Normal and psychopathological personality characteristics of individuals in alcohol rehabilitation.

Relations between normal and psychopathological personality characteristics were investigated in 72 inpatient male alcoholics, who were administered the Personal Styles Inventory (PSI) and the Minnesota Multiphasic Personality Inventory (MMPI). Results support the PSI circumplex model for normal personality traits. All PSI scales correlated significantly with one or more MMPI scales, including the basic MMPI orthogonal factors Anxiety (r?=?.55) and Repression (r?=?-.47), showing a relation between normal and pathological personality attributes. The mean MMPI profiles for subjects categorized by normal (PSI) personality traits corresponded significantly to basic MMPI profile types identified in previous research. Implications for counseling alcoholics and developing treatment programs using information from a broader based personality assessment approach are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The comorbidity of alcoholism and personality disorders in a clinical population: Prevalence and relation to alcohol typology variables.

This study assessed prevalence rates and overlap among Diagnostic and Statistical Manual of Mental Disorders ( 3rd ed., revised; DSM-III—R; American Psychiatric Association, 1987) personality disorders in a multisite sample of 366 substance abusers in treatment. In addition, the relation of antisocial personality disorder (APD), borderline personality disorder (BPD), and paranoid personality disorder (PPD) to alcohol typology variables was examined. Structured diagnostic interviews and other measures were administered to participants at least 14 days after entry into treatment. Results indicated high prevalence rates for APD and non-APD disorders. There was extensive overlap between Axis I disorders and personality disorders, and among personality disorders themselves. APD, BPD, and PPD were linked to more severe symptomatology of alcoholism and other clinical problems. However, only APD and BPD satisfied subtyping criteria, after controlling for other comorbidity. Implications for classifying alcoholics by comorbid disorders are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparing borderline definitions: DSM-III borderline and schizotypal personality disorders.

Compared the two types of borderline disorder formally defined by Diagnostic and Statistical Manual of Mental Disorders (DSM-III), borderline personality disorder and schizotypal personality disorder (SPD), at the diagnostic category and individual criterion level. Unlike previous research in this area, which had focused on inpatient and outpatient populations, the sample was a psychometrically defined, nonpatient sample including Ss meeting DSM-III criteria for each disorder. The results indicated that the two diagnostic categories each define a type of borderline with distinctive combinations of features. Perceptual and cognitive distortion, however, seem to be present in both and define an area of overlap between the two disorders. The implications of these findings for the revision of the SPD diagnostic criteria in DSM-III are discussed, and the theoretical separation of two subtypes of borderline personality is affirmed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The addictive personality is the behavior of the addict.

Research on the relation between personality and the etiology of alcohol and drug abuse has revealed a single consistent finding: a correlation between antisocial behavior in childhood and adolescence and alcoholism in adulthood. It is antisocial behavior, however, and not antisocial personality, that most observers identify as a precursor of alcoholism. Unfortunately, the high rates of antisocial behavior in our society render it an inefficient predictor of alcohol and drug abuse. Research on the link between personality and the course of alcohol and drug abuse has suggested that substantial numbers of abusers meet Diagnostic and Statistical Manual of Mental Disorders criteria for antisocial personality disorder and that depression also frequently accompanies alcohol and drug dependence. No personality factors and no other behaviors have reliably differentiated abusers from others: Antisocial behavior and depression are behaviors that are symptomatic, respectively, of disregard for society's rules and of clinical dysphoria. Moreover, the depressed behavior of alcoholics appears largely to be consequent rather than antecedent to their alcoholism. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ability of alcoholics to escape detection by the MMPI.

The ability of two groups of respondents to dissimulate successfully on special alcohol scales and validity measures of the Minnesota Multiphasic Personality Inventory (MMPI) was evaluated. Forty White male alcohol-dependent inpatients and 40 matched nonalcoholic general medical patients each completed the MMPI twice: once under instructions to answer honestly and once under dissimulation instructions. Results showed that, under honest conditions, any of six special alcohol scales had a hit rate of about 80%. In the dissimulation condition, both alcoholic and medical patients were capable of producing significantly more benign profiles on both the general clinical and the special alcohol scales. However, the Positive Malingering (Mp) and Social Desirability (Sd) dissimulation scales were able to detect approximately 80% of the deceptive profiles, whereas others were somewhat less accurate. When the best dissimulation scale (Mp) and the best special alcohol scale (MacAndrew; MAC) were used in this study, only 3 of 40 dissimulating alcoholics were not identified as either alcoholics or dissimulators. Implications for use of the MMPI as an instrument for alcoholism screening are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical study of the relation of borderline personality disorder to Briquet's syndrome (hysteria), somatization disorder, antisocial personality disorder, and substance abuse disorders

