Alcoholic subtypes and the MacAndrew Alcoholism Scale.

Forty-five alcoholics in treatment (29 males and 16 females) who reported substantial alcohol dependence but scored in the nonalcoholic range on the MacAndrew Alcoholism Scale (MAC) were matched with 45 alcoholics who reported a similar degree of alcohol dependence and obtained alcoholic-range scores on the MAC. Results reveal that high MAC alcoholics were characterized by gregariousness, social drinking, belligerence and aggression while drinking, and a high degree of alcohol-related legal problems. Low MAC alcoholics appeared to be a different or less distinctive type of alcoholic; although they were less outgoing and preferred not to drink with others, they experienced a wide range of serious alcohol-related consequences. Low MAC alcoholics were not more likely to have a history of nonsubstance use psychiatric diagnosis and treatment. Cloninger, Bohman, and Sigvardsson's (1981) alcoholic typology was related to MAC scores: There was a greater likelihood that high-MAC alcoholics were Type II and low MAC alcoholics Type I.     

Behavioral,psychological, and historical correlates of MacAndrew scale scores among male alcoholics

Male alcoholic veterans (N=194) were divided into four groups on the basis of their scores on the MacAndrew scale (MAC) of the Minnesota Multiphasic Personality Inventory (MMPI) and compared on psychological and sociodemographic measures and self-reported alcohol, drug, and legal histories. Nineteen subjects scored in the nonalcoholic (NA) range of the MAC (i.e., false negatives, MAC23). Remaining subjects, scoring in the alcoholic range of the MAC, were divided into thirds by MAC scores (lowest third, L-MAC=24–28,n=53; middle third, M-MAC=29–31,n=63; highest third, H-MAC>31,n=59). Groups did not differ on age, any important sociodemographic variables, or scores on the Profile of Mood States, State-Trait Anxiety Inventory, Symptom Checklist-90, or Rod and Frame Test. Significant group differences were obtained on several MMPI scales. Lower MAC scores were associated with higher scores onL, K, D, andR, and lower scores onMa. There was also a tendency for subjects with lower MAC scores to score higher onSi. NA subjects began drinking and heavy drinking later than other subjects, although groups did not differ on duration, quantity, or frequency of drinking. Subjects with higher MAC scores more often reported drinking in bars, drinking liquor straight, alcohol-related job disruptions, and previous use of marijuana, hallucinogens, and barbiturates. Subjects with higher MAC scores had more often been arrested, convicted, fined, and jailed for alcohol-related offenses but not for other offenses. Results are examined with respect to MacAndrew's distinction between primary and secondary alcoholics and with respect to the possible relations of MAC to important person variables such as sensation seeking.The authors wish to thank Craig MacAndrew for his helpful critical reading of an early draft of this paper. We also thank Theresa Hilliard, Shirley White, Vicki Brumbelow, and Pam Thompson for editorial assistance and Audrey Jefferson for help with data preparation.     

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.     

Drinking practices among black and white alcoholics and alcoholics of different personality types

In order to examine the effects that race and personality type have on self-reported drinking practices, samples of 49 White and 49 Black male alcoholics were matched on age and education, and classified into two personality types according to MMPI scores. The results of multivariate and univariate analyses of variance yielded significant main effects. White alcoholics reported a greater: (a) use of alcohol for symptomatic relief of psychological distress, (b) loss of motor control and tendency to engage in destructive acts, and (c) daily consumption of beverage alcohol than Black alcoholics. Alcoholics with psychiatric-appearing MMPI profiles reported greater: (a) social benefits of alcohol use, (b) alcohol use for symptomatic relief of psychological distress, and (c) perceptual distortions associated with alcohol withdrawal than alcoholics with characterlogical-appearing MMPIs. Results were discussed in terms of need to control confounding effects of biosocial variables in cross-cultural research and implications that these effects may have on the generalizability of alcoholic personality typologies.     

Drinking Practices Among Black and White Alcoholics and Alcoholics of Different Personality Types

In order to examine the effects that race and personality type have on self-reported drinking practices, samples of 49 White and 49 Black male alcoholics were matched on age and education, and classified into two personality types according to MMPI scores. The results of multivariate and univariate analyses of variance yielded significant main effects. White alcoholics reported a greater: (a) use of alcohol for symptomatic relief of psychological distress, (b) loss of motor control and tendency to engage in destructive acts, and (c) daily consumption of beverage alcohol than Black alcoholics. Alcoholics with psychiatric-appearing MMPI profiles reported greater: (a) social benefits of alcohol use, (b) alcohol use for symptomatic relief of psychological distress, and (c) perceptual distortions associated with alcohol withdrawal than alcoholics with characterlogical-appearing MMPIs. Results were discussed in terms of need to control confounding effects of biosocial variables in cross-cultural research and implications that these effects may have on the generalizability of alcoholic personality typologies.     

