EASS Speaker Spotlight: Use of Daily Surveys to Understand Substance Use Behavior
The Rutgers University Center of Alcohol and Substance Use Studies is pleased to announce that Dr. Tim Trull will be giving a virtual presentation as part of the Emerging Addiction Science Seminar Series on March 9, 2023. Dr. Trull is a Curators’ Distinguished Professor and Byler Distinguished Professor of Psychological Sciences at the University of Missouri department of Psychological Sciences. He is the director of the Personality and Emotion Lab. Dr. Trull’s research interests are in the areas of diagnosis and classification of mental disorders, personality disorders, substance use disorders, psychometrics and clinical assessment, as well as the relationship between personality and psychopathology, quantitative methods, and ambulatory assessment. Dr. Trull has marked expertise in ambulatory assessment, emotion dysregulation, addictions, and quantitative methods. Dr. Trull has examined the use of daily surveys and ecological momentary assessment (EMA), which allow researchers to study substance use at the event-level. This type of methodology is useful in understanding within-person indicators of substance use, as well as between-person trends, and has the advantage of reducing the demand on participants to retrospectively report use. Dr. Trull and colleagues found that use of traditional retrospective reporting methods (i.e., timeline followback) had low agreement with EMA and daily survey reports. In one study,1 Dr. Trull and colleagues prompted a sample of adults reporting cannabis use to complete four daily surveys and a morning survey about the previous day, regarding alcohol and cannabis use over the course of 14 days. In addition to prompted surveys, participants self-initiated a survey following each cannabis use episode. After the 14 days, participants completed a timeline followback (TLFB) measure reporting on alcohol and cannabis quantity on each day over the study period. Results showed significant differences in frequency and quantity reports between the EMA, morning report, and TLFB assessments, with poor agreement across these assessment types.
These findings highlight the utility of EMA methodology to capture event-level use patterns and suggest that retrospective reports are not an optimal substitution for daily measures. Using EMA methodology in a separate study,2 Dr. Trull and colleagues sought to understand the momentary subjective experiences of alcohol related to drinking behavior. A sample of 113 adults were prompted to complete six daily EMA surveys over the course of 21 days. In addition to the daily prompts, participants were instructed to self-initiate a survey at the start of each drinking event. These self-initiated surveys triggered additional surveys at 30-, 60-, 120-, and 180-minute intervals to determine if individuals continued drinking. Participants completing questions regarding their drinking and their subjective experiences associated with alcohol, including items about sedating effects (e.g., dizziness, sluggishness) and stimulating effects (e.g., feeling talkative, energized) commonly associated with alcohol. The importance of measuring subjective experiences is that they have been found to be related to risk of alcohol use problems in longitudinal studies. Trull and associates found that, after controlling for context and craving, subjective stimulation effects were not associated with continued drinking at the momentary level. However, when aggregated for the day, increased stimulation effects were associated with increased odds of continued drinking. Conversely, greater subjective sedation effects were associated with decreased odds of continued drinking at the momentary and day level. The researchers concluded that their findings suggest that low sedation is a risk factors for alcohol use at the event level, whereas stimulation effects may have a positive reinforcing effect and incur greater risk for heavier drinking in future drinking episodes.
Dr. Trull and colleagues also have combined EMA methodology with innovative technology to understand relations between potency and cannabis outcomes.3 This approach helps to address the difficulty in cannabis research of assessing potency of cannabis. Unlike alcohol, in which there is a defined standard drink based on ounces and alcohol by volume, there is no such metric for cannabis. Further, individuals often do not know the potency of their use products, making it difficult to understand the impact of cannabis quantity on outcomes. The researchers used the Purpl Pro, a portable device that measures the THC and CBD concentration of cannabis flowers using near-infrared spectroscopy with accuracy similar to that of lab measures, yielding results in approximately one minute. Using the Purpl Pro, 50 participants provided samples of their cannabis for potency testing and then completed a 14-day EMA study assessing relations between potency and subjective intoxication. There was a significant, positive relation between THC concentration and subjective intoxication. The researchers concluded that these findings provide preliminary support for the feasibility of the Purpl Pro in cannabis research.
Click for additional details and to register for Dr. Trull’s presentation for the Emerging Addiction Science Seminar Series.
1 Freeman, L. K., Haney, A. M., Griffin, S. A., Fleming, M. N., Vebares, T. J., Motschman, C. A., & Trull, T. J. (2022). Agreement between momentary and retrospective reports of cannabis use and alcohol use: Comparison of ecological momentary assessment and timeline followback indices. Psychology of Addictive Behaviors. https://doi.org/10.1037/adb0000897
2 Wycoff, A. M., Motschman, C. A., Griffin, S. A., Freeman, L. K., & Trull, T. J. (2022). Momentary subjective responses to alcohol as predictors of continuing to drink during daily-life drinking episodes. Drug and Alcohol Dependence, 241, 109675. https://doi.org/10.1016/j.drugalcdep.2022.109675
3 Trull, T. J., Freeman, L. K., Fleming, M. N., Vebares, T. J., & Wycoff, A. M. (2022). Using ecological momentary assessment and a portable device to quantify standard tetrahydrocannabinol units for cannabis flower smoking. Addiction, 117(8), 2351-2358. https://doi.org/10.1111/add.15872