High school polydrug users and abusers

Among 433 high school seniors, 12% were determined to be either polydrug users or abusers. In comparison to the non-polydrug users, polydrug users and abusers were significantly more likely to indicate: (1) physical abuse by and many conflicts with parents; (2) self-ratings of lazy, bored, rejected, and unhealthy, (3) serious suicidal thoughts, delinquent behavior, early use of marijuana and alcohol, and the tendency to drink more than six alcoholic drinks at a sitting; and (4) agreement with the following statements: "If something feels good, I usually do it and don't worry about the consequences" and "I try to play as much as possible and work as little as possible." These findings suggest that many polydrug users and abusers are either seeking pleasure or trying to escape pain. Because of the different reasons behind polydrug use, a variety of treatment and prevention strategies will be necessary to curb the polydrug problem among adolescents.     

Individual differences in reaction to the abuse of LSD

The present report is of individual differences in reaction to the abuse of LSD in a sample of hospitalized polydrug abusers. Reports of flashback phenomena were clearly related to the frequency of ‘bad trips’, the occurence of visual hallucinations during intoxication and the extent of LSD use. An examination of the relationship between scores on the EPQ and drug-related phenomena indicated that N was significantly correlated with both the frequency of ‘bad trips’ and the extent of flashbacks.     

WOMEN, HOMELESSNESS, AND SUBSTANCE ABUSE Moving Beyond the Stereotypes

This study examined the characteristics of homeless women with sub stance abuse problems. Data were collected on a sample of 323 home less substance abusers. First, 49 women and 274 men were compared to demonstrate distinct problems and treatment needs of the women. Results showed that the women were more likely than the men to abuse drugs, but less likely to receive substance abuse treatment. In addition, women spent more time in doubled-up living arrangements, and were more likely to receive outpatient psychiatric treatment. Second, two subgroups of women were compared: those who had been homeless for 6 months or less, and those who had been homeless longer than 6 months during their lifetime. The women who had been homeless longer were less educated, younger when they first became homeless, and were more likely to abuse alcohol, to have been assaulted, and to have attempted suicide. Implications for research and treatment are discussed.     

Suicide attempts among drug abusers.

The relationship between substance abuse and suicide is indicated by the high rate of attempted suicide among alcoholics and drug abusers as well as the increased likelihood of repeated attempts in these populations. This study reports on the psychological characteristics of male drug suicide attempters who are in treatment for their addiction problem. Data collected from 166 veterans included background information, symptoms, mood, social functioning, and attitude measures. Of the drug abuse patients, 26 percent reported having made a suicide attempt. These subjects were found to be significantly more depressed, angry, insecure, and anxious than the nonsuicide-attempt drug abusers. Treatment staff need to be sensitized to the possibility of repeated suicide attempts among substance abuse patients.     

Personality and Coping Styles in the Prediction of Dropout From Treatment for Cocaine Abuse

This study was designed to distinguish between dropouts and completers of residential therapeutic community treatment for cocaine abuse on the basis of the Millon Clinical Multiaxial Inventory II (MCMI-II; Millon,1987) and Ways of Coping Checklist (WCCL; Folkman, Lazarus, Dunkel-Schetter, DeLoagis, & Gruen, 1986) scales, which measure detached, dependent, and independent personality and coping styles. Dropouts were differentiated from completers in two discriminant functions defined, in part, by scores on scales that tap a fiercely independent orientation with manipulative, exploitive, and confrontive interpersonal features. Also contributing to the discriminant functions identified in this study were scores on scales that measure responsiveness to direction from others associated with strong desire for social approval and ability to establish self-control of emotional and behavioral reactions.     

Factors that distinguish aggression toward animals from other antisocial behaviors: Evidence from a community sample

