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. 2009 Dec;50(12):1523-31.
doi: 10.1111/j.1469-7610.2009.02113.x. Epub 2009 Jul 21.

Adolescent attitudes toward psychiatric medication: the utility of the Drug Attitude Inventory

Lisa Townsend  1 , Jerry Floersch, Robert L Findling
Affiliations

Adolescent attitudes toward psychiatric medication: the utility of the Drug Attitude Inventory

Lisa Townsend et al. J Child Psychol Psychiatry. 2009 Dec.

Abstract

Background: Despite the effectiveness of psychotropic treatment for alleviating symptoms of psychiatric disorders, youth adherence to psychotropic medication regimens is low. Adolescent adherence rates range from 10-80% (Swanson, 2003; Cromer & Tarnowski, 1989; Lloyd et al., 1998; Brown, Borden, and Clingerman, 1985; Sleator, 1985) depending on the population and medication studied. Youth with serious mental illness face increased potential for substance abuse, legal problems, suicide attempts, and completed suicide (Birmaher & Axelson, 2006). Nonadherence may increase the potential for negative outcomes. The Drug Attitude Inventory (DAI) was created to measure attitudes toward neuroleptics and to predict adherence in adults (Hogan, Awad, & Eastwood, 1983). No studies have been identified that have used this instrument in adolescent psychiatric populations. The present study was undertaken to evaluate the utility of the DAI for measuring medication attitudes and predicting adherence in adolescents diagnosed with mental health disorders.

Method: Structural equation modeling was used to compare the factor structure of the DAI in adults with its factor structure in adolescents. The relationship between adolescent DAI scores and adherence was examined also.

Results: The adult factor structure demonstrated only "fair" fit to the adolescent data (RMSEA = .061). Results indicated a low, but significant positive correlation (r = .205, p < .05) between DAI scores and adherence.

Conclusions: Lack of optimal model fit suggests that DAI items may require alteration to reflect adolescent experiences with psychiatric medication more accurately. Differences between adolescents and adults in developmental stage, symptom chronicity, diagnosis, and medication class may explain why the adult model demonstrated only "fair fit" to the adolescent data and why the correlation between DAI scores and adherence was low. The DAI may be improved for use with adolescents by creating items reflecting autonomy concerns, diagnostic characteristics, treatment length, and side effect profiles relevant to adolescent experiences.

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Conflict of interest statement

Disclosures: Dr. Findling receives or has received research support, acted as a consultant and/or served on a speaker's bureau for Abbott, AstraZeneca, Bristol-Myers Squibb, Celltech-Medeva, Cypress Biosciences, Forest, GlaxoSmithKline, Johnson & Johnson, Lilly, New River, Novartis, Otsuka, Pfizer, Sanofi-Aventis, Shire, Solvay, Supernus Pharmaceuticals, and Wyeth.

The other authors have no relationships to disclose.

Figures

Figure 1
Figure 1
DAI Structural Equation Model-Conceptual Diagram
See this image and copyright information in PMC

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