A mixed methods approach to improve the measurement of Alcohol-Induced Blackout: ABOM-2
Alcohol-induced blackouts describe memory loss resulting from alcohol consumption. Approximately half of college students report experiencing a blackout in their lifetime. Blackouts are associated with an increased risk for negative consequences, including serious injury. Research has documented two types of blackouts, en bloc (EB) and fragmentary (FB), which are thought to be distinct processes. This distinction has yet to be demonstrated empirically. This study used a mixed methods approach to improve the assessment of FB and EB among young adults. Study 1 used three rounds of cognitive interviewing with college students (N=31) to refine existing assessment items. Nineteen refined blackout items were retained for Study 2. Study 2 utilized face validity, factor analysis, item response theory, and external validation to test the two-factor blackout model among heavy-drinking college students (N=474) and to develop and validate a new blackout measure (ABOM-2). Two items were removed for poor face validity. Iterative factor analyses demonstrated that the remaining items were well-represented by correlated EB and FB factors and informed the removal of items with cross loadings, resulting in 11 items. Item response theory analyses informed the removal of 3 additional (redundant) items, resulting in 4 FB and 4 EB items in the final scale. External validation analyses demonstrated convergent, discriminant, and incremental validity over the original ABOM scale. The resulting Alcohol-Induced Blackout Measure-2 (ABOM-2) improves measurement of the continuum of blackout experiences among college students and will facilitate examination of EB and FB as differential predictors of alcohol-related outcomes in future studies.