MacAndrew Alcoholism Scale-Revised Research Articles

Fluid intelligence, traits of personality and personality disorders in a cohort of adult KS patients with the classic 47, XXY karyotype.

Klinefelter's syndrome (KS) is associated with specific neurobehavioral features and personality traits. The aim of our study was to investigate fluid intelligence, personality traits and personality disorders (PD) and possible correlations with testosterone in a cohort of adult KS patients. We analyzed 58 adult KS patients with the classic 47, XXY karyotype. The Structured Clinical Interview for axis II disorders was used to assess DSM IV personality disorders. Personality traits were assessed using MMPI-2. Fluid intelligence was tested by using Raven's Standard Progressive Matrices (SPM) Test. Testosterone blood concentration was measured by CMIA. PD prevalence was 31%. Four altered MMPI scales (Social Responsibility, Dominance, Ego Strength and Repression) were found in more than 40% of patients. Overcontrolled hostility and MacAndrew Alcoholism Scale-Revised scales were altered in the PD- group only. Biz-Odd Thinking and Post-Traumatic Stress Disorder scale were associated with the presence of personality disorder. The raw SPM score was 44±10.8 without any significant correlation with testosterone. No significant difference in mean age, SPM raw score and MMPI score was observed between eugonadal, hypogonadal and treated patients. Most KS patients had average fluid intelligence. PD prevalence was higher than in the general population. Testosterone was not correlated with fluid intelligence, personality traits or PD, but a reduction in marital distress was observed in treated patients. This could suggest that testosterone therapy can improve physical symptoms and this effect could also improve relationship abilities and wellness awareness.

Assessing the Accuracy of the Substance Abuse Subtle Screening Inventory-3 Using DSM-5 Criteria

The Substance Abuse Subtle Screening Inventory-3 (SASSI-3; Miller & Lazowski, 1999) is a substance use screen that uses logically derived, or obvious questions, as well as subtle, or empirically derived questions. The SASSI-3 can be completed, scored and interpreted in 15 minutes. Side one consists of 67 true-false items selected for their ability to statistically differentiate between a criterion group of persons with substance dependence and a control group of non-substance dependent persons. The 67 empirically derived items are used in an effort to defeat dissimulation and are similar in nature and purpose to items found on the MacAndrew Alcoholism Scale-Revised (MAC-R; MacAndrew, 1965). As such, these empirically derived items are useful with individuals who are either intentionally or unintentionally denying a substance use (Laux, Piazza, Salyers, & Roseman, 2012). These comprise the Symptoms scale (SYM), which assesses the symptoms and consequences of drug and alcohol use; the Obvious Attributes scale (OAT), a measure of the obvious symptoms of substance dependence; the Subtle Attributes scale (SAT), an indirect measure of substance use that employs items with non-substance-related content; the Defensiveness scale (DEF), which measures denial or minimization; the Supplemental Addiction Measure scale (SAM), which discriminates general defensiveness from defensiveness related to substance use; the Family Versus Control Subjects scale (FAM), which identifies those who are likely to focus on the thoughts and feelings of others to their own neglect; the Correctional scale (COR), used to detect response patterns similar to those produced by persons with a history of criminal behaviors; and the Random Answering Pattern scale (RAP), designed to identify haphazard answering. Side one also includes questions about respondents' marital status, employment status, education, ethnicity and income.Side Two consists of 12 items specific to alcohol use and 14 items regarding use of other substances. Response options to these 26 items are never, once or twice, several times, and repeatedly. These 26 items comprise the Face Valid Alcohol (FVA) and Face Valid Other Drugs (FVOD) scales and are similar to items found on the Michigan Alcoholism Screening Test (MAST; Selzer, 1971) and the CAGE (Ewing, 1984). The SASSI-3 is interpreted using nine decision rules. The first five decision rules are based solely on the unique contributions of individual scales. The remaining four decision rules involve a combination of two or more scales. A decision rule is coded yes if the associated SASSI-3 scale or scales' raw score is equal to or greater than the decision rule's cut score. Otherwise, the decision rule is coded as no. The respondent is determined to have a high probability of having a substance dependence disorder if any of the decision rules are met (Miller & Lazowski, 1999, p. 10).Not only does the SASSI-3 do a better job of identifying alcohol use disorders than the MAST, CAGE and MAC-R (Laux, Perera-Diltz, Smirnoff, & Salyers, 2005; Laux, Salyers, & Kotova, 2005), it provides the added benefit of screening for drug use other than alcohol. The most recent inquiry into substance use screens indicated that the SASSI-3 is the substance use screen most frequently used by Master Addictions Counselors certified by the National Board for Certified Counselors (Juhnke, Vacc, Curtis, Coll, & Paredes, 2003).The SASSI-3 Manual (Miller & Lazowski, 1999) reported a sensitivity (true positive) rate of 94.6% and specificity (true negative) rate of 93.2%. Subsequent field research produced results consistent with the psychometric claims made in the SASSI-3 Manual (Burck, Laux, Harper, & Ritchie, 2010; Burck, Laux, Ritchie, & Baker, 2008; Calmes et al., 2013; Hill, Stone, & Laux, 2013; Laux, Perera-Diltz, Smirnoff, & Salyers, 2005; Laux, Salyers, & Bandfield, 2007; Laux, Salyers, & Kotova, 2005; Wright, Piazza, & Laux, 2008). …

P01-71 - Connections between personality and the symptomatology of alcohol use disorder