Animal cruelty is a form of passive and active aggression that is largely undocumented and unreported. Given that animals are voiceless victims, we have to rely on witnesses and frontline staff (e.g., veterinarians) to report incidents of abuse, which suggests the number of convicted animal abusers is an under‐representation of actual perpetrators. The primary aim of the current study was to identify the static and dynamic factors that distinguish animal abusers from non‐abuse offenders (i.e., individuals who self‐reported antisocial behavior, but not animal abuse), and non‐offenders (i.e., individuals who have not engaged in any antisocial behavior) in a community sample. The secondary aim was to identify the potential pathways that distinguish animal abuse perpetration from other types of antisocial behavior. Three hundred and eighty‐four participants took part in this retrospective, correlational study. We found that animal abusers share similar socio‐demographic characteristics to other offenders but are distinct in their exposure to animal harm/killing during childhood. Low animal‐oriented empathy and low self‐esteem distinguished animal abusers from non‐abuse offenders when controlling for confound variables and other psychological characteristics. We also found that low animal‐oriented empathy mediated the relationship between childhood exposure to animal killing and animal abuse perpetration, and that this relationship was stronger among participants with anger regulation issues. This is the first study to examine similarities and differences between animal abusers, non‐abuse offenders, and non‐offenders on socio‐demographic and psychological characteristics. The findings highlight potential treatment targets that are unique to animal abusers with implications for prevention and intervention strategies.

     

Delusions and hallucinations of cocaine abusers and paranoid schizophrenics: a comparative study

We compared delusions and hallucinations of 100 cocaine abusers and 100 paranoid schizophrenic subjects admitted to an East Texas state psychiatric hospital. Subjects in both groups feared that individuals or organized groups might harm them in some way, but delusions of the paranoid schizophrenic subjects were more often bizarre than those of the cocaine abuse subjects. "Cocaine bugs" (parasitosis) were more often found in the cocaine abuse subjects. Command hallucinations were found in both groups, but the commands of the schizophrenic group more often related to harming or killing others. Cocaine abusers had a greater frequency of visual hallucinations (47 to 7), distinguished by shadows, flashing lights ("snow lights"), objects moving and bugs crawling on the arm. Finally, the most distinguishing characteristics were identity delusions, possession delusions, grandiose delusions (other than identities and possessions), and delusions that their families were imposters (Capgras Syndrome) reported by paranoid schizophrenics. No such delusions were reported by the cocaine abusers.     

Personality characteristics of substance abusers: an MCMI cluster typology of recreational drug users treated in a therapeutic community and its relationship to length of stay and outcome.

The purpose of this investigation was to define homogeneous personality subtypes among substance abusers treated in a long-term, inpatient, drug-free therapeutic community and to determine how the resulting typology was related to length of stay and treatment outcome. A hierarchical agglomerative cluster analysis was performed on the Millon Clinical Multiaxial Inventory (MCMI) scale scores of 235 admissions to a therapeutic community. Five cluster types emerged, which were similar to typologies found in studies with alcoholic inpatients. A concordant solution evolved when a different clustering algorithm was used with the same sample and when clustering was done with a different group of substance abusers. As hypothesized, clusters of patients with average MCMI elevations that indicated avoidant, schizoid, and antisocial qualities tended to stay in treatment fewer days and relapsed earlier during the 1-year follow-up. The implications for substance abuse treatment are discussed.     

Personality Characteristics of Substance Abusers: An MCMI Cluster Typology of Recreational Drug Users Treated in a Therapeutic Community and Its Relationship to Length of Stay and Outcome

The purpose of this investigation was to define homogeneous personality subtypes among substance abusers treated in a long-term, inpatient, drug-free therapeutic community and to determine how the resulting typology was related to length of stay and treatment outcome, A hierarchical agglomerative cluster analysis was performed on the Millon Clinical Multiaxial Inventory (MCMI) scale scores of 235 admissions to a therapeutic community. Five cluster types emerged,, which were similar to typologies found in studies with alcoholic inpatients. A concordant solution evolved when a different clustering algorithm was used with the same sample and when clustering was done with a different group of substance abusers. As hypothesized, clusters of patients with average MCMI elevations that indicated avoidant, schizoid, and antisocial qualities tended to stay in treatment fewer days and relapsed earlier during the 1-year follow-up. The implications, for substance abuse treatment are discussed.     

Intraorganizational and interorganizational job change: A discriminant analysis

Using March and Simon's (1958) participation model as a framework, this study employs the 1973–77 Quality of Employment Survey panel data to compare the determinants of intraorganizational and interorganizational job change. Two discriminant functions were significant, the first distinguishing between intraorganizational changers and stayers and the second between interorganizational changers and stayers. Moreover, the variables that distinguished between intraorganizational changers and stayers were either different from or opposite in influence to those distinguishing between interorganizational changers and stayers.     

