International Journal of the Addictions
ISSN: 0020-773X (Print) (Online) Journal homepage: http://www.tandfonline.com/loi/isum19
The Effect of Therapeutic Intervention on the Assessment Scores of Narcotic Addicts Chester D. Copemann & Paula L. Shaw To cite this article: Chester D. Copemann & Paula L. Shaw (1975) The Effect of Therapeutic Intervention on the Assessment Scores of Narcotic Addicts, International Journal of the Addictions, 10:5, 921-926, DOI: 10.3109/10826087509027347 To link to this article: http://dx.doi.org/10.3109/10826087509027347
Published online: 03 Jul 2009.
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Date: 26 March 2016, At: 02:41
The International Journal of the Addictions, 10(5), 921-926, 1975
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Research Note
The Effect of Therapeutic Intervention on the Assessment Scores of Narcotic Addicts Chester D. Copemann,t Ph.D. State University of New York at Stony Brook
Stony Brook, N e w York
Paula
L. Shaw, M.A.
Alba-Neck Halfway House Amityville, New York
In the past, assessment studies of addict populations have confined themselves primarily to the search for a global addict personality. Most of the studies, however, have indicated that addicts cannot be differentiated from other socially deviant groups on current psychological tests (Mensh, 1970; Mott, 1972). For example, the literature has consistently reported that opiate users tend to score average or above on standard intelligence
* Based, in part, upon a Ph.D. dissertation submitted to the Graduate School, State University of New York at Stony Brook, by the senior author. This paper relates to a program administered by Suffolk County and funded by the New York State Drug Abuse Control Commission. t To whom requests for reprints should be addressed at Department of Psychology, State University of New York at Stony Brook, Stony Brook, Long Island, New York 11790. 92 1 Copyright 0 1975 by Marcel Dekker, Inc. All Rights Reserved. Neither this work nor any part may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, microfilming, and recording, or by any information storage and retrieval system, without permission in writing from the publisher.
COPEMANN AND SHAW
Downloaded by [The University Of Melbourne Libraries] at 02:41 26 March 2016
922
tests (Gerard and Kornetsky, 1955; Knight and Prout, 1951 ; Noble, 1970). Mott (1972) reviewed four studies comparing Eysenck Personality Inventory scores of opiate users and various control groups. The result was that no significant difference was found between opiate users and the general population on extraversion, while the opiate users tended to obtain slightly higher scores on the index of neuroticism. Although numerous studies continue to report results regarding the addict’s performance on standard psychological tests, few studies have reported on posttest results following therapeutic intervention (DeLeon, Skodol, and Rosenthal, 1973). This paper reports pre- and posttest results obtained on a sample of addicts who completed treatment at the behaviorally oriented Alba-Neck Halfway House (Copemann and Shaw, 1974) on Long Island, New York.
METHOD Instrumentation and Procedure
The Wechsler Intelligence Scale for Adults (Wechsler, 1959, Lazarus’ Assertiveness Questionnaire (1 97 1), and the Eysenck Personality Inventory (Eysenck and Eysenck, 1964) were administered to each resident individually during the first 2 weeks of residency. If the resident was physically addicted at time of entry and in need of detoxification, test administration was postponed postdetoxification. For those residents completing treatment, the tests were readministered on an individual basis at the end of treatment. In the case of the EPT, Form B was used for posttest purposes. Since Lazarus (1971) did not provide any scoring procedures for the Assertiveness Questionnaire which he developed, a method of quantifying the questionnaire was developed for this project. Each appropriate answer was scored five points, replies indicating “sometimes” or “maybe” were scored 2.5 points, and inappropriate answers were scored zero. With the exception of the scoring procedures instituted for the Assertiveness Questionnaire, administration and scoring of the assessment instruments were carried out according to instructions in the accompanying test manuals. Subjects
The sample (N = 14) consisted of young (mean age = 22.5 years) male (N = 6 ) and female ( N = 8) Blacks who were part of a larger group of addicts receiving treatment at the Alba-Neck Halfway House. All sub-
923
THERAPEUTIC INTERVENTION AND ASSESSMENT SCORES
Downloaded by [The University Of Melbourne Libraries] at 02:41 26 March 2016
jects were heroin users and had completed treatment at the facility. Sixtyfour percent ( N = 9) of the sample had not completed grade twelve, and the mean grade level completed was eleven. Residents who terminated treatment prematurely were not available for testing, therefore, only scores for those subjects who were both pre- and posttested are reported.