IntroductionTemperament and character factors and specific impulse control-related personality traits are connected to the developmental and clinical aspects of alcohol use disorder (AUD).Objectives/aimsTo reveal the underlying personality structure of individual differences in the symptom severity of AUD. Therefore temperament and character, impulsivity and aggression were assessed in relation to alcohol addiction severity.MethodsSixty-three patients with AUD were involved. Temperament and Character Inventory-Revised was used to quantify temperament and character dimensions. Impulsivity was assessed by the Barratt Impulsivity Scale-11 (BIS) and aggression by the Buss-Perry Aggression Questionnaire (BPAQ). To determine symptom severity of AUD the Severity of Alcohol Dependence Questionnaire (SADQ), the Alcohol Use Disorders Identification Test (AUDIT), the MacAndrew Alcoholism Scale-Revised (MAC-R) and the number of DSM-IV alcohol dependence symptoms were registered. To analyze the connections between symptom severity indicators and personality factors Pearson and Spearman correlation analysis were applied, p < 0.05 were considered significant.ResultsSADQ (r = 0.290), AUDIT (r = 0.345), MAC-R (r = 0.504) and the DSM-IV alcohol dependence symptoms (Spearman rho = 0.271) correlated positively with novelty-seeking temperament factor. SADQ (r = 0.262) and AUDIT (r = 0.293) scores correlated positively with BIS. Furthermore SADQ (r = 0.382), AUDIT (r = 0.318), MAC-R (r = 0.416) correlated positively with BPAQ.ConclusionsNovelty-seeking, impulsivity and aggression as indicators of impulse control have different theoretical backgrounds but a common root. This study has revealed that the adverse consequences of lower impulse control can lead to more severe symptoms of AUD. These connections between impulse control and the symptomatology could contribute to a better understanding of the clinical complexity of AUD.

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.

A Psychometric Evaluation of the SASSI-3 in a College Sample

Although the Substance Abuse Subtle Screening Inventory-3 (SASSI-3; F. G. Miller & L. E. Lazowski, 1999) is widely used with college students (L. Myerholtz & H. Rosenberg, 1998), it is unclear whether the SASSI-3 is appropriate for use with this population. The authors investigated the SASSI-3's psychometric capabilities in a college student sample (N = 230). They found that the SASSI-3's psychometric properties are equal to or exceed those of the Michigan Alcoholism Screening Test (M. L. Selzer, 1971), the CAGE (J. A. Ewing, 1984), and the MacAndrew Alcoholism Scale-Revised (C. MacAndrew, 1965).

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).

Use of the MMPI-A to Detect Substance Abuse in a Juvenile Correctional Setting

In this study, we examined the ability of the MMPI-A (Butcher et al., 1992) to detect substance abuse problems in a juvenile correctional setting. Specifically, we evaluated the Alcohol/Drug Problem Acknowledgment scale (ACK; Weed, Butcher, & Williams, 1994), the Alcohol/Drug Problem Proneness scale (PRO; Weed et al., 1994), and the MacAndrew Alcoholism Scale-Revised (MAC-R; Butcher et al., 1992) in the prediction of substance abuse. In addition, the incremental validity of ACK in comparison to PRO was evaluated, as was the incremental validity of PRO in comparison to ACK. The sample consisted of 123 boys and girls from a juvenile correctional facility in Northeastern Ohio. Results indicate that ACK and PRO, but not MAC-R, were related to interviewer ratings of substance abuse. Results point to the superiority of ACK over PRO in substance abuse identification.

MMPI-2 with male and female state and federal prison inmates.

This study examined the base rates, patterns, and configurations of male and female prisoners on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; J. N. Butcher, W. G. Dahlstrom, J. R. Graham, A. Tellegen, & B. Kaemmer, 1989) validity, basic, supplementary, and content scales and compares them with the MMPI-2 adult norms and with the performance of offenders on the original MMPI (S. R. Hathaway & J. C. McKinley, 1943). Expectations as to which scales would show significant and meaningful elevations and effect sizes were generally upheld. The most prominent MMPI-2 scales are Infrequency, 4, 6, 9, MacAndrew Alcoholism Scale-Revised, and Antisocial Practices for both genders, and Scales 5 and Addiction Admission Scale among women. Scales 0 and Responsibility scale appeared to be inhibitory scales. Men and women had similar profile configurations, but the female offenders' scores were more deviant than those of the men.

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.

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.

Concurrent validity of the MMPI-A in a counseling program for juvenile offenders.

This study was conducted to examine the concurrent validity of the MMPI-A (Minnesota Multiphasic Personality Inventory-Adolescent) in an adolescent offender setting. From a sample of 50 court-adjudicated youths participating in an outpatient counseling program, 42 valid MMPI-A profiles were obtained, 33 of which were accompanied by counselor ratings of behavior problems. The highest mean elevations on the MMPI-A were on scales MAC-R (MacAndrew Alcoholism Scale-Revised), A-Con (Adolescent Conduct Problems), A-Sch (Adolescent School Problems), Pd (Psychopathic Deviate), and IMM (Adolescent Immaturity). Counselor ratings of behavior problems correlated highly with scales ACK (Alcohol and Drug Acknowledgment Scale), A-Sch, A-Ang (Adolescent Anger Problems), Ma (Hypomania), and PRO (Alcohol/Drug Problem Proneness). This pattern of results supports the concurrent validity of the MMPI-A for use in this setting.

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.