PsychologicalReportr, 1975, 36,299-309. @ Psychological Reports 1975 CREDIBILITY OF SOURCES OF INFORMATION ABOUT
DRUGS
E. ROBERT SINNETT, ALLAN PRESS. RODNEY A. BATES1 Kansas State University AND WILLIAM M. HARVEY Narcoric~Swvice Council, Znc., St. Louis
Summary.-Several samples of youthful drug users and non-users were asked to rate the credibility of a variety of sources of information about drugs. For both users and non-users these sources can be scaled along dimensions of authority, drug experience, and friendship. The profile of credibility of these sources differed markedly for users and non-users. There are clear implications of these findings for drug education and drug counseling. Concern about drug- abuse has led to intense and widespread interest in the preventive value of drug education. Initially some hoped that scare tactics alone would be a deterrant. Subsequently reliance on factual information was thought to be an effective approach, presumably on the assumption that man will use available information in a rational way. However, recent findings have not apparently appreciably influenced the consumption of alcohol or tobacco and the same relationship holds for use of drugs and knowledge of their effects (de Lone, 1972). Another facet of this rational approach was the faulty character of the information disseminated. That is, drug education materials and programs have been severely criticized for inaccuracies in material, the use of scare tactics, and the failure to separate values from scientific information (American Psychiatric Association, 1972; Brotman & Suffet, 1973; de Lone, 1972). The flaws have been so grave that the National Coordinating Council on Drug Education sought a moratorium on the production and distribution of films and literature. In this same release (American Psychiatric Association, 1972 ) , however, there was recognition of the complexity of the issues. The Executive Director stated that "information does not influence behavior until it is processed by an individual in terms of his own experiences, feelings, and life style." Another characteristic of some drug-education efforts was their apparent absurdity. There have been some materials, especially those oriented toward children which, though not intentionally humorous, created that impression (Blue Cross, 1972; National Institute of Mental Health, 1972a, 1972b; U.S. Department of Justice, 1970). Examples are coloring books, story books, an Alice in Wonderland script in which different characters were abusing different drugs, and a programmed learning brochure in which the reader is advised after completing the section on narcotics: "It is a good time to take a brief rest." Subsequently the section on stimulants is presented. Relatively early during the recent surge of interest in drug education, 'Now
at
Panhandle Mental Healeh Center, Scortsbluff, Nebraska.
300
E. R. SINNETT, ET AL.
Halleck ( 1970) questioned the assumption that drug education would discourage youth from experimentation with illegal drugs. He felt that it might even encourage the use of drugs. Later this position has been upheld by others. Tennant, Weaver, and Lewis (1973) have presented four case studies of the outcomes of drug education. The results were quite mixed. In one study there was a reduction in hospital admissions for the experimental group, but it was felt that subjeccs may have learned to use drugs safely. However, some subjects felt the use of drugs was encouraged by educational programs. Weaver and Tennant (1973) reported on another program in which it could not be demonstrated that the program reduced drug use or prevented experimentation with drugs. Thus, a variety of factors have contributed to disillusionment with informational drug education. Only recently in October, 1973 was the proposed moratorium (vide supra) lifted. A new era is emerging in drug education. Recent studies on drug use have examined personality variables, developmental influences, peer relationships and the role of credibility of the source of information. Hanneman (1973) has compared the process of learning about drugs with the emotional involvement of learning about birth control. Neither type of information is neutral. An enlightened position paper about the goals and methods of drug education has been written by Wald and Abrams ( 1972). Out-of-school education, the use of discussion, the use of peer resources, and the bringing of education to the potential consumer via hotlines, mobile units, free clinics and crisis centers are advocated. In particular, Wald and Abrams also argue that the information source must be someone who is borh liked and trusted. Smart and Fejer (1972) report that high school students vary considerably in their trust of various sources of information. Physicians and scientists are highly trusted. Drug users, however, rely heavily on friends and their own experience. From the clinically oriented literature there are recurrent themes of youths' alienation from society and distrust of authority. This orientation is particularly characteristic of those using illicit drugs. The high credibility of peers and ex-addicts are also recurrent themes. Nonetheless, there has been relatively little formal study of the differential credibility of sources of information. For example, valid information transmitted from a source of low credibility might have little influence on a target population of a drug education program. Similarly, sources of high credibility might readily influence others even with inaccurate information. Clearly, too, one's own experience and the congruity of the information being disseminated should also be taken into account. The aim of this study is twofold: first, to ascertain the dimensions of credibility of sources of information about drugs, and second, to determine whether users and non-users differ in the sources they find credible.
CREDIBILITY OF SOURCES: DRUG INFOLVATION
Drug education in recent years has emanated from many quarters, both traditional and non-traditional. In order to explore the differential credibility of a variety of sources, some 45 sources were designated for study. These sources were from the following categories: government agencies, law enforcement, mental health, medicine, education, media, the drug scene, family and friends, and own experiences. Except for sources such as TV and newspaper articles no particular medium of presentation was implied. These sources were presented in random order\ith instructions for the subjects to make a numerical percentage rating of how much they "trusc, believe in . . . consider credible" each source. Beside each source a continuous scale of 0 to 100% was presented. Examples of ratings for low trust and high trusc were offered. The subjects were 88 Manhattan, Kansas high school upperclassmen enrolled in an elective course in psychology (hereafter referred to as the High School students). In addition, 20 drug abusers who were voluntary clients of the Narcotics Service Council, Inc., in St. Louis (hereafter referred to as Council clients) were studied. The mean ages of the groups were quite similar: High School, 17.1; Council clients, 16.6. Also they were quite similar in mean number of years of education: High School, 11.7; Council clients, 10.6. The identifying data gathered were as follows: age, sex, years of educacion, size of hometown and experience with street drugs. The street drugs potentially available ro the Ss in both communities were manifold: marijuana, amphetamines, barbiturates, LSD, and narcotics. None had been addicted to heroin although some had tried it occasionally. Because of the concern about invariance of factors over heterogeneous samples, data from two other groups will be presented in part. Namely, a summary of factor analyses of the credibility ratings of a large group ( N = 272) of junior high and high school youth from a rural area in Kansas, and an older but heterogeneous group of 83 college students (mean age, 25.6; mean education, 15.1 yr.) enrolled in a drug education course. RESULTS A one-way analysis of variance for repeated measures was performed on the mean credibility ratings for the high school sample. The differences between the mean credibility ratings were significant (F = 35.11, df = 44/836,
TJ. S. Office of Education, Police Officer, Social Worker, Pusher, Lab Technician, Underground Newspaper, Psychologist, Addict, College Professor, Ex-addict, Guidance Counselor, Father, Department of Health, Education B: Welfare, U.S. Fwd and Drug Administration, Scientific Journals. Mothcr, Narcotics Agent. U.S. Justice Department, Experienced user of drugs, National Institute of Mental Health, Judge, Psychiatrist, Newspaper Articles. Adult female friend, Adult male friend, Minister, Ex-user of drugs, Policeman, National Institute of Health, Seeing others on Drugs, Own Experience, Male Friend, FBI, Bureau of Narcotics and Dangerous Drugs, Doctor, TV,Male Friend Drug User, Female Friend, High School Teacher, Reports of Chemical Analyses, Nurse, Drug Educator, Pharmacist, Female Friend Drug User, Sheriff.
