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Center for Substance Abuse Treatment. Enhancing Motivation for Change in Substance Abuse Treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1999. (Treatment Improvement Protocol (TIP) Series, No. 35.)
This publication is provided for historical reference only and the information may be out of date.
Enhancing Motivation for Change in Substance Abuse Treatment.
Show detailsAlcohol Effects Questionnaire
| This questionnaire consists of a series of
statements that describe possible effects following alcohol use.
We would like to find out about your present beliefs about
alcohol. Please read each of the statements and respond according to your experiences with a heavy (5 drinks or more per occasion) amount of alcohol. If you believe alcohol sometimes or always has the stated effect on you, check AGREE. If you believe alcohol never has the stated effect on you, check DISAGREE. Then, in the column to the far right, fill in the number that best corresponds to the strength of your belief, according to the following scale: 1 = Mildly Believe 10 = Strongly Believe For example, if you strongly believe that alcohol makes you more intelligent, you would check AGREE and enter a "10" in thefar column. Please answer every questionwithout skipping any. For a HEAVY (5 or more drinks per occasion) amount of alcohol | ||||
|
| Agree | Disagree | Strength of Belief | |
| 1. | Drinking makes me feel flushed. | ____ | ____ | ____ |
| 2. | Alcohol decreases muscular tension in my body. | ____ | ____ | ____ |
| 3. | Drinking makes me feel less shy. | ____ | ____ | ____ |
| 4. | Alcohol enables me to fall asleep much more easily. | ____ | ____ | ____ |
| 5. | I feel powerful when I drink, as if I can really influence others to do what I want. | ____ | ____ | ____ |
| 6. | I'm more clumsy after I drink. | ____ | ____ | ____ |
| 7. | I'm more romantic when I drink. | ____ | ____ | ____ |
| 8. | Drinking makes the future seem brighter to me. | ____ | ____ | ____ |
| 9. | If I have had alcohol it is easier for me to tell someone off. | ____ | ____ | ____ |
| 10. | I can't act as quickly when I've been drinking. | ____ | ____ | ____ |
| 11. | Alcohol can act as an anesthetic for me; that is, it can deaden the pain. | ____ | ____ | ____ |
| 12. | I often feel sexier after I've been drinking. | ____ | ____ | ____ |
| 13. | Drinking makes me feel good. | ____ | ____ | ____ |
| 14. | Alcohol makes me careless about my actions. | ____ | ____ | ____ |
| 15. | Alcohol has a pleasant, cleansing, tingly taste to me. | ____ | ____ | ____ |
| 16. | Drinking increases my aggressiveness. | ____ | ____ | ____ |
| 17. | Alcohol seems like magic to me. | ____ | ____ | ____ |
| 18. | Alcohol makes it hard for me to concentrate. | ____ | ____ | ____ |
| 19. | After drinking, I'm a better lover. | ____ | ____ | ____ |
| 20. | When I'm drinking, it is easier to open up and express my feelings. | ____ | ____ | ____ |
| 21. | Drinking adds a certain warmth to social occasions for me. | ____ | ____ | ____ |
| 22. | If I'm feeling restricted in any way, drinking makes me feel better. | ____ | ____ | ____ |
| 23. | I can't think as quickly after I drink. | ____ | ____ | ____ |
| 24. | Having drinks is a nice way for me to celebrate special occasions. | ____ | ____ | ____ |
| 25. | Alcohol makes me worry less. | ____ | ____ | ____ |
| 26. | Drinking makes me inefficient. | ____ | ____ | ____ |
| 27. | Drinking is pleasurable because it's enjoyable for me to join in with other people who are enjoying themselves. | ____ | ____ | ____ |
| 28. | After drinking, I am more sexually responsive. | ____ | ____ | ____ |
| 29. | I feel more coordinated after I drink. | ____ | ____ | ____ |
| 30. | I'm more likely to say embarrassing things after drinking. | ____ | ____ | ____ |
| 31. | I enjoy having sex more if I've had alcohol. | ____ | ____ | ____ |
| 32. | I'm more likely to get into an argument if I've had alcohol. | ____ | ____ | ____ |
| 33. | Alcohol makes me less concerned about doing things well. | ____ | ____ | ____ |
| 34. | Alcohol helps me sleep better. | ____ | ____ | ____ |
| 35. | Drinking gives me more confidence in myself. | ____ | ____ | ____ |
| 36. | Alcohol makes me more irresponsible. | ____ | ____ | ____ |
| 37. | After drinking it is easier for me to pick a fight. | ____ | ____ | ____ |
| 38. | Alcohol makes it easier for me to talk to people. | ____ | ____ | ____ |
| 39. | If I have alcohol it is easier for me to express my feelings. | ____ | ____ | ____ |
| 40. | Alcohol makes me more interesting. | ____ | ____ | ____ |
- [Table], Alcohol Effects Questionnaire - Enhancing Motivation for Change in Subs...[Table], Alcohol Effects Questionnaire - Enhancing Motivation for Change in Substance Abuse Treatment
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