Stephen Strack

Coping strategies and associated features of medically ill patients.

&NA; This study examined the psychological and behavioral correlates of three major coping strategies used by medically ill patients in dealing with their illness; namely, confrontation, avoidance, and acceptance‐resignation. The subjects consisted of 223 male medical patients with a variety of life‐threatening and chronic illnesses. Coping responses were measured by the Medical Coping Modes Questionnaire, while other variables were tapped by a variety of self‐report and test measures, as well as by interview data. Significant correlates were found for each of the coping strategies accounting for 10 to 53% of the variance. These included demographic, illness, and psychological variables. Employment of acceptance‐resignation as a coping strategy was particularly evident in patients with little expectation of recovery and a lack of hope. Effectiveness of coping appeared to be negatively linked to frequent use of avoidance and acceptance‐resignation in life‐threatened patients. Overall, it seems that a variety of variables across several domains accompany the use of a particular coping strategy; that choice of a specific strategy is most likely multidetermined; and that the configuration of variables associated with a particular strategy is likely to be different for each coping strategy. Coping behavior is a subtle, multifashioned expression the complete grasp of which demands an integrative approach.

Contributions to the Dimensional Assessment of Personality Disorders Using Millon's Model and the Millon Clinical Multiaxial Inventory (MCMI–III)

For over 35 years, Mllions (1996) model of personality and the Millon Clinical Multiaxial Inventory (Millon, 1977, 1987, 2006) have been useful resources for clinicians to understand and assess personality disorders (PDs) and clinical syndromes in psychiatric patients. In this article, we highlight significant features of the model and test that have proved valuable to personologists in their quest for a more satisfactory taxonomy of PDs based on continuously distributed traits. We also describe Millons (1996) prototypal domain approach to personality that combines dimensional and categorical elements for the description of PDs and their normal counterparts.

Coping with conflict situations: middle-aged and elderly men.

In this study we investigated the coping responses of fairly healthy, middle-aged (40-64 years, n = 76) and elderly (65-92 years, n = 106) men to five conflict situations (i.e., decision making, defeat in a competitive circumstance, frustration, authority conflict, and peer disagreement). Coping responses were measured by the Life Situations Inventory, developed to assess three forms of coping: problem-solving, avoidance, and resignation. Scales were based on a 28-item questionnaire and were derived rationally through item analysis. Alpha coefficients ranged from .75 to .82. Elderly subjects used avoidance significantly less often than did middle-aged subjects in handling decision-making and authority-conflict situations. No differences were noted between the age groups in use of problem solving or resignation. Both middle-aged and elderly persons favored use of problem solving in managing all conflicts. Results suggest that studies that do not address potential interactions between age and stress situation may be missing an important element in the age-coping relation.

Personality profiles of police candidates.

Recently, Eber (1991) reported on several large-scale studies of law enforcement candidates. The main measures were the two parts of the Clinical Analysis Questionnaire (Krug, Cattell, & IPAT, 1980). Part I consists of the 16 Personality Factor Questionnaire Scales, while Part II is devoted to 12 measures of psychopathology. The most striking finding was a clear personality profile characterized by a strong pattern of self-discipline or Control, Tough Poise, and low Anxiety. Our study hypothesis was that several police personality profiles would be found. This conjecture was tested on the 16PF scores of two samples of 275 police candidates by means of the Ward (1963) hierarchical clustering procedure and the Milligan/Sokal (1980) nonhierarchical K-means cluster procedures. Three distinct score profiles were isolated in both samples.

A study of Benjamin's eight-facet Structural Analysis of Social Behavior (SASB) model.

The study purpose was to evaluate the cluster, or facet, version of Benjamins (1974, 1996b) Structural Analysis of Social Behavior (SASB) in independent samples of 133 normal participants and 182 psychiatric cases. We first tested for the presence of 3 circumplexes, Focus on the Other, Focus on the Self, and Introject in the 36 items that are hypothesized to define each of them. Next, intercorrelations of 8 item-based facet scales were assessed for internal consistency, factor structure, and circular order, with the expectation that the scales would be reliable, yield 2 higher-order factors, and demonstrate a circumplex structure. Principal components analysis was applied followed by varimax rotation. Data for both normal participants and patients uniformly confirmed the presence of 4 item-level factors and 2 cluster-based factors for each circle. Alpha coefficients for facet scales were typically high, but some were as low as .50. The principal difference between the normal participants and patients was that the circumplex was incomplete in the patient data with poor differentiation of the vertical and horizontal variables.

