Associations between the Brief Assessment of Alcohol Demand (BAAD) questionnaire and alcohol use disorder severity in UK samples of student and community drinkers

Abstract

Value based choice and compulsion theories of addiction offer distinct explanations for the persistence of alcohol use despite harms. Choice theory argues that problematic drinkers ascribe such high value to alcohol that costs are outweighed, whereas compulsion theory argues that problematic drinkers discount costs in decision making. The current study evaluated these predictions by testing whether alcohol use disorder (AUD) symptom severity (indexed by the AUDIT) was more strongly associated with the intensity item (maximum alcohol consumption if free, indexing alcohol value) compared to the breakpoint item (maximum expenditure on a single drink, indexing sensitivity to monetary costs) of the Brief Assessment of Alcohol Demand (BAAD) questionnaire, in student (n = 579) and community (n = 120) drinkers. The community sample showed greater AUD than the student sample (p = .004). In both samples, AUD severity correlated with intensity (students, r = 0.63; community, r = 0.47), but not with breakpoint (students, r = −0.01; community, r = 0.12). Similarly, multiple regression analyses indicated that AUD severity was independently associated with intensity (student, ΔR2 < 0.20, p < .001; community, ΔR2 = 0.09, p = .001) but not breakpoint (student, ΔR2 = 0.003, p = .118; community ΔR2 = 0.01, p = .294). There was no difference between samples in the strength of these associations. The value ascribed to alcohol may play a more important role in AUD severity than discounting of alcohol-associated costs (compulsivity), and there is no apparent difference between student and community drinkers in the contribution of these two mechanisms.