults with substance use disorder. The SAS holds promise for use in research and clinical settings to assess the influence of impaired substance use disorder awareness on treatment outcomes.

A measure of illness awareness in alcohol use disorder-Alcohol Use Awareness and Insight Scale (AAS)

INTRODUCTION

Impaired illness awareness in individuals with alcohol use disorder can negatively affect treatment adherence, rehabilitation, and other clinical outcomes. However, the construct of illness awareness in alcohol use disorder and its clinical implications remain to be better conceptualized and understood. The objective of this study was to develop and psychometrically test a scale designed to assess impaired illness awareness in individuals with alcohol use disorder.

METHODS

We developed the Alcohol Use Awareness and Insight Scale (AAS), a self-report measure that assesses the core theoretical domains of illness awareness, including general disorder or problem awareness, accurate symptom attribution, awareness of the need for treatment, and the negative consequences of the disorder in individuals with alcohol use disorder (www.illnessawarenessscales.com). Data from 99 participants was obtained using a web-based survey platform, Dynata.

RESULTS

The AAS displayed good convergent (r = 0.88, p < 0.001) and discriminant validity with measures of illness recognition and affect states, respectively. The AAS also exhibited good internal consistency (Cronbach's α = 0.89) and one-month test-retest reliability (intra-class correlation = 0.84). Exploratory factor analysis resulted in the retention of a single component.

CONCLUSIONS

The AAS is a novel instrument developed to measure impaired illness awareness in individuals with alcohol use disorder. The AAS may be useful in clinical or research settings in evaluating the influence of subjective alcohol use disorder awareness on interventions to promote treatment adherence and other clinical outcomes.