Characteristics of seriously emotionally disturbed youth with and without substance abuse in intensive case management

Youth with emotional disturbance who have substance abuse problems are of particular concern to child-serving agencies. Approximately 22% of the youth served in New York State's Intensive Case Management Program for Children and Youth (CYICM) have identified substance abuse problems. We compared youths enrolled in CYICM who abuse substances with those who do not abuse substances. Adolescents with substance abuse problems differed from non-abusing adolescents. The abusing cohort was most likely to be emancipated minors, not enrolled in school, less likely to be members of a minority group, and more likely to have private health care coverage. They also evidenced a different constellation of symptoms than the non-abusing cohort, with abusers tending to display suicidal symptoms and behaviors and sexual acting out. Abusers were also more likely to have been admitted to private psychiatric hospitals and to have had crisis contacts in emergency rooms. Similar to non-abusers, however, abusers spent significantly fewer days as inpatients in state hospitals, and had fewer admissions to these hospitals following their enrollment in CYICM.     

MMPI substance abuse scales on drug addicts with and without concurrent alcoholism

The range and utility of the MMPI-derived MacAndrew Alcoholism Scale (MAC) and the Heroin Addiction Scale (He) was assessed with a large sample of drug addicts with and without concurrent alcoholism. Results indicated that addicts with a co-existing alcohol problem obtained higher MAC scores than addicts without a current alcohol problem. Opiate abusers scored higher on the MAC than non-opiate abusers. No such effects were observed with the He scale. The MAC is a particularly robust scale that taps generic substance abuse and may even be sensitive enough to detect alcoholism in drug addicts.     

A psychometric study of the Drug Use Disorders Identification Test-Extended in a Norwegian sample

Motivation is a widely used concept in substance use treatment, and is commonly seen as a premise for change during treatment. Different measures of motivation have been suggested. A relatively new instrument is the Drug Use Disorders Identification Test-Extended (DUDIT-E), developed in Sweden. This instrument has recently been introduced in Norway. The present study examined the Motivational Index of the Norwegian version of the Drug Use Disorders Identification Test-Extended (DUDIT-E). We tested whether the three-factor model ("Positive aspects of substance abuse"; "Negative aspects of substance abuse"; and "Treatment readiness") suggested by previous studies could be replicated in a sample of Norwegian inpatients. Responses to the DUDIT-E were obtained from 105 patients admitted to inpatient substance abuse treatment in Northern Norway. Exploratory common factor analyses were used to compare the factor structure from the current sample with the Swedish sample of mainly detoxification patients and prison inmates. The current sample did not include prison inmates, and it consisted of more women than the Swedish sample. The samples did not differ according to age or substance dependency. The analyses suggested that six primary factors was the most efficient way of combining the item scores, and not 11 as in the Swedish sample. A second-order factor analysis found best support for a two-factor solution, and hence, did not replicate the previously suggested three-factor model either. Several regression analyses comparing the efficiency of the different ways of combining the DUDIT scores in primary or secondary factor scores indicated that the model involving six sum scores had best merit and should be explored further.     

Ability of substance abusers to escape detection on the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A) in a juvenile correctional facility

The ability of respondents to underreport successfully on substance abuse and validity scales of the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A; Butcher et al., 1992) was evaluated. Incarcerated teens (67 substance abusing, 59 non-substance abusing) completed the MMPI-A twice: once under standard instructions (SI) and once under instructions to fake good (FG). Under SI, substance scales correctly classified about 60% to 85% of adolescents. Under FG, substance- and non-substance-abusing juveniles produced lower scores on substance scales. However, the Lie Scale (L) was able to detect more than 75% of deceptive profiles and about 77% of honest profiles. When scale L and the best substance scale were used in combination, only about 18% of faking substance abusers were not identified as either substance abusers or as underreporting. For feigning substance abusers, only about 10% of substance abusers were detected, with about 72% being categorized as faking and needing further assessment.     

Psychometric vs. attentional correlates of early onset alcohol and substance abuse

Adolescent inpatients with a diagnosis of alcohol abuse (n=28), nonalcohol substance abuse disorders (n=15), or psychiatric disorders without substance abuse (n=46) were examined on measures of attentional, intellectual, and personality functioning. High scores on a personality measure, the Substance Abuse Proclivity Scale (SAP), was the best predictor of substance abuse in general. Alcohol abusers were differentiated from other substance abusers by their increased impairment on the Continuous Performance Test. Adolescents with alcohol abuse did not manifest the types of cognitive impairments associated with chronic alcoholism. These data suggest that certain attentional impairments may be associated with early onset alcohol abuse and that earlier conceptions of the role of attentional impairments in risk prediction for alcohol abuse are supported.This research was supported by the Four Winds Foundation.     

