Showing papers in "Psychology of Addictive Behaviors in 1998"
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TL;DR: Alterman et al. as discussed by the authors developed a set of psycho-metrically sound, standardized addiction severity index (ASI) intake scales based on both lifetime and recent problem items that are designed as a reliable and objective alternative to the interviewer severity ratings (ISRs).
Abstract: Addiction Research and Treatment Center Analyses were performed to construct and confirm the validity of new conjoint intake and 6-month follow-up scales for the Addiction Severity Index (A. T. McLellan, L. Luborsky, G. E. Woody, & C. P. O'Brien, 1980) applied to a diverse sample of substance dependence patients (N = 1,008). A multistage scaling strategy identified 5 psychometrically integral addiction problem scales. Exploratory item and factor analyses, confLrrnatory oblique item clustering, and variance partitioning verified that the scales comprised relatively little common variance and that each retained a substantial amount of unique and reliable variance. Resulting scales (Psychiatric, Drug, Alcohol, Family, and Legal Problems, respectively) were highly internally consistent and structurally stable overall, at intake and follow-up and across gender, age, ethnicity, and substance abuse categories. Concurrent and predictive validity over 2 years were supported for clinical subsamples based on comorbid psychopathology and mood, HIV risk behaviors, personality indices, urine toxicology, and criminal records. The Addiction Severity Index (ASI) is probably the most commonly used instrument in the field of substance abuse and has been a Arthur I. Alterman, Terry G. Cook, David Metzger, Megan J. Rutherford, and John S. Cacciola, Depart- ment of Psychiatry, University of Pennsylvania, and Treatment Research Center, Veterans Affairs Medical Center, Philadelphia; Paul A. McDermott, Graduate School of Education, University of Pennsylvania; Lawrence S. Brown, Jr., Addiction Research and Treatment Center, Brooklyn, New York. Megan J. Rutherford is now at the Alcohol and Drug Institute, University of Washington. This research was supported by the National Institute on Drug Abuse Grant (DA05186), the National Institute of Alcohol Abuse and Alcohofism Grant AA08480, and a Department of Veterans Affairs grant. Correspondence concerning this article should be addressed to Arthur I. Alterman, Treatment Research Center, 3900 Chestnut Street, Philadelphia, Pennsylvania 19104. Electronic mail may be sent to Alterman@Research.TRC.UPenn.Edu. remarkably useful multidimensional clinical and evaluation tool (Cacciola et al., 1997; Stoffel- mayr, Mavis, & Kasim, 1994). At the same time, research in the past decade has begun to demonstrate some limitations in the two sets of ASI problem indices used to summarize respon- dent status. One set, the interviewer severity ratings (ISRs), is the interviewer's determina- tion of a summary score based on lifetime and recent problems that describes the "need for treatment" at intake in each of the ASI's seven problem areas. However, the interrater reliabil- ity of ISRs has been shown to be modest when applied by raters in the field (Alterman, Brown, Zaballero, & McKay, 1994; Hodgins & EI- Guebaly, 1992; Stoffelmayr et al., 1994). Our group has recently developed a set of psycho- metrically sound, standardized ASI intake scales based on both lifetime and recent problem items that are designed as a reliable and objective alternative to the ISRs (McDermott et al., 1996). The composite scores (CSs) are arithmeti- cally derived scales, used both at intake and at 233
TL;DR: This article found that drug-abusing couples had higher scores (indicating more frequent use of dysfunctional communication behaviors) on three of the five CRAC subscales (i.e., Abusiveness, Problem-Solving Skills, and Attribution of Blame) and a higher CRAC total score (a global measure of communication skill) than distressed couples.
Abstract: Couples with a drug-abusing husband (n = 17) and non-substance-abusing, distressed couples (n = 17) completed several self-report measures of relationship adjustment and participated in videotaped marital conflict-resolution discussions that were coded with the Clinician Rating of Adult Communication (CRAC). Although no differences were found between the couple types on the self-report inventories, drug-abusing couples had higher scores (indicating more frequent use of dysfunctional communication behaviors) on 3 of the 5 CRAC subscales (i.e., Abusiveness, Problem-Solving Skills, and Attribution of Blame) and a higher CRAC total score (a global measure of communication skill) than distressed couples. In addition, the CRAC total score for drug-abusing couples was negatively related to husbands' percentage of days abstinent during the year before entering substance abuse treatment.
TL;DR: The authors found that expectations about the efficacy of alcohol treatment were affected by the perceived motivation of clients and therapists, and that therapists were able to reverse expected negative outcomes for impression management clients.
Abstract: Respondents read a narrative depicting a drunk-driving offender seeking help for alcohol problems and were randomly assigned to receive 1 of 3 types of client motivation (autonomous motivation, compulsory treatment, or impression management) and 1 of 2 types of therapist motivation (autonomous vs. controlled motivation). Maximal treatment efficacy was expected when both client and therapist were autonomously motivated. Minimal treatment efficacy was expected when the client entered treatment only to manage impressions and when the therapist exhibited controlled motivation. Compulsory treatment undermined beliefs about client interest in treatment. Finally, autonomously motivated therapists were expected to be able to reverse expected negative outcomes for compulsory treatment and impression management clients. It was found that expectations about the efficacy of alcohol aeam~nt were affected by the perceived motivation of clients and therapists.
TL;DR: The syndrome now known as bulimia is entirely different from the syndrome first described in its earliest use in the literature of classical Greece, and the syndrome of syncope to which the diagnostic term Bulimia was originally applied is identified as "hypoglycemia."
Abstract: The syndrome now known as bulimia is entirely different from the syndrome first described in its earliest use in the literature of classical Greece. Xenophon used the term bulimia in 399 B.C. to describe fainting in the cold with disturbed appetite. This use persisted across thousands of years of vivid debates in which bulimia was repeatedly differentiated from fames canina, an eating disorder characterized by excessive eating and vomiting. The centrality of syncope in bulimia disappeared during the 18th century, and the peripheral feature of hunger became the denning symptom. In very recent times, bulimia has been adopted as a formal name for a psychogenic eating disorder. The syndrome of syncope to which the diagnostic term bulimia was originally applied is identified as "hypoglycemia."