Predicting Methadone Maintenance Treatment Outcomes Using the Addiction Severity Index and the MMPI‐2 Content Scales (Negative Treatment Indicators and Cynism Scales)

Abstract

We studied the ability of the Minnesota Multiphasic Personality Inventory-2 Content Scales (Negative Treatment Indicators [TRT] and Cynicism [CYN]) and the domain scales of the Addiction Severity Index (ASI) in predicting outcome from a methadone maintenance program. Participants were 108 African American males treated in a VA health care outpatient methadone maintenance treatment program and followed for up to 1 year after admission. Dependent variables were 1) length of stay and the percentage of 2) missed medication days, 3) toxicology urine samples free from illicit drugs, 4) full-time employment, 5) attendance at scheduled counseling sessions, and 6) counselor ratings of patient progress. A stepwise linear regression equation indicated that low drug severity scores on the ASI and low scores on percentage of missed medication predicted patients who were clean 1 year later; low scores on the psychological domain of the ASI predicted attendance at counseling sessions; a discriminant function analysis (consisting of percent of missed medication, percentage of clean urines, and ratings of patient progress) successfully predicted patient status (i.e., dropouts vs. "active patients") with 85% accuracy. Although the TRT and CYN were related to some ASI domains, they were not associated with any outcome variable. Results suggest that some ASI scores serve as important indicators of patient progress in methadone maintenance treatment.

Physical health as a motivator for substance abuse treatment among medically ill adults: Is it enough to keep them in treatment?

“…For example, McCaul, Svikis, and Moore (2001) found that race, sex, and employment status, but not substance use patterns, predicted treatment participation and retention among adult patients admitted to an outpatient substance abuse treatment clinic. Craig and Olson (2004) found that drug severity and psychological domain scores on the Addiction Severity Index (ASI) predicted attendance among persons enrolled in an outpatient methadone maintenance program. Higher functional support on intake has also been shown to be a modest positive predictor of treatment retention and alcohol use reduction, but not drug use reduction, among clients admitted to an outpatient treatment program (Dobkin, Civita, Paraherakis, & Gill, 2002).…”

Correlates of alcohol use among methadone-maintained adults

“…Clients who reported higher levels of preadmission substance use are more likely to report use of these substances at follow-up than their counterparts (Ottomanelli, 1999). Higher addiction severity scores (alcohol and drug use) are also correlated with poorer MMT outcome (Craig and Olson, 2004). …”

Predicting nonmutual therapy termination with the personality assessment inventory

“…Findings with regard to these variables using standardized assessment instruments have been mixed. Whereas factors related to amenability have consistently demonstrated relationships to poor treatment outcome, research on treatment motivation has received more mixed results using both performance-based (e.g., Rorschach: Ackerman, Hilsenroth, Baity, & Blagys, 2000;Alpher, Perfetto, Henry, & Strupp, 1990;Hilsenroth, Handler, Toman, & Padawer, 1995;Nygren, 2004;Viglione, 1999) and self-report (e.g., Minnesota Multiphasic Personality Inventory [MMPI]: Chisholm, Crowther, & Ben-Porath, 1997;Craig & Olson, 2004;Geer, Becker, Gray, & Krauss, 2001;Gilmore, Lash, Foster, & Blosser, 2001;Hilsenroth et al, 1995;Minnix et al, 2005) methods. For example, although the MMPI-2 Negative Treatment Indicators scale was designed to evaluate problematic client beliefs about psychotherapy, including low motivation for change, it has been somewhat effective in predicting treatment problems in some studies (e.g., Gilmore et al, 2001) but ineffective in several others (e.g., Hilsenroth et al, 1995;Minnix et al, 2005).…”