E. R. SINNETT, ET AL.
302
< .001).
A similar analysis was done on the data of Council clients (F = < .001). For purposes of multiple comparisons of the individual means, Duncan's new multiple-range test was used. Any pair of sources not connected by the same line differ significantly at P < .01. Those sources connected by a line do not differ significantly; see Table 1. P
63.91, df = 4 4 / 3 6 , P
TABLE 1 MEANCREDIBILITY RATINGSOF SOURCESBY NORMALHIGH SCHOOL STUDENTS AND COUNCILCLIENTSAND DUNCAN'STESTS High School Srudents Source M Duncan Pusher Addict Underground News Female Friend User Male Friend User Experienced User Newspaper TV Female Friend Male Friend Own Experience High School Teacher Adult Female Friend Adult Male Friend Judge Shenff Seeing Others on Drugs College Professor Minister Justice Department Narcotics Agent Mother Nurse Psychiatrist Father
NIh4H Social Worker ~iycho~o~ist NIH Police Officer Phararnacist Office of Education Drug Educator HEW Scientific Journals Lab Technician Chemical Analyses FDA BNDD Doctor
Council Clients Source M Duncan Policeman 10.5 Sheriff 13.0 Police Officer 14.9 15.1 Narcotics Agent FBI 17.0 -Justice Department TV Mother Office of Education Father Judge Minister Newspaper HEW High School Teacher BNDD NIH FDA Scienrific Journals Psychiatrist College Professor NIMH Guidance Counselor Pusher Social Worker Psychologist Nurse Doaor Addia Underground News Female Friend Adult Female Friend Lab Technician 53.3 Drug Educator 53.7 Seeing Others on Drugs 53.7 Female Friend User 55.1 Chemical Analyses 55.3 Adult Male Friend 57.8 Ex-user 58.2 Pharmacist 59.0 Male Friend User 60.8 Male Friend 63.5 Ex-addict 65.2 Experienced User 68.5 Own Experience 86.0
CREDIBILITY OF SOURCES: DRUG INFORMATION
303
Table 2 shows the t tescs for the mean differences in credibility ratings between the samples of high school Ss and Council clients. This comparison reflects the difference in drug use between the groups. The high school group, which was unselected with respect to drug use, had many Ss who reported no experience with street drugs (62 Ss of 88) but all of the Council clients had had experience with a variety of street drugs. MEANCREDIBILITY RATINGS Source
TABLE 2 TESTSOF DIFFERENCES BETWEENMEANS
AND t
High School
(N = 88)
Office of Education Police Officer Social Worker Pusher Lab Technician Underground Newspaper Psychologist Addict College Professor Ex-addict Guidance Counselor Father
69.5 68.3 64.6 14.1 71.9 27.2 65.4 20.9 55.1 62.9 61.0
Council
I
( N = 20) 24.6 14.9 46.5 45.2 53.3 51.6 46.8 51.2 42.2 65.2 45.1
7.60% 8.70% 2.86t -5.05% 3.16t -3.78% 3.12t 4.3W 2.29 -0.31 2.70.
13.0
6.69$
Narcotics Agent Justice Department Experienced User NIMH Judge. Psychiatrist Newspaper Adult Female Friend Adult Male Friend Minister Ex-user Policeman NIH Seeing Others on Drugs Own Exwrience Male ~ r i e n d
FBI
BNDD Doctor
TV
Male Friend User Female Friend High School Teacher Chemical Analyses Nurse Drug Educator Pharmacist Female Friend User Sheriff
*#
< .01.
t# < .005.
- -
3p
< .001.