RESULTS WAI S
The mean IQ for the sample at the time of entry was 99.4 (SD = 14.90). A breakdown of IQ scores for the sample showed that the majority of subjects (86%) tended to score in the “average” range defined for the WAIS, with a few subjects scoring below and above average. Table 1 shows that there was a 16-point increase in full scale IQ for the sample, with similar increases in the verbal and performance IQ scores. Using the t test for correlated means, all differences between pre- and posttest scores were found to be significant ( p < .005). Since the test-retest reliability coefficients are .96 (S.E. = 3.00), .93 (S.E. = 3.97), and .97 (S.E. = 2.60) for the verbal, performance, and full scale IQ of the WAIS, respectively, the differences obtained for the sample appear to be greater than differences attributable to chance or practice effects. Further analysis of the data (Table 2) shows that there was a marked shift in the distribution of IQ scores ( z = 3.55, p < .001). Assertiveness
In general, the sample at the time of entry tended to be somewhat unassertive, with a mean assertiveness score of 78 (SD = 12.42). An Table 1 Posttest Changes in 10 Scores Mean IQ scores Test Pretest ( N = 14) Posttest ( N = 13) Difference a
t
=
-4.00, df = 1 2 , < ~ ,005
* t = -5.85, df = 1 2 , p < .001 t
=
-4.42, df = 12, p < .001
Verbal 100 116.7 16.7“
+
Performance 96.7 11 2.3 +15.6*
Full scale
99.4 115.4 16.0‘
+
924
COPEMANN AND SHAW
Table 2 Distribution of Posttest 10 Scores
Downloaded by [The University Of Melbourne Libraries] at 02:41 26 March 2016
Pretest
Posttest
Scores
No.
%
No.
%
80-90 (dull-normal) 90-109 (average) 1 1 0 - 1 19 (bright-normal) 120-129 (superior) TOTALS
1 11
8 84 8 0
0 3 6
0 23 46 41
1
0 13
100
4 13
loo
Table 3 Posttest Changes in Assertiveness
Test
Mean
SD
Pretest ( N = 14) Posttest ( N = 13) Difference
78
12.42 9.40
85 +7
Table 4 Posttest Assertiveness Classification
Assertive Test Pretest Posttest Difference
Unassertive
No.
%
No.
%
3 7 +4
21 54 33
I1 6 -5
79 46 -33
examination of the distribution of these scores showed that the degree of assertiveness tended to range from a low of 50 to a high of 100, with 21% of the sample earning scores in the “assertive” range. The degree of assertiveness among subjects in the sample at posttest increased from a mean of 78 to a mean of 85 (SD = 9.40) (Table 3); an increase of seven points which was significant ( t = 3.07, df = 12, p < .01). There was also a marked shift in the distribution of assertiveness scores (Table 4), which was significant (x2 = 4.94, df = 1, p < .03). EPI
At the time of entry, subjects in the sample had a mean extraversion score of 11 (SD = 4.00), a neuroticism score of 11 (SD = 6.66), and
THERAPEUTIC INTERVENTION A N D ASSESSMENT SCORES
925
Downloaded by [The University Of Melbourne Libraries] at 02:41 26 March 2016
Table 5 Posttest EPI Scores Extraversion
Neuroticism
Lie
Test
Mean
SD
Mean
SD
Mean
SD
Pretest ( N = 14) Posttest ( N = 13) Difference
13 13 0
4.00 4.33
11 12 +I
6.66 6.30
2 1 -1
1.25 1.03
a lie score of 2 (SD = 1.25); all considered normal by the norms provided for the EPI. These scores were also identical to the American college norms reported in the manual for the EPI (Eysenck and Eysenck, 1964). The posttest scores contained in Table 5 do not reflect any change in extraversion o r neuroticism for the sample.
DISCUSSION Gerard and Kornetsky (1955) interpreted the results of their study as indicating “the inability of the addicts to function at their full intellectual potential.” However, the authors did not produce any data to support this interpretation. The significant increase in IQ scores presented in Table 1 provides partial support for the interpretation that the addict, at the time of his addiction, was not functioning at full intellectual capacity. Drug treatment programs have primarily relied on abstinence and relapse rates as criteria for successful treatment. The preliminary findings of this report tend to suggest the use of psychological instruments in assessing the behavioral and psychological effect of clinical intervention.