A comparison of alcoholics whose drinking is totally uncontrolled and those whose drinking is mainly controlled

The analysis of drinking patterns of 77 married male alcoholics for the period of 12 months immediately following their intake into a treatment trial suggested the importance of a variable which has been neglected in the literature on alcohol dependence. Although only 3 had returned to a pattern of drinking which was, by their own and by their wives' accounts, totally controlled, there were wide individual differences amongst the remainder in the uniformity with which drinking was uncontrolled. Two extreme groups were identified: in 22 cases patients and their wives were agreed that drinking had been totally uncontrolled; in 14 cases patients and wives were agreed that drinking had been mainly controlled. There were no differences between these two groups in the amount of abstinence reported but there were major differences in other respects. Mainly controlled drinkers were more likely to think that they had no drinking problem or that their problem was of very recent origin, reported significantly fewer symptoms, were much less likely to be institutionalized during the 12 month period, were less likely to think of themselves as alcoholics and were less likely to express a preference for abstinence as a target. The hypothesis is suggested that this drinking pattern variable may serve as a differential predictor of successful outcome following abstinence-oriented or controlled drinking-oriented treatment.     

An operant treatment procedure for alcoholics

For many years total abstinence was regarded as the appropriate criterion for the successful treatment of alcoholism. It is suggested that given societal norms for social consumption of alcohol, plus the social reinforcers which maintain beverage alcohol ingestion, social drinking may serve as a realistic treatment goal. The efficacy of a social drinking criterion was clearly demonstrated by Bigelow et al. (1972). Chronic alcoholic in-patients were placed in a choice situation in which they earned the opportunity to participate in an ‘enriched’ environment contingent upon either moderate drinking or abstinence. Subjects overwhelmingly chose the moderate drinking alternative. Results also suggested that moderate drinking is more reinforcing than abstinence for alcoholics. Further support for the moderate drinking concept was rendered by Mills, Sobel and Schaeffer (1971) in a study which made electric shock contingent on gulping drinks, ordering straight alcoholic drinks and ordering and consuming more than three drinks. Time-out (Cohen et al., 1971), positive reinforcement (Cohen et al., 1971) and social contracting procedures (Miller, 1972) have been effectively employed to reduce drinking behavior from maladaptive to adaptive frequencies.

The present study attempts to extend treatment with a controlled drinking outcome to out-patient alcoholics     

Abstinence or control: The outcome for excessive drinkers two years after consultation

This report presents the two-year follow-up results for a sample of married male alcoholics who had been the subjects of a controlled treatment trial. Cumulative relapse curves for the two-year period were found to be similar in form to those which Hunt and Matarazzo (1970) have drawn for drug addicts, alcoholics and smokers. Outcome at 12 and 24 months were compared: changes from good to bad outcome, or vice versa, were rare. The degree of hardship reported by wives remained predictive of outcome two years later. Not all drinking reported at two years was uncontrolled. Of 26 men with a good outcome. 11 were agreed by husband and wife to be abstaining, and 10 were agreed to be controlling their drinking. Most of the latter had not shown lengthy periods of abstinence prior to resuming drinking. Controlled drinkers reported fewer symptoms at intake (morning drinking, shakes, secret drinking, hallucinations etc.), were more likely to have been sub-diagnosed as Alpha alcoholics (psychologically dependent), and were more likely to have been only briefly counselled. Abstainers reported more symptoms at intake, were more likely to be sub-diagnosed as Gamma alcoholics (physically dependent), and were more likely to have been intensively treated. These results suggest an interaction between degree of dependence, type of treatment, and goal of treatment. If confirmed by future research this would have strong implications for the planning of comprehensive alcoholism treatment services.     

an alcoholic is good and sober: sentiment change in AA

An Alcoholic is a stigmatized, deviant identity. This longitudinal study of 55 Alcoholics Anonymous (AA) participants found that even chronic alcohol abusers viewed alcoholics negatively, in keeping with normative understandings. However, following mandated AA attendance, there was significant change in social sentiments for alcohol-related concepts and meanings for feelings and objects related to drinking, as sentiments became similar to AA subculture understandings. In AA, "an alcoholic" is good. Sentiment change, AA ideology, and the implications for identity and normative behavior are discussed.     

