Situation Temptation Scales – Alcohol Version

Abstract

The Situation Temptation Scales- Alcohol Version (STS-AV) is a psychometric instrument designed to measure an individual’s level of temptation or perceived lack of self-efficacy in specific high-risk situations related to alcohol use. Developed within the framework of the Transtheoretical Model (TTM), the STS-AV assesses the likelihood of relapse by gauging the strength of the urge to drink across various internal and external contexts. The scale is crucial for tailoring intervention strategies, particularly in the later stages of change (Action and Maintenance), where managing situational temptation is key to preventing relapse in individuals recovering from alcohol use disorder (AUD).

Keywords

Situation Temptation Scales, STS-AV, Alcohol use disorder, Transtheoretical Model, TTM, Relapse prevention, Self-efficacy, Cravings, Alcohol withdrawal, Substance abuse assessment.

Authors

Carlo C. DiClemente, J. Peter Carbonari, R.P.G. Montgomery, S.O. Hughes, M.M. Velasquez.

Purpose

The primary purpose of the Situation Temptation Scales- Alcohol Version is to quantify the intensity of temptation experienced by individuals attempting to maintain abstinence from alcohol. This measurement directly corresponds to the inverse concept of alcohol abstinence self-efficacy. By identifying specific situations—such as those involving negative emotions, physical discomfort, or social pressure—that pose the highest risk of relapse, clinicians and researchers can better predict outcomes and customize treatment plans according to the individual’s vulnerability profile.

The instrument is often utilized alongside measures of processes and stages of change (as defined by the TTM) to provide a comprehensive profile of an individual’s readiness for and challenges in recovery.

Construct

The STS-AV measures the psychological construct of Situational Temptation, which is defined as the intensity of the urge to engage in a specific addictive behavior (alcohol consumption) when faced with particular high-risk circumstances. Conceptually, temptation is inversely related to self-efficacy; high temptation implies low self-efficacy to cope with a situation without resorting to the substance.

The scale operationalizes temptation across four primary dimensions, reflecting common relapse precipitants: Negative Affect, Social/Positive situations, Physical and Other Concerns, and Cravings and Urges. The responses are anchored on a 5-point Likert scale ranging from “Not at all tempted” to “Extremely tempted,” reflecting the subjective strength of the urge in hypothetical scenarios.

Validity

The validity of the STS-AV is primarily supported by its strong theoretical grounding in the Transtheoretical Model (Prochaska & DiClemente, 1983). The scale demonstrates construct validity by showing expected inverse correlations with measures of abstinence self-efficacy and predictive validity in relation to relapse outcomes. Studies, such as those conducted by DiClemente and colleagues (1994), have consistently shown that high scores on the STS-AV are indicative of a higher risk for relapse among individuals in the Action or Maintenance stages of recovery.

Reliability

The reliability of the STS-AV, typically assessed via internal consistency (Cronbach’s Alpha), varies across the subscales and versions, but generally demonstrates acceptable to excellent reliability, especially for the Negative Affect and Social/Positive dimensions.

Reliability estimates for the 20-item version (DiClemente et al., 1994) indicated the following internal consistencies:

• Negative Affect: .99
• Social/Positive: .86
• Physical and Other Concerns: .60
• Withdrawal/Urges: .70

Reliability estimates reported in Project DELTA studies showed slightly different, yet generally strong, results:

• Negative Affect: .81
• Social/Positive: .75
• Physical and Other Concerns: .63
• Withdrawal/Urges: .70

Factor Analysis

Factor analysis has consistently supported a multi-dimensional structure for the STS-AV, confirming the theoretical distinction between different types of high-risk situations. The scale generally organizes items into four distinct factors, though the precise grouping can vary slightly between the 20-item and 12-item versions, and specific study populations (e.g., Project DELTA).

The four identified factors, common across both major versions, are: Negative Affect (situations involving emotional distress, anger, or depression); Social/Positive (situations involving celebration, relaxation, or peer pressure); Physical and Other Concerns (situations involving physical pain, fatigue, or worries); and Cravings and Urges (situations involving direct physical or psychological need for alcohol).

Instrument

Test Type: Self-report questionnaire, Psychological assessment scale.

Format: Paper-and-pencil or digital administration; uses a 5-point Likert scale (1=Not at all tempted to 5=Extremely tempted).

Language Available: English (Primary).

