Validity of Adolescent Self-Report of Substance Use

Abstract

The validity of self-report of substance use was examined in 367 adolescents referred for a substance use assessment between 1996 and 2000. Referrals came from a wide variety of sources, including pediatricians, the courts, and social services, as well as their parents. Average age of the sample was 15, 52% were male, and 82% were Caucasian. Adolescents were first asked about the details of their substance use by a clinician using a structured interview with established reliability and validity (Adolescent Drug and Alcohol Diagnosis). They were subsequently asked to provide a urine sample, a requirement they were unaware of when being interviewed about their substance use. If the urine sample was deemed valid by the laboratory technician, it was analyzed by means of fluorescence polarization immunoassay and paper chromatography. If positive screens were obtained for any substance, the sample was subjected to gas chromatography/mass spectrometry for confirmation and quantification. Biochemical test results were compared to self-report. Overall, 28% (96/338) of the self-reports were not corroborated by urinalysis. In adolescents who reported nonuse of a substance, 26% (56/219) had a positive urinalysis. More surprisingly, 34% (40/119) of adolescents reporting substance use in the urinalysis detection window had a negative urinalysis. The present study found self-report of substance use in adolescents to only have fair validity. It is recommended that biochemical corroboration be routinely used for this population.

Keywords:

• urinalysis
• adolescent
• substance use
• self-report
• validity

Notes

¹The journal's style utilizes the category substance abuse as a diagnostic category. Substances are used or misused; living organisms are and can be abused. Editor's note.

Additional information

Notes on contributors

Robert J. Williams

Robert Williams, Ph.D., is a professor in the School of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada. Dr. Williams is a clinical psychologist by training and was the regional psychologist for Manitoba Health & Family Services (Thompson region) from 1986 to 1996. From 1996 to 2001 he was both a clinician and a researcher at the Addiction Centre, Foothills Medical Centre in Calgary, Alberta. In January 2001 Dr. Williams accepted a faculty position at the University of Lethbridge. Dr. Williams has published in the areas of seasonal affective disorder, fetal alcohol syndrome, adolescent addictions, and problem gambling. His current research mandate is the study of gambling.

Nadine Nowatzki

Nadine Nowatzki is a Research Associate in the School of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada. Ms. Nowatzki completed a Master of Arts degree in Sociology in 1998 from the. University of Saskatchewan. She worked at a university in Mexico from 1998 to 2000, and then worked as a volunteer development worker in VietNam from 2000 to 2001. Ms. Nowatzki has taught in the areas of research methodology and sociology of health, and works on research projects focused on gambling, addictions, and other health related subjects.