The Role of Sexual Trauma in the Treatment of Chemically Dependent Women: Addressing the Relapse Issue

A review of the literature indicates a high incidence of sexual trauma among women who seek treatment for substance abuse. Additionally, clients who have experienced sexual trauma appear to be more susceptible to relapse, the return to substance abuse. This article explores issues surrounding sexual trauma and chemical dependency. It aims to provide direction for relapse prevention with a relapse-prone population. Application of traditional milieu substance abuse treatment for sexual trauma survivors is explored. Recommendations for working with sexual trauma survivors who are also substance abusers are presented, as are suggestions for research.     

Are Disease and Other Conceptions of Alcohol Abuse Related to Beliefs About Outcome and Recovery?1

Visitors to a science center (N= 189) responded to a questionnaire measuring their agreement with different conceptions of alcohol abuse (disease, sin, habit, and addiction conceptions) and their beliefs regarding treatment for alcohol abusers. Respondents who agreed with a disease concept thought alcohol abuse was a more serious problem, were more skeptical of statements about recovery, and were more likely to feel that treatment was necessary to achieve change, compared to those who disagreed with or were neutral toward the disease concept. Agreement with the sin, habit, and addiction conceptions was not related to beliefs about treatment and outcome. The utility of promoting various conceptualizations of alcohol abuse is discussed.     

Sex differences on the MMPI-2 substance abuse scales in psychiatric inpatients.

Sex differences on the MMPI-2 addiction scales (MacAndrew Alcoholism Scale-Revised, Addiction Acknowledgement Scale, Addiction Potential Scale) and their ability to distinguish between substance-abusing and nonabusing psychiatric inpatients were examined. Men obtained higher mean raw scores than women on the MacAndrew Alcoholism Scale-Revised and the Addiction Acknowledgement Scale, and substance abusers scored higher on all three scales. Even relatively low cutoff scores, however, on the MacAndrew Alcoholism Scale-Revised resulted in false negative rates of 37 to 39%. The results support the utility of the MMPI-2 substance abuse scales; however, lower cutoff scores should be used with women and within a psychiatric population.     

Personality characteristics in primary benzodiazepine-dependent patients: Comparison with controls and polydrug users

The present study applied Karolinska Scales of Personality (KSP) to study (i) if patients with benzodiazepine dependence have a characteristic personality profile, (ii) if the personality characteristics in patients with benzodiazepine dependence differ from those of polydrug users and normal controls, (iii) if differences in treatment outcome existed between the groups, and (iv) if the possible difference in treatment outcome was associated with any particular personality characteristic shown by the patients. The personality characteristics of primary benzodiazepine dependent patients (BDZ) and a group of polydrug users (MIX) were studied initially (during the first week in project as an inpatient) and approximately one year after drug discontinuation, and a comparison was made with healthy controls on both test occasions. The results showed that the personality of both groups of patients differed significantly from the Controls in the following characteristics: Detachment, Socialization, Somatic Anxiety, Muscular Tension, Psychic Anxiety, and Psychasthenia. Significant differences existed between the polydrug and benzodiazepine users in Somatic and Psychic Anxiety as well as in Socialization. The MIX group differed significantly from the BDZ group and from the Controls in Suspicion. Results of treatment outcome indicated that the benzodiazepine dependent patients were significantly more successful in quitting their drug use compared to polydrug users. Further, the results demonstrated that patients scoring high in the investigated personality characteristics are those who fail the treatment goal of quitting their drug use, especially the patients with a high level of anxiety and detachment.     

Twelve‐Step Groups,Attributions of Blame for Personal Sadness,Psychological Well‐Being,and the Moderating Role of Gender1

Two studies investigated links among 12‐step group participation, gender, attributions of blame for personal sadness, and psychological well‐being. Study I used a correlational design to examine these links cross‐sectionally among substance abusers who identified alcohol as their primary drug problem. Study 2 used an experimental design to examine prospective links among these variables for substance abusers who were also adult children of alcoholics. Females engaged in more blame than did males, and personal blame was negatively related to psychological well‐being in Studies 1 and 2. Most significantly, 12‐step group participation was associated with lower personal blame among females but not among males across both studies. These results indicate that 12‐step groups can reduce personal blame among females who have substance abuse problems.