OBJECTIVE: The criteria for borderline personality disorder seem to select patients with very high rates of Briquet's syndrome (hysteria), somatization disorder, antisocial personality disorder, and substance abuse disorders. This study was undertaken to determine whether systematic assessment of patients with borderline personality disorder would reveal characteristic features of that condition which would distinguish it from these other disorders. METHOD: Eighty-seven white female patients (75 in St. Louis and 12 in Milan, Italy) who had borderline personality disorder according to both the DSM-III-R criteria and the Revised Diagnostic Interview for Borderlines were further examined with the DSM-III-R Checklist and the Perley-Guze Hysteria Checklist to determine their patterns of psychiatric comorbidity. RESULTS: Every patient had at least one additional DSM diagnosis. Patients in St. Louis and Milan averaged five and four additional diagnoses, respectively. Eighty-four percent of the patients in St. Louis met criteria for either somatization disorder, Briquet's syndrome, antisocial personality disorder, or substance abuse disorders. Patterns of comorbidity for panic (51%), generalized anxiety disorder (55%), and major depression (87%) in St. Louis were consistent with those in other studies. CONCLUSIONS: The data indicate that the boundaries for the borderline condition are not specific and identify a high percentage of patients with these other disorders. Furthermore, the comorbidity profiles closely resemble the psychiatric profiles of patients with these disorders. If the borderline syndrome is meant to include all of these disorders, its usefulness as a diagnosis is limited. Until the fundamental features of borderline personality disorder that distinguish it from the others are identified, it is recommended that clinicians carefully assess patients for these other diagnoses. Efforts should be made to change the borderline personality disorder criteria by shifting away from overlap with the criteria for the other disorders.     

Axis I comorbidity of borderline personality disorder

OBJECTIVE: The purpose of this study was to assess the lifetime rates of occurrence of a full range of DSM-III-R axis I disorders in a group of patients with criteria-defined borderline personality disorder and comparison subjects with other personality disorders. METHOD: The axis I comorbidity of 504 inpatients with personality disorders was assessed by interviewers who were blind to clinical diagnosis and who used a semistructured research interview of demonstrated reliability. RESULTS: Four new findings emerged from this study. First, anxiety disorders were found to be almost as common among borderline patients (N=379) as mood disorders but far more discriminating from axis II comparison subjects (N=125). Second, posttraumatic stress disorder (PTSD) was found to be a common but not universal comorbid disorder among borderline patients, a finding inconsistent with the view that borderline personality disorder is actually a form of chronic PTSD. Third, male and female borderline patients were found to differ in the type of disorder of impulse in which they "specialized." More specifically, substance use disorders were significantly more common among male borderline patients, while eating disorders were significantly more common among female borderline patients. Fourth, a lifetime pattern of complex comorbidity (i.e., met DSM-III-R criteria for both a disorder of affect and a disorder of impulse at some point before the patients' index admission) was found to have strong positive predictive power for the borderline diagnosis as well as a high degree of sensitivity and specificity. CONCLUSIONS: These results suggest that the lifetime pattern of axis I comorbidity characteristic of borderline patients and distinguishing for the disorder is a particularly good marker for borderline personality disorder.     

MMPI scores of counselors on alcoholism prior to and after training.

Compared the MMPI scores of male alcoholism counselors before and after a 9-mo counselor training program. All Ss were recovered alcoholics or drug addicts. Few significant standard score differences were found, although raw score data reveal considerable shifting in individual scores. Additional data indicate that MMPI Pd and Ma scores measure rather enduring traits of addictive personalities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Safety and tolerability of intravenous cibenzoline for acute termination of spontaneous sustained ventricular tachycardia. Cibenzoline and spontaneous VT

OBJECTIVE: To examine the rate of persistence of borderline personality disorder (BPD), the existence of concomitant personality disorders on follow-up, and the predictors of outcome in patients who met criteria for BPD compared with patients with borderline features who failed to meet all of the criteria. METHOD: This prospective cohort study reassessed subjects for BPD diagnosis and cooccurring personality pathology at 7 years follow-up. Initial measures of borderline and comorbid personality psychopathology were used to predict levels of borderline or other personality disorder psychopathology at follow-up. RESULTS: Of the 57 subjects who initially met the criteria for BPD, 30 (52.6%) were found to have remitted BPD, and 27 (47.4%) were characterized as having persistent BPD. The remitted group met significantly fewer comorbid personality disorder diagnoses than the persistent group (mean = 0.8, mean = 3.5 respectively; P < 0.05). Results also indicated that the initial level of borderline psychopathology was predictive of borderline psychopathology at follow-up, which explained 17% of the variance. CONCLUSIONS: This prospective follow-up study found that almost 50% of former inpatients with BPD continue to test positive for BPD at 7 years follow-up, and these persistent BPD patients also had significantly more comorbid personality psychopathology. Borderline psychopathology at follow-up was primarily predicted by the level of borderline psychopathology recorded at the initial assessment.     

