Measuring the Awareness Levels of Individuals with Alcohol and Substance Use Disorders: Tertiary Prevention Standards and Development of Uskudar Result Awareness and Harm Perception Scales

Rationale: Alcohol and substance use disorders are types of brain diseases that have psychological components which damage many life areas of the affected individual. Since investigating alcohol use alone is insufficient in the diagnostic evaluation process, self-awareness and the individual's long-term psychological well-being are important in the treatment process. Primary prevention is used for preventing disease in healthy people, whereas secondary prevention is used for early diagnosis of people at risk. Tertiary prevention is important to prevent the recurrence of the disease. Since substance use disorders are a chronic problems, a new need has emerged for tertiary protection in rehabilitation standards.

Methodology: In this study, we aimed to develop two scales that can provide ideas about rehabilitation standards by determining the awareness of individuals with or without alcohol and substance use disorders. By so, experts in the field can have information about the risk status of their patients in the follow-up process of rehabilitation, with the data obtained from the harm perception and result awareness dimensions in the scales. The sample consisted of 1134 participants, 41 of whom had substance use disorders.

Results: Among the two scales developed in the study, the Uskudar Result Awareness Scale (USRAS) consisting of 25 items and 6 factors explained 58.4% of the total variance. The Uskudar Harm Perception Scale (USHPS), consisting of 36 items and 10 factors, explained 56.3% of the total variance. Confirmatory factor analysis of the two scales resulted in acceptable goodness-of-fit values. (X²/df < 3; RMSEA < 0.08; NFI > 0.90; NNFI > 0.95; CFI > 0.95; GFI > 0.90; AGFI > 0.85).

Discussion: Comparisons showed that the resulting awareness of the non-SUD group was moderate (X = 3.81), whereas the SUD group had a low result awareness (X = 3.20); the effect size of the difference between the two groups was found to be high (d = 1.45; >0.8). On the other hand, the harm perception of the non-SUD group was found in the low-risk group (X = 3.78); the harm perception of the SUD group was found in the moderate-risk group (X = 3.43). According to Cohen's d calculations, the effect size of the difference between the two groups is high (d = 1.43; >0.8). It was concluded that both of the scales are valid and safe. They can be included in the treatment process and future studies.