1. When I am in agony because of stopping or withdrawing from alcohol use.
2. When I have a headache.
3. When I am feeling depressed.
4. When I am on vacation and want to relax.
5. When I am concerned about someone.
6. When I am worried.
7. When I have the urge to try just one drink to see what happens.
8. When I am being offered a drink in a social situation.
9. When I dream about taking a drink.
10.When I want to test my will power over drinking.
11.When I am feeling a physical need or craving for alcohol.
12.When I am physically tired.
13.When I am experiencing some physical pain or injury.
14.When I feel like blowing up because of frustration.
15.When I see others drinking at a bar or a party.
16.When I sense everything is going wrong for me.
17.When people I used to drink with encourage me to drink.
18.When I am feeling angry inside.
19.When I experience an urge or impulse to take a drink that catches me unprepared.
20.When I am excited or celebrating with others.
1. When I am feeling depressed.
2. When I am concerned about someone.
3. When I am worried.
4. When I have the urge to try just one drink to see what happens.
5. When I want to test my will power over drinking.
6. When I am feeling a physical need or craving for alcohol.
7. When I am physically tired.
8. When I am experiencing some physical pain or injury.
9. When I feel like blowing up because of frustration.
10.When I see others drinking at a bar or a party.
11.When people I used to drink with encourage me to drink.
12.When I am excited or celebrating with others.
The Transtheoretical Model (TTM; Prochaska & DiClemente‚ 1983; Prochaska‚ DiClemente‚ & Norcross‚ 1992)
Confidence: Negative Affect (.88)‚ Social/Positive (.82)‚ Physical and Other Concerns (.83)‚ Withdrawal/Urges (.81) “DiClemente‚ et. al (1994)”
Confidence: Negative Affect (.64)‚ Social/Positive (.61)‚ Physical and Other Concerns (.67)‚ Withdrawal/Urges (.63) “Project DELTA”
1=Not at all confident‚ 2=Not very confident‚ 3=Moderately confident‚ 4=Very confident‚ 5=Extremely confident
20 Item Version
· Negative Affect 3‚ 6‚ 14‚ 16‚ 18
· Social/Positive 4‚ 8‚ 15‚ 17‚ 20
· Physical and Other Concerns 2‚ 5‚ 9‚ 12‚ 13
· Cravings and Urges 1‚ 7‚ 10‚ 11‚ 19
12 Item Version
· Negative Affect 1‚ 3‚ 9
· Social/Positive 10‚ 11‚ 12
· Physical and Other Concerns 2‚ 7‚ 8
· Cravings and Urges 4‚ 5‚ 6
This instrument can be found at: http://habitslab.umbc.edu/self-efficacy-scales/
DiClemente‚ C. C. (1986). Self-Efficacy and the addictive behaviors. Journal of Social and Clinical Psychology‚ 4‚ 302-315.
DiClemente‚ C.C.‚ Carbonari‚ J.P.‚ and Montgomery‚ R.P.G. (1994). The alcohol abstinence self-efficacy scale. Journal of Studies on Alcohol‚ 55‚ 141-148.
DiClemente‚ C. C.‚ Fairhurst‚ S. K.‚ & Piotrowski‚ N. A. (1995). Self-Efficacy and addictive behaviors. In J. E. Maddux‚ ed.‚ Self-Efficacy‚ adaptation‚ and adjustment: Theory‚ research‚ and application (pp. 109-141). New York: Plenum.
Velicer‚ W.F.‚ DiClemente‚ C.C.‚ Rossi‚ J. S.‚ Prochaska‚ J. O. (1990). Relapse situations and self-efficacy: An integrative model. Addictive Behaviors‚ 15‚ 271-283.