Assessing contemporary substance abusers with the MMPI MAC Andrews Alcoholism Scale: a review.

We reviewed 71 United States-based MacAndrew Alcoholism Scale (MAC), as revised (MAC-R) studies totaling almost 32,000 Ss, with adolescent and adult substance abusers, from studies published since the last MAC reviews (1989) through 2001. Results suggest that the MAC, and to some extent, the MAC-R, significantly correlates with measures of alcohol and substance abuse in both male and female adolescents and adults, across a diverse spectrum of the use-abuse continuum. Nonclinical groups (100%) scored below the clinical ranges on the MAC/MAC-R, while 79% of adolescent substance abusing groups scored > R 23, indicative of problems with substance abuse. Persons who abused alcohol, drugs, and polydrugs had mean MAC/MAC-R scores > 23, which ranged from 77% to 100% of the cases. The MAC/MAC-R does well in discriminating persons who abuse substances compared to nonclinical, nonabusing groups, but appears to lose diagnostic efficiency with psychiatric patients, and especially with medical patients with seizure disorders. Using R > 25 seems to improve diagnostic accuracy with this population. Meaning of false positives and false negatives were explored and discussed.

Predicting methadone maintenance treatment outcomes using the Addiction Severity Index and the MMPI-2 Content Scales (Negative Treatment Indicators and Cynism scales).

We studied the ability of the Minnesota Multiphasic Personality Inventory-2 Content Scales (Negative Treatment Indicators [TRT] and Cynicism [CYN]) and the domain scales of the Addiction Severity Index (ASI) in predicting outcome from a methadone maintenance program. Participants were 108 African American males treated in a VA health care outpatient methadone maintenance treatment program and followed for up to 1 year after admission. Dependent variables were 1) length of stay and the percentage of 2) missed medication days, 3) toxicology urine samples free from illicit drugs, 4) full-time employment, 5) attendance at scheduled counseling sessions, and 6) counselor ratings of patient progress. A stepwise linear regression equation indicated that low drug severity scores on the ASI and low scores on percentage of missed medication predicted patients who were clean 1 year later; low scores on the psychological domain of the ASI predicted attendance at counseling sessions; a discriminant function analysis (consisting of percent of missed medication, percentage of clean urines, and ratings of patient progress) successfully predicted patient status (i.e., dropouts vs. "active patients") with 85% accuracy. Although the TRT and CYN were related to some ASI domains, they were not associated with any outcome variable. Results suggest that some ASI scores serve as important indicators of patient progress in methadone maintenance treatment.

Predicting the outcome of methadone maintenance treatment with the Negative Treatment Indicators content scale from the MMPI-2.

Scores on the Negative Treatment Indicators content scale from the MMPI-2 were not significantly correlated with 5 measures of treatment outcome among 108 male patients on methadone maintenance. These results and those from other studies using this content scale as an independent variable with substance abusers suggest that the scale has yet to demonstrate consistent predictive validity with this population.

Validity of projective drawing indices of male homosexuality.

We investigated the hypothesis that certain signs in the Draw-A-Person projective technique reflect male homosexuality. Human figure drawings from gay and 88 heterosexual men, with no clinical psychological symptoms, were submitted to trained raters who were blind to the purpose of this research. The raters independently judged whether 21 signs, previously referenced in the literature as suggestive of male homosexuality, were present in the figure drawings. Only two signs, hair and hips, differentiated between groups. Results were interpreted in the light of changing social attitudes towards homosexuals and methodological problems of prior studies.

Figure-drawing indices of psychological accessibility.

We investigated the hypotheses that windows, doors, pathways, and size of the house in the House drawing of the House-Tree-Person projective drawing technique reflect psychological and social accessibility by correlating these variables with the Social Introversion scale of the MMPI-2. Subjects were 153 nonclinical, community adults, and 146 clinical patients currently receiving mental health services. While there were strong correlations among these figure-drawing variables, suggesting some common underlying dimension, these scores were not significantly correlated with psychological accessibility as measured by the Si scale of the MMPI-2. Possible interpretations were suggested.

Prevalence of Personality Disorders among Cocaine and Heroin Addicts.

Using the MCMI-III, we studied rates of personality disorders among 443 inpatient drug abusers (i.e., 160 opiate addicts and 283 cocaine addicts). For both samples the disorders of antisocial (60%), passive-aggressive (negativistic) (34%), and depressive personality disorders (32%) showed higher prevalence rates. Previous studies (N = 13) using different measures (e.g., SCID, SDIP, MCMI-I) reported similar findings in terms of overall prevalence of specific personality disorders, although actual rates varied by population.

MCMI-III Scores on Substance Abusers With and Without Histories of Suicide Attempts.

Sixty-eight patients with a history of suicide attempt were compared to 340 patients without a history of suicide attempt using the MCMI-III, a frequently used test for measuring personality disorders. Patients with a suicide attempt history scored higher on Schizoid, Avoidant, Depression, Dependent, Passive-Aggressive (Negativistic), Self-Defeating, and Paranoid and significantly lower on Histrionic and Compulsive and scored higher on all clinical syndrome scales except for Drug Dependence and Delusional Disorder. Logistic regression correctly predicted the no-suicide-history group with 97% accuracy, but only accurately predicted 16% of the patients with a suicide attempt history. A discriminant function analysis correctly predicted 90% of the patients with a suicidal attempt history and 63% of the patients with no history of suicide attempt. Results suggest that MCMI-III scores may be able to detect patients with a history of suicide attempt, using multivariate statistics.