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= Measuring Alcohol Consumption =

Introduction
There are two main ways of measuring individual’s alcohol consumption. It may be measured using an aggregate format where individuals’ report the quantity and frequency of their alcohol consumption, for example, with morning reports of the drinking the night before, and experience sampling. Such aggregated measures are frequently utilised when risk factors, prevalence and the various consequences of alcohol consumption are monitored in a given population. Alternatively, individuals may complete a retrospective or prospective diary to report their alcohol consumption. An example of the former measuring instrument for measuring alcohol consumption is the existing, well established, Timeline Follow-Back (TLFB). An example of the latter measuring tool for individual alcohol consumption is the relatively recent measuring instrument, the Typical and Atypical Drinking Diary (TADD).

Timeline Follow-Back (TLFB)
The Timeline Follow-Back (TLFB) can be regarded as an assessment interview designed to aid individuals to recall their alcohol consumption. Sobell and Sobell designed the TLFB method, in the 1970s. In the TLFB method research participants receive a calendar and report on the days of their alcohol use over a period of time. The calendar may produce information about the participant’s frequencies, quantities of behaviour and patterns. Additionally, the information can help participants to consider their patterns of alcohol use and it can also provide insight for researchers. TLFB has also been used to obtain information from participants about substance misuse.

Typical and Atypical Drinking Diary (TADD)
The Typical and Atypical Drinking Diary (TADD) can be regarded as a 6-item questionnaire completed by research participants to measure their consumption of alcohol. The participant records their alcohol consumption in the past six weeks in two different diaries. One consisting of typical weeks and the other consisting of atypical weeks, classed as weeks when drinking was lighter or heavier than typical. The participant is requested to report both the pattern and the quantity of their alcohol consumption during each day for a seven-day week running from Monday to Sunday. Participants also had to name the alcohol, state the quantity and the percentage of alcohol contained in each drink and when each session of drinking commenced and ended. A table accompanies the diaries so the participant can see their drink sizes and the amount of alcohol they contain. Lastly, the participant is requested to report how often the drinking occurred on both a typical and an atypical week during the six-week period. The results achieved through the TADD method have been strongly correlated with the TLFB.

Comparison between TLFB and TADD
The TLFB is a measurement used to aid drinkers to recall their alcohol intake. Researchers generally use a calendar as a recording device so that participants may record which days they drank alcohol and the amount of drinks of alcohol they consumed. Researchers prompt participants by asking them about the events they engaged in on different days of a week to aid recall of alcohol consumption.

The TADD is a measurement tool consisting of a six-item questionnaire and two diaries. One diary is used for the recording of typical drinking consumption and the other diary is used for the recording of atypical drinking consumption, either heavier, or lighter drinking sessions. The TADD seeks more information from the participant than does the TLFB. For example, the name, quantity, and alcohol content, how long the drinking session lasted, and whether it was a heavy or less heavy drinking session. The TADD requires the drinker to record their alcohol consumption in the two diaries, whereas the TLFB frequency involves prompting by a researcher, to aid recall.

The application of TLFB and TADD
The TLFB has been applied to research participants to measure the differences in alcohol consumption and binge drinking in underage drinkers. The research wished to provide insight into the situational variation in underage drinkers consumption of alcohol, including their binge drinking. The researchers applied the TLFB instrument to obtain retrospective situational variations in the consumption of alcohol during a specified time period. The researchers compared a TLFB measure of alcohol consumption with a quality frequency measure for recording the amount of alcohol consumed in 429 underage participants. All participants completed both alcohol measures and they reported their alcohol problems. The results from the TLFB and the quality frequency measures converged in the typical daily amount of alcohol consumed. However, the TLFB yielded more details about the drinker’s situational variation in their alcohol consumption and it provided a clear distinction between intermittent and regular binge drinkers. It was found that regular binge drinkers reported more alcohol problems.