The acquisition of taste aversions in humans with eating and drinking disorders

A written questionnaire or interview concerned with acquisition of illness-induced (taste) aversions to foods and drinks was given to three groups of people with eating and drinking disorders. These groups consisted of 101 male and 1 female hospitalized alcoholics, 8 male and 8 female college-student heavy consumers of alcohol and 18 females with anorexia nervosa and/or bulimia. In most respects taste-aversion acquisition in these three groups was similar to taste-aversion acquisition in a general college-student population previously studied by Logue, Ophir and Strauss (1981), and to taste-aversion acquisition in other species. In all three groups the aversions were more likely to be reported as having been formed through forward rather than simultaneous or backward conditioning, and long-delay learning was frequent. The aversions usually formed to the tastes rather than to the appearance or other aspects of the foods and drinks. Extinction appeared more effective in decreasing the aversions than did forgetting. While the illness responsible for the aversions forming was usually attributed to the subsequently aversive food or drink, in at least one third of the cases subjects reported that something else might have caused their illness. Aversions were more likely to have formed to relatively less familiar and less preferred foods and drinks. However, the hospitalized alcoholics reported fewer aversions, less generalization of aversions, and stronger nausea as the cause of the aversions than did Logue et al.'s (1981) subjects. About 15% of these subjects reported taste aversions to alcoholic beverages. The college-student heavy consumers of alcohol reported no generalization of their taste aversions, but in other respects were similar to Logue et al.'s subjects. Thirty-one percent of these subjects reported taste aversions to alcoholic beverages. The anorexic and bulimic subjects were also similar to Logue et al.'s subjects with the exception that they, like the hospitalized alcoholics, reported stronger nausea as the cause of the aversions. These data may help to understand and treat people with eating and drinking disorders     

Application of the MacAndrew alcoholism scale to alcoholics with psychiatric diagnoses

The MacAndrew Alcoholism scale scores of 140 male 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.     

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.     

Male alcoholics,secondary psychopathy and Eysenck's theory of personality

The scores of several samples of male alcoholics and others on the MAC Scale (an MMPI-derived scale for the differentiation of male alcohol abusers from non-substance-abusing male psychiatric outpatients) are summarized, and the responses of the false negatives and false positives from the scale's standardization samples are analyzed. The following 7conclusions were reached: (1) There are two broad classes of male alcoholics—those who fall into the E + N + quadrant of secondary psychopathy and those who fall into the E - N + quadrant of neurotic introversion; (2) Unselected runs of male alcoholics populate these two quadrants in a quite stable ratio of 17 to 3, respectively; (3) Pari passu, Eysenck's placement of alcoholics in the E + N + quadrant will be upheld in approximately 85% of the cases while those who hold that alcoholics are ‘dysthymics who also drink too much’ will find themselves in error in approximately similar degree.     

Transient versus enduring depression among alcoholics in inpatient treatment

The purposes of this study are (1) to determine the incidence of significant clinical depression among alcoholics at treatment intake at a Veterans Medical Center, (2) to subdivide alcoholics who show significant clinical depression into enduring and transient depressive subgroups, and (3) to identify demographic and psychometric variables useful in discriminating between these two subgroups. Results indicate that of the 60% of VA inpatient alcoholics who showed evidence of significant clinical depression at intake, approximately equal numbers met criteria for inclusion in transient and enduring depressive subgroups. Patients with enduring and transient depression, as defined in this study, were differentiated on the basis of age, drinking pattern, and selected scales from two psychometric instruments which measure depression, confused and disorganized thinking, and an avoidant personality style. These findings may be useful in assisting clinicians in differentiating between alcoholic patients with transitory depression associated with alcohol consumption and/or withdrawal and alcoholic patients with more serious and enduring depression, which may require additional pharmacologic and/or psychotherapeutic intervention.     

Factors influencing drinking behavior in alcoholic panickers and non-panickers

Male alcoholics who (a) experienced panic attacks prior to abusing alcohol, (b) experienced panic attacks subsequent to abusing alcohol, and (c) had not experienced panic attacks were compared on three sets of measures: the Panic Attack Questionnaire, the Restrained Drinking Scale, and the Inventory of Drinking Situations. The results showed that two groups of Ss who experienced panic attacks were more likely than non-panickers to use drugs other than alcohol, began drinking at an earlier age, had a greater proportion of parents with panic and alcohol related problems, had higher drinking restraint scores, and drank in more situations. The Ss who experienced panic attacks prior to abusing alcohol were more likely than the other groups to drink in situations similar to those related to agoraphobic fears. It was postulated that alcoholics who experience panic attacks, especially those who experienced panic attacks prior to abusing alcohol may be using alcohol to reduce anxiety or fear related to panic attacks.     