Population Group: Individuals with substance use disorders, particularly those seeking or engaged in treatment for alcohol use disorder.

Age Group: Adults (Typically 18+).

Population Details: Used widely in clinical and research settings focused on addiction recovery and relapse prevention.

Test Methodology: Respondents rate how tempted they would be to drink alcohol in each specified situation.

Keywords

Addiction assessment, Psychological measurement, Relapse risk, Self-efficacy, Alcohol abuse, DiClemente, TTM, Situational assessment.

Authors

Author ORCID Identifier: Not provided in source content.

Affiliation Email addresses: Not provided in source content.

Correspondence Address: Not provided in source content. (Instrument information is hosted at: http://habitslab.umbc.edu/situation-temptation-scales/)

Permissions & Fee and Test Year

The Situation Temptation Scales- Alcohol Version is generally considered a freely available research instrument, often associated with the work of Dr. Carlo C. DiClemente. The primary psychometric development and initial factor structure were established around 1994, corresponding to the publication by DiClemente, Carbonari, and Montgomery. Researchers should consult the primary source documentation for specific usage permissions. The original PDF describing the scale’s use and psychometrics can be downloaded here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2827205/pdf/nihms177208.pdf

Reference’s

• DiClemente, C.C. (2007). Mechanisms, Determinants and Process of Change in the Modification of Drinking Behavior. Alcoholism: Clinical and Experimental Research, 31(S3), 13S-20S.
• DiClemente, C.C., Carbonari, J.P., and Montgomery, R.P.G. (1994). The alcohol abstinence self-efficacy scale. Journal of Studies on Alcohol, 55, 141-148.
• DiClemente, C.C., Carbonari, J.P., & Velasquez, M.M. (1992). Alcoholism treatment mismatching from a process of change perspective. Drug and Alcohol Abuse Reviews: Vol 3, Alcohol Abuse Treatment. Watson, R.R., ed. Totowa, NJ: The Humana Press, pp. 115-142.
• DiClemente, C.C., and Hughes, S.O. (1990). Stages of Change Profiles in Outpatient Alcoholism Treatment. Journal of Substance Abuse, 2, 217-235.
• Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51(3), 390–395.

Items of the Situation Temptation Scales- Alcohol Version

20 item version

1. When I am in agony because of stopping or withdrawing from alcohol use.
2. When I have a headache.
3. When I am feeling depressed.
4. When I am on vacation and want to relax.
5. When I am concerned about someone.
6. When I am worried.
7. When I have the urge to try just one drink to see what happens.
8. When I am being offered a drink in a social situation.
9. When I dream about taking a drink.
10. When I want to test my will power over drinking.
11. When I am feeling a physical need or craving for alcohol.
12. When I am physically tired.
13. When I am experiencing some physical pain or injury.
14. When I feel like blowing up because of frustration.
15. When I see others drinking at a bar or a party.
16. When I sense everything is going wrong for me.
17. When people I used to drink with encourage me to drink.
18. When I am feeling angry inside.
19. When I experience an urge or impulse to take a drink that catches me unprepared.
20. When I am excited or celebrating with others.

12 item version

1. When I am feeling depressed.
2. When I am concerned about someone.
3. When I am worried.
4. When I have the urge to try just one drink to see what happens.
5. When I want to test my will power over drinking.
6. When I am feeling a physical need or craving for alcohol.
7. When I am physically tired.
8. When I am experiencing some physical pain or injury.
9. When I feel like blowing up because of frustration.
10. When I see others drinking at a bar or a party.
11. When people I used to drink with encourage me to drink.
12. When I am excited or celebrating with others.

Scoring Key (20 Item Version):

• Negative Affect: 3, 6, 14, 16, 18
• Social/Positive: 4, 8, 15, 17, 20
• Physical and Other Concerns: 2, 5, 9, 12, 13
• Cravings and Urges: 1, 7, 10, 11, 19

Scoring Key (12 Item Version – DiClemente et al.):

• Negative Affect: 1, 3, 9
• Social/Positive: 10, 11, 12
• Physical and Other Concerns: 2, 7, 8
• Cravings and Urges: 4, 5, 6

Scoring Key (12 Item Version – Project DELTA):

• Negative Affect: 1, 3, 10
• Social/Positive: 2, 5, 12
• Physical and Fatigue: 7, 8, 9
• Cravings and Urges: 4, 6, 11