Development of an institutionalized chronic alcoholic scale.

Numerous scales have been formed from the MMPI that purport to be measures of alcoholism. Research has shown, however, that none of the scales adequately differentiates alcoholics from neurotics. C. MacAndrew's (1965) scale, which was constructed for this purpose, has also been shown to be an inadequate measure. The present study describes the development of the Institutionalized Chronic Alcoholic Scale (ICAS) by means of item analysis. Ss were 70 alcoholic (mean age 42 yrs) and 70 neurotic (mean age 41.3 yrs) inpatients at a VA hospital. The scale correctly identified 85.71% of the alcoholics and 84.29% of the neurotics. Cross-validation showed that the ICAS was able to identify 85% of the alcoholics and 87.5% of the neurotics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of familial risk, personality, and expectancies on alcohol use and abuse.

This study tested a structural model of the association between familial risk, personality risk, alcohol expectancies, and alcohol abuse in a sample of 224 young adult offspring of alcoholics and 209 offspring of nonalcoholics. The results provided support for 2 personality-risk pathways, a social deviance proneness and an excitement/pleasure seeking path, that accounted for a significant portion of the association between a familial alcoholism and alcohol abuse. The path from familial alcoholism to social deviance proneness lead directly to alcohol problems. The path from familial alcoholism to excitement/ pleasure seeking was associated with increased drinking, which, in turn, was associated with alcohol problems. Positive alcohol expectancies accounted for part of the association between excitement seeking and alcohol use. The results suggest 2 different biopsychosocial mechanisms that elevate risk for abuse in the offspring of alcoholics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Empirical correlates of the Overcontrolled-Hostility scale and the MMPI 4-3 high-point pair.

Compared the behavioral correlates of the MMPI 4-3 high-point pair of the Overcontrolled-Hostility (O-H) scale in a sample of university psychology clinic outpatients: 18 4-3 patients, 29 O-H patients, and 50 controls. Ss were assigned to the 4-3 condition if they met the following criteria: (a) Scales 3 (Hysteria) and 4 (Psychopathic Deviate)?≥?T score of 65; (b) Scale 4 (Psychopathic Deviate)?>?Scale 3 (Hysteria)?≥?all other clinical scales. Ss with T scores of 65 or higher on the O-H scale were placed in the O-H condition. Findings indicate that the behavioral correlates of these 2 groups of Ss were more similar to each other than they were to the controls. Although the 4-3 high-point pair and O-H scale appeared to be measuring the same general personality pattern, marked by rigid denial and overcontrolled hostility, important differences are noted. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Serotonin transporter gene variants in alcohol-dependent subjects with dissocial personality disorder

BACKGROUND: We tested the hypothesis that a functional biallelic repetitive element in the 5' regulatory region of the human serotonin transporter gene (SLC6A4) confers susceptibility to serotonin-related personality traits underlying alcohol dependence with dissocial behavior. METHODS: The association study was focused on 64 alcohol-dependent subjects with a dissocial personality disorder (according to ICD-10) who were derived from 315 German alcohol-dependent subjects. The Tridimensional Personality Questionnaire (TPQ) was applied to assess personality dimensions in 101 alcohol-dependent men, including 39 dissocial alcoholics. RESULTS: Our association analyses revealed a trend towards a higher frequency of the short (S) allele of the SLC6A4 polymorphism in dissocial alcoholics compared to 216 German controls (chi 2 = 2.81, df = 1, p = 0.094). Dissocial alcoholics carrying the S/S genotype exhibited significant lower scores of harm avoidance compared to those lacking it (U-test, p = 0.015). Significantly higher novelty seeking scores were obtained in dissocial alcoholics carrying the S allele relative to those lacking it (U-test, p = 0.021). CONCLUSIONS: Our tentative association findings in dissocial alcoholics suggest that the S allele of the 5' regulatory SLC6A4 polymorphism confers susceptibility to a temperamental profile of high novelty seeking and low harm avoidance that has been postulated to underlie dissocial (type-2) alcoholism according to Cloninger's neurogenetic theory of personality.     