SUMMARY The findings presented tend to support already established trends reported in the literature concerning the performance of opiate users on standard psychological tests. Evidence which suggests that addicts are not functioning at full intellectual capacity was presented for the first time. Moreover, the use of psychological tests as outcome measures for drug treatment was indicated. REFERENCES COPEMANN, C. Aversive Counterconditioning and Social Retraining: A Learning Theory Approach to Drug Rehabilifation. Doctoral dissertation, State University of New York at Stony Book, 1973.
Downloaded by [The University Of Melbourne Libraries] at 02:41 26 March 2016
926
COPEMANN AND SHAW
COPEMANN, C., and SHAW, P. A behaviorally oriented treatment program for drug addiction; a preliminary report. Addictive Dis. 1974. In press. DELEON, G., SKODOL, A,, and Rosenthal, M. Changes in psychopathological signs of resident drug addicts. Arch. Gen. Psvchiat. 28: 131, 1973. EYSENCK, H., and EYSENCK, S. Manual of the Eysenck Personality Inventory. San Diego: Educational Testing Service, 1964. GERARD, D., and KORNETSKY, C. Adolescent opiate addiction: A study of control and addict subjects. Psychiatr. Quart. 29: 451, 1955. KNIGHT, R., and PROUT, C. A study of the results of hospital treatment of drug addiction. Amer. J. Psychiar. 108: 303, 1951. LAZARUS, A. Behavior Therapy and Beyond. New York: McGraw-Hill, 1971. MENSH, N. Drug addiction. In C. Costello (ed.) Symptoms of Psychopathology: A Handbook. New York: Wiley, 1970. MOTT, J. The psychological basis of drug dependence: The intellectual and personality characteristics of opiate users. Brit. J. Addictions. 67: 89, 1972. NOBLE, P. Drug taking in delinquent boys. Brit. Med. J. 1 : 102, 1970. WECHSLER, D. Wechsler Adult Intelligence Scale Manual. New York: Psychological Corp., 1955.
ISSN: 0020-773X (Print) (Online) Journal homepage: http://www.tandfonline.com/loi/isum19
The Effect of Therapeutic Intervention on the Assessment Scores of Narcotic Addicts Chester D. Copemann & Paula L. Shaw To cite this article: Chester D. Copemann & Paula L. Shaw (1975) The Effect of Therapeutic Intervention on the Assessment Scores of Narcotic Addicts, International Journal of the Addictions, 10:5, 921-926, DOI: 10.3109/10826087509027347 To link to this article: http://dx.doi.org/10.3109/10826087509027347
Published online: 03 Jul 2009.
Submit your article to this journal
Article views: 3
View related articles
Citing articles: 3 View citing articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=isum19 Download by: [The University Of Melbourne Libraries]
Date: 26 March 2016, At: 02:41
The International Journal of the Addictions, 10(5), 921-926, 1975
Downloaded by [The University Of Melbourne Libraries] at 02:41 26 March 2016
Research Note
The Effect of Therapeutic Intervention on the Assessment Scores of Narcotic Addicts Chester D. Copemann,t Ph.D. State University of New York at Stony Brook
Stony Brook, N e w York
Paula
L. Shaw, M.A.
Alba-Neck Halfway House Amityville, New York
In the past, assessment studies of addict populations have confined themselves primarily to the search for a global addict personality. Most of the studies, however, have indicated that addicts cannot be differentiated from other socially deviant groups on current psychological tests (Mensh, 1970; Mott, 1972). For example, the literature has consistently reported that opiate users tend to score average or above on standard intelligence
* Based, in part, upon a Ph.D. dissertation submitted to the Graduate School, State University of New York at Stony Brook, by the senior author. This paper relates to a program administered by Suffolk County and funded by the New York State Drug Abuse Control Commission. t To whom requests for reprints should be addressed at Department of Psychology, State University of New York at Stony Brook, Stony Brook, Long Island, New York 11790. 92 1 Copyright 0 1975 by Marcel Dekker, Inc. All Rights Reserved. Neither this work nor any part may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, microfilming, and recording, or by any information storage and retrieval system, without permission in writing from the publisher.
