Addiction Acknowledgement Scale Research Articles

Assessing behavioral patterns of Internet addiction and drug abuse among high school students.

BackgroundInternet addiction and drug abuse isolate adolescents from their family and friends and cause damage to their health, relations, emotions, and spirit. In the society, adolescents’ addiction extracts high cost on health care, educational failure and mental health services.ObjectivesThe aim of this study was to assess the behavioral patterns of Internet and drug addiction among urban and rural students in Urmia, Iran.MethodsA sectional and descriptive–analytical approach with stratified sampling method was employed to recruit 385 high school students from urban and rural areas. The Internet Addiction Test (IAT) and the Addiction Acknowledgement Scale (AAS) were used for data collection.ResultsThe total score of Internet addiction among the students was 41.72 ± 17.41. Approximately two-third of the students were not addicted to the Internet. The mean score of the AAS was 1.87 ± 1.23 among boys and 1.75 ± 1.31 among girls. Moreover, 8.31% of the students were prone to abusing substances. A statistically significant relationship was found between mother’s literacy level and Internet addiction behavior of students (p=0.009).ConclusionConcentrating on adolescents’ behavioral patterns and their tendency toward misusing Internet and drugs is a notable procedure. Therefore, focusing on adolescents’ health and institutionalizing appropriate training programs for adolescents and their families are vital.

Predictive Ability for Drug Use in Sub-Clinical Students with Attention Deficit Hyperactivity Disorder by Questionnaire Survey

Dear Editor, I read with interest the article by Bayrami et al., reporting the predictive ability of drug use for subjects with attention deficit hyperactivity disorder (ADHD) symptoms (1). The target 361 subjects were sampled randomly from 5129 university students, and a cross-sectional survey was conducted by using a questionnaire. Recently, Lichtenstein et al. conducted a follow-up study to know the effect of medication for 25,656 ADHD patients on criminality (2). They concluded that the use of medication for ADHD reduces significantly the risk criminality. These two surveys contain completely different population from the viewpoint on the severity of ADHD. Although Bayrami et al. mentioned that there was a positive relationship between ADHD symptoms and drug use, a further study is needed to make a finalconclusion. First, their study is a cross-sectional study, and cause-effect relationship cannot be defined. Second, the target subjects are composed mainly of healthy young population, and clinical diagnosis of ADHD has not been made. Third, Pearson's moment correlation coefficient using scores from the questionnaire on ADHD and addiction acknowledgment scale score or Mac Andrew alcoholism scale scores showed under 0.4. This means that the relationship is not so strong, although a significant relationship was observed. This fact was also clarified by the multiple regression analysis, which was presented in Tables 2 and 3. Adjusted square values of R (multiple correlation coefficients) were under 0.16, which meant that each explanation rate was under one-sixthof all the variance. Before describing the predictive ability as they conducted, I recommend to describe the characteristics of the target university students. By this process, trace ability of their results by other researchers would improve. In anyway, there is a need for more studies to conclude the effect of ADHD symptoms on drug use including alcoholism.

Predicting a tendency to use drugs from child and adult attention deficit hyperactivity disorder symptoms in adults.

BackgroundAdult attention deficit hyperactivity disorder (ADHD) increases the risk of several psychiatric disorders, like substance use disorders (SUDs).ObjectivesThis study aimed to predict the tendency for drug use from child and adult ADHD symptoms in adults among male students from Tabriz University, Iran.Patients and MethodsFor this purpose, 361 students were selected via a stratified random sampling from different faculties of Tabriz University. The students completed the Conners Adult ADHD Rating Scale self-report form and subscale (CAARS) questionnaire, Addiction Acknowledgment Scale (AAS) and MacAndrew Alcoholism Revised-Scale (MAC-R).ResultsTo analyze the data Pearson correlation and multiple regressions (step by step) were used. Results indicated that there is a significant relationship between scores on the AAS and MAC-R via child and adult ADHD symptoms (P = 0.01). Moreover, we found that those with the highest addiction acknowledgment (13%) exhibited adult ADHD (total) and child ADHD. Alcohol potential (15%) was related to scores of child ADHD and impulsivity.ConclusionsAccording to this result behavioral disorders, especially ADHD, have an effect on the tendency to use drugs and therefore the primary treatment of behavioral disorders could prevent future drug abuse.

Evaluation of Alcohol and Other Drug Use and the Influence of Social Desirability

The purpose of this study was to explore the relationship between the evaluation of alcohol and other drug use by what has been called direct measures, that is, scales that include obvious or explicit items on consumption, indirect measures, composed of camouflaged or nonobvious items on consumption, and the social desirability construct. The following use and/or addiction scales were given to a sample of 506 university students of both sexes: the Alcohol Use Disorders Identification Test (AUDIT), Addiction Acknowledgment Scale (AAS), CAGE Alcohol Questionnaire, Addiction Potential Scale (APS), MacAndrew Alcoholism Scale-Revised (MAC-R), and a self-report on alcohol and other drug use designed for this study. The relationships between these scales and the social desirability construct, measured with the Edwards Social Desirability Scale (DS) and the Paulhus Balanced Inventory of Desirable Responding (BIDR) were also explored. Although the results do not allow us to arrive at a conclusion as to which scales are the most valid for evaluating the use of alcohol and other drugs, the data do show adequate convergent validity. The correlations found among the use and social desirability scales employed were negative and statistically significant.

