People with TBI appear to be reliable reporters of their own drinking behavior.

Past Studies

Previous research has been instrumental in the development of questionnaires for clinical assessment of alcohol use. In several studies of substance abuse, researchers found that the person with a substance abuse problem and family members agreed on how much and when the drinker drank. Researchers and clinicians have been hesitant to rely on the answers of a person with both a substance abuse problem and a TBI because of concern that cognitive problems like memory and impaired self-awareness may lead to inaccurate self reports.

This Study

One hundred and seventy-five persons with TBI from an outpatient clinic were asked to complete a questionnaire about their drinking behavior. The same questionnaire was given to one of their family members. The person with TBI answered it about himself or herself and the family member answered it about the person with TBI. Persons of all levels of injury severity (mild, moderate, severe) were included in the study. Among this group, the average length of coma was 5.6 days, the average age was 39.2 years and 65% were men. Forty seven percent of the people in the study did not drink while 25% were moderate drinkers and 10% were heavy drinkers.

Over 95% of family members agreed with the person with TBI regarding their drinking behavior. In the 8 cases where there was disagreement, the person with the TBI reported heavier drinking than did the family member. When researchers separated the sample into groups based on severity of injury, greater agreement was found in the mild and moderate severity categories. There was also greater agreement when the family member was a spouse or significant other and less agreement when the family member was a parent. Whether the family member was living with the person with TBI or not made no difference in the level of agreement.

Caveats

The questionnaires were mailed to the persons with TBI before their outpatient appointment. They were instructed to fill out one set, have someone that “knew them well” fill out the other set, and not to discuss their answers with one another. No actual control was exerted over this part of the data collection process. Further, while the self-report and the family member report were in agreement, there is no way to know if the reports reflect the actual drinking behavior.

Bottom Line

It appears that the person with TBI reliably reports their drinking behavior. Therefore, family members and clinicians can expect that these reports are as accurate as those of a family member would be. Additional studies of this type would be useful in confirming the findings of this study.

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