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The Millon Clinical Multiaxial Inventory, Version 2 (MCMI-II) was released to replace the MCMI-I. Research into the factor structure of the items of the MCMI-I showed components consistent with the underlying construction theory. No such work has been done with the new MCMI-II. For this study, we analyzed the personality disorder and clinical syndrome items across two subject samples. For 579 Veterans Administration patients and 492 normal college students, six personality factors were identified. The samples shared Hostility, Histrionic/Schizoid, Dependent, Compulsive, and a Sadistic variant. For the clinical syndrome items, eight factors were isolated for veterans and seven for normals. Depression, Alcohol Abuse, Drug Abuse, Crying, and Mania were shared factors. Most of the factors were found to be highly consistent with MCMI-II scale keyings.
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PMID:An MCMI-II item-level component analysis: personality and clinical factors. 195 78

A survey was conducted to better understand complaints of fatigue in patients previously diagnosed as having polio. Eighty-six individuals with postpolio syndrome and 20 healthy controls completed a questionnaire about their fatigue, the Beck Depression Inventory, and the CAGE questionnaire. The results showed that fatigue in postpolio syndrome usually occurred on a daily basis and increased in severity as the day progressed. Both the study group and controls described their fatigue as tiredness and a lack of energy. However, physical weakness was reported only in the postpolio group. Minimal physical exercise exacerbated fatigue in 48% of the postpolio group, whereas it diminished fatigue in 70% of the controls and in 15% of the postpolio group. Twenty-seven percent of the postpolio group and none of the controls reported mild to moderate depressive symptoms. However, depression, age, alcohol abuse, and employment status did not significantly affect the differences between groups in reported prevalence or description of chronic fatigue. Criteria to separate psychologic from organic causes of fatigue and treatment interventions are discussed.
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PMID:Fatigue in postpolio syndrome. 199 Oct 11

These data, in combination with the literature reviewed above, demonstrate several important points for those who work in clinics where elders with sexual problems are seen: 1. The currently available literature on the relation of sexual dysfunction to psychiatric disorder in the elderly is not extensive, and much of the literature is limited by methodologic flaws. There is a clear need for improved research methods and a broader data base. Nonetheless, the existing studies indicate that psychologic disorders are found in conjunction with sexual dysfunction commonly enough that clinicians must regularly assess for their presence. 2. The cause of sexual problems is seldom simple or entirely clear. Diagnoses of psychologic concerns and disorders that might relate to sexual dysfunction are common, and most older patients' sexual dysfunction will have a mixed cause, with both medical and psychologic factors playing an important role in the development and maintenance of sexual dysfunction. In our series of patients, 52.8% had diagnosable psychologic difficulties that were assumed to be related to the sexual difficulties. Another large group (39.9%) had psychologic factors (although not diagnosable disorders) that were assumed to contribute to the current manifestation of sexual dysfunction. Thus, it should not be assumed, as it was in years past, that when one likely causative factor is identified (e.g, diabetes, performance anxiety, or depression), the cause of the dysfunction has been identified. 3. The types of psychopathology seen in sex clinics are typically fairly limited, with the largest proportions by far being alcohol abuse or depression (50.1% and 62.1%, respectively, of all psychologic diagnoses in our clinic). Major psychopathology is relatively underrepresented. We suspect this underrepresentation does not reflect a true population characteristic but, rather, a selection difference; patients with major psychopathology such as schizophrenia either do not complain of sexual dysfunction to their therapists or are not referred for treatment by their therapists. 4. The presenting complaints of patients with a psychologic disorder do not differ significantly from those of patients without a psychologic disorder in a general sexual dysfunction clinic. 5. Treatment outcome, especially the rate of successful treatment, does not differ between those with and those without psychologic diagnoses when physicians and psychologists work together on an interdisciplinary team to offer treatment.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Psychologic disorder and sexual dysfunction in elders. 200 86

The prevalence and frequency of drug and alcohol abuse among higher education faculty and staff is not known. Higher education is a cultural environment which, on the one hand, is stressful and, on the other, permits a high degree of autonomy. This relationship of stress and autonomy is predicted to produce drug and alcohol abuse. Information is gathered by anonymous, self-report questionnaires, on the frequency and prevalence of faculty and staff drug and alcohol use at a regional university. Responses show alcohol and drug use within the last year and month among four higher education occupational groups: faculty, administrators, clerical staff, and physical plant/custodial staff. While stress was found to be weakly correlated with some drug use in the last month, depression was consistently correlated with drug use and moderately correlated with suicidal thoughts and tendencies, as well as job dissatisfaction. Drug and alcohol abuse is a factor in behavioral problems that affect faculty/staff and can be addressed through Employee Assistance Programs.
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PMID:Correlates of drinking and drug use by higher education faculty and staff: implications for prevention. 201 64