Substance Use Scales of the Minnesota Multiphasic Personality Inventory

Three drug and alcohol use screening scales are embedded within the Minnesota Multiphasic Personality Inventory—2: the MacAndrew Alcoholism Scale (MAC) and its revised version (MAC-R), the Addiction Acknowledgement Scale (AAS), and the Addiction Potential Scale (APS). The current study evaluated the reliability reporting practices among 210 studies administering the MAC/MAC-R, APS, and/or AAS. Furthermore, reliability generalization methods were used to characterize the previously reported reliability estimates associated with each instrument. The vast majority of studies (90.6%) did not provide measurement reliability data, suggesting a need for improved psychometric reporting. Data from the remaining studies yielded mean and median score reliability estimates below .70 for each of the identified measures. Although limited in some instances by sample size constraints, results suggest that these instruments tend not to produce scores with acceptable levels of reliability for most research or clinical situations.

Diagnostic Accuracy and Factor Structure of the AAS and APS Scales of the MMPI-2

Receiver operating characteristics analysis and sensitivity analysis were used to compare the diagnostic accuracy of the Addiction Acknowledgement Scale (AAS; Weed, Butcher, McKenna, & Ben-Porath, 1992) and Addiction Potential Scale (APS; Weed et al., 1992) of the Minnesota Multiphasic Personality Inventory-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) to that of the MacAndrew Alcoholism Scale-Revised (Butcher et al, 1989), the CAGE (Mayfield, McLeod, & Hall, 1974), and Svanum's scale (Svanum & McGrew, 1995) in a sample of 338 university students. The AAS was the most accurate of these 5 scales at identifying current alcohol dependence (as measured by a structured diagnostic interview) and appears to offer considerable promise as an alcohol screening instrument. In contrast, the APS performed the most poorly of the 5 scales being evaluated, yielding results that would be of minimal clinical utility. Factor analysis yielded a 2-factor solution for the AAS (Acknowledgement of Alcohol/Drug Problems; Positive Alcohol Expectancies) and a 4-factor solution for the APS (Satisfaction with Self; Cynicism/Pessimism; Impulsivity; Risk-Taking).

Adherence to Substance Abuse Treatment: Clinical Utility of Two MMPI-2 Scales

In this study, we examined the ability of the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) Addiction Acknowledgment scale (AAS; Weed, Butcher, McKenna, & Ben-Porath, 1992) and Negative Treatment Indicators scale (TRT; Butcher, Graham, Williams, & Ben-Porath, 1990) to predict adherence to and outcomes from substance abuse treatment. There was no evidence that the AAS was related to treatment adherence or outcome in our sample. However, results did reveal a significant positive relation between scores on the TRT scale and readmission to the hospital. Further analyses identified an optimal score for use in similar clinical populations and settings, and characteristics of high and low scorers. Compared to low scorers, high TRT scorers were more likely to not return for treatment after an initial screening interview. If they did return for treatment, high TRT scorers were more likely to experience fewer treatment days and to be rated as having lower motivation, poorer participation, and poorer comprehension of program materials. These findings provide promising initial evidence of the utility of the TRT scale for identifying patients who may be at a high risk for unsuccessful substance abuse treatment.

Assessment of substance abuse in psychotherapy clients: The effectiveness of the MMPI-2 substance abuse scales.

The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) contains 3 scales, the MacAndrew Alcoholism Scale-Revised (MAC-R), the Addiction Potential Scale (APS), and the Addiction Acknowledgement Scale (AAS), that were developed to identify alcohol and drug abusing individuals. The current study was designed to measure the effectiveness of these scales at detecting substance abuse problems in a community-based mental health sample. MAC-R, APS, and AAS scores were obtained from 64 therapists who identified 68 substance abusing and 392 nonabusing psychotherapy clients. The results indicated that mean scores on all 3 scales were higher for the substance abusers than for nonabusers. Furthermore, discriminant analysis found all 3 scales to be effective screening tools. The AAS was the best single predictor, and a combination of the AAS and MAC-R provided the best overall discrimination. The implications of early substance abuse detection on treatment effectiveness are 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.

Using the MMPI-2 to detect substance abuse in an outpatient mental health setting.

This study examined the utility of the MMPI-2 in detecting substance-abuse problems in an outpatient mental health setting. Specifically, the utility of the Addiction Acknowledgment Scale (AAS; N. C. Weed, J. N. Butcher, T. McKenna, & Y. S. Ben-Porath, 1992), the Addiction Potential Scale (APS; N. C. Weed et al., 1992), and the MacAndrew Alcoholism Scale-Revised (MAC-R; J. N. Butcher, W. G. Dahlstrom, J. R. Graham, A. Tellegan, & B. Kaemmer, 1989) in the prediction of substance abuse was evaluated. In addition, the incremental validity of the AAS and the APS in comparison to the MAC-R scale was evaluated. The sample consisted of 500 women and 333 men from a large community mental health center in Northeastem Ohio. Results indicated that the MAC-R scale, the AAS, and the APS were related to interviewer ratings of substance abuse in this outpatient treatment setting. Specifically, the results pointed to the superiority of AAS over APS in substance-abuse identification and the significant contribution of AAS to the information available from the MAC-R scale alone.

