Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

3. Psychological Evaluation 49Self-report questionnaires can also yield important information by quantifyingthe presence and severity of psychiatric disorder that is not severe enough towarrant a diagnosis but may nonetheless be a contributor to, or a consequence of,substance abuse. Thus, self-rating scales may provide a more valid picture of theseverity of psychopathology than that afforded by only an interview. For example,the MMPI (Hathaway & McKinley, 1951) contains three validity scales thatmeasure the person’s test-taking attitude; hence, truthfulness and a response biastoward either over- or underreporting symptoms are documented. A disadvantageis that the MMPI profile does not yield a diagnosis. However, the configuration ofscores in the 10 basic scales, in conjunction with the many specialized scales,makes it possible to identify personality disorders, family problems, health disturbances,and social maladjustment comprehensively.Other self-report rating scales can be employed when either time or expertiseis not available to conduct a structured interview or obtain an MMPI profile.The most commonly used test in this regard is the Symptom Checklist90—Revised (Derogatis, 1983). This self-rating scale is brief and easy to score.Severity of psychopathology is quantified across nine dimensions of psychopathology.The importance of evaluating psychopathology in the substance use disorderscannot be overemphasized. Treatment of the underlying psychiatric disordermay itself, in many cases, be sufficient to ameliorate a substance use disorder.For this reason, it is essential to document the type, onset, and presentationof psychopathology as it relates to alcohol or drug use behavior. In addition,documentation of psychiatric illness in other family members, using instrumentssuch as the Family History Chart (Mann, Sobell, Sobell, & Pavan, 1985)and the Family Informant Schedule and Criteria (Manuzza, Fryer, Endicott, &Klein, 1985), can assist in obtaining a clear picture of the primary psychiatricdisorder.PersonalityCertain personality characteristics are commonly associated with the etiologyand maintenance of alcohol and drug abuse. The extent to which the particularfeature presages the onset of substance use or is shaped by the long-term consequenceof consumption needs to be ascertained on a case-by-case basis. Traitssuch as low self-esteem, impulsivity, aggressiveness, and behavioral undercontrolare highly prevalent in the drug-abusing population.No single instrument currently assesses all dimensions of personality thatmay be relevant to understanding drug use behavior. The MMPI, described previously,is very useful for profiling psychopathology and facilitating the formulationand testing of hypotheses about specific personality characteristics. However,other inventories are also informative for elucidating the role of particulartraits on the risk for and maintenance of drug abuse. Notably, the Multidimen-