Which came first: the readiness or the change? Longitudinal relationships between readiness to change and drinking among college drinkers

Aims Although readiness to change (RTC) is cited as a key mechanism underlying drinking behavior change, empirical evidence supporting RTC as a predictor of college drinking has been mixed. Considering methodological limitations of previous studies, the current aim was to conduct a more comprehensive test of longitudinal relationships between readiness to change and college drinking. Design In this correlational, longitudinal study, we used a series of cross-lagged path analyses to test associations between RTC and college drinking outcomes over a 2-year period. Setting Data collection was conducted via online surveys on a university campus in the US Pacific Northwest. Participants Participants (n = 818; 58% women) were college students who reported at least one heavy-drinking episode in the past month and participated in a randomized controlled trial of personalized normative feedback interventions. Measurements Drinking quantity-frequency items and the Rutgers Alcohol Problem Index assessed drinking outcomes. The Readiness to Change Questionnaire assessed RTC. Findings For drinking-related problems, the best-fitting model included cross-lagged paths between RTC and subsequent drinking-related problems. For drinking quantity-frequency, best-fitting models also included the cross-lagged paths between drinking quantity-frequency and subsequent RTC. Higher RTC almost uniformly predicted higher subsequent levels of drinking and greater experience of drinking-related problems, and drinking quantity-frequency variables were primarily positive predictors of subsequent RTC. Conclusions Contrary to previous assumptions, 'the Readiness to Change Questionnaire' does not appear to be predictive of lower levels of subsequent drinking.