53.2
304
E. R. SINNETT', ET AL.
Another analysis concerned the credibility of sources of information about drugs using the following subgroups: high school non-user, high school user, and Council drug abuser. The high school users were characterized by occasional use or some experimentation with a few substances such as marijuana or a psychedelic as opposed to the Council clients who made frequent use of mulciple substances sometimes including dangerous substances such as heroin. In all instances where there was a significant F ratio, the high school users were incermediace between the non-users and the abusers. Thus, the credibility ratings differ as a function of degree of drug use, except for the refinement noted above. Since the results are so similar to those of Table 2, these analyses are not presented in detail. Although the possibility of town-size differences between the samples from high school and the Council was considered as a confounding variable, it did not load heavily on any of the factors emerging in the factor analysis. Also, in the college class sample described above an improved measure of hometown size failed co differentiate Ss in amount of drug experience or to show any high loadings on any of the credibility of sources factors. The drug users seemed generally less trusting of sources of information than non-users: for the 45 sources, the non-users showed higher credibility ratings on 32. In order to determine whether the two groups were similar in the dimensional structure of the credibility space, the credibility ratings for the high school sample and the Council sample were factor analysed separately to ascertain whether they might reasonably be combined. All factor analyses used the principal axes method, with unity in the diagonals and Varimax rotation. The first factor for both groups appeared to be quite similar in chat high loadings were characterized by authority, e.g., government agencies, law enforcement, medical and mental health sources. Also, in each analysis the second factor seemed to reflect drug experience, e.g., male friend user, female friend user, ex-user. The third factors of the two analyses did not seem congruent. Program RELATE (Stone, Gunn, & Lindem, 1973) was run on the two factor analyses to determine whether there was sufficient similarity to warrant pooling the two samples for factor analysis. The cosine between the angles of Factor 1 of each of the two studies was quite high ( 3 4 ) ; similarly the cosine between the Factor I1 dimensions for each sample was high (.69). Therefore, the samples were combined and factor analysed wich the result that four well-defined factors emerged, three of which were quite interpretable. Because of che concern about factorial invariance, data from two other samples, a college drug education class ( N = 83) and a rural junior high and high school sample ( N = 2 7 2 ) , were factor analysed. Table 3 presents a summary of the selected highest loadings which define the factors. The factors differed somewhat in size across the three studies. Factor I, Authority, ac-
CREDIBILITY OF SOURCES : DRUG INFORMATION
305
TABLE 3 Source
Study 1+
Study 2 t
Highest Rotated Loadings, Factor I (Authority) HEW .90 .82 FDA .85 .76 Police Officer .78 .88 Narcotics Agent .68 .88 Policeman .82 .87 NIH .82 .70 FBI .77 .86 BNDD .79 .85 Justice Department .78 .83 .81 .78 Judge Physician .80 .56 Sheriff .80 .79 Highest Rotated Loadings, Factor I1 (Drug Experience) Ex-user .79 .83 Ex-addict .72 .SO Experienced User .68 .75 Addict .55 -74 Seeing Others on Drugs .65 .39 Male Friend User .61 .46 Female Friend User .60 .42 Pusher .49 .35 Underground Newspaper .53 .35 Highest Rotated Loadings, Factor 111 (Friendship) Adult Male Friend .84 .87 Female Friend .73 .89 Adult Female Friend .83 .86 Male Friend .75 .88 *High School Normal and St. Louis Ss ( N = 1 0 8 ) . +College Drug Class Ss (N = 8 3 ) . $Rural Junior High and High School Ss ( N = 2 7 2 ) .
Study 3$ .66 .74 (omitted) .44 .54 .54 .76 .80 .61 .62 .68 .64
counted for 36% of the common variance in Srudy 1; 37% in Study 2; and 28% in Study 3. Factor 11, Drug Experience, accounted for 14% of the common variance in Scudy 1; 9% in Srudy 2; and 11% in Study 3. Factor 111, Friendship, accounted for 5 % of the common variance in Study 1; 13% in Study 2; and 7% in Study 3. Finally, since the high school and Council samples differed so markedly in their credibility ratings an accempc was made to separate users of screec drugs from non-users by means of a regression analysis. For these analyses those among the high school sample who had had experience with street drugs were combined with the Council sample into a User group, h e remainder of the high school sample was categorized as a Non-user group. The total sample of
E. R. SINNETT, ET AL.
306
104 Ss was subdivided into two equal random samples and non-linear discrirninant function weights (Truet, Cornfield, & Kannel, 1967; Wainer, 1972) were derived to separate Users and Non-users on sample A. These weights were then cross-validated on sample B. For purposes of comparison another set of weights was also developed, first on sample B and then applied to sample A. The two formulae and their effectiveness in discriminating Users from Non-users are presented in Table 4. The weights derived from sample A produced 11 mis~Iassificationson sample A and 15 misclassifications on sample B. The weights derived from sample B produced 14 misclassifications on sample B and 14 misclassifications on sample A. Both sets of weights are essentially equally effective in that they produce 78.8% correct classification and 76.9% correct classification, respectively. Thus, it appears that users and non-users have different profiles of credibility sources. TABLE 4 Equationt derived from random Sample A XI = - 1.65611 1.373811 Cutoff poinc = .630
+
Equation derived from random Sample B xs = v.84371 .2724II Cutoff point = .520
+
No. Correctly Classified by XI
+ .6288III - ,3897
+ .6797III - .5522
%
No. Correctly Classified by 2-2
%
Sample I 43 82.7 Sample 2 39 75.0 Total 82 78.8 "The linear equations presented are transformed to non-linear form as follows: P = 1/(1 e-') tFor each equation, roman numerals refer to factor scores.
+
For the most part, sex differences are absent: sex of subject does not load on any of the three factors. However, there was a difference in that male friends were seen as a more credible source of information about drugs by drug users. Female friends were seen as equally credible sources by both Users and Nonusers. These analyses are based on Tukey's B applied to credibility ratings for three levels of drug use: High School non-users, High School users, and the Council sample.
DISCUSSION The results demonstrate unequivocally that sources of information vary significantly in their credibility for Ss of high school age, an age group in which illicit drug use is generally relatively high although not at its peak. Sources
CREDIBILITY OF SOURCES: DRUG INFORiiATION
307
differ in their credibility for high users vs a group unselected for drug use or when comparing users and non-users. For the sample of normal high school students those actively involved with the drug scene received the lowest rating of credibility (Pusher, 14.1% and Addict, 20.9%); Authorities were the most trusted source of informzcion (Physician, 78.2%; Bureau of Narcotics and Dangerous Drugs, 75.0%). For the drug abusers, law enforcement sources were the least credible (Policeman, 10 5 % ; Sheriff, 13.0% ). By far the most credible source was users' Own Experience (86.0%). This source differed significantly ( P < .01) from all other 44 sources. In terms of drug education, one might infer, therefore, that prior or even future experiences may heavily influence what S will believe about drugs. When material is put forth at odds with S's experience, it is likely that the source may be discredited. Many drug educators have been concerned about this incongruity particularly with respect to warnings disseminated about the hazards of marijuana, i.e., they feel that the user's pleasure and lack of suffering may lead him to disbelieve other drug education information. The factor analyses indicate that sources of information are categorized along a dimension of authority, one of drug experience and of friendship. However, there are some sources which might logically be subsumed under an authority dimension but which seem free from the stigma of the establishment: pharmacist, lab technician, and chemical analyses were among the highly credible sources for both users and non-users. An analogous relationship exists for the ex-addict as a credible source of information: although the ex-addict might be expected to have the stigma of association with the drug scene, he is relatively high in credibility to both user and non-users. The ex-addict has been widely used as a resource in current drug treatment programs (Glasscote, Sussex, Jaffe, Ball, & Brill, 1972). The differential pattern of credibility of sources of information for users and non-users has clear implications for drug education and drug counseling. If one is presenting to a !mown non-using population, authorities should be included as sources of information. If one is working wich a group known to have significant use of illicit drugs, those wich drug experience and peers or friends should be utilized. Analyses of street drugs and ex-addicts have a broad spectrum of credibiliry and would be useful in panel presentations and when directing information to populations where the amount of experience with illicit drugs is unknown. The profile of credibility factor scores might also be used to identify users or high risk persons. However, the principle of informed consent should be observed. If such subjects might be assigned to special programs, they should realize this possibility in advance. The findings of this study are congruent with others which indicate rebelliousness, social deviance, and distrust of authority among drug users (Becker,
