The sensitivity of 11 substance abuse scales from the MMPI to change in clinical status.

Evaluated the sensitivity of 11 scales (for the identification of individuals prone to substance abuse) from the Minnesota Multiphasic Personality Inventory (MMPI) to current substances abuse. 137 male substance abusers (aged 21–57 yrs) took the MMPI within 48 hrs of admission to a hospital and after 4 wks. Inpatient treatment and abstinence did not result in reliable increases in scores on any substance abuse scales. Therefore, these scales did not appear to be appropriate measures of change as a result of intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cholinesterase inhibition by derivatives of 2-amino-4,6-dimethylpyridine

Previous studies suggest that many transsexuals evidence an Axis I diagnosis according to the DSM-IV classification (e.g., psychoses, major affective disorder). The current study examined retrospectively the comorbidity between gender dysphoria and major psychopathology, evaluating the charts of 435 gender dysphoric individuals (318 male and 117 female). All had undergone an extensive evaluation, addressing such areas as hormonal/surgical treatment, and histories of substance abuse, mental illness, genital mutilation, and suicide attempts. In addition, a subgroup of 137 individuals completed the MMPI. Findings revealed over two thirds were undergoing hormone reassignment, suggesting a commitment to the real-life cross-gender process. One quarter had had problems with substance abuse prior to entering treatment, but less than 10% evidenced problems associated with mental illness, genital mutilation, or suicide attempts. Those completing the MMPI (93 female and 44 male) demonstrated profiles that were notably free of psychopathology (e.g., Axis I or Axis II criteria). The one scale where significant differences were observed was the Mf scale, and this held true only for the male-to-female group. Psychological profiles as measured by the MMPI were more "normal" in the desired sex than the anatomic sex. Results support the view that transsexualism is usually an isolated diagnosis and not part of any general psychopathological disorder.     

Self-report and observer measures of substance abuse among homeless mentally ill persons in the cross-section and over time

The comparability of self-report and observer measures of substance abuse among 118 homeless mentally ill persons was assessed using cross-sectional and longitudinal measures. Possible correlates of nondisclosure were identified from demographic variables and clinical indicators. Lifetime abuse reported at baseline was a sensitive predictor of subsequent abuse behavior in the project, but cross-sectional measures based only on self-report or observer ratings failed to identify many abusers. A total of 17% of the subjects never disclosed abuse that was observed during the project. The level of substance abuse is likely to be severely underestimated among homeless mentally ill persons when only one self-report measure is used at just one point in time. This problem can, however, largely be-overcome by incorporating information from observers and from multiple follow-ups or by focusing on lifetime rather than current abuse. We also conclude that underreporting may bias estimates of some correlates of substance abuse.     

Characteristics of families of children who refuse post-divorce visits

Compared to 88 non-refusers, 12 children who refused post-divorce visits with their noncustodial parents were significantly more likely to be female, to be the oldest child at home, to be in special education, and to have at least one parent with evidence of psychopathology, particularly substance abuse, violence toward spouse, suicidal behavior, or psychosis. Most children in both groups lived primarily with their mothers.     

Fantasy proneness and psychopathology.

In Study 1, we administered objective (MMPI) and projective (Rorschach) measures to high fantasy prone individuals (upper 4% of college population), medium fantasy prone individuals (middle range), and nonfantasizers (lowest 4%). Subjects who were fantasizers appeared to use fantasy for defensive or adaptive purposes compared with others and produced 8/9 modal code types on the MMPI. On the basis of the MMPI findings, a subset of fantasizers could be described as exhibiting a significant degree of psychopathology. In Study 2, a second sample of fantasy prone individuals could not be distinguished from comparison groups in contacts with professionals for help with psychological problems, use of psychotropic medication, or number of close friendships. Although fantasizers perceived themselves as less well adjusted than comparison subjects and reported greater difficulty in distinguishing fantasy from reality, most fantasizers rated their psychological functioning as adequate and above and did not differ from less fantasy prone subjects in ratings of positivity of self-concept. As demonstrated in Study 1, a subset of fantasizers did appear to be more pathological than other subjects were, with three fantasizers reporting a history of psychiatric hospitalizations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

In experimental diabetes the decrease in the eye of lens carnitine levels is an early important and selective event

