A typology of antisociality in methadone patients.

Multistage cluster analyses with replications were used to sort score profiles of 252 methadone maintained men on 4 continuous measures of antisociality--childhood conduct disorder and adult antisocial personality disorder symptoms, the revised Psychopathy Checklist, and the Socialization scale of the California Psychological Inventory. The analysis yielded 6 replicable and temporally stable cluster groups varying in degree and pattern of antisociality. The groups were statistically compared on sets of external criterion variables--Addiction Severity Index measures of past and recent substance abuse and functioning and lifetime criminal history. Axis I and II symptomatology, anxiety and depression, object relations and reality testing, hostility, guilt, and machiavellianism. The expression of antisociality in the 6 groups and differences found among them on the external variables supported the validity of a more complex conceptualization of antisociality than is provided by antisocial personality disorder.

Nicodermal patch adherence and its correlates.

The patch adherence behavior of 101 smokers receiving 8 weeks of the nicodermal patch was examined while undergoing one of three levels of adjunctive psychosocial treatment. Additionally, regression analyses were undertaken to: (1) identify subject variables predictive of patch adherence and (2) to determine the predictive validity of patch treatment dropout, smoking and patch adherence during patch treatment to smoking 9 and 26 weeks post-treatment entry. Fifty-five percent of the patients wore the patch as prescribed for at least 50 of 56 treatment days. A multiple regression model including the Fagerström severity of dependence score, psychosocial treatment group, and the URICA commitment score predicted 18% of the variance in days of patch use. All treatment dropouts were found to be smoking at followup. Although both smoking and low patch compliance during treatment were significant predictors subjects of week 9 and 26 smoking for the remaining subjects, at the individual variable level of analysis, only smoking during treatment predicted week 9 and 26 outcomes in a two-variable predictor model.

Contrasts between admitters and deniers of drug use.

This study evaluated the agreement between self-reported drug use and urinalysis results in 232 men and 27 women opiate-dependent patients at 2, 7, and 24 months following admission to methadone maintenance treatment. Differences between deniers, those who stated that they had not used drugs, but whose urinalysis results were positive, and admitters of drug use on several psychosocial variables, Axis I and II pathology and degree of psychopathy were examined. Generally, more drug use was acknowledged by self-report than found in urinalyses. Evidence was limited that deniers were consistently different than admitters. Deniers had a significantly greater increase from initial psychopathy ratings made using interview only information to final psychopathy ratings made utilizing interview and collateral information.

Predictive validity of the Addiction Severity Index's composite scores in the assessment of 2-year outcomes in a methadone maintenance population.

The current research tested the predictive validity of 6 of the 7 Composite Scores (CSs) of the Addiction Severity Index (ASI) in 310 methadone maintenance patients assessed at treatment entry using the ASI and other measures, and followed for 2 years. Logistic regression was used to estimate the sensitivity and specificity of the CSs at intake in predicting their respective validity criterion measures at follow up. Except for the Medical CS, each of the other 5 CS measures significantly predicted its validity criterion measure. The CSs measuring drug use, alcohol abuse, psychopathology, and legal problems had high specificity (88% [corrected] for the Drug CS, 91% for the Alcohol CS, 96% for the Legal CS, and 100% for the Psychological CS). The CSs measuring employment problems had high sensitivity (76%). The results support the predictive validity of most of the ASI CSs as measures of specific problems as well as the validity of the multidimensional construct on which the ASI is based.

Generalizability of the clinical dimensions of the Addiction Severity Index to nonopioid-dependent patients.

Clinical dimensions (CDs) for the Addiction Severity Index recently have been established for application among opioid-dependent patients in methadone treatment (P. A. McDermott et al., 1996). This article examines the generalizability of the CDs to other substance-dependent patients. A sample of 2,027 adult nonopioid-dependent patients was identified; it comprised 581 primarily cocaine-dependent, 544 primarily alcohol-dependent, and 803 polydrug-dependent patients and 99 patients who were dependent on other varied drugs. Generality of dimensions was assessed through confirmatory components analysis, structural congruence, internal consistency, and variance partitioning in higher order factoring. The CDs were found generalizable overall and to specific nonopioid-dependent subgroups, and across patient gender and age, and to African American and White patients. Preliminary concurrent and predictive validity data supported the CD structure.