308
E. R. SINNETT, ET AL.
1963; Blum, 1969; Ingraham, in press; Kandel, 1973; Jessor, Jessor, & Finney, 1973; Pittel, Calef, Gryler, Hilles, Hofer, & Kempner, 1971; Victor, Grossman, & Eisernan, 1973). They are also consistent with Hanneman's study ( 1973) showing the low credibility of media and the high credibility of friends. Somewhat similar findings have been found in a study of beliefs concerning food by Cohen (1973). Direct experience with food, experts, and personal relationships have been the most influential clusters of information. A problem analogous to that in drug education exists when nutrition educators are involved in working with information which is at odds with an individual's experience. It is likely that the credibility of information about alcohol could also be studied using the approaches of Cohen and chose employed in this report. REFERENCES AMERICAN PSYCHIATRIC ASSOCIATION. Drug council seeks halt in drug abuse education. Psychiatric News, 1972, Dec. 20, 1. BECKER, H. S. Outsiders: studies i n the sociology o f deviance. New York: Free Press, 1963. BLUECROSS AND BLUESHIELD. Happy valley and the drug witch. Kansas City: Author, 1972. BLUM,R. H. Siudents and drugs. Vol. 11. San Francisco: Jossey-Bass, 1969. BRo~AN,R., & SUFFET,F. Illicit drug use: preventive education in the schools. Psychiatric Annals, 1973, 3, 48-69. COHEN,H. G. How do people think about food? an exploratory investigation. Unpublishrd Ph.D. thesis, Kansas State Univer., 1974. DELONE, R. H. The ups and downs of drug abuse education. Saturday Review, 1972, 55, 27-32. GLASSCOTE, R., SUSSEX,J., JAFFE, J., BALL,J., & BRILL,L. T h e treatment o f drug abure. Washington, D.C.: Joint Information Service, 1972. HALLECK, S. L. The great drug education hoax. T h e Progressive, July, 1970, 34, 30-33. HANNEMAN, G. H. Communicating drug-abuse information among college students. Public Opandon Quarterly, 1973, 37, 171-191. INGRAHAM,L. H. The Nam and rhe world; a description of heroin use by U. S. Army enlisted men serving in the Republic of South Vietnam. Psychiatry, in press. JESSOR, R., JESSOR, S. L., & FINNEY,J. A social psychology of marijuana use: longitudinal studies of high school and college youth. Journal o f Personality and Social P~ychology, 1973, 26, 1-15. KANDEL, D. Adolescent marijuana use: role of parents and peers. Science, 1973, 181, 1067-1070. NATIONAL INSTITUTE OF MENTAL HEALTH.Curious Alice. DHEW Publication No. (HSM) 72-9040, 1972. ( a ) NATIONAL INSTITUTE OF MENTAL HEALTH. The social seminar. DHEW Publication No. (HSM) 72-9134, 1972. ( b ) PlTTEL, S. M., CALEP, V., GRYLER,R. B., HILLES,L., HOPER,R., & KEMPNER,P. Develo mental factors in adolescent drug use. Jorrrnal o f the American Aclldemy of c h i & Psychiatry, 1971, 10, 640-660. SMART,R. G., & FEJER, D. Credibility of sources of drug information for high school students. Iournal o f Drug Issues, 1972, 2 , 8-18. STONE,L. A,, GUNN,R.. & L~NDEM, A. C. Multidimensional scale structures compared. Perceptual and Motor Skills, 1973, 36, 1308-1310. TENNANT, F. S., WEAVER, S. C., & L ~ I S C. , E. Outcomes of drug education: four case studies. Pediatrics, 1973, 52, 246-251.
CREDIBILITY OF SOURCES: DRUG INFORMATION
309
TRUET, J., CORNFIELD, J., 8: KANNEL,W . A multivariate analysis of the risk of coronary heart disease in Framingham. Joztrnul o f Chronic Diseases, 1967, 20, 511-524. U.S. D E P A R ~ E NOF T JUSTICE, BUREAUOP NARCOTICSAND DANGEROUSDRUGS. Kaiy's coloving book abolrt drugs and heallb. Washington, D. C.: U. S. Gov't Print. Off., 1970. VICTOR,H. R., GROSSMAN,J. C., 8: EISENMAN,R. Openness to experience and marijuana use in high school students. Journal o f Consulting and Clinical Psychology, 1973, 4 1 , 78-85. WAINER,H. A prediction for decision making in the U.S. Senate. Paper presented at the annual meeting of the Midwestern Psychological Association, Cleveland, May. 1972. WALD,P. M., & ABRAMS, A. Drug education. Staff pa r 2 In P. M. Wald & P. Hutt (Eds.), Dealing with drug abuse: a report to ~ o ; dFoundation. New York: Praeger, 1772. Pp. 123-172. WEAVER, S. C., 8r TENNANT. F. S.. JR. Effectiveness of drug education programs for secondary school students. American Journal o f Psychiatry, 1973, 130, 812-814.
tE
Accepted D e c e m b a 9, 1974.
