Matching treatment to alcoholism subtypes.

In the field of alcoholism treatment, as in mental health treatment more generally, no one treatment model is equally effective for all patients and problem types. Literature in both alcohol treatment and in psychotherapy research suggests some relationships in common between treatment efficacy and patient coping style, drinking patterns, and family dynamics. This literature suggests that "internalizing" alcoholics, whose drinking tends to be steady and to be functionally interwoven with family dynamics, will benefit more from family systems oriented treatments than from symptom- or individually focused treatments. Conversely, "externalizing" alcoholics may derive more benefit from symptom-focused cognitive and behavioral treatments than from family systems treatment. An ongoing research project designed to test these hypotheses and the development of treatment manuals that may increase differential treatment efficacy is described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Failure of MMPI scales to predict treatment completion

Four previously reported scales of the Minnesota Multiphasic Personality Inventory (Admission, Control, Denial and Dependence) which distinguished between alcoholics who completed or withdrew from hospital treatment were reassessed. None of the measures differentiated completers from drop-outs.     

Predicting successful completion of an aftercare program following treatment for alcoholism: The role of dispositional optimism.

In this study we investigated several variables as potential predictors of success in completing a transition program after treatment for alcoholism. Subjects were 54 men who had completed a 30-day treatment program and who were subsequently admitted to a 90-day inpatient aftercare program. The outcome measure was successful completion of this latter program. Predictor variables were dispositional optimism, hassles, uplifts, and several demographic variables. Optimism was positively associated with successful outcome. The simple association between uplifts and outcome also approached significance, but in the opposite to expected direction. Discriminant analyses used both of these variables, as well as age and education level, as predictors of successful outcome. There was no evidence of a role for hassles. Discussion centers on the importance of dispositional optimism as a predictor of successful adaptation in a variety of behavioral domains. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of motivational interviewing on participation and outcome in residential alcoholism treatment.

Tested motivational interviewing (a strategy to increase motivation for change) as a preparation for residential alcoholism treatment. 28 consecutive alcoholism admissions to a psychiatric hospital were assigned alternately to receive or not to receive a 2-session motivational assessment and interview shortly after intake, in addition to standard evaluation and treatment procedures. Patients who received the motivational interview participated more fully in treatment (as evidenced by therapist ratings) and showed significantly lower alcohol consumption at a 3-mo follow-up interview. The beneficial effects of motivational interviewing on outcome were mediated by increased participation in treatment. The extent to which the received treatment outcome conformed to patients' pretreatment expectations was predictive of outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of professional journals in internship alcoholism treatment training.

Examined 137 psychology internship supervisors' ratings of the clinical utility of 24 professional journals in alcoholism treatment training (ATT). The highest rated journal was Journal of Studies on Alcohol and Addictive Behaviors. Ss also listed texts and readings used in their ATT program. Ss seemed to draw their materials relevant to ATT from a diverse group of journal and text outlets. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

MMPI profiles of opiate addicts: predicting response to treatment

Although many studies document the use of the MMPI to classify opiate users, the predictive validity of the resulting subgroups is rarely reported. In this study, we used cluster analysis to identify MMPI profile types that predicted differential response to methadone maintenance treatment. Participants (N = 151) completed MMPIs shortly after entry into treatment. Cluster analysis of MMPI scores produced four distinct subgroups that differed significantly in severity of psychosocial problems measured at admission and on the mean number of drug-free urine specimens submitted during the 24-week study period. Cluster 1 participants evidenced low levels of psychological disturbance, improved their urinalysis results over time, and submitted the most posttest drug-free urine specimens. Cluster 2 was the only other group that improved significantly over time, even though these patients were the most psychologically disturbed. The results suggest the relation between psychological problems and outcome may be more complex than is commonly assumed.     

An assessment of comorbid psychological problems in a residential criminal justice drug treatment program.

161 probationers remanded to 4 mo of mandatory treatment at a criminal justice substance abuse treatment facility were assessed for evidence of psychopathology by means of the Millon Clinical Multiaxial Inventory-II and other psychosocial functioning scales. Overall, 80% of the sample was classified as having psychological problems, 72% had significant drug abuse problems, and 58% had concurrent psychopathology and drug abuse problems (i.e., comorbidity). Comparisons between psychopathology-only, drug problem-only, and comorbid groups indicated that probationers with both drug use and psychological problems engaged in more preadmission illegal activity, had more social impairments, and indicated higher motivation for treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Locus of control and patient attrition from an alcoholism treatment program.

Investigated the relationship of male alcoholics' locus of control scores to dropping out of treatment at various stages. No differences were found among Ss who left at 2 wks, dropped out between 2 wks and 60 days, or completed the 60 dys, or among patients who completed or left the 1-yr aftercare program in total, personal, sociopolitical control scores. Ss who dropped out of aftercare had significantly lower total and personal control scores, and a significantly greater change in personal control in the internal direction, at the end of the intensive treatment than those who completed the aftercare, contrary to prediction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Use of the MMPI with student nurses.

The group form of the MMPI was administered to 81 freshmen student nurses, and a matched group of 50 freshmen college women. The data were compared with norms published by Weisgerber (see 29: 967) and Beaver (see 29: 1484). Despite some differences, it is concluded that the Iowa nurses accord with Weisgerber's norms. Although a significant difference between nurses and non-nurses is found on Beaver's scale (comprising 65 MMPI items) however, only 13 items significantly differentiate between the groups, and 27 produce characteristic answers opposite to the ones cited by Beaver. "It is concluded that… (Beaver's)… scale needs considerably more study and validation before it could possibly be used… ." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Utilizing expectancies in alcoholism treatment.

