Which came first: the readiness or the change? Longitudinal relationships between readiness to change and drinking

Abstract: 

Aims: Although readiness to change (RTC) is cited as a key mechanism underlying drinking behavior change, empirical evidence supporting RTC as a predictor of college drinking has been mixed. Considering methodological limitations of previous studies, the current aim was to conduct a more comprehensive test of longitudinal relationships between readiness to change and college drinking. Design: In this correlational, longitudinal study, we used a series of cross-lagged path analyses to test associations between RTC and college drinking outcomes over a 2-year period. Setting: Data collection was conducted via online surveys on a university campus in the US Pacific Northwest. Participants: Participants (n = 818; 58% women) were college students who reported at least one heavy-drinking episode in the past month and participated in a randomized controlled trial of personalized normative feedback interventions. Measurements: Drinking quantity–frequency items and the Rutgers Alcohol Problem Index assessed drinking outcomes. The Readiness to Change Questionnaire assessed RTC. Findings: For drinking-related problems, the best-fitting model included cross-lagged paths between RTC and subsequent drinking-related problems. For drinking quantity–frequency, best-fitting models also included the cross-lagged paths between drinking quantity–frequency and subsequent RTC. Higher RTC almost uniformly predicted higher subsequent levels of drinking and greater experience of drinking-related problems, and drinking quantity–frequency variables were primarily positive predictors of subsequent RTC. Conclusions: Contrary to previous assumptions, ‘the Readiness to Change Questionnaire’ does not appear to be predictive of lower levels of subsequent drinking.