Most addiction services treat one problem at a time: alcohol here, gambling
there, an eating disorder somewhere else. PROMIS was built on a different idea,
and that idea was tested in published research carried out with our own
patients. This page explains the science behind how we work, and the assessment
tool that came out of it: the Shorter PROMIS Questionnaire (SPQ).
What is the Shorter PROMIS Questionnaire?
The Shorter PROMIS Questionnaire (SPQ) is a self-report tool that assesses
several different addictive behaviours at once, rather than screening for a
single addiction in isolation. It uses 16 scales covering substance and
behavioural areas: nicotine, recreational drugs, prescription drugs, alcohol,
gambling, sex, caffeine, food bingeing, food starving, exercise, shopping, work,
relationships and compulsive helping (Christo et al., 2003).
The point of measuring all of these together is clinical, not academic. People
rarely have just one problem. Someone who stops drinking may find that gambling,
work or an eating problem moves into the space the alcohol used to fill. Looking
across behaviours at the start of treatment helps the clinical team see the
whole pattern instead of one symptom.
Where the research came from
The SPQ grew out of a line of academic work carried out using clinical records
from the PROMIS Recovery Centre, in collaboration with researchers at the
University of Kent.
- 1995, the founding study. Stephenson, Maggi, Lefever and Morojele
published an archival study of behavioural tendencies reported by 471 patients
admitted to the centre between 1988 and 1993. Analysing responses across 16
behavioural areas, they identified two broad underlying factors, described as
"Nurturance" and "Hedonism" (Stephenson et al., 1995).
- 2003, validating the SPQ. A paper in Addictive Behaviors further
validated the Shorter PROMIS Questionnaire as a tool for assessing multiple
addictive behaviours at the same time, using 497 consecutive admissions to the
PROMIS Recovery Centre between 1995 and 1999 (Christo et al., 2003).
- 2004, addictive orientations. A further Addictive Behaviors paper
developed the concept of "addictive orientations", examining how addictive
behaviours cluster within hedonistic and nurturant groupings (Haylett,
Stephenson & Lefever, 2004).
The strength of this work is reflected in the fact that it supported two doctoral
theses. Neo Morojele's PhD grew out of the earlier research, and Samantha
Haylett's later University of Kent thesis (2001) developed the work on addictive
orientations. The SPQ has since been used by other researchers beyond PROMIS,
including in studies of addictive behaviours in young adults.
The idea behind it: addiction as a pattern, not a single habit
The thread running through this research is that addictive behaviours tend to
travel together. A person's difficulty is often better understood as an
addictive orientation, a tendency that can express itself through more than
one behaviour, rather than as a single isolated habit.
That understanding still shapes how PROMIS works today. It is why our
assessment looks at the whole picture rather than one
presenting problem, and why our [residential and primary-care
treatment](/about/services/primary-care) is designed to address co-occurring
substance and behavioural addictions together.
The PROMIS Research Group
The original PROMIS Questionnaire was created by PROMIS's founder, Dr Robert
Lefever, who also formed the PROMIS Research Group to study addictive behaviours.
The academic research was led by Professor Geoffrey Stephenson of the University
of Kent, working with PROMIS clinicians, and the published papers had many
contributors across 1995, 2003 and 2004. Robin Lefever, who leads PROMIS today,
was invited by his father to join the research group and was among the
contributors to the validation work, including the 2003 Shorter PROMIS
Questionnaire paper listed in the references below. You can read about the
current clinical team on our team page.
Read the research
The papers below are peer-reviewed and publicly listed. We separate published
research from treatment information deliberately: this page is about the science,
not a description of a programme.
- Stephenson, G. M., Maggi, P., Lefever, R. M. H., & Morojele, N. K. (1995).
Excessive behaviours: an archival study of behavioural tendencies reported by
471 patients admitted to an addiction treatment centre. Addiction Research,
3(3), 245-265. doi:10.3109/16066359509005241
- Christo, G., Jones, S. L., Haylett, S., Stephenson, G. M., Lefever, R. M. H.,
& Lefever, R. (2003). The Shorter PROMIS Questionnaire: further validation of
a tool for simultaneous assessment of multiple addictive behaviours.
Addictive Behaviors, 28(2), 225-248. doi:10.1016/S0306-4603(01)00231-3
- Haylett, S. A., Stephenson, G. M., & Lefever, R. M. H. (2004). Covariation in
addictive behaviours: a study of addictive orientations using the Shorter
PROMIS Questionnaire. Addictive Behaviors, 29(1), 61-71.
doi:10.1016/S0306-4603(03)00083-2
Talk to us
If you recognise more than one of these patterns in yourself or someone you
love, that is exactly what our model is built to address. You can speak with our
team in confidence through our contact page, or read more about
the assessment that begins treatment.
*This page describes published research for general information. It is not a
diagnostic tool. The SPQ is used as part of a clinical assessment by qualified
staff, not as a self-diagnosis.*