Substance abuse problems, psychiatric severity, and HIV risk in Millon Clinical Multiaxial Inventory-II personality subgroups.

Abstract

This study identified clinically meaningful psychopathology subgroups of drugdependent male veterans based on cluster analysis of Millon Clinical Multiaxial Inventory-II (MCMI-II) records completed shortly after inpatient admission. A high pathology cluster subgroup was denned by clinically significant elevations on multiple personality disorder and symptom scales. An antisocial cluster subgroup was identified by a highly significant mean elevation on the Antisocial scale and secondary clinical elevations on the Aggressive and Narcissistic scales. Finally, a subclinical cluster subgroup was defined by the absence of clinically significant elevations on any MCMI-II scales. In comparison with members of the other two groups, members of the high pathology subgroup exhibited more substance abuse and psychiatric problems and less favorable attitudes relevant to HIV-AIDS risk reduction.

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

“…Although no studies to date have evaluated patient-treatment matching and MCMI-derived subtypes, some have speculated on the treatment implications for the more common types (Matano et al, 1994;McMahon et al, 1998). For example, an individual with a subclinical profile or a low-severity cluster might not need additional services beyond standard addiction counseling.…”

“…Cluster analyses of the MCMI-I and MCMI-II generally have yielded three to six subtypes, including antisocial-narcissistic, avoidant-passive-aggressive, dependent, histrionic, high psychiatric severity, and no elevation (Bartsch & Hoffman, 1985;Craig, 1988;Craig, Bivens, & Olson, 1997;Craig & Olson, 1990;Craig, Verinis, & Wexler, 1985;Donat, 1988;Donat, Walters, & Hume, 1991;Fals-Stewart, 1992;Haller, Miles, & Dawson, 2002;Matano, Locke, & Schwartz, 1994). McMahon, Malow, and Penedo (1998) have described the four most common MCMI-I and MCMI-II clusters as antisocial-narcissistic, neurotic (anxious-depressed), high (Axis I and II) pathology, and subclinical. Although numerous studies have identified subtypes through either protocol sorting or cluster analysis, no study has compared the validity of these alternative approaches or evaluated their treatment-matching relevance in individuals with substance abuse, and very few have used the more recently developed MCMI-III.…”

“…With regard to cluster analysis, Fals-Stewart (1992) found that avoidant-schizoid and antisocial groups had shorter retention in a longterm residential therapeutic community and relapsed faster during a 1-year follow-up (see McMahon et al, 1993). Haller et al (2002) found that an MCMI-II cluster with elevated narcissistic, histrionic, and compulsive scales had better retention in a day treatment program for pregnant cocaine abusers than did a high-severity cluster with multiple scale elevations.Although no studies to date have evaluated patient-treatment matching and MCMI-derived subtypes, some have speculated on the treatment implications for the more common types (Matano et al, 1994;McMahon et al, 1998). For example, an individual with a subclinical profile or a low-severity cluster might not need additional services beyond standard addiction counseling.…”

Big Five Traits Related to Short-Term Mating: From Personality to Promiscuity across 46 Nations

“…To explain mating specific to the short-term context, however, the traits of low agreeableness and low conscientiousness may be necessary additions. Low agreeableness and low conscientiousness have been linked with social dominance and antisocial tendencies (Paulhus and Williams, 2002;Wiebe, 2004)-tendencies that may serve as key factors in turning short-term mating desires into short-term mating behavior (Aromaeki, Lindman, and Eriksson, 2002;Asendorpf, 1998;Linton and Wiener, 2001;McHoskey, 2001;Mealey, 1995), especially extra-pair mating (Egan and Angus, 2004;Schmitt, 2004;Schmitt et al, 2004) and risky sexual practices (McMahon, Malow, and Penedo, 1998).…”

Antisocial Psychopathy and HIV Risk among Alcohol and Other Drug (AOD) Abusing Adolescent Offenders

“…Generally, higher levels of antisocial symptoms have been associated with increased HIV risk behavior and HIV seroprevalence rates [15][16][17][18] . A subtype of psychopathic personality disorder [5,6] , Antisocial Personality Disorder (APD), has been linked among AOD abusers to condom nonuse, multiple sex partners, prostitution, sexually transmitted diseases, unfavorable HIV risk attitudes, injection drug use, early onset injection drug use, needle sharing and needle sharing partners [17][18][19][20][21][22][23][24][25] . While Abbott et al [26] found no association between APD and HIV risk behaviors, the significance of the role of such externalizing psychopathologies has continued to be affirmed, particularly in comorbid samples of AOD abusers [27][28][29] .…”