Terry G. Cook

The 2-Year Test-Retest Reliability of the Psychopathy Checklist-Revised in Methadone Patients

The 2-year test-retest reliability of the Psychopathy Checklist-Revised (PCL-R) was examined in 200 men and 25 women methadone patients. Stability of the PCL-R was generally good whether it was evaluated as a dichotomous or dimensional measure. Utilizing a diagnostic cutoff score of 25 or more the intraclass correlation coefficients (ICCs) were .48 for men and .67 for women. For the Total PCL-R score ICCs were .60 and .65 for men and women, respectively. Factor 1 was more reliably measured in women compared to men (.63 vs. .43). For men, Factor 1 was significantly less reliable than Factor 2 or the Total score. For women, Factor 2 was significantly less reliable than the Total PCL-R score or Factor 1.

Nicodermal patch adherence and its correlates

The patch adherence behavior of 101 smokers receiving 8 weeks of the nicodermal patch was examined while undergoing one of three levels of adjunctive psychosocial treatment. Additionally, regression analyses were undertaken to: (1) identify subject variables predictive of patch adherence and (2) to determine the predictive validity of patch treatment dropout, smoking and patch adherence during patch treatment to smoking 9 and 26 weeks post-treatment entry. Fifty-five percent of the patients wore the patch as prescribed for at least 50 of 56 treatment days. A multiple regression model including the Fagerström severity of dependence score, psychosocial treatment group, and the URICA commitment score predicted 18% of the variance in days of patch use. All treatment dropouts were found to be smoking at followup. Although both smoking and low patch compliance during treatment were significant predictors subjects of week 9 and 26 smoking for the remaining subjects, at the individual variable level of analysis, only smoking during treatment predicted week 9 and 26 outcomes in a two-variable predictor model.

A typology of antisociality in methadone patients

Multistage cluster analyses with replications were used to sort score profiles of 252 methadone maintained men on 4 continuous measures of antisociality--childhood conduct disorder and adult antisocial personality disorder symptoms, the revised Psychopathy Checklist, and the Socialization scale of the California Psychological Inventory. The analysis yielded 6 replicable and temporally stable cluster groups varying in degree and pattern of antisociality. The groups were statistically compared on sets of external criterion variables--Addiction Severity Index measures of past and recent substance abuse and functioning and lifetime criminal history. Axis I and II symptomatology, anxiety and depression, object relations and reality testing, hostility, guilt, and machiavellianism. The expression of antisociality in the 6 groups and differences found among them on the external variables supported the validity of a more complex conceptualization of antisociality than is provided by antisocial personality disorder.

Contrasts between admitters and deniers of drug use

This study evaluated the agreement between self-reported drug use and urinalysis results in 232 men and 27 women opiate-dependent patients at 2, 7, and 24 months following admission to methadone maintenance treatment. Differences between deniers, those who stated that they had not used drugs, but whose urinalysis results were positive, and admitters of drug use on several psychosocial variables, Axis I and II pathology and degree of psychopathy were examined. Generally, more drug use was acknowledged by self-report than found in urinalyses. Evidence was limited that deniers were consistently different than admitters. Deniers had a significantly greater increase from initial psychopathy ratings made using interview only information to final psychopathy ratings made utilizing interview and collateral information.

Generalizability of the Clinical Dimensions of the Addiction Severity Index to Nonopioid-Dependent Patients

Clinical dimensions (CDs) for the Addiction Severity Index recently have been established for application among opioid-dependent patients in methadone treatment (P. A. McDermott et al., 1996). This article examines the generalizability of the CDs to other substance-dependent patients. A sample of 2,027 adult nonopioid-dependent patients was identified; it comprised 581 primarily cocaine-dependent, 544 primarily alcohol-dependent, and 803 polydrug-dependent patients and 99 patients who were dependent on other varied drugs. Generality of dimensions was assessed through confirmatory components analysis, structural congruence, internal consistency, and variance partitioning in higher order factoring. The CDs were found generalizable overall and to specific nonopioid-dependent subgroups, and across patient gender and age, and to African American and White patients. Preliminary concurrent and predictive validity data supported the CD structure.

Social competence in opiate-addicted individuals: Gender differences, relationship to psychiatric diagnoses, and treatment response☆

Only one prior study has examined social competence (SC) in drug addicted individuals. That study of cocaine-addicted individuals found gender differences in SC as well as differences based on the type of comorbid psychiatric diagnoses given. This study attempts to replicate findings from that cocaine study in a sample of opiate-addicted individuals and explores the relationship of SC to short-term treatment response. Gender differences in SC were examined in 28 women and 44 men attending a community methadone maintenance program. The question of differences in SC based on comorbid psychiatric diagnoses and treatment response were examined in a sample of 198 men attending a Veterans Administration methadone program. Women were found to have significantly lower SC than men. No significant differences in SC were revealed based on the presence of specific psychiatric diagnoses. SC was not related to short-term treatment response.

The relationship of object relations and reality testing deficits to outcome status of methadone maintenance patients

Impairments in the ability to form and maintain meaningful interpersonal relationships and in the ability to distinguish between internal and external stimuli are related to an individuals psychological health. The Bell Object Relations and Reality Testing Inventory (BORRTI) scores of 146 methadone patients were used to evaluate whether transitory (TI) or chronic impairments (CIs) in object relations and reality testing were related to more severe drug use, family and social problems, psychological distress, as well as more time in treatment, seeking additional treatments, or taking psychiatric medication. The results showed no significant relationship between BORRTI scores and family or social problems, time in treatment, or the months of heroin use between follow-up evaluations. However, severity of drug use was related to an impairment in a specific dimension of object relations-egocentricity. There was a significant relationship between TIs and CIs in object relations and reality testing with levels of psychological distress and the likelihood of taking psychiatric medication.