Ethnic differences in psychiatric disorders among adolescent substance abusers in treatment

The present study describes the diagnostic profile of over 800 adolescents admitted to residential therapeutic community programs for treatment of drug abuse and related problems. The relationship between race/ethnicity and psychiatric disturbance is examined, and the association among these factors to outcome is investigated. Over 90% of the sample had a DSM-III-R nonsubstance diagnosis. There were significant differences among the race/ethnic groups on attention deficit-hyperactivity and the disruptive behavior and affective disorders. In general, African-American adolescents yielded the lowest rates of disturbance across all categories of disorders. There was no relationship among race/ethnicity, psychiatric disturbance, and 1-year posttreatment outcomes.     

Multidimensional differences between adolescent substance abusers and users

High-school-aged adolescents responded to a 48-item survey about their substance use. From an original sample of 190 respondents, groups were created through consequence variables (e.g., school, family, medical, and legal problems) into abuse (n = 41) and use (n = 115) categories. Variables were organized along multidimensional lines: stimulus (e.g., frequency of substance use, use in school), organismic (e.g., age, grade), and response (e.g., driving a car while under the influence). From 27 comparisons of the abuse and use groups 16 significant differences emerged.     

MMPI profiles of women in codependency treatment.

The Minnesota Multiphasic Personality Inventory (MMPI) profiles of 73 women presenting themselves for treatment of codependency in a 10-day residential setting were examined. Results suggest a significant amount of psychopathology to be present in this population. More than 50% of these individuals produced clinically significant elevations of five or more scales, and 38% produced elevations on six or more scales.     

Effects of scoring norms on adolescent psychiatric patients' MMPI profiles.

Effects of employing standard adult and age-appropriate norms on the profile elevation, patterning and classification of adolescent patients' MMPI profiles were examined. More elevated and more often psychotic profiles were obtained with adult norms. Some sex differences were observed, but patient race was not an important source of profile variation.     

An MMPI typology of cocaine abusers.

Three types were found in a cluster analysis of scores on the Minnesota Multiphasic Personality Inventory (MMPI) of 100 men voluntarily presenting for treatment of cocaine abuse. Type 1 (n = 59) had a mean MMPI profile consistent with the hypothesized grouping of persons who self-medicate with cocaine as a means of overcoming depression. The relatively normal mean MMPI profile obtained by Type 2 (n = 37) suggested little indication of significant psychopathology. Type 3's (n = 4) mean MMPI profile suggested either severe disturbance or profile invalidity. Types were found to differ in the nature of drug use, reactions to cocaine, education level, and social class, but not on the scales of the Adjective Check List.     

The influence of elevated F scales on the validity of adolescent MMPI profiles

The Minnesota Multiphasic Personality Inventories (MMPI) of adolescent outpatients were examined to determine whether characteristically elevated F scales indicated an exaggeration of psychopathology. A treatment condition designed to reduce the motivation to exaggerate psychopathology did not lower scores of the F and F-K indices when subjects were administered a second MMPI. Similarly, actuarial interpretations for the second protocols were not more frequently selected by therapists as more valid, regardless of treatment condition and elevation of the F and F-K indices on the first MMPI profile. Elevations of Scales F, Pd/4, and Sc/8 characterized the adolescent MMPI profiles.     

Diagnostic profiles of offenders in substance abuse treatment programs

This study examined the association of Axis I and Axis II disorders among offenders who were in prison-based substance abuse treatment in a national multi-site study. Participants (N = 280) received a psychosocial assessment and a structured diagnostic interview in two separate sessions. Logistic regression models examined the association between lifetime mood and anxiety disorders with two personality disorders, and the relationship of Axis I and Axis II disorders (alone and in combination) to pre-treatment psychosocial functioning. Over two-thirds of the sample met criteria for at least one mental disorder. Borderline personality disorder was strongly associated with having a lifetime mood disorder (odds ratio = 7.5) or lifetime anxiety disorder (odds ratio = 8.7). Individuals with only an Axis II disorder, or who had both Axis I and Axis II disorders, had more severe problems in psychosocial functioning than those without any disorder. Clinical treatment approaches need to address this heterogeneity in diagnostic profiles, symptom severity, and psychosocial functioning.     

Comparison of million personality profiles of chronic residential substance abusers and a general outpatient population.

Several theories and studies have suggested that particular personality disorders or psychiatric symptoms should be associated with substance abuse. The current study was done to clarify these relationships by comparing scale profiles on the Millon Clinical Multiaxial Inventory obtained by 144 inpatient residentially treated substance-abuse clients and 1000 general clinical outpatient clients in psychotherapy. A surprisingly large number of significant differences were noted. Substance-abuse clients displayed relative elevations on scales for Alcohol and Drug Abuse, Hypomania, Antisocialism, Narcissism, Schizoidism, Paranoia, Psychotic Thinking, and Psychotic Delusions. General clinical outpatients showed relative elevations on Anxiety, Somatoform, Dysthymia, Borderline, and Compulsive scales. Some possible meanings of these findings were explored and suggestions for research given.     

MMPI profiles of problem peace officers

The Minnesota Multiphasic Personality Inventory (MMPI) profiles of officers who had been involved in serious disciplinary actions were compared with those of a matched group of officers who had not been involved in such actions. A multivariate analysis of variance (MANOVA) found the profiles of the two groups to be significantly different, with Scales F, 5, 6, and 9 significantly higher and Scale L significantly lower for the problem group. In addition, subjects in the problem group were twice as likely to have a high-point elevation T-score greater than or equal to 70 as their nonproblem counterparts. Overall, these results indicate that any degree of psychopathology, as reflected by MMPI profile elevations, increases the likelihood of serious job performance problems. In addition, a presentation of self as conventional and moderately defended is associated with a lesser likelihood of job difficulty, whereas characteristics such as hypersensitivity, impulsivity, and poor frustration tolerance contribute to significant job problems.     

Correlates of success following treatment for adolescent substance abuse

To date, little research is available examining the course and features of recovery from substance abuse following adolescent treatment. The current study evaluated the functioning of 142 teens for 2 years following treatment for substance abuse. Adolescent drug and alcohol outcome was examined in relation to functioning on five major life domains: academic involvement, interpersonal problems, emotional well-being, family relations, and social and occupational activities. Results of this investigation demonstrate that psychosocial functioning is associated with adolescent posttreatment drug and alcohol use. Teens who were abstinent and those with less substance use involvement generally displayed better functioning. The relationship between teen alcohol and drug use and improvement in functioning varied across psychosocial domains. Clinical implications of these findings are discussed along with advances in teen substance abuse research and treatment.