ASSESSMENT OF ADDICTIVE BEHAVIORS Assessment of ADDICTIVE BEHAVIORS SECOND EDITION Edited by DENNIS M. DONOVAN G. ALAN MARLATT THE GUILFORD PRESS New York London © 2005 The Guilford Press A Division of Guilford Publications, Inc. 72 Spring Street, New York, NY 10012 www.guilford.com All rights reserved No part of this book may be reproduced, translated, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher. Printed in the United States of America This book is printed on acid-free paper. Last digit is print number:987654321 Library of Congress Cataloging-in-Publication Data Assessment of addictive behaviors / edited by Dennis M. Donovan and G. Alan Marlatt. – 2nd ed. p. cm. Includes bibliographical references and index. ISBN 1-59385-175-8 (alk. paper) 1. Compulsive behavior—Diagnosis. 2. Compulsive behavior— Treatment. 3. Substance abuse. 4. Psychodiagnostics. I. Donovan, Dennis M. (Dennis Michael) II. Marlatt, G. Alan. RC533.A86 2005 616.86—dc22 2005000901 About the Editors Dennis M. Donovan, PhD, was affiliated with the Addictions Treatment Cen- ter at the Seattle Department of Veterans Affairs Medical Center for over 20 years, while engaging in clinical, administrative, training, and research activi- ties. During that time he was also instrumental in the development of, and served as the Associate Director of, the first Center of Excellence in Substance Abuse Treatment and Education (CESATE) within the national Department of Veterans Affairs. He currently serves as the Director of the University of Washington’s Alcohol and Drug Abuse Institute and holds the faculty ranks of Professor in the Department of Psychiatry and Behavioral Sciences, and Ad- junct Professor in the Department of Psychology at the University of Washing- ton in Seattle. He has written over 120 journal articles, 30 book chapters, and 3 books in the area of alcoholism and addictive behaviors, with emphases on social learning theory and biopsychosocial approaches to the etiology, maintenance, and treatment of addictions; the clinical assessment process and assessment measures; treatment entrance and engagement; evaluation of treat- ment process and outcome; relapse prevention; and patient–treatment match- ing. Dr. Donovan’s research has been funded by the National Institute on Al- cohol Abuse and Alcoholism (NIAAA), the National Institute on Drug Abuse (NIDA), and the Center for Substance Abuse Treatment (CSAT). He has served as Associate Editor and as a member of the editorial boards for the Journal of Studies on Alcohol, Psychology of Addictive Behaviors, and Addic- tion. He has also been a member of the Clinical and Treatment Research Re- view Committee of NIAAA and the Behavioral AIDS Research Review Com- mittee of NIDA. Dr. Donovan is a member of a number of national professional organizations and served as President of the Society of Psycholo- gists in Addictive Behaviors. He has also been elected a Fellow of Division 50 (Division on Addictions) of the American Psychological Association. G. Alan Marlatt, PhD, Director of the Addictive Behaviors Research Center and Professor of Psychology at the University of Washington, is renowned for his innovative theoretical and clinical work in the addictions field. Over the v vi About the Editors past two decades, he has made significant advances in developing programs for both relapse prevention and harm reduction for a range of addictive be- haviors. In addition to coediting the first editions of Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors (1985) and Assessment of Addictive Behaviors (1988), Dr. Marlatt is the editor of Harm Reduction: Pragmatic Strategies for Managing High-Risk Behaviors (1998), coeditor of Changing Addictive Behavior: Bridging Clinical and Public Health Strategies (1999), and coauthor of Brief Alcohol Screening and Intervention for College Students (BASICS): A Harm Reduction Approach (1999), all pub- lished by The Guilford Press. He is a Fellow of both the American Psychologi- cal Association and the American Psychological Society, and is a former presi- dent of the Association for Advancement of Behavior Therapy. He served as a member of the National Advisory Council on Drug Abuse at the National In- stitute on Drug Abuse from 1996 to 2002, and served on the National Advi- sory Council on Alcohol Abuse and Alcoholism Subcommittee on College Drinking from 1998 to 2001. Dr. Marlatt currently holds a Senior Research Scientist Award from the National Institute on Alcohol Abuse and Alcohol- ism, and received the Innovators