different calculations. Quantity per occasion is the average or typical amount of drinking on a given occasion or day. Frequency of the drinking occasion probes for how often in a given time interval (e.g., per week, per month) a person consumes a given amount. Because QF methods ask for average amounts, some of the methods have included measures of variability or maximum consumption to correct for occasional heavy drinking. Thus, for some methods, maximum quantity and frequency of the maximum quantity are sought. Variability of quantity per occasion was introduced in some methods to assess the proportion of drinking occasions in which different numbers of drinks (e.g., 1 to 2, 5 to 9, ≥ 10) were consumed. Aggregate volume is the average drinks per day in the interval.

Although the first QF measure (Straus and Bacon 1953) inquired about drinking in the past year, subsequent revisions inquired about drinking in the past 30 days. By today's standards, this method was primitive as it only asked for the average amount consumed on a given occasion and the average frequency of drinking for the three beverage types.

One major criticism of early QF measures was that measuring only quantity and frequency gave no indication of the variability of a respondent's drinking (Room 1990). Early QF methods were seen as insensitive to individuals who drank infrequently but consumed large amounts when they did drink. For example, Knupfer (1966, 1984) has pointed out that 2 drinks every day for a week represents the same total volume as the person who drinks 14 drinks on Friday or 7 drinks twice a week, but these are very different drinking patterns.

Cahalan and his colleagues developed two alternative QF measures that were intended to increase the sensitivity of QF measures by assessing the variability of drinking habits (Alanko 1984; Room 1990). For each beverage type, these two methods

sought frequency of drinking and the "proportion of drinking occasions" for the various numbers of drinks. Both measures, their category classifications, and calculations are described in detail elsewhere (Cahalan et al. 1969). The first measure, the Quantity-Frequency-Variability (QFV), expanded on the QF measure by including a measure of maximum quantity per occasion (Cahalan et al. 1969). The proportion of occasions for the QFV is determined by asking how often the person consumed 5+, 3-4, and 1-2 drinks. Proportions were defined on a 4-point scale from "nearly every time" to "never." Based on respondents' answers to the alcoholic beverage consumed most often, a complicated classification schema with 11 classes of quantity and variability components was developed (see Cahalan et al. 1969, pp. 12-16). The QFV index is derived by combining the QV classification for the beverage most often consumed with frequency of drinking any alcoholic beverage. Although somewhat arbitrary, these QFV classifications led to identification of five drinker groups: heavy, moderate, light, infrequent, and abstainers.

The second variability of drinking measure developed by these researchers was the Volume-Variability (VV) index (Cahalan and Cisin 1968). The VV index classifies individuals' drinking into one of eight categories (see Cahalan et al. 1969, p. 215) based on the aggregate volume (Q x F) and the maximum quantity variables. The VV index was developed based on the "principle that spacing or bunching of drinks is more important than aggregate volume in characterizing an individual's drinking patterns” (Cahalan et al. 1969, p. 17). The index computes a person's average daily volume (multiplying the frequency of drinking each beverage-i.e., number of days drinking per 30 days-by estimated quantity of the beverage consumed per occasion) and then classifies people as to whether they ever had as many as five drinks on one occasion (see Cahalan et al. 1969, pp. 213-215). Using the QF questions, an estimate of the average number of drinks per occasion is computed.

Cahalan and his colleagues recommended some type of VV index because it has "all of the useful characteristics of the QFV index and also preserves the distinction between those who consume a given volume by bunching or massing their drinks and those who space them out” (Cahalan et al. 1969, p. 17). The VV compared to the QFV index appears to be more sensitive to differences in the middle range of drinking (noted in Khavari and Farber 1978).

As more surveys were conducted, it became apparent that the upper range category of five or more drinks was insensitive to very heavy drinking (i.e., substantial numbers of individuals were reporting such consumption). Thus, Cahalan and his colleagues combined two methods: "proportion of occasions" questions for 5+, 3-4, and 1-2 drinks, and then added nonbeverage-specific questions for 8-11 and 12+ drinks for a 1-year reporting period (see Room 1990).