35 veterans who participated in an assertion training program as part of their treatment for alcoholism completed the Alcohol Expectancy Questionnaire (AEQ; [S. A. Brown et al; see PA, Vol 65:1217]) and self-evaluations of social competence. The participants were rated on social interaction skills by an independent observer during their initial and final training sessions. Analyses indicated significant relations between the Social and Physical Pleasure scale of the AEQ and improvement in Ss' social competence. Findings provide modest support for the utility of incorporating alcohol expectancies in treatment allocation decisions and suggest that targeting certain expectancies may optimize treatment effect. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Combined MMPI and demographic data in predicting length of neuropsychiatric hospital stay.

Data available on 316 psychiatric patients, soon after admission to a hospital, were used in a multiple regression formula and in less formal statistical techniques to predict length of stay. Demographic and MMPI predictors made possible early identification of long stay patients at greater than base rate frequency. The asymptote of prediction was reached when 6 of 24 variables had been included, suggesting that further search in the area would be redundant. Prediction with the 5 prediction schema was stable on a cross-validation sample of 352. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Theoretical and practical foundations of an inpatient post-traumatic stress disorder and alcoholism treatment program.

Describes the structure and process of an inpatient program for the treatment of posttraumatic stress disorder (PTSD) and alcoholism. The therapeutic community setting uses lifespan developmental and social learning models to provide patients with (1) a framework for understanding what has happened to them, (2) tools for more effective coping, (3) an arena to experience the discomfort of previous coping mechanisms, and (4) the anxiety/pleasure of creating and practicing a new and more effective repertoire of skills. The program is divided into 3 phases. Phase 1 focuses on solidifying motivation for change through assessment, education, and interpersonal work. Phase 2 represents the action stage, and incorporates exposure-based therapy in a developmental framework to address trauma issues. Phase 3 emphasizes maintenance and generalization of patients' learning via modified relapse prevention training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of HIV-positive and HIV-negative crack users enrolled in a residential addiction treatment program

This study compared 96 HIV-Positive (HIV+) and 357 HIV-Negative (HIV-) crack users who were participating in the same drug-free, residential treatment program. Comparisons were made on sociodemographic, health, criminal justice, psychosocial, and recovery motivation variables. As predicted, the HIV(+) participants were more apt than the HIV(-) participants to be female and recently homeless. Also as predicted, HIV(+) participants had poorer subjective health, had more convictions for various criminal offenses, and were less apt to acquire employment during treatment when compared to the HIV(-) participants. Contrary to prediction, HIV(+) participants reported more social support, were not less committed to abstinence or 12-step groups, and were not less apt to complete the treatment program in comparison to the HIV(-) participants. These results suggest that HIV(+) crack users can be successfully treated in a rigorous treatment program. Future research should examine post-treatment outcomes among HIV-infected persons.     

Use of MMPI short forms with psychiatric patients.

Compared the use of 2 MMPI short forms, the MMPI-168 and the Mini-Mult, with the complete MMPI using 2,721 psychiatric inpatients and 634 outpatients. Estimated Full Scale MMPI scores for both short forms showed very high relationships with actual Full Scale scores, and the degree of profile agreement for the 3 highest scales was also quite high, although comparisons of the MMPI-168 and Mini-Mult demonstrated a number of significant differences which affect profile interpretation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Narrative completion in the treatment of trauma.

Describes the creation of narratives, the form for processing everyday experience. Complete narratives segment experience, link action and character, identify affect, and make meaning or sense. Trauma disrupts narrative processing by interfering with psychophysiological coordination, cognitive processes, and social connections. Incomplete narrative processing of traumatic experiences causes symptoms of posttraumatic distress. Two case illustrations of traumas that are not narratively complete suggest approaches for clinical practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An aversion-desensitization treatment for alcoholism.

Gave to 21 30-58 yr. old male alcoholic patient volunteers in a state hospital a mean of 11 hr. in 1 of 3 treatments: (a) interpersonal aversion (in which S watched his own audiovideo-recorded drinking "confessions" while being systematically derogated by 2 therapists), followed immediately by systematic desensitization to drinking-related anxieties; (b) interpersonal aversion, followed by a control procedure consisting of friendly interaction; or (c) group discussion. Ss were given the Alcadd Test and MacAndrews' Alcoholism scale (derived from the MMPI) before, after, and 6-9 mo. following treatment. Follow-up interview data show that 5 of the 7 traceable Ss given the interpersonal aversion-systematic desensitization treatment reported abstinence, compared with only 1 of 7 treated by the interpersonal aversion-control procedure. This significant difference was supported by changes on the Alcadd Test but not on the Alcoholism scale. Difficulties in contacting Ss for follow-up precluded complete comparisons with the group-discussion Ss. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of a rehabilitation program for alcoholic inpatients based on the MMPI

The Minnesota Multiphasic Personality Inventory (MMPI) was administered to 53 male inpatients of alcohol dependence syndrome (ICD-10) at the time of their admission to the Alcoholism Rehabilitation Program (ARP) of Shiga Mental Health Center Hospital and again at the time of their discharge. The pretreatment profile had high peaks above 60 on the scale F, Hs, D, Hy, Pd, Pa, Pt, Sc and MAS. The 20 scales in the 27 examined scales changed significantly after the 84 days' treatment in the direction of reduced symptoms (Table 3). The changes in scores between pre and post treatment objectively showed that the ARP was effective as the treatment of alcoholism. It might be the base of all the recovery that the subjects regained their intelligence through the sobriety. Their changes in scores failed to predict their prognoses.