Personality characteristic differences between alcoholics who leave treatment against medical advice and those who don't

Mozdzierz, Gerald J.; Macchitelli, Frank J.; Conway, Judith A.; Krauss, Herbert H.

doi:10.1002/1097-4679(197301)29:1<78::aid-jclp2270290128>3.0.co;2-0

Cited by 21 publications

(6 citation statements)

References 7 publications

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“…Two studies found that patients who left early were more defensive and more apt to deny their discomfiture (Mozdzierz, Macchitelli, Conway, & Krauss, 1973;Nelson & Hoffmann, 1972). The alcoholic inpatient's cognitive style is also involved in whether he stays in the hospital.…”

Section: Alcoholismmentioning

confidence: 99%

“…It turned out to be important in 24 out of 26 studies (92.3%) that considered it (Blenkner, 1954;Brown & Kosterlitz, 1964;Chappel et al, 1973;Errera et al, 1967;Freedman, et al, 1958;Garfield et al, 1963;Gibby et al, 1954;Heilbrun, 1962;Heine & Trosman, 1960;Hewitt, 1969;Hiler, 1959;Katz & Solomon, 1958;Kissin et al, 1973;Lake & Levinger, 1960;E. Meyer et al, 1967;Miller et al, 1968;Mozdzierz et al, 1973;Nelson & Hoffman, 1972;Pittel et al, 1972;Rickels, 1968;Robson et al, 1965;Taulbee, 1958;Wittkower & Russell, 1956) and irrelevant in only 2 out of 24 studies (8.3%) (Affleck & Garfield, 1961;Lorr et al, 1958).…”

Section: Psychological Mindednessmentioning

confidence: 99%

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Dropping out of treatment: A critical review.

Baekeland

Lundwall²

1975

Psychological Bulletin

1,016

554

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After a discussion of methodological issues of the past 20 years, literature on dropping out of treatment was critically reviewed in six areas: hospital treatment of general psychiatric and tubercular patients, outpatient treatment of internal medical conditions, alcoholism, heroin addiction, general psychiatric outpatient psychotherapy, and double-blind drug studies. Fifteen factors were found to predict dropping out in 100%, 83%-88%, and 60%-75% of the relevant studies: (a) social isolation and/or unaffiliation, therapist attitudes and behavior, discrepancies between patient and therapist treatment expectations; (b) passive-aggressive behavior, family attitudes and behavior, motivation, behavioral and/or perceptual dependence, psychological mindedness and/ or -denial, symptom levels and symptom relief, socioeconomic status, sociopathic features, alcoholism and/or drug dependence; (c) age, sex, and social stability.One of the most vexing problems facing the physician, whether he is a surgeon, internist, or psychiatrist, is that far too many of those entrusted to his care, both inpatients and outpatients, drop out of treatment before they have completed it to his satisfaction. Although the question of the dropout has most often engaged the attention of psychiatrists, it also crops up from time to time in papers by internists, for whom there is no reason to believe that it is any less serious a problem. Where studied, the dropout problem has usually been in the context of treating chronic conditions that require prolonged treatment. The extent of this problem can be inferred ^rom the fact that in general psychiatric clinics, 20%-57% of the patients fail to return after the first visit (Blenkner,

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Section: Alcoholismmentioning

confidence: 99%

Section: Psychological Mindednessmentioning

confidence: 99%

Dropping out of treatment: A critical review.