DRUGS
E. ROBERT SINNETT, ALLAN PRESS. RODNEY A. BATES1 Kansas State University AND WILLIAM M. HARVEY Narcoric~Swvice Council, Znc., St. Louis
Summary.-Several samples of youthful drug users and non-users were asked to rate the credibility of a variety of sources of information about drugs. For both users and non-users these sources can be scaled along dimensions of authority, drug experience, and friendship. The profile of credibility of these sources differed markedly for users and non-users. There are clear implications of these findings for drug education and drug counseling. Concern about drug- abuse has led to intense and widespread interest in the preventive value of drug education. Initially some hoped that scare tactics alone would be a deterrant. Subsequently reliance on factual information was thought to be an effective approach, presumably on the assumption that man will use available information in a rational way. However, recent findings have not apparently appreciably influenced the consumption of alcohol or tobacco and the same relationship holds for use of drugs and knowledge of their effects (de Lone, 1972). Another facet of this rational approach was the faulty character of the information disseminated. That is, drug education materials and programs have been severely criticized for inaccuracies in material, the use of scare tactics, and the failure to separate values from scientific information (American Psychiatric Association, 1972; Brotman & Suffet, 1973; de Lone, 1972). The flaws have been so grave that the National Coordinating Council on Drug Education sought a moratorium on the production and distribution of films and literature. In this same release (American Psychiatric Association, 1972 ) , however, there was recognition of the complexity of the issues. The Executive Director stated that "information does not influence behavior until it is processed by an individual in terms of his own experiences, feelings, and life style." Another characteristic of some drug-education efforts was their apparent absurdity. There have been some materials, especially those oriented toward children which, though not intentionally humorous, created that impression (Blue Cross, 1972; National Institute of Mental Health, 1972a, 1972b; U.S. Department of Justice, 1970). Examples are coloring books, story books, an Alice in Wonderland script in which different characters were abusing different drugs, and a programmed learning brochure in which the reader is advised after completing the section on narcotics: "It is a good time to take a brief rest." Subsequently the section on stimulants is presented. Relatively early during the recent surge of interest in drug education, 'Now
at
Panhandle Mental Healeh Center, Scortsbluff, Nebraska.
300
E. R. SINNETT, ET AL.
Halleck ( 1970) questioned the assumption that drug education would discourage youth from experimentation with illegal drugs. He felt that it might even encourage the use of drugs. Later this position has been upheld by others. Tennant, Weaver, and Lewis (1973) have presented four case studies of the outcomes of drug education. The results were quite mixed. In one study there was a reduction in hospital admissions for the experimental group, but it was felt that subjeccs may have learned to use drugs safely. However, some subjects felt the use of drugs was encouraged by educational programs. Weaver and Tennant (1973) reported on another program in which it could not be demonstrated that the program reduced drug use or prevented experimentation with drugs. Thus, a variety of factors have contributed to disillusionment with informational drug education. Only recently in October, 1973 was the proposed moratorium (vide supra) lifted. A new era is emerging in drug education. Recent studies on drug use have examined personality variables, developmental influences, peer relationships and the role of credibility of the source of information. Hanneman (1973) has compared the process of learning about drugs with the emotional involvement of learning about birth control. Neither type of information is neutral. An enlightened position paper about the goals and methods of drug education has been written by Wald and Abrams ( 1972). Out-of-school education, the use of discussion, the use of peer resources, and the bringing of education to the potential consumer via hotlines, mobile units, free clinics and crisis centers are advocated. In particular, Wald and Abrams also argue that the information source must be someone who is borh liked and trusted. Smart and Fejer (1972) report that high school students vary considerably in their trust of various sources of information. Physicians and scientists are highly trusted. Drug users, however, rely heavily on friends and their own experience. From the clinically oriented literature there are recurrent themes of youths' alienation from society and distrust of authority. This orientation is particularly characteristic of those using illicit drugs. The high credibility of peers and ex-addicts are also recurrent themes. Nonetheless, there has been relatively little formal study of the differential credibility of sources of information. For example, valid information transmitted from a source of low credibility might have little influence on a target population of a drug education program. Similarly, sources of high credibility might readily influence others even with inaccurate information. Clearly, too, one's own experience and the congruity of the information being disseminated should also be taken into account. The aim of this study is twofold: first, to ascertain the dimensions of credibility of sources of information about drugs, and second, to determine whether users and non-users differ in the sources they find credible.
CREDIBILITY OF SOURCES: DRUG INFOLVATION
Drug education in recent years has emanated from many quarters, both traditional and non-traditional. In order to explore the differential credibility of a variety of sources, some 45 sources were designated for study. These sources were from the following categories: government agencies, law enforcement, mental health, medicine, education, media, the drug scene, family and friends, and own experiences. Except for sources such as TV and newspaper articles no particular medium of presentation was implied. These sources were presented in random order\ith instructions for the subjects to make a numerical percentage rating of how much they "trusc, believe in . . . consider credible" each source. Beside each source a continuous scale of 0 to 100% was presented. Examples of ratings for low trust and high trusc were offered. The subjects were 88 Manhattan, Kansas high school upperclassmen enrolled in an elective course in psychology (hereafter referred to as the High School students). In addition, 20 drug abusers who were voluntary clients of the Narcotics Service Council, Inc., in St. Louis (hereafter referred to as Council clients) were studied. The mean ages of the groups were quite similar: High School, 17.1; Council clients, 16.6. Also they were quite similar in mean number of years of education: High School, 11.7; Council clients, 10.6. The identifying data gathered were as follows: age, sex, years of educacion, size of hometown and experience with street drugs. The street drugs potentially available ro the Ss in both communities were manifold: marijuana, amphetamines, barbiturates, LSD, and narcotics. None had been addicted to heroin although some had tried it occasionally. Because of the concern about invariance of factors over heterogeneous samples, data from two other groups will be presented in part. Namely, a summary of factor analyses of the credibility ratings of a large group ( N = 272) of junior high and high school youth from a rural area in Kansas, and an older but heterogeneous group of 83 college students (mean age, 25.6; mean education, 15.1 yr.) enrolled in a drug education course. RESULTS A one-way analysis of variance for repeated measures was performed on the mean credibility ratings for the high school sample. The differences between the mean credibility ratings were significant (F = 35.11, df = 44/836,
TJ. S. Office of Education, Police Officer, Social Worker, Pusher, Lab Technician, Underground Newspaper, Psychologist, Addict, College Professor, Ex-addict, Guidance Counselor, Father, Department of Health, Education B: Welfare, U.S. Fwd and Drug Administration, Scientific Journals. Mothcr, Narcotics Agent. U.S. Justice Department, Experienced user of drugs, National Institute of Mental Health, Judge, Psychiatrist, Newspaper Articles. Adult female friend, Adult male friend, Minister, Ex-user of drugs, Policeman, National Institute of Health, Seeing others on Drugs, Own Experience, Male Friend, FBI, Bureau of Narcotics and Dangerous Drugs, Doctor, TV,Male Friend Drug User, Female Friend, High School Teacher, Reports of Chemical Analyses, Nurse, Drug Educator, Pharmacist, Female Friend Drug User, Sheriff.
