Measuring drug urges by questionnaire: Do not balance scales

Measures designed to assess self reported drug urges are routinely balanced, that is, they contain a relatively equal number of positively and negatively worded stems. Using smoking urges as an example, we explored the effect of item wording on responses to self-report items. One hundred sixteen cigarette smokers responded to 32 positively worded statements and their 32 negatively worded counterparts adapted from the Questionnaire of Smoking Urges. For 59% of the paired statements, the negatively worded item was scored higher than the positively worded item. Significant mean differences item means for 56% of the paired statements were significantly different at the .01 levels and only moderate correlations (mean = 54; range = .04 to .79) between item pairs were found. Balanced scales may have greater costs than benefits in the assessment of drug urges.