Baekeland

Lundwall²

1975

Psychological Bulletin

1,016

554

View full text Add to dashboard Cite

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“…A diagnosis of sociopathic personality was linked with discharge against medical advice by Greenwald & Bartemeier (1963) while Altman et al (1972ft) linked discharge against advice with 'impulsivity' and a disregard for rules and regulations, a conclusion which seems somewhat circular. When more specific psychological characteristics have been studied, denial of illness 787 (Mozdzierz et al 1973) and lack of insight in psychosis (Nelson, 1975;Lin et al 1979;Marder et al 1983; Bartko et al 1988) have been linked to poor compliance. More detailed studies of patient attitudes to illness and treatment have been conducted by Soskis & Bowers (1969) and McGlashan & Carpenter (1981).…”

Section: Introductionmentioning

confidence: 99%

A two-year prospective study of treatment compliance in patients with schizophrenia

1992

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SYNOPSIS The study is a prospective investigation of the factors associated with treatment compliance in 61 patients discharged from hospital with a ward diagnosis of schizophrenia. All cases were classified using reliable diagnostic criteria and all were followed up for two years. Compliance was assessed by inspection of records and by analysis of urine. Sociodemographic factors and illness variables were unrelated to compliance. Some aspects of a patient's insight and attitude, namely, a belief that medication had helped during the admission, a stated willingness to take treatment after discharge and a generally optimistic outlook, were associated with improved compliance. Other variables which showed such an association were the absence of the drug sideeffect akinesia, good previous compliance and voluntary, as opposed to compulsory, admission to hospital.

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“…Huber and Danahy (1975) found that only the Psychopathic Deviate (Pd) scale significantly differentiated completers from noncompleters. Mozdzierz, Macchitelli, Conway, and Krauss (1973) found that noncompleters tended to produce more defensive profiles than did completers, whereas Krasnoff…”

mentioning

confidence: 99%

Use of MMPI subtypes in predicting completion of a residential alcoholism treatment program.

Sheppard¹,

Smith²,

Rosenbaum³

1988

Journal of Consulting and Clinical Psychology

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To obtain data on patient characteristics relevant to treatment outcome, the Minnesota Multiphasic Personality Inventory (MMPI) was administered to 86 men 3-5 days following their admission to a 30-day residential alcoholism treatment program. Cluster analyses yielded three subtypes whose mean MMPI code lypes were as follows: Type I comprised a 4-2-8 code type, with marked additional pathology: Type II comprised a 4-9/9-4 code type; and Type III comprised a 2-4/4-2 code type. The subtypes differed significantly in their rates of treatment completion, with Type II yielding a greater proportion of program dropouts. To investigate the effect of time of MMPI administration on subtype results, 68 subjects who remained in treatment were readministered the MMPI 14-16 days following admission. A comparison of Time 1 and Time 2 typologies highlights the importance of test administration time and provides some explanation for previous discrepant findings.Although large numbers of people seek treatment for substance abuse problems, it has been reported that less than 30% complete their treatment programs (U.S. Department of Health, Education, and Welfare, 1980). Research to identify the factors that predict treatment success has focused on two areas.First, the importance of investigating treatment features that predict treatment outcome is clear, and a body of literature addressing this issue is beginning to emerge. Second, researchers have investigated the patient variables that predict success in treatment programs.Among patient characteristics, background and demographic variables have proven to be powerful predictors of treatment outcome. Demographic variables have been found to account for a large portion of the variance between those who complete treatment programs and those who do not (Hoffman & Jansen, 1973; Hoffman, Jansen, & Wefring, 1972). Many individual treatment programs, however, have tended to attract groups that are somewhat homogeneous demographically.Nondemographic predictions of treatment outcome that use single Minnesota Multiphasic Personality Inventory (MMPI) scales to assess patient characteristics have yielded conflicting results. Huber and Danahy (1975) found that only the Psychopathic Deviate (Pd) scale significantly differentiated completers from noncompleters. Mozdzierz, Macchitelli, Conway, and Krauss (1973) found that noncompleters tended to produce more defensive profiles than did completers, whereas Krasnoff

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Personality characteristic differences between alcoholics who leave treatment against medical advice and those who don't

Cited by 21 publications

References 7 publications

Dropping out of treatment: A critical review.

Dropping out of treatment: A critical review.

A two-year prospective study of treatment compliance in patients with schizophrenia

Use of MMPI subtypes in predicting completion of a residential alcoholism treatment program.

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