The TADD has been applied to research participants to assess their emotion regulation and alcohol use. The research wished to provide an insight in the part that alcohol plays in the regulation of emotion. Each participant in the research received the TADD questionnaire along with three other alcohol measurement questionnaires. The participants were also placed in two groups, one group received a Brief Aspirations and Concerns in Life Inventory (BACLI) questionnaire and the other group received a Personal Concerns Inventory (PCI) questionnaire. The researchers aimed to firstly, evaluate and compare the new BACLI to the well-established PCI, and secondly, to compare the relationships between the variables of individual emotion and motivational regulation, and the consumption of alcohol and problem drinking. The research results upheld the hypothesis that the BACLI composite score would be similar to that produced by the PCI. The research findings also gave partial support for the research hypothesis that emotional and motivational variables would predict individual’s consumption of alcohol. Finally, the findings also fully supported the research hypothesis that emotional and motivational variables would predict an individual’s drinking problems.

Reliability and validity of both methods
Early work by Midanik (1988) reported on a review of the literature on the measurement of alcohol consumption to assess the validity of individual’s self-reported use of alcohol. Midanik (1988) found, despite the findings of studies that have concluded that self-reports are valid that there is much variation depending on what factor is being validated and the way in which its level of accuracy is measured. Drinking patterns are less easily validated when they are reported in surveys of drinking practices, than reports of recent consumption. Moreover, reports made by others close to the drinker have not yielded more valid information on alcohol consumption. In relation to problems associated with alcohol consumption, only a small proportion of visible problems can be subsequently validated. The researcher concluded that new ways of validating the consumption of alcohol and problems associated with alcohol should be undertaken to ensure that researchers are able to refine their techniques for data collection so that confidence in their research results can be maintained.

When the outcomes of participants’ self-reports that measure the frequency and amount of alcohol consumed have been assessed, it is generally thought that such reports are valid and reliable. Providing that such participants are not under the influence of alcohol and feel that their confidentiality is totally assured. However, retrospective or prospective diary reports of alcohol consumption generate extensive detailed information and greater accuracy, despite being time-consuming. Seeking the daily amount of alcohol consumed, the retrospective diary is able to assess rather more non-patterned periods of drinking, and such reports produce higher estimates of the quantity of the peak level of drinking and the frequency level of heavy drinking, in direct contrast to questionnaires that seek answers to questions about the individual’s typical or usual consumption of alcohol. The TLFB retrospective diary data collection method has been found by many researchers, for example, Sobell and Sobell (1982) to have strong test-retest reliable correlations, unlike the outcomes generated from the TLFB frequency and quantity measures of individual consumption.

Moreover, research by Simons et al., (2015) examined and assessed the data on alcohol consumption provide by sixty young adults over a 647 day period of individual self-monitoring, using a transdermal alcohol sensor. This sensor was a bio-chemical measure. The researchers employed a transdermal alcohol form of assessment using a WrisTAS, to investigate the element of convergent validity of a one week TLFB, as well as two other forms of alcohol measurement, morning reports of the drinking the night before and experience sampling. Three pharmacokinetic indices of area beneath curve, peak concentration, and the time to reach that peak were assessed from the signal from the transdermal sensor and the between and within person difference in the symptoms of alcohol dependence. The experience sampling data self-reported an amount of drinking days the WrisTAS corroborated their reports, with a value of 85.74 per cent. When the TLFB was assessed and the morning reports combined with experience sampling were assessed there was an 87.27 per cent agreement with the participants’ reports of drinking days. The reported level of drinking days did not differ when the participant was wearing, or not wearing the transdermal sensor. The researchers concluded that the participants had provided reliable and consistent reports of alcohol consumption irrespective of biochemical verification. Therefore individuals do give valid self-reports of their alcohol consumption. Additionally, assessments of the outcomes on the TLFB showed convergent validity. Early work by Sobell, Agrawal, Annis, Ayala-Velazquez, Echeverria, Leo & Ziólkowski  (2001) found TLFB methods of measurement to be psychometrically sound.

Work by Hogan (2005) compared the TADD questionnaire with a retrospective diary method and a Quality Frequency method. Hogan (2005) found that the TADD questionnaires overestimated the levels of individual’s drinking in comparison to records of drinking in the individual’s previous weeks’ drinking levels, on a TLFB. However, the TADD compared well with the TLFB results for estimating both the amount of binge drinking sessions and drinking days. TADD is an important alternative to TLFB and it has the advantage of providing more details than the TLFB. It is clear that there is a level of reliability and validity with the TADD measurement device.