S.M.M. Lammers

Compulsive smoking: the development of a Rasch homogeneous scale of nicotine dependence

The unidimensionality of nicotine dependence has not been established firmly yet. The aim of this study was to assess the dimensionality of nicotine dependence, preferably meeting the strict assumptions of the Rasch model. First, we examined the validity of the Fagerström Test for Nicotine Dependence (FTND) [Br. J. Addict. 86 (1991) 1119.] in 1525 smokers who participated in a national survey considering smoking behavior. Two factors were found, suggesting that the FTND does not measure a unidimensional construct. Factor analysis of 19 other dependence items in 512 smokers resulted in four factors of which three were interpretable: compulsive smoking, social problems due to smoking, and physical dependence. We focused on smoking compulsivity. This factor turned out to consist of a four-item Rasch homogeneous scale. Two items of the FTND with face validity of smoking compulsivity were found to fit into the scale. The results of Rasch analysis were in support of a continuum of compulsivity. Difficulty refraining from smoking in places where it is forbidden was found to indicate highest compulsivity. Several correlates with smoking compulsivity were found. We conclude that compulsive smoking is one important dimension of nicotine dependence, which may account for the considerable relapse of this disorder.

Submission and Rebellion: Excessive Drinking of Women in Problematic Heterosexual Partner Relationships

Functionality of alcohol use for coping with partner relationship problems was explored in a group of 45 alcohol-dependent women with semistructured interviews. Six functions were categorized, three of them referring to adjustment and three to opposition to the partner. Respondents who had started excessive drinking mainly in response to problems with the partner reported more partner-related functions than respondents for whom a problematic partner relationship was not an important factor in the development of excessive drinking. Respondents of the first group also reported other characteristics of their relationship, notably they said more often that their partner was dominant. It was concluded that for a subgroup of women with alcohol problems, alcohol use may be a way of coping with a situation of powerlessness toward the partner.

Psychological Functions of Drinking in Alcohol Dependent Women: An Exploration Based on a Dimensional Framework

Psychological functions of alcohol are consequents of drinking that the drinker experiences as positive or as having positive aspects. A taxonomy of functions of alcohol was constructed on the basis of four dimensions. In semi-structured interviews with 45 volunteer alcohol dependent women, 35 functions were distinguished, which could be placed in the taxonomy and reliably coded. Functions of alcohol not only consisted of reduction of stress but also of effects on a variety of behaviors. Functionality of alcohol use was often indirect, i.e. not directly related to the (real or expected) pharmacological action of alcohol but to its social and cultural meanings. Almost twice as many functions were reported for the maintenance period of drinking as in the early drinking history. Early functions were limited to specific areas; the later functions extended to a range of personal problems. The taxonomy can serve as a tool for a more systematic study of the functionality of alcohol.