COPEMANN AND SHAW
Downloaded by [The University Of Melbourne Libraries] at 02:41 26 March 2016
922
tests (Gerard and Kornetsky, 1955; Knight and Prout, 1951 ; Noble, 1970). Mott (1972) reviewed four studies comparing Eysenck Personality Inventory scores of opiate users and various control groups. The result was that no significant difference was found between opiate users and the general population on extraversion, while the opiate users tended to obtain slightly higher scores on the index of neuroticism. Although numerous studies continue to report results regarding the addict’s performance on standard psychological tests, few studies have reported on posttest results following therapeutic intervention (DeLeon, Skodol, and Rosenthal, 1973). This paper reports pre- and posttest results obtained on a sample of addicts who completed treatment at the behaviorally oriented Alba-Neck Halfway House (Copemann and Shaw, 1974) on Long Island, New York.
METHOD Instrumentation and Procedure
The Wechsler Intelligence Scale for Adults (Wechsler, 1959, Lazarus’ Assertiveness Questionnaire (1 97 1), and the Eysenck Personality Inventory (Eysenck and Eysenck, 1964) were administered to each resident individually during the first 2 weeks of residency. If the resident was physically addicted at time of entry and in need of detoxification, test administration was postponed postdetoxification. For those residents completing treatment, the tests were readministered on an individual basis at the end of treatment. In the case of the EPT, Form B was used for posttest purposes. Since Lazarus (1971) did not provide any scoring procedures for the Assertiveness Questionnaire which he developed, a method of quantifying the questionnaire was developed for this project. Each appropriate answer was scored five points, replies indicating “sometimes” or “maybe” were scored 2.5 points, and inappropriate answers were scored zero. With the exception of the scoring procedures instituted for the Assertiveness Questionnaire, administration and scoring of the assessment instruments were carried out according to instructions in the accompanying test manuals. Subjects
The sample (N = 14) consisted of young (mean age = 22.5 years) male (N = 6 ) and female ( N = 8) Blacks who were part of a larger group of addicts receiving treatment at the Alba-Neck Halfway House. All sub-
923
THERAPEUTIC INTERVENTION AND ASSESSMENT SCORES
Downloaded by [The University Of Melbourne Libraries] at 02:41 26 March 2016
jects were heroin users and had completed treatment at the facility. Sixtyfour percent ( N = 9) of the sample had not completed grade twelve, and the mean grade level completed was eleven. Residents who terminated treatment prematurely were not available for testing, therefore, only scores for those subjects who were both pre- and posttested are reported.
RESULTS WAI S
The mean IQ for the sample at the time of entry was 99.4 (SD = 14.90). A breakdown of IQ scores for the sample showed that the majority of subjects (86%) tended to score in the “average” range defined for the WAIS, with a few subjects scoring below and above average. Table 1 shows that there was a 16-point increase in full scale IQ for the sample, with similar increases in the verbal and performance IQ scores. Using the t test for correlated means, all differences between pre- and posttest scores were found to be significant ( p < .005). Since the test-retest reliability coefficients are .96 (S.E. = 3.00), .93 (S.E. = 3.97), and .97 (S.E. = 2.60) for the verbal, performance, and full scale IQ of the WAIS, respectively, the differences obtained for the sample appear to be greater than differences attributable to chance or practice effects. Further analysis of the data (Table 2) shows that there was a marked shift in the distribution of IQ scores ( z = 3.55, p < .001). Assertiveness
In general, the sample at the time of entry tended to be somewhat unassertive, with a mean assertiveness score of 78 (SD = 12.42). An Table 1 Posttest Changes in 10 Scores Mean IQ scores Test Pretest ( N = 14) Posttest ( N = 13) Difference a
t
=
-4.00, df = 1 2 , < ~ ,005
* t = -5.85, df = 1 2 , p < .001 t
=
-4.42, df = 12, p < .001
Verbal 100 116.7 16.7“
+
Performance 96.7 11 2.3 +15.6*
Full scale
99.4 115.4 16.0‘
+
924
COPEMANN AND SHAW
Table 2 Distribution of Posttest 10 Scores
Downloaded by [The University Of Melbourne Libraries] at 02:41 26 March 2016
Pretest
Posttest
Scores
No.
%
No.