E. R. SINNETT, ET AL.
302
< .001).
A similar analysis was done on the data of Council clients (F = < .001). For purposes of multiple comparisons of the individual means, Duncan's new multiple-range test was used. Any pair of sources not connected by the same line differ significantly at P < .01. Those sources connected by a line do not differ significantly; see Table 1. P
63.91, df = 4 4 / 3 6 , P
TABLE 1 MEANCREDIBILITY RATINGSOF SOURCESBY NORMALHIGH SCHOOL STUDENTS AND COUNCILCLIENTSAND DUNCAN'STESTS High School Srudents Source M Duncan Pusher Addict Underground News Female Friend User Male Friend User Experienced User Newspaper TV Female Friend Male Friend Own Experience High School Teacher Adult Female Friend Adult Male Friend Judge Shenff Seeing Others on Drugs College Professor Minister Justice Department Narcotics Agent Mother Nurse Psychiatrist Father
NIh4H Social Worker ~iycho~o~ist NIH Police Officer Phararnacist Office of Education Drug Educator HEW Scientific Journals Lab Technician Chemical Analyses FDA BNDD Doctor
Council Clients Source M Duncan Policeman 10.5 Sheriff 13.0 Police Officer 14.9 15.1 Narcotics Agent FBI 17.0 -Justice Department TV Mother Office of Education Father Judge Minister Newspaper HEW High School Teacher BNDD NIH FDA Scienrific Journals Psychiatrist College Professor NIMH Guidance Counselor Pusher Social Worker Psychologist Nurse Doaor Addia Underground News Female Friend Adult Female Friend Lab Technician 53.3 Drug Educator 53.7 Seeing Others on Drugs 53.7 Female Friend User 55.1 Chemical Analyses 55.3 Adult Male Friend 57.8 Ex-user 58.2 Pharmacist 59.0 Male Friend User 60.8 Male Friend 63.5 Ex-addict 65.2 Experienced User 68.5 Own Experience 86.0
CREDIBILITY OF SOURCES: DRUG INFORMATION
303
Table 2 shows the t tescs for the mean differences in credibility ratings between the samples of high school Ss and Council clients. This comparison reflects the difference in drug use between the groups. The high school group, which was unselected with respect to drug use, had many Ss who reported no experience with street drugs (62 Ss of 88) but all of the Council clients had had experience with a variety of street drugs. MEANCREDIBILITY RATINGS Source
TABLE 2 TESTSOF DIFFERENCES BETWEENMEANS
AND t
High School
(N = 88)
Office of Education Police Officer Social Worker Pusher Lab Technician Underground Newspaper Psychologist Addict College Professor Ex-addict Guidance Counselor Father
69.5 68.3 64.6 14.1 71.9 27.2 65.4 20.9 55.1 62.9 61.0
Council
I
( N = 20) 24.6 14.9 46.5 45.2 53.3 51.6 46.8 51.2 42.2 65.2 45.1
7.60% 8.70% 2.86t -5.05% 3.16t -3.78% 3.12t 4.3W 2.29 -0.31 2.70.
13.0
6.69$
Narcotics Agent Justice Department Experienced User NIMH Judge. Psychiatrist Newspaper Adult Female Friend Adult Male Friend Minister Ex-user Policeman NIH Seeing Others on Drugs Own Exwrience Male ~ r i e n d
FBI
BNDD Doctor
TV
Male Friend User Female Friend High School Teacher Chemical Analyses Nurse Drug Educator Pharmacist Female Friend User Sheriff
*#
< .01.
t# < .005.
- -
3p
< .001.
