The utility of the Michigan Alcoholism Screening Test in the detection of alcoholics and problem drinkers

This study examined the vulnerability of the Michigan Alcoholism Screening Test (MAST), a widely used, direct alcohol inventory, to positive dissimulation. An earlier study by developers of the MAST suggested that most alcoholics were unable to alter their scores and thereby avoid detection by the instrument. But closer examination indicated that a standard scoring procedure was not employed. This study examined the ability of alcoholics to avoid detection by the MAST when using a standard scoring procedure. As predicted, alcoholics readily manipulated their MAST scores and avoided detection when so motivated. These results are discussed, indications and contraindications for use are included, and recommendations regarding future research are made.     

An adolescent version of the Michigan Alcoholism Screening Test

Item content of the Michigan Alcoholism Screening Test (MAST) was modified to make it more appropriate for young persons. The resulting test was found to have lower internal consistency than the adult MAST, but the elimination of five items with comparatively poor psychometric properties yielded an acceptable alpha coefficient of .73. A unitary factor model for the adolescent MAST was not confirmed; indeed, the revised test appeared to be factorially complex. Recommendations for further revisions are discussed.     

A Comparison of Primary Alcoholics,Secondary Alcoholics,and Nonalcoholic Psychiatric Patients on the MacAndrew Alcoholism Scale

The MacAndrew Alcoholism (MAC) and Sc scales of the Minnesota Multiphasic Personality Inventory (MMPI) were examined in four groups of 20 male patients. Comparisons were made among primary alcoholics, secondary alcoholics (i.e., alcoholic psychiatric patients), nonalcoholic psychiatric patients (mixed diagnoses), and conservatively defined, nonalcoholic schizophrenics. Primary alcoholics scored higher on the MAC scale than did secondary alcoholics and other groups; schizophrenics scored lower than all other groups. Primary alcoholics were lower on the Sc scale than schizophrenics but did not differ from other groups. The results support MacAndrew's (1981) distinction between primary and secondary alcoholics and suggest that the MAC scale may enhance differentiation among diagnoses other than alcoholism.     

Application of the MacAndrew Alcoholism Scale to Alcoholics With Psychiatric Diagnoses

The MacAndrew Alcoholism scale scores of 140 mate patients from a large VA hospital were examined to assess whether the MAC scale can detect alcoholism among patients with psychiatric diagnoses. There were five diagnostic groups, each with 28 patients: alcoholics, alcoholics with neurotic disorders, alcoholics with personality disorders, nonalcoholic patients with neurotic disorders, and nonalcoholic patients with personality disorders. The MAC scale was able to differentiate alcoholics and nonalcoholic psychiatric patients, but was unable to differentiate either of the alcoholic psychiatric groups from its nonalcoholic psychiatric counterpart. Thus, it appears that the MAC scale may be unable to identify alcoholism among patients with combined alcoholic-psychiatric diagnoses.     

The Clinical Utility of the MMPI-2 in Diagnosing Unipolar Depression Among Male Alcoholics

The correspondence between Scale 2 elevations on the MMPI-2 and SCID-diagnosed unipolar depression (major depression and dysthymia) and alcohol-induced depression was evaluated among 106 consecutive male admissions to an inpatient alcohol treatment unit. Valid profiles were obtained from 87 subjects, 15% of whom were diagnosed with unipolar depression and another 4.5% with presumed alcohol-induced depression. The sensitivity of Scale 2 (the probability that a depressed subject would obtain an elevated score) ranged from .19 to .42. Positive predictive power (the probability that a subject who obtained an elevated score had a depressive disorder) ranged from .23 to .38. Neither Scale 2 alone nor Scale 2 paired in 2-point code types predicted the presence or absence of comorbid depressive disorders among male alcoholics.     

Parental Alcoholism and Coping: A Comparison of Female Children of Alcoholics With Female Children of Nonalcoholics

The authors assessed potential differences between children of alcoholics and children of nonalcoholics in depression and choice of coping strategies. Although significant group differences were detected for level of depression, mean depression scores for both groups fell within the no depression range on the Beck Depression Inventory. No significant differences in coping strategies were detected.     

Using the Million Clinical Multiaxial Inventory's Scale B and the MacAndrew Alcoholism Scale to Identify Alcoholics With Concurrent Psychiatric Diagnoses

The ability of the MacAndrew Alcoholism Scale (MAC) and Scale B of the Millon Clinical Multiaxial Inventory (MCMI) to discriminate independently defined alcoholics with psychiatric diagnoses from other psychiatric patients was examined for males and all alcoholics, using three different criteria of alcoholism. The MAC identified from 80% to 87% of male alcoholics and 76% to 82% of all alcoholics, and from 25% to 52% of male nonalcoholics and 55% to 75% of all nonalcoholics, resulting in a large number of false positives. Scale B identified from 31% to 60% of male alcoholics and 33% to 43% of all alcoholics, and from 73% to 85% of male nonalcoholics and 85% to 94% of all nonalcoholics. The operating characteristics of Scale B showed that it was not as efficient in identifying alcoholics as previous work had indicated. We suggest that Scale B should not be used and the MAC should be used cautiously to discriminate alcoholics with psychiatric disorders from patients without alcoholism.     