The relationship between a history of substance use disorder and the early course of psychotic illness was examined in 96 subjects with schizophrenia and 106 subjects with affective psychosis followed in the Suffolk County Mental Health Project, a longitudinal study of first-admission psychosis. Subjects received a structured diagnostic interview and clinical ratings at baseline assessment and again 6 months later. The 6-month assessment included information about treatment received during the interval. A lifetime history of substance use disorder was associated with worse clinical functioning at 6 months for schizophrenia subjects, but not for those with affective psychosis. There were no significant associations of substance use disorder with type of treatment during the interval or with self-reported compliance with medication. Schizophrenia subjects were more likely than subjects with affective psychosis to report cannabis use during the interval and to meet criteria for cannabis use disorder.     

Psychopathology on the streets: Psychological assessment of the homeless.

Reported rates of mental illness and substance abuse in homeless populations vary widely and are frequently based on clinical impressions. Using structured interviews and objective measures of pathology, including the Minnesota Multiphasic Personality Inventory-168 (MMPI-168) and specified criterion of disorder, we surveyed demographics, psychopathology, and substance abuse in a homeless population. The population was relatively young, male, and White. Serious alcohol abuse was indicated in about a third of the cases, and serious street drug abuse in a quarter. Severe psychopathology as indicated by scores three standard deviations about the mean on the MMPI psychotic scales was found in a third of the cases. With overlap among categories of disorder considered, over 50% of the population met criterion for severe psychological disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevalence and severity of substance use disorders and onset of psychosis in first-admission psychotic patients

BACKGROUND: Past studies have found inconsistent evidence that substance use disorders are related to earlier onset of schizophrenia or more severe symptoms. This study examines prevalence and severity of current substance use disorders and onset of psychotic illness in a multi-facility sample. METHODS: Data are from the Suffolk County Mental Health Project, an epidemiological study of first admission psychosis. The SCID and instruments measuring symptomatology, personality and background characteristics were administered. Respondents were stratified into three groups: (a) no life-time substance diagnosis; (b) in remission or reporting current mild use at admission; and (c) current moderate-severe substance abuse at admission. RESULTS: Using the SCID severity rating, 17.4% of males and 6.2% of the females had moderate or severe current substance abuse, while 41.5% of males and 68.2% of females had no lifetime substance diagnosis. In almost all cases categorized as moderate-severe, the substance diagnosis predated onset of psychosis. Females categorized as moderate-severe have an earlier age of onset of psychosis than did females in the other groups. There were only slight differences in symptom severity among the groups but more marked antisocial behaviour in the moderate-severe group. Variables discriminating the moderate-severe from non-abuse groups were BPRS thought disturbance, adult anti-social behaviour and current cigarette smoking for males and adult anti-social behaviour and child-teen antisocial behaviour for females. CONCLUSIONS: Severity of substance abuse does not appear to be a pivotal correlate of the early features of psychotic illness.     

Two approaches to the measurement of adaptive style: comparison of normal, psychosomatically ill, and delinquent adolescents

OBJECTIVE: This project evaluated the discriminant validity of two self-report measures of adaptive styles. METHOD: The Weinberger Adjustment Inventory, which assesses distress, restraint, denial, and repressive defensiveness, and the Bond Defense Style Questionnaire, which assesses immature, neurotic, and mature defenses, were administered to 272 adolescents: normal comparison group boys (n = 63), normal comparison group girls (n = 68), girls with psychosomatic disorders (n = 75), and incarcerated delinquent boys (n = 66). Multivariate analyses of covariance, analyses of covariance, and discriminant analyses (with socioeconomic status and age as covariates) were conducted. RESULTS: Adaptive styles from the Defense Style Questionnaire differentiated the adolescent groups better than did the Weinberger Adjustment Inventory styles. CONCLUSION: Measurement of adaptive style by the Defense Style Questionnaire may be a useful adjunct to other measures of psychopathology and can assist in assessment of risk, treatment planning, and treatment progress.     

