Browsing by Subject "Alcoholics -- Identification"
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Item Application of the MacAndrew alcoholism scale to alcoholics with psychiatric diagnoses(Texas Tech University, 1984-12) Preng, Kathryn WallaceThe MacAndrew Alcoholism Scale (MAC: MacAndrew, 1965) has demonstrated significant discriminative power in separating male alcoholics from male psychiatric patients, but there are two different interpretations of MAC scale scores. Apfeldorf and Hunley (1981) have proposed that high MAC scores measure an alcoholic response pattern and low scores measure a psychiatric response pattern. In contrast, MacAndrew (1981) has proposed that high MAC scores measure a reward seeking orientation, and low scores measure an orientation to avoid punishment. These researchers concur, however, in questioning the MAC'S ability to detect alcoholism which coexists with psychiatric diagnosis. Therefore, the present study examined the MAC's performance with alcoholic psychiatric patients. Subjects were 140 male V. A. Hospital patients assigned to one of five diagnostic groups (Alcoholics, Alcoholic Personality Disorders, Alcoholic Neurotics, Personality Disorders, or Neurotics) based on DSM-III diagnoses. All patients completed a valid MMPI which was used to determine MAC scores. MAC scale scores successfully differentiated the Alcoholic group from the combined psychiatric groups which was consistent with previous research. However, the MAC scale did not effectively discriminate alcoholics from patients with character disorder diagnoses. The MAC scale failed to differentiate either of the alcoholicpsychiatric groups from its psychiatric counterpart. The alcoholicvi psychiatric groups did not obtain intermediate MA£ scores as Apfeldorf and Hunley's ideas would suggest. In fact, the Alcoholic Personality Disorder group scored significantly higher than the Alcoholic Neurotic group, which would suggest that these psychiatric diagnoses influence the MAC scale in different ways. Further investigation revealed that the majority of patients in the highest scoring group did not appear to possess a reward seeking orientation. At present, MacAndrew's theory has not been tested adequately. Specifically, future research needs to assess whether high and low scorers actually possess the characteristics proposed by MacAndrew. Recommendations for other research and for the clinical application of the MAC scale are discussed.Item Racial variations on the MacAndrew alcoholism scale of the MMPI(Texas Tech University, 1982-08) Walters, Glenn DarylSpecial alcoholism scales have teen developed using the MMPI in an attempt to achieve a more accurate identification of alcoholics than is possible with the standard MMPI scales. One such MMPI-derived alcoholism scale is the 49-item MacAndrew Alcoholism Scale (MAC: MacAndrew, 1965). Research has consistently supported the efficacy of the MAC in a variety of settings. However, the influence of moderator variables like age, sex, and race on the MAC have yet to receive sufficient empirical investigation. This study was conducted in order to determine the effect of one of these moderator variables (i.e., race) on the MAC performance of alcoholic and nonalcoholic inpatients. Subjects for this study were 73 (27 black, 46 white) male alcoholic inpatients and 73 (27 black, 46 white) male nonalcoholic psychiatric inpatients. Two independent variables, race (black, white) and abuse status (alcoholic, nonalcoholic) were investigated by means of a 2X2 factorial design in order to determine their effect on the dependent measure, MAC scores. The behavioral/personality correlates of the MAC were determined separately for black and white patients. Black and white alcoholics did not differ significantly on the MAC (both in terms of group mean MAC scores and accurate identification of patients using cutting scores). Black nonalcoholics, on the other hand, scored significantly higher than white nonalcoholics on the MAC and were less accurately identified by means of MAC cutting scores. As a result, the MAC was observed to successfully discriminate between white alcoholics and nonalcoholics (66.3%) but not between black alcoholics and nonalcoholics (55.5%). This study also found that black and white patients demonstrated similar behavioral/personality correlational patterns with the MAC. The inability of the MAC to discriminate between black alcoholics and nonalcoholics suggests that it may not be as useful with black patients as it has been with white patients. The results of the present investigation are consistent with Gynther's (1972) contention that significant racial variations exist on the MMPI, in this case on a special MMPI scale, the MAC. It was concluded, therefore, that clinically significant black-white differences were observed on the MAC.Item The substance abuse proclivity scale: an improvement over the MacAndrew Alcoholism Scale?