Substance use in individuals with mild to borderline intellectual disability: A comparison between self-report, collateral-report and biomarker analysis. (April 2017)

• Record Type: Journal Article
• Authors: VanDerNagel, Joanneke E.L.; Kiewik, Marion; van Dijk, Marike; Didden, Robert; Korzilius, Hubert P.L.M.; van der Palen, Job; Buitelaar, Jan K.; Uges, Donald R.A.; Koster, Remco A.; de Jong, Cor A.J.
• Is Part Of: Research in developmental disabilities. Volume 63(2017:Apr.)
• Page Start: 151
• Page End: 159
• Publication Date: 2017-04
• Subjects: Substance use -- Intellectual disability -- Assessment -- Questionnaire -- Biomarker -- Self-report -- Collateral-report -- Smoking -- Alcohol -- Illicit drugs; Developmental disabilities -- Periodicals; Developmentally disabled -- Research -- United States -- Periodicals; Developmentally disabled children -- Education -- Research -- United States -- Periodicals; Developmental Disabilities -- Periodicals; Disabled -- Periodicals; Mental Retardation -- rehabilitation -- Periodicals; Personnes atteintes de troubles du développement -- Recherche -- États-Unis -- Périodiques; Enfants atteints de troubles du développement -- Éducation -- Recherche -- États-Unis -- Périodiques; Développement, Troubles du -- Recherche -- États-Unis -- Périodiques; 616.858800
• DOI: 10.1016/j.ridd.2016.04.006
• Languages: English
• ISSNs: 0891-4222

Abstract

Highlights: We assessed substance use using self-report, collateral-report, and biomarkers. Willingness to participate in self-report was higher than in biomarker sampling. Substance use rates in MBID from self-report and collateral-report were similar. Self-reported use in MBID was not lower compared to positive biomarker results. Biomarker analysis had limited additional value to self-report. Abstract: Background and aims: Individuals with mild or borderline intellectual disability (MBID) are at risk of substance use (SU). At present, it is unclear which strategy is the best for assessing SU in individuals with MBID. This study compares three strategies, namely self-report, collateral-report, and biomarker analysis. Methods and procedures: In a sample of 112 participants with MBID from six Dutch facilities providing care to individuals with intellectual disabilities, willingness to participate, SU rates, and agreement between the three strategies were explored. The Substance use and misuse in Intellectual Disability − Questionnaire (SumID-Q; self-report) assesses lifetime use, use in the previous month, and recent use of tobacco, alcohol, cannabis, and stimulants. The Substance use and misuse in Intellectual Disability − Collateral-report questionnaire (SumID-CR; collateral-report) assesses staff members' report of participants' SU over the same reference periods as the SumID-Q. Biomarkers for SU, such as cotinine (metabolite of nicotine), ethanol, tetrahydrocannabinol (THC), and its metabolite THCCOOH, benzoylecgonine (metabolite of cocaine), and amphetamines were assessed in urine, hair, and sweat patches. Results: Willingness to provide biomarker samples was significantly lower compared to willingness to complete the SumID-Q (p < 0.001). Most participants reported smoking, drinking alcohol, and using cannabis at least once in their lives, and about a fifth had ever used stimulants. Collateralreported lifetime use was significantly lower. However, self-reported past month and recent SU rates did not differ significantly from the rates from collateral-reports or biomarkers, with the exception of lower alcohol use rates found in biomarker analysis. The agreement between self-report and biomarker analysis was substantial (kappas 0.60–0.89), except for alcohol use (kappa 0.06). Disagreement between SumID-Q and biomarkers concerned mainly over-reporting of the SumID-Q. The agreement between SumID-CR and biomarker analysis was moderate to substantial (kappas 0.48 − 0.88), again with the exception of alcohol (kappa 0.02). Conclusions and implications: In this study, the three strategies that were used to assess SU in individuals with MBID differed significantly in participation rates, but not in SU rates. Several explanations for the better-than-expected performance of self- and collateral-reports are presented. We conclude that for individuals with MBID, self-report combined with collateralreport can be used to assess current SU, and this combination may contribute to collaborative, early intervention efforts to reduce SU and its related harms in this vulnerable group.