A contrast of the three more common illnesses with the ten less common in a study and 18-month follow-up of 314 psychiatric emergency room patients. II. Characteristics of patients with the three more common illnesses

The three more common illnesses diagnosed in the sample of 314 emergency room patients were (in order of frequency) affective disorder (N = 135), alcoholism (N = 112), and antisocial personality (N = 57). This study describes the occurrence and frequency of affective disorders and evaluates the relative usefulness of three separate sets of diagnostic criteria for the depressive phase of the illness, which are considered in three self-evident, mutually exclusive groups, the definition of which depends on chronology of onset in relation to other diagnoses. Findings show a 3:2 ratio of primary affective disorder to secondary affective disorder. The 112 diagnoses of alcoholism were based on defined criteria that separated "definite" (N = 102) from probable (N = 10) alcoholism. A high incidence of secondary affective disorder (38%) in patients with a first diagnosis of alcoholism is noted. The third most common diagnosis, antisocial personality, was based on defined criteria requiring a specified number of manifestations both before and after age 15 years. Only 11% of the antisocial personality patients received a single diagnosis of antisocial personality. An additional diagnosis of alcoholism occurred in 61%. Besides antisocial symptoms, the 57 patients reported 74 different nonantisocial symptoms, supporting the conclusion that antisocial personality patients may be as susceptible to neurotic and psychotic symptoms as other patients.     

Personality disorder correspondence among the MMPI, MBHI, and MCMI

MMPI, MBHI, and MCMI personality disorder scales were analyzed for convergent and discriminant validity. Friedman's ANOVA indicated that there were no significant differences among the sample's averaged scale scores. Further analyses of these data, however, demonstrated that the Millon instruments classified significantly more of the sample as personality disordered when compared to Morey's MMPI personality disorder scales. In addition, codetype correspondence among the three instruments was only 4 to 6%. When the instruments were analyzed in a pair-wise fashion, codetype correspondence increased to approximately 10 to 20%. These data indicate that these personality disorder scales do not demonstrate construct equivalence, particularly at the level of the individual profile.     

MMPI characteristics of alcoholics: A review.

Empirical research concerning the usefulness of the Minnesota Multiphasic Personality Inventory (MMPI) in the identification of personality characteristics of alcoholics is reviewed. Scales, profile configurations, and item analyses are discussed. No single personality type is characteristic of all alcoholics. Although six cluster types occur with consistency, none of these types is unique to alcoholics. A focus on individual differences in future research and treatment planning is suggested. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Individual hemisphericity and maladaptive behaviors.

Individual hemisphericity of 13 nonparanoid schizophrenics, 12 depressives, 20 manic-depressives, 5 schizo-affectives, 25 alcoholics, and 25 Ss with personality disorders (antisocial type) was compared by utilizing the conjugate lateral eye-movement index. In the population of 100 right-handed males, 45% were found with right hemisphericity, 41% with bilaterality, and 14% with left hemisphericity. Right hemisphericity was found associated with nonparanoid schizophrenia, depression, and alcoholism; bilaterality was found to be related to manic-depression, schizo-affective disorder, and antisocial personality. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of the MMPI and the Mini-Mult with alcoholics.

Used both standard profiles and Mini-Mult grids to score the Minnesota Multiphasic Personality Inventory (MMPI) results of male inpatient alcoholics. Data on the number of instances in which the Mini-Mult accurately predicted the validity, high points, and elevated scales of its paired MMPI profile are presented. Results suggest caution in using the Mini-Mult in a given setting without local cross-validation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of the MMPI and the MMPI-2 for a sample of peace officers.

166 peace officers completed the MMPI and the MMPI-2 in one sitting. Results showed an overall concordance of 78% for the 2 tests when normal, high-point, and 2-point code types were grouped together and compared. A subset of well-defined profiles produced a concordance rate of 90%. Comparison of profile characteristics showed that half of the Ss produced the same high-point code type, one-third produced the same 2-point code type, 70% produced normal profiles on both tests, and all MMPI and MMPI-2 scales were highly correlated. These figures are highly similar to those found previously for 2 administrations of the MMPI. When the MMPI was compared to the MMPI-2 scored on original norms, 2 scales were found to differ significantly: Men and women both scored lower on Scale D (Depression) of the revised test; on Scale Mf (Masculinity-Femininity) of the MMPI-2, women scored higher and men scored lower. (PsycINFO Database Record (c) 2010 APA, all rights reserved)