53.2
304
E. R. SINNETT', ET AL.
Another analysis concerned the credibility of sources of information about drugs using the following subgroups: high school non-user, high school user, and Council drug abuser. The high school users were characterized by occasional use or some experimentation with a few substances such as marijuana or a psychedelic as opposed to the Council clients who made frequent use of mulciple substances sometimes including dangerous substances such as heroin. In all instances where there was a significant F ratio, the high school users were incermediace between the non-users and the abusers. Thus, the credibility ratings differ as a function of degree of drug use, except for the refinement noted above. Since the results are so similar to those of Table 2, these analyses are not presented in detail. Although the possibility of town-size differences between the samples from high school and the Council was considered as a confounding variable, it did not load heavily on any of the factors emerging in the factor analysis. Also, in the college class sample described above an improved measure of hometown size failed co differentiate Ss in amount of drug experience or to show any high loadings on any of the credibility of sources factors. The drug users seemed generally less trusting of sources of information than non-users: for the 45 sources, the non-users showed higher credibility ratings on 32. In order to determine whether the two groups were similar in the dimensional structure of the credibility space, the credibility ratings for the high school sample and the Council sample were factor analysed separately to ascertain whether they might reasonably be combined. All factor analyses used the principal axes method, with unity in the diagonals and Varimax rotation. The first factor for both groups appeared to be quite similar in chat high loadings were characterized by authority, e.g., government agencies, law enforcement, medical and mental health sources. Also, in each analysis the second factor seemed to reflect drug experience, e.g., male friend user, female friend user, ex-user. The third factors of the two analyses did not seem congruent. Program RELATE (Stone, Gunn, & Lindem, 1973) was run on the two factor analyses to determine whether there was sufficient similarity to warrant pooling the two samples for factor analysis. The cosine between the angles of Factor 1 of each of the two studies was quite high ( 3 4 ) ; similarly the cosine between the Factor I1 dimensions for each sample was high (.69). Therefore, the samples were combined and factor analysed wich the result that four well-defined factors emerged, three of which were quite interpretable. Because of che concern about factorial invariance, data from two other samples, a college drug education class ( N = 83) and a rural junior high and high school sample ( N = 2 7 2 ) , were factor analysed. Table 3 presents a summary of the selected highest loadings which define the factors. The factors differed somewhat in size across the three studies. Factor I, Authority, ac-
CREDIBILITY OF SOURCES : DRUG INFORMATION
305
TABLE 3 Source
Study 1+
Study 2 t
Highest Rotated Loadings, Factor I (Authority) HEW .90 .82 FDA .85 .76 Police Officer .78 .88 Narcotics Agent .68 .88 Policeman .82 .87 NIH .82 .70 FBI .77 .86 BNDD .79 .85 Justice Department .78 .83 .81 .78 Judge Physician .80 .56 Sheriff .80 .79 Highest Rotated Loadings, Factor I1 (Drug Experience) Ex-user .79 .83 Ex-addict .72 .SO Experienced User .68 .75 Addict .55 -74 Seeing Others on Drugs .65 .39 Male Friend User .61 .46 Female Friend User .60 .42 Pusher .49 .35 Underground Newspaper .53 .35 Highest Rotated Loadings, Factor 111 (Friendship) Adult Male Friend .84 .87 Female Friend .73 .89 Adult Female Friend .83 .86 Male Friend .75 .88 *High School Normal and St. Louis Ss ( N = 1 0 8 ) . +College Drug Class Ss (N = 8 3 ) . $Rural Junior High and High School Ss ( N = 2 7 2 ) .
Study 3$ .66 .74 (omitted) .44 .54 .54 .76 .80 .61 .62 .68 .64
counted for 36% of the common variance in Srudy 1; 37% in Study 2; and 28% in Study 3. Factor 11, Drug Experience, accounted for 14% of the common variance in Scudy 1; 9% in Srudy 2; and 11% in Study 3. Factor 111, Friendship, accounted for 5 % of the common variance in Study 1; 13% in Study 2; and 7% in Study 3. Finally, since the high school and Council samples differed so markedly in their credibility ratings an accempc was made to separate users of screec drugs from non-users by means of a regression analysis. For these analyses those among the high school sample who had had experience with street drugs were combined with the Council sample into a User group, h e remainder of the high school sample was categorized as a Non-user group. The total sample of
E. R. SINNETT, ET AL.
306
104 Ss was subdivided into two equal random samples and non-linear discrirninant function weights (Truet, Cornfield, & Kannel, 1967; Wainer, 1972) were derived to separate Users and Non-users on sample A. These weights were then cross-validated on sample B. For purposes of comparison another set of weights was also developed, first on sample B and then applied to sample A. The two formulae and their effectiveness in discriminating Users from Non-users are presented in Table 4. The weights derived from sample A produced 11 mis~Iassificationson sample A and 15 misclassifications on sample B. The weights derived from sample B produced 14 misclassifications on sample B and 14 misclassifications on sample A. Both sets of weights are essentially equally effective in that they produce 78.8% correct classification and 76.9% correct classification, respectively. Thus, it appears that users and non-users have different profiles of credibility sources. TABLE 4 Equationt derived from random Sample A XI = - 1.65611 1.373811 Cutoff poinc = .630
+
Equation derived from random Sample B xs = v.84371 .2724II Cutoff point = .520
+
No. Correctly Classified by XI
+ .6288III - ,3897
+ .6797III - .5522
%
No. Correctly Classified by 2-2
%
Sample I 43 82.7 Sample 2 39 75.0 Total 82 78.8 "The linear equations presented are transformed to non-linear form as follows: P = 1/(1 e-') tFor each equation, roman numerals refer to factor scores.
+
For the most part, sex differences are absent: sex of subject does not load on any of the three factors. However, there was a difference in that male friends were seen as a more credible source of information about drugs by drug users. Female friends were seen as equally credible sources by both Users and Nonusers. These analyses are based on Tukey's B applied to credibility ratings for three levels of drug use: High School non-users, High School users, and the Council sample.
DISCUSSION The results demonstrate unequivocally that sources of information vary significantly in their credibility for Ss of high school age, an age group in which illicit drug use is generally relatively high although not at its peak. Sources
CREDIBILITY OF SOURCES: DRUG INFORiiATION
307
differ in their credibility for high users vs a group unselected for drug use or when comparing users and non-users. For the sample of normal high school students those actively involved with the drug scene received the lowest rating of credibility (Pusher, 14.1% and Addict, 20.9%); Authorities were the most trusted source of informzcion (Physician, 78.2%; Bureau of Narcotics and Dangerous Drugs, 75.0%). For the drug abusers, law enforcement sources were the least credible (Policeman, 10 5 % ; Sheriff, 13.0% ). By far the most credible source was users' Own Experience (86.0%). This source differed significantly ( P < .01) from all other 44 sources. In terms of drug education, one might infer, therefore, that prior or even future experiences may heavily influence what S will believe about drugs. When material is put forth at odds with S's experience, it is likely that the source may be discredited. Many drug educators have been concerned about this incongruity particularly with respect to warnings disseminated about the hazards of marijuana, i.e., they feel that the user's pleasure and lack of suffering may lead him to disbelieve other drug education information. The factor analyses indicate that sources of information are categorized along a dimension of authority, one of drug experience and of friendship. However, there are some sources which might logically be subsumed under an authority dimension but which seem free from the stigma of the establishment: pharmacist, lab technician, and chemical analyses were among the highly credible sources for both users and non-users. An analogous relationship exists for the ex-addict as a credible source of information: although the ex-addict might be expected to have the stigma of association with the drug scene, he is relatively high in credibility to both user and non-users. The ex-addict has been widely used as a resource in current drug treatment programs (Glasscote, Sussex, Jaffe, Ball, & Brill, 1972). The differential pattern of credibility of sources of information for users and non-users has clear implications for drug education and drug counseling. If one is presenting to a !mown non-using population, authorities should be included as sources of information. If one is working wich a group known to have significant use of illicit drugs, those wich drug experience and peers or friends should be utilized. Analyses of street drugs and ex-addicts have a broad spectrum of credibiliry and would be useful in panel presentations and when directing information to populations where the amount of experience with illicit drugs is unknown. The profile of credibility factor scores might also be used to identify users or high risk persons. However, the principle of informed consent should be observed. If such subjects might be assigned to special programs, they should realize this possibility in advance. The findings of this study are congruent with others which indicate rebelliousness, social deviance, and distrust of authority among drug users (Becker,
