Adherence to Substance Abuse Treatment: Clinical Utility of Two MMPI-2 Scales

Abstract

In this study, we examined the ability of the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) Addiction Acknowledgment scale (AAS; Weed, Butcher, McKenna, & Ben-Porath, 1992) and Negative Treatment Indicators scale (TRT; Butcher, Graham, Williams, & Ben-Porath, 1990) to predict adherence to and outcomes from substance abuse treatment. There was no evidence that the AAS was related to treatment adherence or outcome in our sample. However, results did reveal a significant positive relation between scores on the TRT scale and readmission to the hospital. Further analyses identified an optimal score for use in similar clinical populations and settings, and characteristics of high and low scorers. Compared to low scorers, high TRT scorers were more likely to not return for treatment after an initial screening interview. If they did return for treatment, high TRT scorers were more likely to experience fewer treatment days and to be rated as having lower motivation, poorer participation, and poorer comprehension of program materials. These findings provide promising initial evidence of the utility of the TRT scale for identifying patients who may be at a high risk for unsuccessful substance abuse treatment.

Predictors of Treatment Attrition Among Adult Outpatients With Clinically Significant Suicidal Ideation

“…These include greater clinical severity (e.g., more complex clinical pictures, more comorbid diagnoses, poorer functioning, personality disorders; see Barrett et al, 2008, andSwift &Greenberg, 2012, for review), lower satisfaction with treatment and poorer patient-reported therapeutic alliance (Barrett et al, 2008;Kegel & Flückiger, 2014;Renk & Dinger, 2002;Shamir, Szor, & Melamed, 2010;Wnuk et al, 2013), and lower socioeconomic status and younger age (see Barrett et al, 2008;Swift & Greenberg, 2012 for review). Findings regarding sex, education level, race/ethnicity, and negative attitudes toward treatment have been equivocal (Anestis, Finn, Gottfried, Arbisi, & Joiner, 2015;Barrett et al, 2008;Chisholm, Crowther, & Ben-Porath, 1997;Gilmore, Lash, Foster, & Blosser, 2001;Munley & Busby, 1994;Swift & Greenberg, 2012). It is important to consider, however, that while useful and informative, these studies' findings cannot be directly applied to suicidal individuals because different clinical populations can vary significantly from one another.…”

“…Findings regarding sex, education level, race/ethnicity, and negative attitudes toward treatment have been equivocal (Anestis, Finn, Gottfried, Arbisi, & Joiner, 2015;Barrett et al, 2008;Chisholm, Crowther, & Ben-Porath, 1997;Gilmore, Lash, Foster, & Blosser, 2001;Munley & Busby, 1994;Swift & Greenberg, 2012). It is important to consider, however, that while useful and informative, these studies' findings cannot be directly applied to suicidal individuals because different clinical populations can vary significantly from one another.…”

Predicting drug court treatment completion using the MMPI-2-RF.

“…These studies generally support the use of the MMPI-2 in predicting treatment outcome and provide a rationale for conceptualizing its use in Drug Court settings. Gilmore, Lash, Foster, and Blosser (2001) examined the Addiction Acknowledgement Scale (AAS) and Negative Treatment Indicators (TRT) scales in predicting completion of a 28-day residential drug treatment program. The researchers found the AAS had no predictive value in regards to treatment; however, the TRT scale showed a significant negative correlation with treatment completion.…”

Predicting nonmutual therapy termination with the personality assessment inventory

“…Findings with regard to these variables using standardized assessment instruments have been mixed. Whereas factors related to amenability have consistently demonstrated relationships to poor treatment outcome, research on treatment motivation has received more mixed results using both performance-based (e.g., Rorschach: Ackerman, Hilsenroth, Baity, & Blagys, 2000;Alpher, Perfetto, Henry, & Strupp, 1990;Hilsenroth, Handler, Toman, & Padawer, 1995;Nygren, 2004;Viglione, 1999) and self-report (e.g., Minnesota Multiphasic Personality Inventory [MMPI]: Chisholm, Crowther, & Ben-Porath, 1997;Craig & Olson, 2004;Geer, Becker, Gray, & Krauss, 2001;Gilmore, Lash, Foster, & Blosser, 2001;Hilsenroth et al, 1995;Minnix et al, 2005) methods. For example, although the MMPI-2 Negative Treatment Indicators scale was designed to evaluate problematic client beliefs about psychotherapy, including low motivation for change, it has been somewhat effective in predicting treatment problems in some studies (e.g., Gilmore et al, 2001) but ineffective in several others (e.g., Hilsenroth et al, 1995;Minnix et al, 2005).…”