What is it about?

The analyses for this project confirmed an alternate factor structure for VA-enrolled Veterans who complete the Revised Brief Addiction Monitor (BAM-R). The BAM-R is the measure most commonly used in VA to measure substance use disorder-related patient experiences and outcomes. This work represents an analysis of the factor structure as well as stability of the structure across two BAM-R administrations in a nationwide sample of VA-enrolled Veterans, providing information about both the structure and also the extent to which the structure is valid across repeated administrations.

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Why is it important?

Currently, clinicians using the BAM-R are instructed to evaluate single item responses and changes over time because the original three-factor structure has not been supported by research. The BAM-R has many items, though, and summary scores representing subscales of the measure would help to provide information about broader domains of substance use disorder experiences and changes. Subscale scores are often used in psychological measurement, and the alternative factor structure proposed suggests that looking at four subscales of the BAM-R may provide helpful information, subscales representing alcohol use, stressors, risk factors, and stability factors. And given that one intended function of the BAM-R is to track responses over a course of treatment, the fact that the four-factor structure is stable over repeated administrations provides one piece of support for use of these four scales to aid in measurement interpretation.

Perspectives

The proposed alternative factor structure proposed may represent a first step towards the development of BAM-R subscales that help with measure interpretation. Clinicians are accustomed to using scale and subscale scores rather than tracking scores and changes individually for a large number of items. Given that the BAM-R is used by nearly every VA substance use disorder treatment setting as well as some substance use disorder settings outside the VA, additional information to help clinicians understand and track BAM-R scores would be helpful for the purposes of assessment, tracking treatment outcomes for individuals, and tracking clinic- and system-wide treatment outcomes.

Melinda Gaddy
VA Eastern Kansas Health Care System

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This page is a summary of: Factor structure and measurement invariance of the Revised Brief Addiction Monitor., Psychological Assessment, March 2021, American Psychological Association (APA), DOI: 10.1037/pas0000973.
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