308
E. R. SINNETT, ET AL.
1963; Blum, 1969; Ingraham, in press; Kandel, 1973; Jessor, Jessor, & Finney, 1973; Pittel, Calef, Gryler, Hilles, Hofer, & Kempner, 1971; Victor, Grossman, & Eisernan, 1973). They are also consistent with Hanneman's study ( 1973) showing the low credibility of media and the high credibility of friends. Somewhat similar findings have been found in a study of beliefs concerning food by Cohen (1973). Direct experience with food, experts, and personal relationships have been the most influential clusters of information. A problem analogous to that in drug education exists when nutrition educators are involved in working with information which is at odds with an individual's experience. It is likely that the credibility of information about alcohol could also be studied using the approaches of Cohen and chose employed in this report. REFERENCES AMERICAN PSYCHIATRIC ASSOCIATION. Drug council seeks halt in drug abuse education. Psychiatric News, 1972, Dec. 20, 1. BECKER, H. S. Outsiders: studies i n the sociology o f deviance. New York: Free Press, 1963. BLUECROSS AND BLUESHIELD. Happy valley and the drug witch. Kansas City: Author, 1972. BLUM,R. H. Siudents and drugs. Vol. 11. San Francisco: Jossey-Bass, 1969. BRo~AN,R., & SUFFET,F. Illicit drug use: preventive education in the schools. Psychiatric Annals, 1973, 3, 48-69. COHEN,H. G. How do people think about food? an exploratory investigation. Unpublishrd Ph.D. thesis, Kansas State Univer., 1974. DELONE, R. H. The ups and downs of drug abuse education. Saturday Review, 1972, 55, 27-32. GLASSCOTE, R., SUSSEX,J., JAFFE, J., BALL,J., & BRILL,L. T h e treatment o f drug abure. Washington, D.C.: Joint Information Service, 1972. HALLECK, S. L. The great drug education hoax. T h e Progressive, July, 1970, 34, 30-33. HANNEMAN, G. H. Communicating drug-abuse information among college students. Public Opandon Quarterly, 1973, 37, 171-191. INGRAHAM,L. H. The Nam and rhe world; a description of heroin use by U. S. Army enlisted men serving in the Republic of South Vietnam. Psychiatry, in press. JESSOR, R., JESSOR, S. L., & FINNEY,J. A social psychology of marijuana use: longitudinal studies of high school and college youth. Journal o f Personality and Social P~ychology, 1973, 26, 1-15. KANDEL, D. Adolescent marijuana use: role of parents and peers. Science, 1973, 181, 1067-1070. NATIONAL INSTITUTE OF MENTAL HEALTH.Curious Alice. DHEW Publication No. (HSM) 72-9040, 1972. ( a ) NATIONAL INSTITUTE OF MENTAL HEALTH. The social seminar. DHEW Publication No. (HSM) 72-9134, 1972. ( b ) PlTTEL, S. M., CALEP, V., GRYLER,R. B., HILLES,L., HOPER,R., & KEMPNER,P. Develo mental factors in adolescent drug use. Jorrrnal o f the American Aclldemy of c h i & Psychiatry, 1971, 10, 640-660. SMART,R. G., & FEJER, D. Credibility of sources of drug information for high school students. Iournal o f Drug Issues, 1972, 2 , 8-18. STONE,L. A,, GUNN,R.. & L~NDEM, A. C. Multidimensional scale structures compared. Perceptual and Motor Skills, 1973, 36, 1308-1310. TENNANT, F. S., WEAVER, S. C., & L ~ I S C. , E. Outcomes of drug education: four case studies. Pediatrics, 1973, 52, 246-251.
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TRUET, J., CORNFIELD, J., 8: KANNEL,W . A multivariate analysis of the risk of coronary heart disease in Framingham. Joztrnul o f Chronic Diseases, 1967, 20, 511-524. U.S. D E P A R ~ E NOF T JUSTICE, BUREAUOP NARCOTICSAND DANGEROUSDRUGS. Kaiy's coloving book abolrt drugs and heallb. Washington, D. C.: U. S. Gov't Print. Off., 1970. VICTOR,H. R., GROSSMAN,J. C., 8: EISENMAN,R. Openness to experience and marijuana use in high school students. Journal o f Consulting and Clinical Psychology, 1973, 4 1 , 78-85. WAINER,H. A prediction for decision making in the U.S. Senate. Paper presented at the annual meeting of the Midwestern Psychological Association, Cleveland, May. 1972. WALD,P. M., & ABRAMS, A. Drug education. Staff pa r 2 In P. M. Wald & P. Hutt (Eds.), Dealing with drug abuse: a report to ~ o ; dFoundation. New York: Praeger, 1772. Pp. 123-172. WEAVER, S. C., 8r TENNANT. F. S.. JR. Effectiveness of drug education programs for secondary school students. American Journal o f Psychiatry, 1973, 130, 812-814.
tE
Accepted D e c e m b a 9, 1974.