Personality pathology and drinking in young men at high and low familial risk for alcoholism.

OBJECTIVE: Three groups varying in familial alcoholism risk were compared with respect to amount of alcohol consumption, presence of personality pathology, and the relationship between personality pathology and alcohol consumption. METHOD: Research subjects were young adult men recruited from local colleges, a trade school and the community. The risk groups included (1) a group with a biological alcoholic father and significant additional familial alcoholism (n = 106); (2) subjects with an alcoholic father, but without significant additional familial alcoholism (n = 100); and (3) a group with no paternal alcoholism and at most only one second/third-degree alcoholic relative (n = 190). Absolute daily ounces of alcohol was determined using a standard quantity-frequency scale. Prevalence of DSM-III-R personality disorders (PDs) was evaluated using the Personality Disorder Questionnaire-Revised both with and without application of an impairment and distress scale. Familial risk determination was based on agreement between four separate self-report assessments. RESULTS: The first group consumed significantly more alcohol than the other two groups, which did not differ in alcohol consumption. The first group's subjects were more likely to meet criteria for virtually all of the PD diagnoses than were the other two groups. A greater proportion of the second group's subjects qualified for various PDs than did the third group's subjects. Personality pathology was consistently or usually associated with more drinking in the first and third groups, respectively, but associated with less consumption in the second group. CONCLUSIONS: Young men with high-density familial alcoholism are at greater risk for the development of alcoholism than those with alcoholic fathers and little additional familial alcoholism. Relationships between personality pathology and alcohol consumption, and possibly the development of alcoholism, differ for the three risk groups.

Social competence in opiate-addicted individuals: gender differences, relationship to psychiatric diagnoses, and treatment response.

Only one prior study has examined social competence (SC) in drug addicted individuals. That study of cocaine-addicted individuals found gender differences in SC as well as differences based on the type of comorbid psychiatric diagnoses given. This study attempts to replicate findings from that cocaine study in a sample of opiate-addicted individuals and explores the relationship of SC to short-term treatment response. Gender differences in SC were examined in 28 women and 44 men attending a community methadone maintenance program. The question of differences in SC based on comorbid psychiatric diagnoses and treatment response were examined in a sample of 198 men attending a Veterans Administration methadone program. Women were found to have significantly lower SC than men. No significant differences in SC were revealed based on the presence of specific psychiatric diagnoses. SC was not related to short-term treatment response.

The 2-year test-retest reliability of the Psychopathy Checklist Revised in methadone patients.

The 2-year test-retest reliability of the Psychopathy Checklist-Revised (PCL-R) was examined in 200 men and 25 women methadone patients. Stability of the PCL-R was generally good whether it was evaluated as a dichotomous or dimensional measure. Utilizing a diagnostic cutoff score of 25 or more the intraclass correlation coefficients (ICCs) were.48 for men and.67 for women. For the Total PCL-R score ICCs were.60 and.65 for men and women, respectively. Factor 1 was more reliably measured in women compared to men (.63 vs.43). For men, Factor 1 was significantly less reliable than Factor 2 or the Total score. For women, Factor 2 was significantly less reliable than the Total PCL-R score or Factor 1.

A congenital Toxoplasma-like disease in ferrets (Mustela putorius furo).

Approximately 30% of 750 neonatal farmed ferret kits died without observed clinical signs. The presence of multifocal necrosis associated with Toxoplasma-like organisms in the liver, lung and heart suggested a diagnosis of toxoplasmosis. Surviving animals from affected litters were stunted but showed no histological or serological evidence of Toxoplasma infection, nor could infection be demonstrated by mouse inoculation. The involvement of animals at one day of age indicated congenitally acquired disease.

Rickets in yearling steers wintered on a swede (Brassica napus) crop.

