Spouse Sobriety Influence Inventory (SSII)

Abstract

The Spouse Sobriety Influence Inventory (SSII) is a comprehensive psychological scale designed to measure the frequency and type of influence strategies used by spouses of individuals struggling with alcohol abuse. Developed by Thomas, Yoshioka, and Ager in 1993, the inventory consists of 52 items that capture a wide range of behaviors—from positive support and encouragement to confrontational, controlling, or negative actions—employed by the spouse over the preceding six months to affect the drinker’s behavior. The SSII is vital for research and clinical settings focused on understanding the dynamics of marital relationships affected by addiction and for developing targeted interventions for co-dependent behaviors or enabling patterns.

Keywords

Alcoholism, Substance abuse, Spousal influence, Drinking control, Sobriety support, Marital coping, Enabling behaviors, Inventory

Authors

Thomas, E. J., Yoshioka, M. R., & Ager, R. D.

Purpose

The primary purpose of the Spouse Sobriety Influence Inventory (SSII) is to systematically quantify the various control and influence efforts exerted by a non-drinking or less-drinking spouse on their partner who abuses alcohol. The instrument was developed to move beyond generalized concepts of “enabling” or “co-dependence” by providing specific, observable behaviors related to influencing sobriety or reducing drinking frequency.

By assessing both supportive and controlling/punitive actions, the SSII allows clinicians and researchers to categorize and analyze the efficacy of different spousal intervention strategies. This detailed assessment is crucial for tailoring therapeutic approaches, particularly those involving couples therapy or family systems interventions for alcohol use disorders.

Construct

The SSII measures the construct of Spousal Influence Strategies regarding alcohol use. This construct is generally divided into two empirically derived sub-constructs:

• Sobriety Support (SSS): Measures positive and constructive strategies aimed at encouraging abstinence or reduction in drinking, such as praising sobriety, suggesting non-alcoholic activities, or seeking professional help for oneself.
• Drink Control (DCS): Measures negative, confrontational, manipulative, or avoidance strategies aimed at stopping or controlling the drinking, such as hiding alcohol, making threats, arguing, or expressing disapproval.

The scale assumes that a spouse’s actions are not monolithic but represent a complex mixture of behaviors, some of which may be helpful in promoting sobriety, while others may exacerbate conflict or lead to negative relationship outcomes.

Validity

The SSII exhibits strong content validity, as the items were derived from extensive observation and clinical interviews regarding spousal interactions in the context of alcohol abuse. Its construct validity is supported by the clear differentiation of items into the two primary subscales (SSS and DCS), reflecting distinct behavioral domains that align with therapeutic models of intervention (e.g., positive reinforcement versus punishment or coercion).

Studies utilizing the SSII, such as those by Thomas, Yoshioka, & Ager (1996), have demonstrated that the subscales predict different outcomes in the drinker’s behavior and the overall quality of the marital relationship, confirming its utility in assessing the complex role of the spouse in the recovery process. The scale provides a behavioral index that is more objective than general self-reports of distress or enabling.

Reliability

The reliability of the SSII is typically assessed through internal consistency measures for its two main subscales. Research indicates that both the Sobriety Support Scale (SSS) and the Drink Control Scale (DCS) possess acceptable to good internal consistency (often measured using Cronbach’s alpha), suggesting that the items within each subscale reliably measure their intended construct. The large number of items (52 total) contributes to the overall stability and comprehensiveness of the instrument.

Factor Analysis

A central finding supporting the structure of the SSII is the clear differentiation achieved through factor analysis. The 52 items were consistently found to load onto two primary, distinct factors, leading to the creation of the two subscales:

• Sobriety Support Scale (SSS): This subscale comprises 7 items (Items 13, 15, 16, 20, 28, 29, and 31). These items capture positive, proactive, and encouraging actions.
• Drink Control Scale (DCS): This subscale comprises the remaining 45 items. These items cover confrontational, negative, restrictive, or avoidant behaviors, including both verbal expressions of disapproval and physical actions (e.g., hiding alcohol or money).

This two-factor structure underscores the conceptual distinction between supportive influence and coercive control efforts made by the spouse.

Instrument

Test Type: Self-report Inventory/Behavioral Frequency Scale

Format: 52 items rated on a 5-point Likert scale based on frequency of occurrence over the past six months.

Language Available: English (Original)

Population Group: Spouses or partners of individuals with alcohol use disorder.

Age Group: Adults (Typically 18+)

Population Details: Individuals in committed relationships (married or cohabiting) with a partner identified as an alcohol abuser or dependent drinker.

Test Methodology: Respondents indicate the frequency of their specific influence behaviors using the following response options: 1 = Always, 2 = Frequently, 3 = Occasionally, 4 = Rarely, 5 = Never. Scoring typically involves summing item responses within the SSS and DCS subscales, often after reversing negative items, though the specific scoring protocol depends on the research application.

Keywords

Spouse Sobriety Influence Inventory, SSII, DCS, SSS, Alcohol use disorder, Family dynamics, Codependence, Marital therapy, Intervention assessment

Authors

Author ORCID Identifier: Not publicly available in source material.

Affiliation Email addresses: [email protected] (R. D. Ager)

Correspondence Address: Not publicly available in source material.