%
80-90 (dull-normal) 90-109 (average) 1 1 0 - 1 19 (bright-normal) 120-129 (superior) TOTALS
1 11
8 84 8 0
0 3 6
0 23 46 41
1
0 13
100
4 13
loo
Table 3 Posttest Changes in Assertiveness
Test
Mean
SD
Pretest ( N = 14) Posttest ( N = 13) Difference
78
12.42 9.40
85 +7
Table 4 Posttest Assertiveness Classification
Assertive Test Pretest Posttest Difference
Unassertive
No.
%
No.
%
3 7 +4
21 54 33
I1 6 -5
79 46 -33
examination of the distribution of these scores showed that the degree of assertiveness tended to range from a low of 50 to a high of 100, with 21% of the sample earning scores in the “assertive” range. The degree of assertiveness among subjects in the sample at posttest increased from a mean of 78 to a mean of 85 (SD = 9.40) (Table 3); an increase of seven points which was significant ( t = 3.07, df = 12, p < .01). There was also a marked shift in the distribution of assertiveness scores (Table 4), which was significant (x2 = 4.94, df = 1, p < .03). EPI
At the time of entry, subjects in the sample had a mean extraversion score of 11 (SD = 4.00), a neuroticism score of 11 (SD = 6.66), and
THERAPEUTIC INTERVENTION A N D ASSESSMENT SCORES
925
Downloaded by [The University Of Melbourne Libraries] at 02:41 26 March 2016
Table 5 Posttest EPI Scores Extraversion
Neuroticism
Lie
Test
Mean
SD
Mean
SD
Mean
SD
Pretest ( N = 14) Posttest ( N = 13) Difference
13 13 0
4.00 4.33
11 12 +I
6.66 6.30
2 1 -1
1.25 1.03
a lie score of 2 (SD = 1.25); all considered normal by the norms provided for the EPI. These scores were also identical to the American college norms reported in the manual for the EPI (Eysenck and Eysenck, 1964). The posttest scores contained in Table 5 do not reflect any change in extraversion o r neuroticism for the sample.
DISCUSSION Gerard and Kornetsky (1955) interpreted the results of their study as indicating “the inability of the addicts to function at their full intellectual potential.” However, the authors did not produce any data to support this interpretation. The significant increase in IQ scores presented in Table 1 provides partial support for the interpretation that the addict, at the time of his addiction, was not functioning at full intellectual capacity. Drug treatment programs have primarily relied on abstinence and relapse rates as criteria for successful treatment. The preliminary findings of this report tend to suggest the use of psychological instruments in assessing the behavioral and psychological effect of clinical intervention.
SUMMARY The findings presented tend to support already established trends reported in the literature concerning the performance of opiate users on standard psychological tests. Evidence which suggests that addicts are not functioning at full intellectual capacity was presented for the first time. Moreover, the use of psychological tests as outcome measures for drug treatment was indicated. REFERENCES COPEMANN, C. Aversive Counterconditioning and Social Retraining: A Learning Theory Approach to Drug Rehabilifation. Doctoral dissertation, State University of New York at Stony Book, 1973.
Downloaded by [The University Of Melbourne Libraries] at 02:41 26 March 2016
926
COPEMANN AND SHAW
COPEMANN, C., and SHAW, P. A behaviorally oriented treatment program for drug addiction; a preliminary report. Addictive Dis. 1974. In press. DELEON, G., SKODOL, A,, and Rosenthal, M. Changes in psychopathological signs of resident drug addicts. Arch. Gen. Psvchiat. 28: 131, 1973. EYSENCK, H., and EYSENCK, S. Manual of the Eysenck Personality Inventory. San Diego: Educational Testing Service, 1964. GERARD, D., and KORNETSKY, C. Adolescent opiate addiction: A study of control and addict subjects. Psychiatr. Quart. 29: 451, 1955. KNIGHT, R., and PROUT, C. A study of the results of hospital treatment of drug addiction. Amer. J. Psychiar. 108: 303, 1951. LAZARUS, A. Behavior Therapy and Beyond. New York: McGraw-Hill, 1971. MENSH, N. Drug addiction. In C. Costello (ed.) Symptoms of Psychopathology: A Handbook. New York: Wiley, 1970. MOTT, J. The psychological basis of drug dependence: The intellectual and personality characteristics of opiate users. Brit. J. Addictions. 67: 89, 1972. NOBLE, P. Drug taking in delinquent boys. Brit. Med. J. 1 : 102, 1970. WECHSLER, D. Wechsler Adult Intelligence Scale Manual. New York: Psychological Corp., 1955.