Self-reproducing system can behave as Maxwell''s demon: theoretical illustration under prebiotic conditions

Twenty three adolescents with a history of cancer, 27 physically abused adolescents, and 23 healthy, nonabused adolescents were administered structured posttraumatic stress disorder (PTSD) interviews and self-report questionnaires regarding family functioning. Thirty five percent of adolescent cancer subjects met criteria for lifetime PTSD as compared to only 7% of the abused adolescents: 17% of the cancer subjects and 11% of the abuse subjects met criteria for current PTSD. Adolescents with cancer viewed their mothers and fathers as significantly more caring and more protective than the comparison and abused adolescents. Cancer subjects who met criteria for lifetime PTSD saw their families as significantly more chaotic than those who did not have PTSD. Eighty three percent of cancer subjects who had lifetime PTSD also had mothers who had PTSD.     

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)     

Relationship of management of substance abusers to psychological and practice pattern characteristics of family physicians.

Surveyed 73 family physician alumni from a university/community-based residency program concerning management of substance abuse. This information was related to current practice patterns and to information about the psychological characteristics of the S. The psychological data were acquired during the 1st year of residency training. Findings suggest that family physicians tend to underdiagnose but frequently manage substance abusers. Physicians who are more likely to manage individuals with substance abuse problems include those engaged in solo practice and those who tend to be orderly, introspective, and less anxious and less guilt prone than others. They also tend to be more experientially oriented and less in need of affection, and they place less value on power and on religion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Successful high-dose chemotherapy combined with autologous bone marrow transplantation in a case of refractory follicular lymphoma

This study investigated the association between two demographic and two psychological variables and treatment retention for 65 perinatal substance abusers. Subjects who lived in the community while attending day treatment were 6.125 times more likely to drp out than subjects who lived in a program-operated shelter (p < .0001). An interaction was found for pregnancy status and antisocial personality disorder (p < .0478). Subjects who were both pregnant and antisocial were 4.876 times more likely to remain in treatment than those who were neither pregnant nor antisocial. Degree of "treatment resistance," measured by the MMPI Negative Treatment Indicators (TRT) Scale, did not predict dropout. These findings indicate that supportive housing can play an important role in preventing dropout for perinatal substance abusers. Additionally, pregnancy may present a "window" of opportunity for treating a hard to reach population, drug abusing women with comorbid ASP.     

Neuropsychological characteristics of three subgroups of Flemish delinquent adolescents.

Sixty-three adjudicated adolescents, aged 14-17 years, were followed for 2 years to examine the neuropsychological characteristics of subgroups of delinquents. Nonrecidivistic subjects (n=29) and late recidivistic subjects (n=22) differed from early recidivistic subjects (n=12) on intelligence, self-control functioning, and memory. Late recidivistic subjects, compared with not recidivistic subjects, showed a lower verbal IQ. The differences remained when controlling for the level of substance abuse. This study suggests that neuropsychological assessment may help in differentiating delinquent adolescents, although more research is needed to unravel the mediating influences of substance abuse and early neuropsychological and academic problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group treatment for substance abuse in schizophrenia

OBJECTIVES: A review of the relevant research suggests a need to develop an appropriate, effective, and replicable treatment to help individuals with schizophrenia and substance abuse problems. This pilot study describes a biweekly group specifically designed to help the individual with both schizophrenia and substance abuse. The components of the group were support, psychoeducation, and skills training. Attention was also paid to the stage of recovery. METHOD: Eighteen subjects attended the group and were assessed pregroup. Thirteen subjects completed a 1-year follow-up, and 5 subjects were assessed between 3 and 6 months. RESULTS: At the follow-up assessment, 8 subjects (44%) were abstinent. CONCLUSIONS: This type of treatment appears to be effective for reducing substance abuse in this population.     

Developments in the self-report assessment of personality and psychopathology in adults.

This article reports on current developments associated with the self-report assessment of personality and psychopathology in adults. Formats for assessment are reviewed, novel approaches to the collection of information concomitant with self-report are introduced, and the dimensionality of domains of personality and psychopathology is discussed. Some alternatives to self-report are offered and topics of questionnaire phrasing, response styles, and faking as ongoing issues for self-report measures are examined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An application of methods for clustered binary responses to a cardiovascular study with small sample size

Many clinicians have come to rely on the broad array of validity scales available on the MMPI and the MMPI-2. In this study, we evaluated the utility of 2 MMPI-2 validity scales, the K scale and VRIN scale, in a sample of 692 psychiatric inpatients. Specifically, the effects of the K-correction procedure and the exclusion of protocols based on VRIN scale elevations were examined on the relation between MMPI-2 basic clinical scales and external criteria including both self-report and clinician ratings of psychopathology. Results indicated that the K-correction procedure commonly used with the MMPI and MMPI-2 did not result in higher correlations with external criteria in comparison to non-K-corrected scores. In contrast, MMPI-2 protocols that produced VRIN T-score values > or = 80 generally produced lower correlations with patients self-reports and clinician ratings of psychopathology in comparison to protocols judged to be valid based on VRIN scale results.     

