Reducing socially desirable responses in epidemiologic surveys: An extension of the Randomized-Response Technique. Epidemiology, 21, 379-382

Institute of Experimental Psychology, University of Duesseldorf, Duesseldorf, Germany.
Epidemiology (Cambridge, Mass.) (Impact Factor: 6.2). 05/2010; 21(3):379-82. DOI: 10.1097/EDE.0b013e3181d61dbc
Source: PubMed


Even though the validity of self-reports of sensitive behaviors is threatened by social desirability bias, interviews and questionnaires are widely used in epidemiologic surveys on these topics.
In the randomized-response technique, a randomization device is used to determine whether participants are asked to respond truthfully or whether they are prompted to provide a prespecified response. In this study, the randomized-response technique was extended by using a cheating-detection modification to obtain more valid data. The survey was on the dental hygiene habits of Chinese college students.
Whereas only 35% of men and 10% of women admitted to insufficient dental hygiene when questioned directly, 51% of men and 20% of women attested to this socially undesirable behavior in a randomized-response survey.
Given the considerable discrepancy between the results obtained by direct questioning and by using the randomized-response technique, we propose that this technique be considered for use in epidemiologic studies of sensitive behaviors.

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Available from: Morten Moshagen, Jan 15, 2014
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    • "A recent study using the Randomized Response Technique (RRT) shows prevalence rates of even 20% for the use of prescription and illicit drugs among university students for CE [33]. Studies using RRT guarantee an especially high degree of privacy, anonymity, and confidentiality when a person is prompted to answer sensitive questions about socially undesirable or illicit behavior [34-38]. "
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    ABSTRACT: Background Surgeons are usually exposed to high workloads leading to fatigue and stress. This not only increases the likelihood of mistakes during surgery but also puts pressure on surgeons to use drugs to counteract fatigue, distress, concentration deficits, burnout or symptoms of depression. The prevalence of surgeons taking pharmacological cognitive enhancement (CE) or mood enhancement (ME) drugs has not been systematically assessed so far. Methods Surgeons who attended five international conferences in 2011 were surveyed with an anonymous self-report questionnaire (AQ) regarding the use of prescription or illicit drugs for CE and ME and factors associated with their use. The Randomized Response Technique (RRT) was used in addition. The RRT guarantees a high degree of anonymity and confidentiality when a person is asked about stigmatizing issues, such as drug abuse. Results A total of 3,306 questionnaires were distributed and 1,145 entered statistical analysis (response rate: 36.4%). According to the AQ, 8.9% of all surveyed surgeons confessed to having used a prescription or illicit drug exclusively for CE at least once during lifetime. As one would expect, the prevalence rate assessed by RRT was approximately 2.5-fold higher than that of the AQ (19.9%; 95% confidence interval (CI), 15.9% to 23.9%, N = 1,105). An even larger discrepancy between the RRT and AQ was observed for the use of antidepressants with a 6-fold higher prevalence (15.1%; 95% CI, 11.3% to 19.0%, N = 1,099) as compared to 2.4% with the AQ. Finally, logistic regression analysis revealed that pressure to perform at work (odds ratio (OR): 1.290; 95% CI, 1.000 to 1.666; P = 0.05) or in private life (OR: 1.266; 95% CI, 1.038 to 1.543; P = 0.02), and gross income (OR: 1.337; 95% CI, 1.091 to 1.640; P = 0.005), were positively associated with the use of drugs for CE or ME. Conclusions The use of illicit and prescription drugs for CE or ME is an underestimated phenomenon among surgeons which is generally attributable to high workload, perceived workload, and private stress. Such intake of drugs is associated with attempts to counteract fatigue and loss of concentration. However, drug use for CE may lead to addiction and to overestimation of one’s own capabilities, which can put patients at risk. Coping strategies should be taught during medical education.
    Full-text · Article · Apr 2013 · BMC Medicine
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    • "Finally, the present study relied on self-reports so the validity of the responses cannot be guaranteed (Tourangeau and Yan, 2007; Moshagen et al., 2010). The effects of these concerns were held to a minimum in the present investigation through assurances of confidentiality and anonymity. "
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    ABSTRACT: Aims: To investigate the relationship between alcohol expectancies and alcohol use in a community sample as a function of age and gender. Methods: The study is based on a national probability sample of 6467 German adults. Respondents were grouped into five age groups ranging from 18 to 59 years. A brief version of the Comprehensive Alcohol Expectancy Questionnaire was used to assess alcohol expectancies. Alcohol use was assessed by the number of drinking days during the past month and the number of drinks on an average drinking day. Results: Prior to conducting group comparisons, measurement invariance across age and gender was established. Latent mean level comparisons showed that the endorsement of both positive and negative expectancies almost linearly decreased with increasing age. However, this decrease was not reflected in alcohol consumption patterns. Structural analysis of the expectancy factors and drinking variables showed that the predictive power of expectancies varied by age and gender. Particularly, expectancies related to social assertiveness and sexual enhancement were strong predictors only in younger, but not in older respondents. Conversely, expectancies related to tension reduction and impairment were the most important predictors of drinking in respondents older than 30 years, but not in younger age groups. Additionally, the onset and course of age-related changes in expectancies was moderated by gender. Conclusions: The present study demonstrates substantial age-related changes in the relationship between alcohol expectancies and alcohol use. Moreover, the profile of alcohol expectancies appears to be more important than their absolute strength.
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