The purpose of this research was to estimate the prevalence of substance abuse and depression among a population-based sample of registered nurses. In addition, to estimate the degree to which substance abuse and depression were associated with nurses, a comparison was made between nurses and other employed individuals. Respondents were obtained from a probability sample of households that were part of the National Institute of Mental Health Epidemiologic Catchment Area Program (ECA). Of the adults interviewed as part of the ECA, 143 were under age 65 and currently working as registered nurses. These nurses were matched by neighborhood of residence (census tract) and gender to a comparison group of non-nurses from the ECA who were also employed at the time of interview. Estimates of the odds of substance use and depression among the nurses (n = 143) and non-nurses (n = 1410) were calculated. Nurses were no more likely to have engaged in illicit drug use or to have experienced depression than non-nurses. Nurses were also less likely to have experienced problems with alcohol abuse than non-nurses.
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PMID:The prevalence of substance abuse among registered nurses. 203 Sep 97

Among people with spinal cord injuries, death from suicide is two to six times more prevalent than in the general population. To determine if individual characteristics and behaviors present during rehabilitation can identify high-risk individuals, records of 5,200 spinal cord injured patients admitted to the Rocky Mountain Regional Spinal Injury System were reviewed. Of 489 deaths, 9% were due to suicide. They were compared with a control group of equal size, matched on age, gender, and injury level. The two groups differed significantly on postinjury despondency; expressions of shame, apathy, and hopelessness; and preinjury family disruption (p less than .01). They also differed on alcohol abuse, active involvement in the injury, preinjury depression or despondency, destructive behavior, and one aspect of etiology (p less than .05). Discriminant analysis yielded a predictive model that correctly classified 81% of the suicide group and 79% of the control group. Many of the demographic predictors identified in this study are similar to those reported in the scientific literature. However, when combined with specific behavioral characteristics manifested during rehabilitation, they comprise an array of variables that permits development of a clinical model for predicting suicide among persons with spinal cord injuries.
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PMID:Behavioral and demographic predictors of suicide after traumatic spinal cord injury. 205 21

Depressive disorders are frequently associated with alcohol abuse. Though many studies have been carried out to clarify the role of antidepressant drugs in the management of alcoholic patients, the data are controversial. The present placebo-controlled study was planned to assess the antidepressant and attenuating drinking-behaviour efficacy of viloxazine (400 mg per os daily) versus a placebo in 30 dysthymic patients affected by alcohol dependence. The results significantly favour viloxazine treatment in alleviating depression and in reducing alcohol abuse. All patients showed baseline haematochemical evidence of liver dysfunction that did not change significantly during the treatment.
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PMID:Alcoholism and depression: a placebo controlled study with viloxazine. 207 86

The present study examines the differences in the presentation of psychopathology between active duty military and veteran patients enrolled in alcohol rehabilitation programs. The Millon Clinical Multiaxial Inventory was used to assess personality disorders, clinical syndromes, and substance abuse. Most veterans were seen as having avoidant and dependent personality disorders as well as a great deal of anxiety and depression. Forty-seven percent were above cutoff scores for alcohol abuse. Air Force patients were predominantly narcissistic and antisocial with much less distress. Only 9% were classified psychometrically as abusers. The results indicate that not only are veteran alcoholics more chronic but that active-duty alcohol abusers are underreporting abuse and care must be used in their assessment.
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PMID:Active-duty and veteran alcoholics: differences in psychopathology presentation. 212 74

Little is known about panic disorder among American Indians. In a pilot project involving two Northwest Coast Indian villages, community health representatives screened the population for panic disorder, substance abuse, and major depression using DSM-III criteria. Accompanying the screening were subsequent patient education and further evaluation by a psychiatrist, a social worker, and primary care physicians. Of fifty community residents who agreed to take the screening examination, seven were found who met diagnostic criteria for panic disorder. Four of the seven had symptoms of alcohol abuse which complicated the course and diagnosis of panic disorder, and individuals with panic disorder reported more than twice the lifetime prevalence of depression in comparison with other community members. Limitations of the study and refinements of study design are needed in future study discussions.
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PMID:Panic disorder among American Indians: a descriptive study. 213 8

This chapter reviews research pertaining to two basic premises regarding problem drinking: that a conceptual clarification is necessary, one which makes an explicit distinction between drinking behavior and alcohol-related problems or adverse consequences, and that an adequate theory of problem drinking must extend beyond the alcohol-specific theories to a broad matrix of biological, behavioral, psychological, and social variables. Both cross-sectional and longitudinal studies of drinking in nonclinical populations show that levels of alcohol consumption are only moderately related to alcohol-related adverse consequences, and that a broad array of variables mediate the extent to which normal-population drinkers will be vulnerable to alcohol problems. Factors contributing to differential vulnerability to alcohol problems include the concurrent use of other drugs, engaging in other problem behaviors, personality characteristics such as impulsivity, prior depression, and a lack of social conformity or conventionality, the lack of a protective family environment, stress, and being female. A model of problem drinking consisting of overlapping, but distinct sets of predictors for drinking behavior and alcohol-related adverse consequences is proposed.
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PMID:Problem drinking and alcohol problems. Widening the circle of covariation. 218 17


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