Drugs Decisional Balance Scales

Drugs Decisional Balance Scales used in psychology are essential tools for clinical and research assessments. This post is based on dissertations submitted by students during their academic programs. At ‘Mental Health,’ we arrange and provide these resources to you. Here is the complete list of resources (Click Here). To access these materials, click on the ‘Avail File’ section below.”

About Drugs Decisional Balance Scales

Purpose of the Tool

The Drugs Decisional Balance Scales (DDBS) are designed to assess an individual’s motivation to engage in or refrain from drug use based on the balance of perceived pros and cons. This scale plays a key role in understanding substance use behaviors by examining how individuals weigh the perceived benefits (pros) and costs (cons) of their drug use. The scale is integral for intervention planning, especially in guiding tailored treatments for individuals in various stages of change regarding their substance use.

Background

The Drugs Decisional Balance Scales were originally based on the Transtheoretical Model (TTM) of behavioral change, a framework developed by Prochaska and DiClemente in the 1980s. The TTM describes the stages people go through when modifying behavior, which include precontemplation, contemplation, preparation, action, and maintenance. The Decisional Balance Scale (DBS) was developed as a component of the TTM to assess the perceived pros and cons of changing a particular behavior. In the context of drug use, this scale helps to measure the internal conflicts a person experiences between continuing drug use and the benefits of abstaining.

The initial development of decisional balance measures focused on smoking cessation (Velicer, DiClemente, & Prochaska, 1985) but was later adapted for a range of problem behaviors, including substance use disorders (Prochaska et al., 1994).

Description

The Drugs Decisional Balance Scales assess two primary dimensions:

Perceived Pros (Benefits) of Drug Use: This subscale captures the positive expectations or perceived rewards of using drugs, such as feelings of euphoria, relief from stress, or social acceptance.
Perceived Cons (Costs) of Drug Use: This subscale measures the negative consequences or perceived harms associated with drug use, including health risks, legal problems, social isolation, and guilt.

Respondents rate items on a Likert-type scale, ranging from strongly disagree to strongly agree, reflecting how strongly they perceive each item as relevant to their own experience with drugs. The resulting scores help identify which factors are most influential in their decision-making processes regarding substance use.

Psychometric Properties

The Drugs Decisional Balance Scales demonstrate solid psychometric properties, with high reliability and validity across various populations, including adolescents, psychiatric patients, and individuals with co-occurring mental health and substance use disorders. The scale has been found to have good internal consistency, with alpha coefficients for both pros and cons subscales often exceeding 0.80.

Moreover, studies such as those by Ward et al. (2004) and Nidecker et al. (2008) provide evidence for the scale’s factorial invariance, meaning the tool effectively measures the same constructs across different groups. This makes it a versatile and dependable tool for both clinical and research settings.

The scale has been applied in various treatment and prevention models, including motivational interviewing and cognitive-behavioral therapy. It is particularly useful for assessing individuals’ readiness to change, aiding clinicians in matching interventions to a person’s specific stage of change.

Age Group

The Drugs Decisional Balance Scales are typically used with adolescents and adults aged 15 and older. It is suitable for individuals who are actively using drugs or who are contemplating the potential consequences of their drug use. The scale has been validated across diverse populations, including college students, psychiatric patients, and individuals with severe mental illness and substance use disorders.

References

Velicer, W. F., DiClemente, C. C., & Prochaska, J. O. (1985). Decisional balance measure for assessing and predicting smoking status. Journal of Personality and Social Psychology, 48, 1279-1289.
Prochaska, J. O., Velicer, W. F., Rossi, J. S., Goldstein, M. G., Marcus, B. H., Rakowski, W., Fiore, C., Harlow, L. L., Redding, C. A., Rosenbloom, D., & Rossi, S. R. (1994). Stages of change and decisional balance for 12 problem behaviors. Health Psychology, 13, 39-46.
Werch, C. E., & DiClemente, C. C. (1994). A multi-component stage model for matching drug prevention strategies and messages to youth stage of use. Health Education Research, 9, 37-46.
Carey, K. B., Maisto, S. A., Carey, M. P., & Purnine, D. M. (2001). Measuring readiness to change substance misuse among psychiatric outpatients: Reliability and validity of self-report measures. Journal of Studies on Alcohol, 62, 79-88.
Velasquez, M. M., Maurer, G., Crouch, C., & DiClemente, C. C. (2001). Group Treatment for Substance Abuse: A Stages-of-Change Therapy Manual. New York, NY: Guildford Publications.
Ward, R. M., Velicer, W. F., & Rossi, J. S. (2004). Factorial invariance and internal consistency for the decisional balance inventory – short form. Addictive Behaviors, 29, 953-958.
DiClemente, C. C., Nidecker, M., & Bellack, A. S. (2008). Motivation and the stages of change among individuals with severe mental illness and substance abuse disorders. Journal of Substance Abuse Treatment, 34(1), 25-35.
Nidecker, M., DiClemente, C. C., Bennett, M. E., & Bellack, A. S. (2008). Application of the Transtheoretical Model of change: Psychometric properties of leading measures in patients with co-occurring drug abuse and severe mental illness. Addictive Behaviors, 33(8), 1021-1030.
Collins, S. E., Carey, K. B., & Otto, J. M. (2009). A New Decisional Balance Measure of Motivation to Change Among At-Risk College Drinkers. Psychology of Addictive Behaviors, 23(3), 464–471. doi: 10.1037/a0015841.

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Drugs Decisional Balance Scales