The Utility of Genetic Counseling Prior to Offering First Trimester Screening Options

In order to evaluate the utility of genetic counseling at the time of first trimester screening in patients with no previously identified genetic concerns, we reviewed family history data for 700 women seen for genetic counseling in Utah during 2005-2006. The mean maternal age was 35 years (Range: 16–47 years). The majority of patients seen were non-Jewish Caucasians (90.8%, 634/700). A three-generation pedigree was obtained from each woman by one of two certified genetic counselors and subsequently classified as “negative” (no birth defects/genetic disorders); “positive” (birth defect or genetic condition with a minimal/low risk of recurrence; additional evaluation/genetic testing during pregnancy not indicated); or “significant” (birth defect or genetic condition with an increased risk of recurrence; additional evaluation/genetic testing during the pregnancy indicated). About 72% (501/700) of the histories were negative, 19% (134/700) were positive, and about 9% (65/700) were significant. Among patients with significant family histories, 66% (n = 43) were women less than 35 years of age. We conclude that assessing a patient’s family history at the time of first trimester serum screening is a valuable resource for pregnancy management.     

Utility of Model of Human Occupation Screening Tool in Sweden

abstract

Occupational therapists in Sweden are expected to use evidence-based practice. To meet this expectation, a helpful tool could be the Model of Human Occupational Screening Tool (MOHOST). The aim of this study was to examine the utility of the Swedish version of MOHOST. Thirty-seven occupational therapists were invited to take part in the examination. A questionnaire covering transferability, feasibility and clinical relevance was developed. The results show that MOHOST-S seems to have suitable utility. The study supports its implementation potential and clinical relevance. It gives a broad picture of the client’s occupational participation and it supports the treatment planning process.     

Issues and Insights: The Synergy of Depravity and Loneliness in Alcoholism: A New Conceptualization,an Old Problem

The author uses the term depraved loneliness to represent the spiritual (or “soul”) sickness alluded to in Alcoholics Anonymous (Alcoholics Anonymous World Services, 1976), arguing that combining these 2 terms to form a single paradigm has not been examined. It is further argued that the synergy of depravity and loneliness, as a singular condition, may precipitate relapse and premature death through suicide by individuals during late recovery from alcoholism. Germinal qualitative research is necessary, and additional study of this proposed condition is encouraged.     

The Efficiency of the Group Rorschach Test in the Psychiatric Screening of Marine Corps Recruits

In a study to extend the theory of cognitive dissonance into the area of person perception, 108 male freshmen dormitory students were led to believe that they either would or would not be sharing a room in the future with a negative other. They were also informed that they were either low, moderate, or high in similarity to this negative other. The major response measure was the extent to which the negative first impression changed in a more positive direction. A 2 × 3 ANOVA showed that both the proximity and similarity manipulations had the predicted effect. However, the trend in similarity was not linear, as hypothesized. Similarity was also found to be a more salient source of dissonance than proximity.     

Collegiate COAs and Alcohol Abuse: Problem Drinking in Relation to Assessments of Parent and Grandparent Alcoholism

In a survey of college students (N = 860), significantly greater problem drinking was indicated by students who reported having a parent or grandparent diagnosed or treated for alcoholism. The highest rates of problem drinking were found among students who reported both an alcoholic parent and grandparent. Students who had experienced distress and family discord from parental alcohol abuse, though without a diagnosed alcoholic parent, also indicated greater problem drinking. The increased alcohol problems of students without a diagnosed alcoholic parent, however, were somewhat different from other children of alcoholics (COAs). Thus, different types of COAs must be considered in research, treatment, and prevention programs.     

The Utility of the Revised Life Orientation Test to Measure Optimism among Hong Kong Chinese

To examine the utility of the revised Life Orientation Test (LOT-R) to measure optimism among Hong Kong Chinese, the psychometric properties of the revised and the original versions of the Life Orientation Test were compared. A total of 248 Hong Kong Chinese undergraduates were studied in the fall and 165 of these participants were tested again 5 months later. Results indicated that the LOT-R is a reliable and valid measure of dispositional optimism among Hong Kong Chinese. Confirmatory factor analysis showed that the LOT-R represents a one-factor model of optimism better than does the original version. Despite its brevity, the LOT-R is psychometrically sounder than the original sclae. These findings point to the feasibility of replacing the original with the revised scale in future research among Hong Kong Chinese. However, the utility of the revised test in cross-cultural comparisons may still be limited by the absence of emic components. Further research on optimism in the Chinese people with the LOT-R should pay more attention to the identification of emic dimensions.     

Alcoholism and the Force of Education

Education in regard to alcoholism has not been a noted success. This problem is examined by approaching the situation from a psychoanalytic view, as well as through the review of the history of the use, abuse, and prohibition of alcohol in this country. Attitudes toward alcohol share much in common with the attitudes to the other instinctual gratifications. Because of the many repressions involved, the problems of transference make their appearance in the performance of the alcoholism educator, as well as the student. The conscious avoidance of patronizing, prohibitionist, and similar attitudes might allow the teacher to present both the advantages and the dangers in the use of alcohol, and thus open the subject to more wholesome consideration.