Psychopathology of Opiate Addiction: Comparative Data from the MMPI and MCMI

Abstract

The MMPI and MCMI were administered to 163 former opiate addicts who were being maintained in a methadone program affiliated with an urban hospital. Highest group mean MMPI scores were found for Psychopathic Deviate, Depression, Hypomania, and Hysteria. For the MCMI, highest group mean clinical syndrome scores were found for Drug Abuse, Alcohol Abuse, Anxiety, and Dysthymia; highest personality disorder scores were found for Antisocial, Narcissistic, Histrionic, and Paranoid. The MCMI Drug Abuse Scale identified only 49% of subjects as having a recurrent or recent history of drug abuse. Frequency and factor analyses documented the heterogeneity of the population with respect to clinical syndromes, as well as the prevalence of personality disorders (86% had elevations on MCMI Personality Scales). Factor and correlational analyses did not provide strong evidence of similar factor structure or convergent validity of the MMPI and MCMI with this population.

Millon Clinical Multiaxial Inventory-III Subtypes of Opioid Dependence: Validity and Matching to Behavioral Therapies.

“…Some might rightly argue with a recommendation to pursue further research with the MCMI-III and might criticize our choice of this instrument given its reputation for underidentification of substance use disorders (Bryer, Martines, & Dignan, 1990;Marsh et al, 1988) and over-identification of other Axis I and II disorders in substance-dependent individuals (Calsyn & Saxon, 1990;Calsyn et al, 1996;Craig, 1988;Marsh et al, 1988). Research on the diagnostic validity and efficiency of the MCMI-I and MCMI-II personality disorder scales is mixed: Some studies have found adequate discriminant and convergent validity (Craig, 1988;Dubro, Wetzler, & Kahn, 1988;Torgersen & Alnaes, 1990), whereas others have found poor validity with the DSM constructs (Piersma, 1987;Repko & Cooper, 1985;Wetzler & Dubro, 1990;Widiger & Sanderson, 1987).…”

“…However, this multivariate classification strategy is a complex, sample-based approach, and decisions about cluster number and names can be subjective. Even when cluster solutions generalize across samples (Ball, 1996), the definition of decision rules to identify subtypes a priori (e.g., cutoff scores from a subset of predictive indicators) remains complex and sample specific.MCMI-I and MCMI-II protocol sorting procedures have most often identified depression or anxiety as the most common Axis I scale elevations, and antisocial or narcissistic as the most common Axis II scale elevations (Calsyn, Fleming, Wells, & Saxon, 1996;Craig & Olson, 1990;Craig & Weinberg, 1992a, 1992bMarsh, Stile, Stoughton, & Trout-Landen, 1988). These primary elevations are often combined with secondary elevations on borderline, passive-aggressive, aggressive-sadistic, histrionic, and alcohol and drug abuse scales.…”

Lorsque le tout est plus grand que la somme de ses parties : la cooccurrence de la toxicomanie et des autres troubles mentaux

“…Les données sur trois cen tres de ré adap ta tion (N = 2 148) (Laflamme-Cusson et al, 1994) in di quaient qu'au cours de leur vie, 75 % des fem mes et 65 % des hom mes avaient souf fert d'an xiété et de ten sions gra ves, 32 % des fem mes et 26 % des hom mes pré sen taient une dé pres sion grave alors que 44 % des fem mes et 36 % des hom mes éprou vaient de la diffi culté à se con cen trer. Les don nées re la ti ves aux trou bles de la per sonna lité vont dans le même sens : les taux va rient entre 53 % et 100 % (Cuf fel, 1996 ;Craig et al, 1990 ;Dou gherty et al, 1989 ;Marsh et al, 1988). Dans huit cen tres de ré adap ta tion du Qué bec, ce taux at teint 88 % en uti li sant le Millon Mul ti pha sic Per so na lity In ven tory (Na deau et al, 1999).…”

Prevalence of Personality Disorders among Clients in Treatment for Addiction

“…Testing took place after 7 days of treatment in order to exclude individuals suffering from acute withdrawal. Participation was voluntary, and all subjects signed a consentfonn.We compared our results with those of 5 studies (4,8,(19)(20)(21) that had used the MCMI-I (Table 1).To better understand the specificity of SD, our results were also compared with those on clinical samples from Quebec. The first comprised 180 subjects treated for erectile ororgasmic disorders.…”

“…Clinical studies have found that the proportion of individuals presenting both SDs and PDs varied from 53% to 100% (2)(3)(4)(5)(6)(7)(8)(9)(10). The most frequently diagnosed disorders are antisocial, borderline, narcissistic, and dependent personality disorders.…”