The Khavari Alcohol Test (KAT; Khavari and Farber 1978) is a 12-question modified version of the QF method used by Cahalan, Cisin, and Crossley (1969). With the KAT, respondents report their usual frequency of drinking, the usual amount consumed per occasion, the maximum amount consumed on any one occasion, and the frequency of the maximum amount. These four questions are asked for each of the three alcoholic beverage types. Respondents are first categorized into 1 of 11 frequency categories and then the individual's drinking is plotted and compared to normative values.

In an effort to avoid the classification of drinkers into discrete categories, Bowman and his colleagues (1975) attempted to develop a continuous measure reflecting the volume and pattern (VP) of a person's drinking. The volume component is an aggregate volume measure derived from QF data, while the pattern component is an adjusted standard deviation measure indicating the degree of Volume Variability over time. Although it attempts to improve on previous

QF methods, the VP method has been criticized for being cumbersome in terms of data manipulation and transformations (see Khavari and Farber 1978). A further problem is the need for very detailed and specific information requiring individual interviews ranging from 30 to 60 minutes.

The NIAAA QF measure is a variant of the original QF measure. The federally contracted surveys conducted in the early 1970's as part of the NIAAA public service advertisement campaigns relied on this 30-day QF measure; the Institute continued to use this QF method in their evaluation of alcoholism treatment centers (Armor et al. 1978).

The Rand QF (Polich et al. 1981), as the NIAAA QF, asks respondents, for each beverage type, how much they consumed on a typical day during the 30 days before their last drink. They were also asked number of days at or exceeding fairly high levels (i.e., 6-9 drinks, 10+ drinks) during that same interval. The authors noted that their intent was to first determine a person's typical drinking pattern and then to assess atypical, heavy drinking.

The Composite QF Index by Polich and Orvis (1979) is an unusual hybrid QF measure that asks about the 30 days before the last drinking occasion for all alcoholic beverages (versus specific types of alcohol). This QF measure also asked about the frequency of heavy drinking (i.e., 8+ drinks) in the past year. By adding questions for the past year to the typical 30-day window, this QF measure could assess heavy drinking that did not occur in the past 30 days.

The Lifetime Drinking History (Skinner and Sheu 1982), a specialized method described earlier under primary measures, inquires about typical quantity and fre quency per occasion as well as the maximum quantity consumed and the frequency of the maximum amount. Unique to the LDH versus other QF methods is specification of lifetime drinking in distinct phases. The num

ber and dates of phases are determined by respondents, and each phase is then treated like a new QF interval.

The Graduated Frequency (GF) measure (Clark and Midanik 1982; Midanik 1994), developed in response to criticism of other types of QF measures that did not account for occasions when different types of beverages were combined (e.g., beer and whiskey on the same day), asks respondents to report the frequency of their drinking for a range of levels of drinking that occurred in the last year. It combines beverage types, with the highest levels being 18 or more drinks. The GF and LDH QF methods are among the few that ask questions with reference to all alcoholic beverages combined.

RECOMMENDED USE: QF methods generally can provide reliable information about total consumption and number of drinking days (Sobell and Sobell 1992).

ADVANTAGES: QF methods provide a quick and easy estimate when information needs are limited to a rough estimate of the total amount consumed or of the total number of drinking days in an interval, or if time is at a premium (e.g., physician's office) and knowledge of atypical drinking is not important.

LIMITATIONS: There is no shortage of reviews and detailed critiques of the problems with QF methods (Polich and Kaelber 1985; Room 1990; Sobell and Sobell 1992). QF measures reflect less drinking and they tend to misclassify drinkers compared to daily diary or timeline reports. Another major problem with QF methods is that they typically fail to correct for days when more than one type of alcoholic beverage is consumed (e.g., three beers and two glasses of wine on the same day). Also, QF methods cannot provide a picture of unpatterned fluctuations in drinking (i.e., QF methods are based on an assumption that the pattern of drinking is constant). Finally, for clinical populations, days of sporadic heavier drinking are import

ant. Unfortunately, such occasions tend to go unreported in QF methods. More elaborate QF methods such as the VP and GF methods take considerably longer to administer, thus compromising the advantage of brevity.