Permissions & Fee and Test Year

The scale was initially developed and published around 1993. Information regarding current fees and explicit permission requirements must be obtained directly from the authors or their affiliated institutions. The instrument is often cited and used in academic settings, suggesting its accessibility for research purposes.

A version of this instrument can be found within the “Healthy Marriages Compendium, Part 2.” The original PDF can be downloaded here: http://www.childtrends.org/wp-content/uploads/2013/09/Healthy-Marriages-Part-II.pdf

Reference’s

• Yoshioka, M.R., Thomas, E.J., & Ager, R.D. (1992). Nagging and other drinking control efforts of spouses of uncooperative alcohol abusers: assessment and modification. Journal of Substance Abuse, 4(3), 309-318.
• Thomas, E. J., Yoshioka, M. R., & Ager, R. D. (1996). Spouse enabling of alcohol abuse: Conception, assessment and modification. Journal of Substance Abuse. 8, 61-80.
• Corcoran, K., & Fischer, J. (2000). Measures for clinical practice: A sourcebook (Vol.1). New York, NY: The Free Press.

Items of the Spouse Sobriety Influence Inventory (SSII)

In the past six months, how often have you:

1. Given the drinker written information about the harmful effects of alcohol (e.g., pamphlets, books)?
2. Expressed disapproval of the drinking?
3. Asked the drinker to stop or reduce his/her drinking?
4. Reminded the drinker of the things he/she said or did when he/she was drunk or had been drinking?
5. Spoke to the drinker before he/she went out in order to get him/her to drink less or not at all in that situation?
6. Encouraged the drinker to enter an alcohol treatment program, seek medical assistance, or to attend an alcohol education program?
7. Sought professional help yourself about the drinking problem (e.g., went to a physician, psychologist, psychiatrist, counselor, social worker, or clergy member)?
8. Hidden or threw out alcohol?
9. Hidden money or the checkbook or spent all the money so there was little left for alcohol?
10. Hit or tried to hurt the drinker physically to make him/her stop drinking?
11. Made a house rule that the drinker cannot drink in the house?
12. Tried to get the drinker to reduce his/her drinking while at a social function (e.g., a party, bar, or club) or to leave a social function before he/she became drunk?
13. Told the drinker that you enjoyed his/her company when he/she was not drinking?
14. Served meals at a different time to interrupt the drinker’s drinking?
15. Suggested or served the drinker non-alcoholic beverages instead of alcoholic beverages?
16. Suggested activities that do not involve alcohol?
17. Hidden valuables or household things so that the drinker could not pawn or sell them to buy alcohol?
18. Cut back on your own drinking to set a good example for the drinker?
19. Questioned the drinker regarding his/her whereabouts or how money was spent when you suspected that he/she had been drinking?
20. Praised the drinker for not drinking or for a reduction in drinking?
21. Tried to stop the drinker from drinking too much by creating a scene or by attempting to make him/her feel small or ridiculous in public?
22. Shown the drinker that his/her drinking is making you upset or ill?
23. Withheld information as punishment for the drinking?
24. Had arguments about problems related to the drinking?
25. Requested that you or someone else accompany the drinker as a means of controlling his/her drinking?
26. Avoided entertaining to prevent the opportunities to drink?
27. Prevented drinking friends form coming to the house?
28. Suggested that you eat in restaurants that do not serve alcohol?
29. Suggested social activities at which alcohol is not available?
30. Tried to stop the drinker from drinking too much by inviting friends or relatives in?
31. Tried to stop the drinker from drinking too much by getting him/her to engage in social activities with nondrinking companions?
32. Tried to stop the drinker from drinking too much by getting him/her to reduce the number of social activities with drinking companions?
33. Threatened to contact someone for help to try to stop him/her from drinking?
34. Asked his/her employer or supervisor to step in?
35. Checked his/her whereabouts to see if he/she was drinking?
36. Tried to reduce problems or stress for the drinker so that he/she would drink less?
37. Tried to stop him/her from drinking too much by actually getting drunk yourself?
38. Refused to talk to the drinker when he/she had been drinking?
39. Said that if the drinker loved you or the children he/she would stop drinking?
40. Told the drinker that the children would lose their respect for him/her because of the drinking?
41. Told the drinker that you were hurt by the drinking or by what he/she did when drinking?
42. Made sarcastic remarks about the drinking?
43. Refused to share the bed with the drinker when he/she was drunk or had been drinking?
44. Withheld sex or other forms of affection because of the drinker’s drinking?
45. Left home, even for part of a day, because of the drinking?
46. Threatened divorce or separation if the drinker did not stop drinking?
47. Demonstrated your strong feelings about his/her drinking by threatening to kill yourself?
48. Cried to reduce the drinker’s drinking?
49. Tried to get even because of the drinking?
50. Said that the drinker must leave or kept him/her out of the house because of his/her drinking?
51. Threatened the drinker about what you would do if he/she continued to drink?
52. Ignored the drinker to get back at him/her when he/she was drunk, had been drinking, or after a drinking episode?

Response Scale: 1 = Always, 2 = Frequently, 3 = Occasionally, 4 = Rarely, 5 = Never

Subscale Breakdown:

• Sobriety Support Scale (SSS): items 13, 15, 16, 20, 28, 29, and 31.
• Drink Control Scale (DCS): The remaining items (1-12, 14, 17-19, 21-27, 30, 32-52).