(Texas Tech University, 1988-12) Yescalis, William JohnThe abuse of alcohol and other drugs has become a major societal problem, Substance abuse among young people is a matter of particular concern. Abuse may be treated or even prevented if abusers and potential abusers can be identified before their problem causes damage to themselves and to society. The Minnesota Multiphasic Personality Inventory (MMPI) is commonly used to identify other forms of psychopathology, but it has proven ineffective in identifying alcoholic personalities. Several special scales have been developed to make this identification. The Mac Andrew Alcoholism Scale (MAC) is generally considered to be the most effective of these special scales. Research has raised questions about this scale's appropriateness in populations which differ from MacAndrew's original sample and its specificity to alcoholism or even to substance abuse in general. The identification problems encountered by researchers of the MAC have led Mac Andrew to postulate that the MAC is a measure not of substance abuse but of a risk-taking, reward-seeking orientation to life. Mac Andrew created the Substance Abuse Proclivity (SAP) scale to provide a measure by which substance abuse or a potential to abuse could be identified in young people. His original study suggested that the SAP would be much more effective for this purpose than the MAC had proved to be. The present study followed the path of much of the MAC research: using the SAP to differentiate groups of male and female adolescent substance abusers hospitalized for treatment from similar general psychiatric inpatient samples. The performance of the SAP was compared with that of the MAC in the same population. The correlations of the two scales were computed, both in their standard form and with their overlapping items removed. The scales were found to be highly correlated in both forms. Substance abusers scored higher on both scales than did nonabusers. Males scored somewhat higher than females, but the differences were not significant. The SAP did not show a notable increment in discriminative power over the MAC, both scales identifying approximately two-thirds of the sample. It was concluded that the SAP is not an improvement over the MAC, and that in the present population neither scale provides adequate discriminative power for clinical utility.Item Validity of the MacAndrew alcoholism scale: racial variations and effects of offender status(Texas Tech University, 1984-08) Hightower, Nancy EllenThe present study investigated the validity of a special alcoholism scale derived from the MMPI, the MacAndrew Alcoholism Scale (MAC). Research has suggested that the MAC is a useful measure for discriminating alcoholics and nonalcoholics in a variety of settings; however, accuracy of classification has differed and consensus has not been reached on moderator variables such as age, sex, race, and offender status. This study was conducted in order to assess the effect of two of these moderator variables, race and offender status, on the MAC scores of alcoholic and nonalcoholic outpatients. Participants in this study were 72 male alcoholic outpatients and 99 male nonalcoholic psychiatric outpatients. Alcoholics and nonalcoholics were further divided according to race (black, white) and offender status (offender, nonoffender). Thus, eight groups were formed: (1) alcoholic, black nonoffenders (ABNO); (2) alcoholic, black offenders (ABO); (3) alcoholic, v;hite nonoffenders (AWNO); (4) alcoholic, white offenders (AWO); (5) nonalcoholic, black nonoffenders (NABNO); (6) nonalcoholic, black offenders (NABO); (7) nonalcoholic, white nonoffenders (NAWNO); and (8) nonalcoholic, white offenders (NAWO). Groups were matched on socioeconomic status. The experimental design was a 2 x 2 x 2 between-groups factorial ANOVA with MAC scores as the dependent variable and abuse status, race, and offender status as independent variables. Black-white differences on the MAC were not observed, suggesting that race is not a moderator variable of MAC performance, at least in matched samples of lower socioeconomic status. Results indicate that offender status is a moderator variable of MAC performance. Alcoholic offenders and alcoholic nonoffenders did not differ significantly on the MAC, either in terms of group mean MAC scores or accurate identification of patients using cutting scores. Nonalcoholic offenders, on the other hand, scored significantly higher than nonalcoholic nonoffenders on the MAC and were less accurately identified by means of MAC cutting scores. Consequently, the MAC was observed to be more successful in discriminating alcoholic and nonalcoholic nonoffenders (73.4%) than it was in differentiating alcoholic and nonalcoholic offenders (63.1%). These findings support the hypothesis that the MAC measures a general dimension of antisociality or acting-out tendency, rather than alcoholism or substance abuse per se.