Combating Substance Abuse Award from the Robert Wood Johnson Foundation in 2001. Previously, he was presented with the Jellinek Memorial Award for Alcohol Studies (1990), the Distinguished Scientist Award from the American Psychological Association’s Society of Clinical Psychology (2000), the Visionary Award from the Network of Col- leges and Universities Committed to the Elimination of Drug and Alcohol Abuse (2002), and the Distinguished Researcher Award from the Research So- ciety on Alcoholism (2004). Contributors Samuel A. Basll, PhD, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut Arthur W. Blume, PhD, Department of Psychology, University of Texas at El Paso, El Paso, Texas Kathleen M. Carroll, PhD, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut R. Lorraine Collins, PhD, Research Institute on Addictions, University at Buffalo, State University of New York, Buffalo, New York Ned L. Cooney, PhD, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, and VA Connecticut Heathcare Center, West Haven, Connecticut Jessica M. Cronce, BS, Department of Psychology, Yale University, New Haven, Connecticut Berenice García de la Cruz, MA, Department of Special Education, University of Texas at Austin, Austin, Texas Dennis M. Donovan, PhD, Alcohol and Drug Abuse Institute and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington Christopher R. Freed, MPhil, MA, The Graduate Center, The City University of New York, New York, New York William H. George, PhD, Department of Psychology, University of Washington, Seattle, Washington Maureen Hillhouse, PhD, UCLA Integrated Substance Abuse Programs, Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine, Los Angeles, California Ronald M. Kadden, PhD, Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut vii viii Contributors Jason R. Kilmer, PhD, Evergreen State College, Olympia, Washington, and Saint Martin’s College, Lacey, Washington Kristen P. Lindgren, MS, Department of Psychology, University of Washington, Seattle, Washington Carmen L. Masson, PhD, Department of Psychiatry, University of California, San Francisco, San Francisco, California Osvaldo F. Morera, PhD, Department of Psychology, University of Texas at El Paso, El Paso, Texas Rebekka S. Palmer, PhD, Department of Psychiatry, Division of Substance Abuse, Yale University School of Medicine, New Haven, Connecticut Richard A. Rawson, PhD, UCLA Integrated Substance Abuse Programs, Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine, Los Angeles, California Lina A. Ricciardelli, PhD, School of Psychology, Deakin University, Burwood, Victoria, Australia Roger A. Roffman, DSW, School of Social Work, University of Washington, Seattle, Washington William G. Shadel, PhD, Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania Howard J. Shaffer, PhD, CAS, Division on Addictions, Harvard Medical School, Boston, Massachusetts Saul Shiffman, PhD, Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania Jane M. Simoni, PhD, Department of Psychology, University of Washington, Seattle, Washington Ruthlyn Sodano, BA, Department of Psychology, University of Albany, State University of New York, Albany, New York James L. Sorensen, PhD, Department of Psychiatry, University of California, San Francisco, San Francisco, California Howard R. Steinberg, PhD, Yale University School of Medicine, New Haven, Connecticut Kari A. Stephens, MS, Department of Psychology, University of Washington, Seattle, Washington Robert S. Stephens, PhD, Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia David A. Wasserman, PhD, Department of Psychiatry, University of California, San Francisco, San Francisco, California James Westphal, MD, Department of Psychiatry, University of California, San Francisco, San Francisco, California Contributors ix Jennifer G. Wheeler, PhD, Sex Offender Treatment Program, Monroe Correctional Complex–Twin Rivers Unit, Monroe, Washington Tina M. Zawacki, PhD, Department of Psychology, University of Texas at San Antonio, San Antonio, Texas Preface Over a decade and a half ago, the introductory chapter for the first edition of this book dealt with the then “emergent” biopsychosocial model of addictive behaviors and its implications for their assessment. Much has happened in the addictions field since that time. We have a clearer and more thorough under- standing of the genetic, biological, cognitive, psychological, and social factors that contribute to the development of addictive behaviors. We have a better understanding of how neurotransmitter systems and behavioral