Application of the MacAndrew Alcoholism Scale to Alcoholics With Psychiatric Diagnoses

Abstract

The MacAndrew Alcoholism scale scores of 140 male patients from a large VA hospital were examined to assess whether the MAC scale can detect alcoholism among patients with psychiatric diagnoses. There were five diagnostic groups, each with 28 patients: alcoholics, alcoholics with neurotic disorders, alcoholics with personality disorders, nonalcoholic patients with neurotic disorders, and nonalcoholic patients with personality disorders. The MAC scale was able to differentiate alcoholics and nonalcoholic psychiatric patients, but was unable to differentiate either of the alcoholic psychiatric groups from its nonalcoholic psychiatric counterpart. Thus, it appears that the MAC scale may be unable to identify alcoholism among patients with combined alcoholic-psychiatric diagnoses.

Korsakoff's syndrome on the MMPI-2

“…MAC-R has been designed as a measure of vulnerability to alcohol or other substance abuse, but has also served as an indicator of past or present alcohol abuse. The scale is supposed to be quite an accurate measure, relatively resistant to response bias (26–28). APS has been designed to identify personality characteristics and lifestyle patterns typically associated with alcohol and drug abuse, whereas the AAS represents an attempt to assess a patient's willingness to report alcohol and drug problems directly (18, 29, 30).…”

MMPI characteristics of alcoholics: A review.

“…However, several studies have indicated that the MAC scale may not be effective in differentiating between Black alcoholics and Black nonalcoholics (Walters et al, 1983;7ager & Megargee, 1981). In addition, Preng and Clopton (1986a) concluded that the MAC scale may not differentiate alcoholics who also have other psychiatric disorders from psychiatric patients who do not have alcohol problems. Given the robustness of the MAC In correlating MAC scores with independent clinical ratings, Lachar, Herman, Grisell, and Schooff (1976) found that, in addition to using alcohol excessively, those who scored high on the MAC scale were rated as assaultive, immature, and as having marital conflicts.…”

“…However, several studies have indicated that the MAC scale may not be effective in differentiating between Black alcoholics and Black nonalcoholics (Walters et al, 1983; Zager & Megargee, 1981). In addition, Preng and Clopton (1986a) concluded that the MAC scale may not differentiate alcoholics who also have other psychiatric disorders from psychiatric patients who do not have alcohol problems. Given the robustness of the MAC scale’s ability to identify persons with alcohol problems, a knowledge of which characteristics and behaviors are being assessed by the scale could add significantly to our understanding of the personality characteristics of alcoholics.…”

Reliability and validity of the time-line follow-back interview among psychiatric outpatients: A preliminary report.

“…The limited research conducted on alcohol assessment among psychiatric patients has focused primarily on screening methods used to identify the presence of abuse or dependence (Teitelbaum & Carey, 1996). To summarize this literature, the alcohol use scales from standard personality tests such as the Minnesota Multiphasic Personality Inventory (Preng & Clopton, 1986) and the Millon Clinical Multiaxial Inventory (Bryer, Martines, & Dignan, 1990) cannot accurately distinguish among alcoholics and nonalcoholics when both groups have a coexisting mental illness. Furthermore, face-valid screening measures such as the Michigan Alcoholism Screening Test (Drake et al, 1990; Toland & Moss, 1989; Zung, 1984) demonstrate low specificity levels among psychiatric patients.…”