Manual for the Benzodiazepine Dependence Questionnaire (BDEPQ)

Manual for the Benzodiazepine Dependence Questionnaire (BDEPQ) Manual for the Benzodiazepine Dependence Questionnaire (BDEPQ)

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13.11.2012 Views

MEASURES OF WITHDRAWAL 51 Table 11: Symptoms of benzodiazepine withdrawal included in withdrawal rating scales Continued (Ashton, 1984) DSM3R (Busto et al., 1989) (Rickels et al., 1990b) (Tyrer et al., 1990) (APA, 1987) (CIAW-B) (PWC) (BWSQ) incontinence menorrhagia, PMT skin rash/itching stu y nose/sinusitis in uenza-like symptoms sore eyes sore eyes feels upset poor coordination unable to control movements confusion

52 ACKNOWLEDGMENT on some structured interview with subjects. No information on the interrater reliabilityisavailable so those wishing to use the scale should conduct reliability trails after interviewers have been trained. Clinical Institute Assessment of Withdrawal - Benzodiazepines (CIAW-B) The CIAW-B was developed using the most sophisticated methods employed on any of the withdrawal rating scales. Items were selected from a pool if they showed changes when maximum changes in blood BZD levels were detected during withdrawal (Busto et al., 1989). This means that the scale is most responsive to acute withdrawal and is perhaps most suited to use in studies of withdrawal. This scale requires training and fortunately video tapes are available for training. Physician Withdrawal Checklist (PWC) This scale, described in Rickels et al. (1990b), is perhaps the most widely used BZD withdrawal scale in the published literature (Rickels et al., 1990a, 1990b, for example). Unfortunately little information about its properties have been published. Again it is completed by a trained clinician. Benzodiazepine Withdrawal Symptom Questionnaire (BWSQ) The BWSQ (Tyrer et al., 1990) provides the only speci c self-report measure of BZD withdrawal. Two forms are available, one to assess any history of BZD withdrawal symptoms and the other to examine symptoms over a de ned period. This scale attempts to distinguish between occurance of symptoms at any time and when associated with changes in BZD dose by asking for separate ratings under these two circumstances. Little psychometric information is available. Many authors (Lader, 1983� Noyes et al., 1991� Petursson & Lader, 1981� Power et al., 1985� Rickels et al., 1990b� Schweizer et al., 1991) employ general measures of anxiety such as the Hamilton Anxiety Rating Scale (Hamilton, 1959, HARS). Although this practice is widespread it would be preferable to use the CIAW-B (Busto et al., 1989) or some other BZD withdrawal scale. Acknowledgment The author acknowledge Maree Teesson, Richard Mattick, Peter Lovibond, Libby Barron, Margaret Eagers, and Gail Merlin for their assistance. This manual has bene ted from Rebecca McKetin's pro reading. Research reported iin this manual was conducted as part of the requirements for the degree of Master of Clinical Psychology, School of Psychology, University of New South Wales. Funding was provided by theSchool of Psychology and National Drug and Alcohol Research Centre, University of New South Wales.

52 ACKNOWLEDGMENT<br />

on some structured interview with subjects. No in<strong>for</strong>mation on <strong>the</strong> interrater<br />

reliabilityisavailable so those wishing to use <strong>the</strong> scale should conduct<br />

reliability trails after interviewers have been trained.<br />

Clinical Institute Assessment of Withdrawal - <strong>Benzodiazepine</strong>s (CIAW-B)<br />

The CIAW-B was developed using <strong>the</strong> most sophisticated methods employed<br />

on any of <strong>the</strong> withdrawal rating scales. Items were selected from a pool if<br />

<strong>the</strong>y showed changes when maximum changes in blood BZD levels were detected<br />

during withdrawal (Busto et al., 1989). This means that <strong>the</strong> scale<br />

is most responsive to acute withdrawal and is perhaps most suited to use<br />

in studies of withdrawal. This scale requires training and <strong>for</strong>tunately video<br />

tapes are available <strong>for</strong> training.<br />

Physician Withdrawal Checklist (PWC) This scale, described in Rickels<br />

et al. (1990b), is perhaps <strong>the</strong> most widely used BZD withdrawal scale in<br />

<strong>the</strong> published literature (Rickels et al., 1990a, 1990b, <strong>for</strong> example). Un<strong>for</strong>tunately<br />

little in<strong>for</strong>mation about its properties have been published. Again<br />

it is completed by a trained clinician.<br />

<strong>Benzodiazepine</strong> Withdrawal Symptom <strong>Questionnaire</strong> (BWSQ) The<br />

BWSQ (Tyrer et al., 1990) provides <strong>the</strong> only speci c self-report measure<br />

of BZD withdrawal. Two <strong>for</strong>ms are available, one to assess any history<br />

of BZD withdrawal symptoms and <strong>the</strong> o<strong>the</strong>r to examine symptoms over a<br />

de ned period. This scale attempts to distinguish between occurance of<br />

symptoms at any time and when associated with changes in BZD dose by<br />

asking <strong>for</strong> separate ratings under <strong>the</strong>se two circumstances. Little psychometric<br />

in<strong>for</strong>mation is available.<br />

Many authors (Lader, 1983� Noyes et al., 1991� Petursson & Lader, 1981�<br />

Power et al., 1985� Rickels et al., 1990b� Schweizer et al., 1991) employ general<br />

measures of anxiety such as <strong>the</strong> Hamilton Anxiety Rating Scale (Hamilton, 1959,<br />

HARS). Although this practice is widespread it would be preferable to use <strong>the</strong><br />

CIAW-B (Busto et al., 1989) or some o<strong>the</strong>r BZD withdrawal scale.<br />

Acknowledgment<br />

The author acknowledge Maree Teesson, Richard Mattick, Peter Lovibond,<br />

Libby Barron, Margaret Eagers, and Gail Merlin <strong>for</strong> <strong>the</strong>ir assistance. This manual<br />

has bene ted from Rebecca McKetin's pro reading. Research reported iin<br />

this manual was conducted as part of <strong>the</strong> requirements <strong>for</strong> <strong>the</strong> degree of Master of<br />

Clinical Psychology, School of Psychology, University of New South Wales. Funding<br />

was provided by <strong>the</strong>School of Psychology and National Drug and Alcohol<br />

Research Centre, University of New South Wales.

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