Utility of the MMPI–2-RF (Restructured Form) validity scales in detecting malingering in a criminal forensic setting: A known-groups design.

The current study examined the utility of the recently released Minnesota Multiphasic Personality Inventory–2 Restructured Form (MMPI–2-RF; Ben-Porath & Tellegen, 2008) validity scales to detect feigned psychopathology in a criminal forensic setting. We used a known-groups design with the Structured Interview of Reported Symptoms (SIRS; Rogers, Bagby, & Dickens, 1992) as the external criterion to determine groups of probable malingering versus nonmalingering. A final sample of 125 criminal defendants, who were administered both the SIRS and the MMPI–2-RF during their evaluations, was examined. The results indicated that the two MMPI–2-RF validity scales specifically designed to detect overreported psychopathology, F-r and FP-r, best differentiated between the malingering and nonmalingering groups. These scales added incremental predictive utility to one another in this differentiation. Classification accuracy statistics substantiated the recommended cut scores in the MMPI–2-RF manual (Ben-Porath & Tellegen, 2008) in this forensic setting. Implications for these results in terms of forensic assessment and detection of malingering are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sources of diagnostic uncertainty for chronically psychotic cocaine abusers

OBJECTIVE: This study determined the sources and frequency of diagnostic uncertainty for patients with chronic psychosis and active cocaine abuse or dependence and assessed the usefulness of prospective follow-up in clarifying diagnosis. METHODS: A total of 165 male patients with chronic psychoses and cocaine abuse or dependence on inpatient units of a Veterans Affairs medical center were evaluated using the Structured Clinical Interview for DSM-III-R (SCID-R), urine tests, hospital records, and interviews with collateral sources. An algorithm allowing key SCID-R items and diagnostic criteria to be designated as provisionally met or uncertain was applied, resulting in a provisional diagnosis and a list of alternate diagnoses. The assessment was repeated 18 months later in an attempt to resolve diagnostic uncertainty. RESULTS: In 30 cases (18 percent), initial assessment produced a definitive diagnosis, including 21 cases of schizophrenia, six of schizoaffective disorder, and three of psychostimulant-induced psychotic disorder. In the other 135 cases, a definitive diagnosis could not be reached because of one or more sources of diagnostic uncertainty, including insufficient periods of abstinence (78 percent), poor memory (24 percent), and inconsistent reporting (20 percent). Reassessment at 18 months led to definitive diagnoses in 12 additional cases. CONCLUSIONS: It was frequently difficult to distinguish schizophrenia from chronic substance-induced psychoses. Rather than concluding prematurely that psychotic symptoms are, or are not, substance induced, clinicians should initiate treatment of both psychosis and the substance use disorder in uncertain cases. The persistence or resolution of psychosis during abstinence and additional history from the stabilized patient or collateral sources may clarify the diagnosis.     

Ethnicity and MMPI performance: A review.

Minnesota Multiphasic Personality Inventory (MMPI) performance as a function of ethnic group membership was reviewed in Asian Americans, Blacks, Hispanics, and Native Americans. There did not appear to be a simple relation between ethnic group membership and MMPI performance, either within or between such populations as normal individuals, psychiatric patients, prisoners, or substance abuse patients. Moderator variables, such as social class, education, and type of setting, seem to play an important role in determining the specific pattern of scores that are found. There is a paucity of studies that have investigated whether there are any empirical correlates of the obtained differences when two ethnic groups are compared on the MMPI, that is, investigations of the external validity of the MMPI in various ethnic groups. It seems premature to conclude that new norms for the MMPI are needed for specific ethnic groups without additional research that examines the issues raised in this review. (PsycINFO Database Record (c) 2010 APA, all rights reserved)