The Use of the MacAndrew Alcoholism Scale in Detecting Substance Abuse and Antisocial Personality

We evaluated the hypothesis that characterological factors, particularly antisocial personality, influence scores on the MacAndrew Alcoholism Scale (MAC). Using the Washington University research criteria to establish diagnoses, the following subgroups were defined: subjects who received no psychiatric diagnoses; subjects who received diagnoses other than alcoholism, drug dependence, or antisocial personality; and subjects who received a diagnosis of alcoholism, drug dependence, and/or antisocial personality, alone or in combination with other psychiatric diagnoses. The highest MAC scores were obtained by subjects diagnosed as having antisocial personality without alcoholism or drug dependence and subjects diagnosed with antisocial personality, drug dependence, and alcoholism. Alcoholics without antisocial personality or drug dependence, and subjects with other psychiatric diagnoses scored lowest. Although higher MAC scores were obtained by males, MAC scores greater than 24 correctly classified the greatest number of males and females as alcoholic, drug dependent and/or antisocial. These findings are interpreted as consistent with MacAndrew's reinterpretation of the scale as assessing a dimension of personality, rather than solely a tendency to addiction.     

The use of the MacAndrew Alcoholism Scale in detecting substance abuse and antisocial personality

We evaluated the hypothesis that characterological factors, particularly antisocial personality, influence scores on the MacAndrew Alcoholism Scale (MAC). Using the Washington University research criteria to establish diagnoses, the following subgroups were defined: subjects who received no psychiatric diagnoses; subjects who received diagnoses other than alcoholism, drug dependence, or antisocial personality; and subjects who received a diagnosis of alcoholism, drug dependence, and/or antisocial personality, alone or in combination with other psychiatric diagnoses. The highest MAC scores were obtained by subjects diagnosed as having antisocial personality without alcoholism or drug dependence and subjects diagnosed with antisocial personality, drug dependence, and alcoholism. Alcoholics without antisocial personality or drug dependence, and subjects with other psychiatric diagnoses scored lowest. Although higher MAC scores were obtained by males, MAC scores greater than 24 correctly classified the greatest number of males and females as alcoholic, drug dependent and/or antisocial. These findings are interpreted as consistent with MacAndrew's reinterpretation of the scale as assessing a dimension of personality, rather than solely a tendency to addiction.     

Associations between depression, distress tolerance, delay discounting, and alcohol-related problems in European American and African American college students

Although levels of heavy drinking and alcohol-related problems are high in college students, there is significant variability in the number and type of problems experienced, even among students who drink heavily. African American students drink less and experience fewer alcohol-related problems than European American students, but are still at risk, and little research has investigated the potentially unique patterns and predictors of problems among these students. Depression, distress tolerance, and delay discounting have been implicated in adult substance abuse and may be important predictors of alcohol problem severity among college students. We examined the relationship between these variables and alcohol-related problems among African American and European American students (N = 206; 53% female; 68% European American; 28% African American) who reported recent heavy drinking. In regression models that controlled for drinking level, depression, distress tolerance, and delay discounting were associated with alcohol problems among African American students, but only depression was associated with alcohol problems among European American students. These results suggest that negative affect is a key risk factor for alcohol problems among college student drinkers. For African American students, the inability to tolerate negative emotions and to organize their behavior around future outcomes may also be especially relevant risk factors.     

Differences in the drinking behavior between alcoholic men and women in the Schwerin district]

The present paper demonstrates some typical differences in drinking behaviour between female and male alcoholics. We investigated especially the difference in quantities of consumed pure alcohol. The ratio of the mean consumption per year by women and men was 1 : 1,9. The difference in due to differences in the drinking habits and a different alcoholic tolerance in both sexes. Generally we found that in both family and society alcohol abuse is less tolerated in women.     

Standardized measures of alcohol-related problems: a review of their use among college students

College students' alcohol consumption has received considerable attention in the scientific literature and the media for its impact on students and the college community. Misuse of alcohol can lead to a wide range of consequences, the most severe being alcohol abuse, dependence, and death. Researchers have struggled to develop effective methods to assess problems related to alcohol, and the literature on college drinking lacks a strong theoretical framework for such assessment. The authors contend that measures of alcohol-related problems for college students should assess specific dimensions pertaining to 3 main domains: alcohol abuse, alcohol dependence, and what the authors define as risky drinking. The authors examined how existing measures fit into this model. In a comprehensive review of the college literature, the authors identified 9 measures (and their revised versions) assessing alcohol-related problems. Their analysis revealed that most measures do not assess comprehensively the domains outlined, and instead provide only partial assessments of the potential consequences of drinking for college students. The authors include directions for future research so that measurement of drinking consequences for college students can be refined.