Rickets was diagnosed in a group of 80 yearling Angus steers wintered for three months on a crop of swedes (Brassica napus) in the Kimbolton area. Growth rate was poor and several steers developed lameness during the final three weeks on the crop. Five animals were euthanased after developing bone fractures. Necropsy of two animals revealed soft ribs, enlarged costochondral junctions and irregularly thickened growth plates in long bones. Histologically there were islands of hypertrophic cartilage within metaphyses and disruption of metaphyseal trabeculae. Thickened, irregular, trabeculae were sometimes lined by wide osteoid seams. Phosphorus deficiency was considered to be the most likely aetiology of the osteodystrophy. The dry matter content of the swedes was only six percent, and in order to satisfy their phosphorus requirements each steer would have had to ingest approximately 330 kg of swedes per day. Rickets is an uncommon disease of grazing animals in New Zealand and to our knowledge this is the first report of its occurrence in cattle.

Phosphorus deficiency in a dairy herd.

Phosphorus deficiency was diagnosed in a 90 cow seasonal supply dairy herd which showed low milk production, ill-thrift, infertility and osteophagia. Serum inorganic phosphorus and pasture phosphorus levels were low, pasture Ca:P ratios high and soil phosphorus levels very low; the soil phosphate retention value was 96%. The deficiency, which had probably existed for several years, was considered to be due to inadequate annual phosphate fertiliser applications on a high phosphate retaining soil. Phosphorus deficiency may have been exacerbated by the application of lime without phosphate several months before the onset of severe clinical disease. The finding of low sodium levels in pasture samples suggested that sodium deficiency may have co-existed and contributed to the clinical picture. Treatment, comprising bone flour dusting of pasture, water trough supplementation and phosphorus-containing injections, appeared to induce ovarian activity in anoestrous cows and suppress osteophagia, though controlled treatment trials were not performed. No improvement was noted in milk production or cow condition. Increased annual super-phosphate and reduced potassium applications were recommended, together with the monitoring of pasture and soil macro elements and serum phosphorus levels. A decision on whether to supplement with sodium would be based on the results of pasture monitoring, since a direct animal test is not currently available. It is suggested that phosphorus deficiency may not be uncommon in dairy herds in some North Island districts; based on the present case, the decline in New Zealand superphosphate quality in the 1970's and recently published data which has shown a high proportion of pasture phosphorus deficient sites in some North Island areas.

The relationship of object relations and reality testing deficits to outcome status of methadone maintenance patients.

Impairments in the ability to form and maintain meaningful interpersonal relationships and in the ability to distinguish between internal and external stimuli are related to an individual's psychological health. The Bell Object Relations and Reality Testing Inventory (BORRTI) scores of 146 methadone patients were used to evaluate whether transitory (TI) or chronic impairments (CIs) in object relations and reality testing were related to more severe drug use, family and social problems, psychological distress, as well as more time in treatment, seeking additional treatments, or taking psychiatric medication. The results showed no significant relationship between BORRTI scores and family or social problems, time in treatment, or the months of heroin use between follow-up evaluations. However, severity of drug use was related to an impairment in a specific dimension of object relations-egocentricity. There was a significant relationship between TIs and CIs in object relations and reality testing with levels of psychological distress and the likelihood of taking psychiatric medication.

Detection of colorectal liver metastases: comparison of laparotomy, CT, US, and Doppler perfusion index and evaluation of postoperative follow-up results.

PURPOSE: To assess the value of the Doppler perfusion index (DPI = the ratio of hepatic arterial to total liver blood flow) as measured with duplex and color Doppler sonography (DCDS) in comparison with computed tomography (CT), conventional ultrasound (US), and laparotomy for the detection of liver metastases in patients with colorectal cancer. MATERIALS AND METHODS: DCDS measurement of the DPI and CT, US, and laparotomy were performed in 161 consecutive colorectal cancer patients. Patients who underwent an apparently curative resection were followed up at 3-month intervals with US and at annual CT. RESULTS: Fifty-six patients had histologically proved liver metastases at initial examination. Liver metastases were detected with DPI, CT, US, and laparotomy in 56, 45, 27, and 36 patients, respectively. After a 1-year follow-up, 23 patients had developed liver metastases, all of which were predicted on the basis of an abnormal DPI value. CONCLUSION: Results suggest that DCDS measurement of the DPI is the most sensitive technique in detection of colorectal liver metastases. All studies should attempt to define normal liver on the basis of follow-up results rather than those of laparotomy.