Linking personality disorders and clinical syndromes on the MCMI-III.

We examined the relationship between personality disorders (PDs) and clinical syndromes (CSs) as measured by the Millon Clinical Multiaxial Inventory-III (MCMI-III; Millon, 1997) in a large, heterogeneous sample of psychiatric patients (N = 2,366) who completed the instrument as part of routine assessment following presentation for treatment. Using separate sets of base rate (BR) and nonoverlapping scale scores, we factor analyzed the PD and CS scales together and then separately. We correlated results from the latter analyses to determine how trait dimensions were associated with syndrome dimensions. We also studied co-occurrence at the scale level by examining CS score profiles of patients who were grouped according to their highest PD scale elevation ≥ BR75. Results for the two score sets were very similar and were consistent with previous research on the MCMI-III and its predecessors that identified 3 underlying dimensions loading both PD and CS scales. Three fourths (76.2%) of the sample had a highest PD scale ≥ BR75, and among these, 90% had at least 1 CS scale ≥ BR75, whereas 62.4% had 3 or more CS scales above this elevation. Findings underscore the substantial overlap between PDs and CSs along 3 dimensions that resemble Horneys (1945) tripartite interpersonal distinction of moving toward, away, and against, as well as Eysencks (1994) higher order factors of neuroticism, extraversion, and psychoticism.

Millon's Normal Personality Styles and Dimensions

Millons normal personality styles and dimensions emanate from the same evolutionary model he developed to explain personality pathology. For him, normal and abnormal personality lie along a continuum with no sharp demarcation to distinguish the two. The major difference is that normal individuals demonstrate adaptive flexibility in responding to their environment, whereas disordered persons exhibit rigid and maladaptive behavior. In this article, I present a historical introduction to Millons ideas on normality, descriptions of his normal personality styles and dimensions, up-to-date empirical findings, and avenues for future research. I conclude that, with additional validity data, Millons model of normal personality may be suitable for an expanded Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) Axis II that allows for diagnosis of normal personality types when a complete personality disorder syndrome is absent.

Item Factor Structure of the Personality Adjective Check List

This study reports on a principal-components analysis of the Personality Adjective Check List (PACL) at the item level. Data came from a national sample of normal adults and included the responses of 1,058 men and 1,194 women (N = 2,252). Analyses were conducted separately for men and women, and for the sexes combined. The scree test was applied to decide on the number of factors to extract. Retained factors were rotated by varimax and direct oblimin procedures. Results were very similar for each analysis, with coefficients of congruence for the five orthogonal factors obtained from men and women separately being .95, .92, .94, .94, and .92. The five unipolar personality dimensions isolated were interpreted as Aggressive/Dominant, Neurotic, Conscientious, Detached/Introverted, and Surgent/Extraverted. These were compared to item factors of the Million Clinical Multiaxial Inventory (MCMI-I), MCMI-II, Adjective Check List (ACL), and to Normans Big Five dimensions.

Personality and symptom dimensions of the MCMI-II: an item factor analysis

The self-reports of a sample of 248 male psychiatric patients on the MCMI-II (Millon, 1987) were factor analyzed at the item level. Principal components analyses with both Varimax and Direct Oblimin rotations were carried out separately on 120 personality disorder items and 51 clinical symptom items. As judged by the scree test, seven factors accounted for the personality disorder items, and five factors accounted for the symptom items. The personality disorder factors were interpreted as Schizotypal, Social Introversion vs. Extraversion, Conformity, Submissive vs. Aggressive, Antisocial, Narcissism, and Hostile Aggression. The symptom factors were hypothesized to represent Depression/Anxiety, Alcohol Dependence, Suicidal Ideation, Hypomania, and Drug Dependence. Agreement with a similar analysis of the MCMI-I was close.

Profile clusters of the MCMI-II personality disorder scales

An analysis was conducted to identify the major personality disorder score profiles to be found in the Millon Clinical Multiaxial Inventory II. Application of Wards agglomerative hierarchical procedure to two subsamples of psychiatric patients (n = 83 for each) yielded four replicated subgroups. A subsequent K-means nonhierarchical approach confirmed four of the Ward clusters. Three subgroups can be characterized as (a) Antisocial, Aggressive (Sadistic), and Passive-Aggressive; (b) Avoidant, Schizoid, and Self-Defeating, and (c) Schizoid, Dependent, and Compulsive. A fourth sizable group is comprised of patients with flat profiles.