ADDICTIVE PERSONALITY AND PSYCHOLOGICAL TESTS

Psychological tests and measurements (psychometrics) are structured ways of evaluating an individual's inner mental life and external behaviors. They present subjects with more or less standard stimuli to which the subjects respond. Depending on the test, these responses tell us something about their intelligence, abilities and skills, educational and vocational interests and achievements, and personality. Often, the tests are especially helpful in diagnosing organic brain disease—its presence, presumed location, and the particular resulting functional deficits. The tests themselves range from structured questionnaires or interviews, to pen-and-pencil tasks, to obtaining responses to purposely ill-defined stimuli such as ink blots (Rorschach test). They have been used (1) to evaluate the probability of the presence of a substance-abuse problem, (2) to examine the impact of substance use on behavior and brain function both acutely and chronically, and (3) to assess personality features—profiling which ones are predisposed to use and abuse or which are the result of such use.

Historically, we have moved from the search for a single trait as cause to looking for a cluster of traits (the addictive personality ), to the recognition that a number of different pathways lead to addictive behavior(s); we now understand that different types of people may use drugs for different reasons. Some underlying trait or combination of traits, however, may predispose individuals to problems with drugs. In addition, the "addictive life" may so structure behavior that it imposes similarities in attitudes, responses, and the like; it may present us with a state-related personality—that is, a pattern of typical response and behavior that is present while living in the drugged state but that disappears, in part or in whole, after a period of abstinence. For example, Vaillant's long-term population studies (1983) have shown that people diagnosed with personality disorders or other psychopathologies while drinking often appear to lose these "illnesses" after they have been alcohol-free for some time.

A review of studies of personality in alcoholics concluded that there appeared to be six constellations: (1) those who drink to escape the pain of frustration; (2) those for whom drink gratifies childish dependency; (3) those who drink to reduce guilt and anxiety; (4) those who escape disappointment into fantasy; (5) social isolates for whom alcohol supplies a pseudo-life; (6) social context-driven alcoholics. Other studies have defined additional groups, such as unsocial aggressive, psychopathic, and inhibited-conflicted. Similar findings and classifications have been described in users of other drugs. The overlapping, but not identical, or at times contradictory descriptions can be accounted for at least partly. Each study has differed from the others in obvious ways: different measures of personality (e.g., the Minnesota Multiphasic Personality Inventory or the Rorschach Inkblot test); different subject populations (e.g., Alcoholics Anonymous members or hospitalized patients); different comparison groups; or different statistical analyses of the data. Future research in the understanding of addictive personality(ies) needs to define in advance each of these parameters and build in true replications.

While psychometric studies of personality have so far led to contradictory or confusing findings, they have proven useful in other ways: A variety of structured questionnaires are good screening devices and help the clinician toward further inquiry concerning alcohol or other drug use; tests of organic brain function have identified both acute and lasting effects of a wide variety of drugs; and the tests have helped us identify some of the common accompanying psychopathologies, such as antisocial personality disorder and depressive illness.

(See also: Causes of Substance Abuse ; Conduct Disorder and Drug Use )

BIBLIOGRAPHY

Barr, H. L. (1977). In Summary report of technical review on the psychiatric aspects of opiate dependence. Arlington: National Institute on Drug Abuse.

Neuringer, C. (1982). Alcoholic addiction: Psychological tests and measurements. In E. M. Pattison & E. Kaufman (Eds.), Encyclopedia handbook of alcoholism (pp. 517-528). New York: Gardner Press.

Vaillant, G. E. (1983). The natural history of alcoholism. Cambridge: Harvard University Press.

William A. Frosch