Robert S. Davidson

An examination of depressed vs. nondepressed alcoholics in inpatient treatment

This study was designed to: (1) identify subgroups of depressed and nondepressed alcoholics who were entering inpatient treatment; (2) compare the groups on the basis of various demographic, social, occupational, educational, health and drinking related variables; and (c) determine whether the groups can be differentiated on the basis of personality and clinical symptoms as measured by clinical diagnostic instruments (N = 243). In comparison with the nondepressed alcoholics, depressed alcoholics in this study were found to have longer histories of problem drinking, more previous treatments for alcohol misuse, more difficulty controlling alcohol consumption, more marital problems, and more physical symptoms related to alcohol abuse. In addition, results of the discriminant analysis suggest that the depressed alcoholics may be distinguished from their nondepressed counterparts on the basis of having a detached interpersonal style, distracted cognition, alienated self-image, and mixed depressed-anxious emotionality.

Reliability of Self-Report of Alcoholics:

Fifty male volunteer chronic alcoholic patients at a VA Medical Center were exposed to a 56-item assessment questionnaire as part of screening for a behavioral research and treatment program. The questionnaire included items in the following areas: family history, demographic information, drinking history, drinking rate and pattern, drinking antecedents and consequences, symptoms, occupational, psychological, and social adjustment. Test-retest reliability coefficients of 15 of the 56 items were above .70, indicating high reliability of both item content and verbal report of the alcoholic patients. Areas of item content were examined for reliability and survival rates. Items which did not survive were discarded or modified and new items added to construct a new 65-item questionnaire.

The Personality and Symptoms Scales of the Millon Clinical Multiaxial Inventory: Sensitivity to Posttreatment Outcomes.

This study examined patterns of consistency and change on the basic personality and symptom scales of the Millon Clinical Multiaxial Inventory (MCMI) in a sample of VA inpatient alcoholics (N = 96), who were administered the MCMI at intake and at 1 month into treatment, and in a sample of drug abusers (N = 33), who received MCMI administrations at intake into treatment and after 1 and 3 months of treatment. Both alcohol and drug abuser samples in this study showed significant changes on most personality and symptom scales between intake and 1 month into treatment. The drug abusers showed small, but significant changes on three personality scales between 1 and 3 months of treatment. No such changes on symptom scales were apparent in this analysis.

Transient versus enduring depression among alcoholics in inpatient treatment

The purposes of this study are (1) to determine the incidence of significant clinical depression among alcoholics at treatment intake at a Veterans Medical Center, (2) to subdivide alcoholics who show significant clinical depression into enduring and transient depressive subgroups, and (3) to identify demographic and psychometric variables useful in discriminating between these two subgroups. Results indicate that of the 60% of VA inpatient alcoholics who showed evidence of significant clinical depression at intake, approximately equal numbers met criteria for inclusion in transient and enduring depressive subgroups. Patients with enduring and transient depression, as defined in this study, were differentiated on the basis of age, drinking pattern, and selected scales from two psychometric instruments which measure depression, confused and disorganized thinking, and an avoidant personality style. These findings may be useful in assisting clinicians in differentiating between alcoholic patients with transitory depression associated with alcohol consumption and/or withdrawal and alcoholic patients with more serious and enduring depression, which may require additional pharmacologic and/or psychotherapeutic intervention.

Concurrent validity of the clinical symptom syndrome scales of the millon clinical multiaxial inventory

This study examined relationships between the clinical symptom syndrome scales of the Millon Clinical Multiaxial Inventory (MCMI) and the various clinically meaningful mood or symptom states measured by the six Profile of Mood States (POMS) scales (N = 243). The MCMI symptom scale--POMS symptom/mood scale relationships found in this study were compared with MCMI symptom scale--MMPI and SCL-90 symptom/mood scale relationships reported in the MCMI manual (Millon, 1983). Results of the present investigation, when combined with results of the previous analyses reported in the MCMI manual, reveal a number of consistent associations of moderate strength between MCMI symptom scales and selected mood or symptom scales from the MMPI and Symptom Checklist-90 as well as from the POMS. Although most relationships between the MCMI symptom scales and the symptom/mood scales of the POMS, MMPI and SCL-90 were consistent with expectation, the Anxiety, Dysthymia and Psychotic Depression scales of the MCMI show limited ability to discriminate appropriately between anxiety and depression in several of the concurrent validity analyses considered herein.

Patterns of stability and change in mood states of alcoholics in inpatient treatment

This study examines patterns of individual stability and group change in mood states as measured by scores on the six Profile of Mood States (POMS) scales in a sample of inpatient alcoholics. Stability coefficients based on POMS scores from administrations at hospital admission and after 6 weeks of inpatient treatment ranged from a low of .36 for the Vigor-Activity scale to a high of .63 for the Confusion-Bewilderment scale. These stability estimates are comparable to those found in a previous study involving nonalcoholic psychiatric outpatients. The significant mean group changes found between admission and 6 weeks on each of the POMS scales consistently reflect improvement in mood and are generally similar in magnitude to those found previously using the POMS with both inpatient alcoholics and nonselected psychiatric outpatients.

A comparison of continuous and episodic drinkers using the MCMI, MMPI, and alceval‐r

This study was designed to identify clinically meaningful differences between continuous and episodic drinkers who were entering inpatient treatment (N = 125) on the basis of information from intake administrations of the revised Alcohol Evaluation Instrument, the Million Clinical Multiaxial Inventory, and the Minnesota Multiphasic Personality Inventory. Separate discriminant analyses based upon (a) the MCMI and ALCEVAL-R and (b) MMPI and ALCEVAL-R yielded correct classification rates of 86% and 85%, respectively. Both analyses suggest that continuous drinkers may be characterized by greater confused and disorganized thinking, agitation, and cynicism and distrust in interpersonal relationships than are episodic drinkers. In contrast, episodic drinkers appear to have somewhat more socially conforming attitudes that may inhibit daily social drinking. Despite this, episodic drinking was associated with a higher divorce rate (71% vs. 32%) and less occupational stability.

Microprocessor-assisted assessment in the clinical research laboratory

The application of microprocessor technology to assessment of alcoholism in a clinical research laboratory is described.

Effects of increasing punishment frequency on Sidman avoidance behavior

Marmoset monkeys, trained to bar press in a Sidman avoidance procedure were punished with decreased, response-contingent shock ratios. Initial increases in response frequencies were rapidly replaced by reduced rates. Avoidance percentages were not appreciably altered, even when every other response was punished. Eventually, an optimal balance was established between adequate avoidance responding and minimal exposure to the punishment contingencies.

Psychological Correlates and Treatment Outcomes for High and Low Social Functioning Alcoholics

This study is designed to identify psychologically meaningful correlates of high and low social functioning among alcoholics and to determine if High Social Alcoholics show greater changes between intake and 1 1/2 months into treatment than Low Social Alcoholics on various psycho-diagnostic measures. High Social group membership was found to be positively associated with scores at intake on the MCMI Compulsive-Conforming Scale. Low Social group membership was positively associated with scores on the POMS Depression-Dejection and Confusion-Bewilderment Scales; and on the MCMI Avoidant, Schizotypal, Passive-Aggressive, Psychotic Thinking, Psychotic Depression, Alcohol Abuse, and Borderline Scales. Repeated measures analyses revealed that, although both groups showed significant changes on a variety of measures, the High Social group showed significantly greater decreases between intake and 1 1/2 months into treatment than the Low Social group on the Avoidant, Dysthymic, Somatoform, and Anxiety Scales of the MCMI and on the Confusion-Bewilderment, Tension-Anxiety, and Fatigue-Inertia Scales of the POMS.