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Using the MMPI2 to detect substance abuse in an outpatient mental health setting

Using the MMPI2 to detect substance abuse in an outpatient mental health setting,10.1037//1040-3590.11.1.94,Psychological Assessment,L. A. R. Stein,Jo

Using the MMPI2 to detect substance abuse in an outpatient mental health setting   (Citations: 9)
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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 Northeastern 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 identificatio n and the significant contribution of AAS to the information available from the MAC-R scale alone. Alcohol and drag use and abuse at times are an integral part of problems presented by clients at outpatient mental health clinics. These difficulties may go undetected when they are not the pri- mary reason for referral, as might be the case in primary mental health settings (Weed, Butcher, McKenna, & Ben-Porath, 1992). One of the most widely used instruments for assessing mental health problems in such settings is the MMPI-2 (Butcher, Dahl- strom, Graham, Tellegen, & Kaemmer, 1989). This study exam- ined the utility of the MMPI-2 in detecting substance-abuse prob- lems in an outpatient setting where substance abuse is not the primary focus of treatment. The MacAndrew Alcoholism Scale (MAC; MacAndrew, 1965) of the original MMPI was developed to differentiate alcoholic from nonalcoholic psychiatric patients. The scale was constructed by contrasting the MMPI responses of 200 male alcoholics seeking treatment at an outpatient clinic with 200 male nonalcoholic psy- chiatric patients from the same facility. MacAndrew (1981) re- viewed more than two dozen studies that demonstrated the ability of the MAC scale to differentiate alcoholic from nonalcoholic participants. The scale seems to be effective with men and women, as well as inpatients and outpatients (Graham & Stronger, 1988). Gottesman and Prescott (1989) indicated that the routine use of the MAC scale to identify substance abusers is not as compelling as many users had assumed. They noted poor construct and pre- dictive validity. However, most of the studies reviewed by them used a cutoff score of 24 in discriminating abusers from nonabus- ers, whereas Graham (1993) recommended a cutoff of 28. In addition, as Graham (1993) pointed out, Gottesman and Prescott (1989) seemed to imply that professionals would decide whether or not a person abuses substances on the basis of MMPI (or
Journal: Psychological Assessment - PSYCHOL ASSESSMENT , vol. 11, no. 1, pp. 94-100, 1999
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    • ...At least one study (Stein, Graham, Ben-Porath, & McNulty, 1999) has examined appropriate MMPI–2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) cutoffs for MAC–R in adult outpatients...
    • ...Results of this investigation indicate that a MAC–R raw score cutoff of 28 is optimal and correctly classified 82% and 86% of men and women, respectively (Stein et al., 1999)...
    • ...In distinguishing between substance abusing and nonsubstance abusing adult outpatients, AAS has been found to be superior to MAC–R (Stein et al., 1999)...
    • ...Stein et al. (1999) found that AAS linear T scores ≥ 65 for women and ≥ 60 for men correctly classified 92% and 85% of women and men, respectively...
    • ...Similar to other studies comparing MAC–R to AAS (Stein et al., 1999) and...
    • ...Unlike results found in adult samples (Greene et al., 1992; Stein et al., 1999), analyses indicate that MAC–R does not effectively distinguish between groups of substance users...
    • ...Similarly, results of this study are consistent with results presented by Weed et al. (1992, 1994), Greene et al. (1992), and Stein et al. (1999) in that PRO and ACK effectively differentiated between adolescents with different levels of substance involvement...
    • ...Our findings are consistent with findings presented by Stein et al. (1999) indicating AAS (which is similar to ACK) as most effective in detecting substance abuse...

    L. A. R. Steinet al. Use of the MMPI-A to Detect Substance Abuse in a Juvenile Correctional...

    • ...The sample of older chemically dependent sisters in this study is somewhat unique as they represent a fairly restricted range of severity of alcoholism with the mean MMPI-2 addiction T-scores falling within the sub-clinical range (M=53.90; SD=7.72) (McKechnie and Hill 2009; Stein et al. 1999)...

    Elizabeth M. Hill. Risk Factors for Alcoholism Among Women Religious: Affect Regulation

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