Cross-validation of MMPI and MMPI-2 predictor scales.

Nineteen Minnesota Multiphasic Personality Inventory (MMPI) or revised Minnesota Multiphasic Personality Inventory (MMPI-2) scales, purported to be predictive of treatment outcome, were related to length of stay (LOS) in a domiciliary and to discharge status from a domiciliary for 335 subjects. The revised MacAndrew Alcoholism Scale (MAC-R), Addiction Acknowledgement Scale (AAS), and Addiction Potential Scale (APS), scales indicating a propensity to use illicit substances, and the Psychopathic Deviate Scale (Pd), indicating acting-out, all correlate negatively with length of stay. AAS also correlates negatively with regular/irregular discharge. Other scales expected to predict treatment outcome do not significantly correlate with either length of stay or type of discharge.

Internal structure of the MMPI-2 Addiction Potential Scale in alcoholic and psychiatric inpatients.

Recently, Weed, Butcher, McKenna, and Ben-Porath (1992) introduced two new scales for assessing alcohol and drug abuse with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989): the Addiction Potential Scale (APS), an empirically derived measure similar to the MacAndrew Alcoholism Scale (MAC; MacAndrew, 1965), and the Addiction Acknowledgement Scale. Like the MAC, the APS was designed to identify the personality dimensions associated with substance abuse. Although there has been evidence to support the discriminative validity of the APS among samples of abusers, nonabusers, and psychiatric inpatients (Greene, Weed, Butcher, Arrendondo, & Davis, 1992; Weed et al., 1992), there has been no attempt to determine the personality dimensions tapped by the APS. Thus our study investigated the internal complexities of the APS. Using MMPI-2 protocols from a sample of alcoholic and psychiatric inpatients, we subjected the APS to a principal components analysis with subsequent varimax rotation. Both qualitative and quantitative methods were used to name the components that were identified. Five components consistently emerged across settings: Satisfaction/Dissatisfaction with Self, Powerlessness/Lack of Self-Efficacy, Antisocial Acting-Out, Surgency, and Risk-Taking/Recklessness, Clinical advantage gained from a knowledge of the internal structure of the APS was illustrated using 6 patients from the alcoholic sample. A rational approach to validating the empirical structure of the APS was discussed as a potential avenue for future research.

Validity of the Substance Abuse Scales of the MMPI-2 in a College Student Sample

This study assessed the validity of three Minnesota Multiphasic Personality Inventory-2-based (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) substance abuse scales. The scales were the MacAndrew Alcoholism Scale-Revised (MAC-R; Butcher et al., 1989) and the recently developed Addiction Acknowledgment Scale and Addiction Potential Scale (AAS & APS; Weed, Butcher, McKenna, & Ben-Porath, 1992). Study participants were 308 male and female college students who completed the MMPI-2 and the substance use disorder modules of the Diagnostic Interview Schedule. The MAC-R and the APS had a nonsignificant-to-weak relationship with substance dependence as defined by the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, 1980). The AAS had a moderate ability to identify the 33 study participants who met DSM-III-R criteria for a substance use disorder, primarily alcoholism. Broadening the definition of substance abuse to a continuum of alcohol/drug problems did not alter the character of findings. These results highlight the relative superiority of direct (AAS) versus subtle (APS, MAC-R) scales to detect substance dependence and support studies that question the overall utility of traditional MMPI scales to identify substance abuse.

New measures for assessing alcohol and drug abuse with the MMPI-2: The APS and AAS.

We introduce two new scales for assessing substance abuse problems with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2): the Addiction Potential Scale (APS), a 39-item empirically derived scale, developed by contrasting the responses of a large residential substance abuse sample with responses from both normative and psychiatric control groups; and the Addiction Acknowledgement Scale (AAS), a 13-item face-valid scale, constructed rationally and with attention to internal consistency. Both new scales are shown to discriminate well between groups and substantially better than other selected substance abuse scales. Covariation between the scales and joint effectiveness are examined. Finally, limitations for their practical utility are expressed, and considerations for future research are identified.

A cross-validation of MMPI-2 substance abuse scales.

We evaluated the efficacy of the Addiction Potential Scale (APS) and the Addiction Acknowledgement Scale (AAS), two new scales designed to assess substance abuse problems with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), in samples from settings different from those used in their development. Results replicate earlier findings that both scales discriminate between psychiatric and substance abuse samples and do so more effectively than other substance abuse scales designed for use with the MMPI and carried over to the MMPI-2. Results also suggest that APS may be more resistant than AAS to response distortion.