Chemical Dependency Assessment Profile

The CDAP evaluates alcohol use, use of other drugs, and polydrug abuse (Harrell et al. 1991). The profile assesses chemical use history, patterns of use, use beliefs and expectancies, use symptoms, self-concept, and interpersonal relations. Content dimensions provide measures of frequency/quantity of use, physiological symptoms, situational stresses, antisocial behavior, interpersonal skills, affective dysfunction, attitude toward treatment, and degree of life impact. Consisting of 232 total items constituting 10 subscales, the questionnaire can be selfadministered by paper and pencil or by computer in about 45 minutes.

With respect to current assessment of drinking, three questions on the CDAP address average daily use of beer, wine, and liquor. One additional question asks about which pattern best describes the person's drinking (e.g., drinking heavily six or more drinks every day; 1-day binges; drinking heavily a couple of times a week). Because of the nature of these four questions, the CDAP does not even allow for a simple QF profile to be developed. Also, the timeframe over which drinking is assessed is not stated.

RECOMMENDED USE: Like all of the composite measures, this is a rather lengthy questionnaire that taps several alcohol-related domains (e.g., consequences, beliefs) but contains few questions about current drinking.

ADVANTAGES: None, over any other measure in table 1.

LIMITATIONS: This questionnaire does not allow for even a simple QF assessment of drinking over a given time period.

Comprehensive Drinker Profile (CDP)

The CDP is a structured intake interview that contains 88 items and must be administered by a clinician or technician (Miller and Marlatt 1984a, b). It yields both qualitative and quantitative indices of alcohol/drug use, symptoms and consequences, dependence, other life problems, medical and family history, and motivation. Also available is a 1hour version (Brief Drinker Profile) of the interview that retains most of the quantitative measures and incorporates the Michigan Alcoholism Screening Test (MAST; Selzer 1971) as part of the interview (Miller and Marlatt 1984a). Parallel forms for followup (Followup Drinker Profile) and collaterals exist (Miller and Marlatt 1984a).

With respect to the client's present drinking, the interviewer first determines which of three patterns (periodic, steady, combination) best characterizes the client's drinking pattern. Based on this classification, the client is then further assessed with respect to either an episodic pattern or a steady pattern drinking grid. The grid is completed by asking about regular consumption for morning, afternoon, and evening drinking, and then a QF data summary is calculated for each client. The period over which the assessment occurs is 1 week and is extended up to 3 months (i.e., 1 week is multiplied by 13). Comparable data between client and collateral reports have been reported for this method (Miller and Del Boca 1994).

RECOMMENDED USE: Provides a detailed intake assessment but with limited current drinking information.

ADVANTAGES: Provides a consistent baseline data set for treatment planning with structured parallel interviews that can be used for followup and with collaterals.

LIMITATIONS: As with all the composite measures, the CDP provides very limited current drinking data for clients-a weekly QF

summary calculation is extended to 3 months by multiplying this figure by 13. It has been suggested that the CDP as an averaging approach may not be best for “irregular, highly variable, or strictly episodic (e.g., adolescent) drinking where there is no consistent pattern" (Miller and Del Boca 1994, p. 113)

Computerized Lifestyle Assessment (CLA)

The CLA includes a brief version of the Family Assessment Measure (FAM) as well as the Alcohol Dependence Scale (ADS) and Drug Abuse Screening Test (DAST). With 350 items and 20 subscales, the CLA examines a broad range of lifestyle activities, provides graphic feedback at various points during the assessment, and generates a printed report on lifestyle strengths, concerns, and risks (Skinner 1993, 1994). The CLA also assesses the respondent's readiness (stage) for change in certain lifestyles and areas. The assessment takes about 20 to 30 minutes and is computer self-administered.

An important feature of the CLA is its capacity to conduct an assessment of alcohol and drug problems using validated instruments. For example, the alcohol section includes the Alcohol Dependence Scale (25 items), a 15-item alcohol-related problem scale, the CAGE screening test, and a recent 28-day drinking history. As part of the overall lifestyle assessment, a 1-month typical QF profile of current drinking is obtained by asking respondents to describe a typical 4 week period in the past year.

RECOMMENDED USE: Can be used as part of a routine intake and assessment of clients in health care and addiction treatment settings, but it has limited current drinking information.

ADVANTAGES: Being computerized, minimal administration time is required. The computerized profile can be used to stimulate self-examination of lifestyle choices for