PSYCHOTIC ANSWERS TO MMPI

IN FORMERLY DRUG ADDICTS

AND IN PSYCHOTIC PERSONS

By Renato COCCHI and Daniela MAGNINI

 

Summary

We analysed and compared the answers given by a group of one-year abstinent opiate addicts and by a group of hospitalized psychotics to the MMPI abbreviated form.

The Group 1 had 21 persons, 16 M + 5 F, average age 28.24 +/- 2.93 years, with range 20-40, and lived since at least one year in a therapeutic community. The Group 2 had 20 persons, 14 M + 6 F, average age 29.75 +/- 6.15 years, with range 20-40. Answers scores comparisons did not show any significant difference as for the scales linked to psychotic behaviour (namely scales Hy, Pd, Pa, Sc).

Psychotic persons had higher scores in scales D and Si, linked to depression and social inhibition (.0009 and .021). Drug addicts showed significantly more answers of aggression in scale A, (.016).

We suggest that the difficulty to maintain a normal half-brain dominance can have played a causal role in both groups. Drug addicts could have used opiates as a bad self-medication to avoid somehow a possible risk of a psychotic outcome.

Key words: MMPI, drug addicts, psychotics, scales of psychoses, half-brain dominance, self-medication, depression, aggressiveness.

 

In a previous paper on troubles of half-brain dominance and cognitive behaviour (Cocchi, 1994) one of us mentioned a personal communication of the present coauthor. So it ran: "It is interesting noting that the administering of the MMPI to drug addicts often produces a massive presence of so-called schizophrenic responses, even though the subjects are not schizophrenic (Magnini 1994)."

Eventually we can do now a statistical analysis now the data collected then.

Subjects, materials and method.

We compared the answers given to MMPI by two groups of subjects. The first group was of opiate drug addicts now in a specific residential community (Group 1); the second was of schizophrenic inpatients in a neuropsychiatric hospital (Group 2).

Group 1 features: 21 Ss (5 F + 16 M) age range 20-40, average 28.24 +/- 2.93 years, with at least 8 years schooling. They were formerly opiate addicts now living in a therapeutic residential community. All they were abstinent since at least one year, to avoid any interfering effect of previously used opiates on cognitive abilities.

Group 2 features: 20 Ss (6 F + 14 M), age range 20-40, average 29.75 +/- 6.15 years, with at least 8 years schooling. All they were schizophrenics according to DSR-III, R and inpatients in a hospital under psychodrug treatment.

The Test used: MMPI, reduced form, scored following the usual rules.

Statistics: Chi Square; "t" test for two independent samples.

 

Results

As for gender distribution the two samples are very close to one another (Chi Square = .009 with 1 degree of freedom (df) and p = .925.)

The difference of average ages of the two samples does not reach any significance ( 28.23 +/- 2.92 vs 29.75 +/- 6.15 years, with t = -1.012, 39 df e p = .318).

The Scale L (Lie scale), Scale F (form of the Ego and the thought) and Scale K (Mechanisms of defence) showed that all subjects performed valid tests.

We summarized the scores of MMPI scales in the Table 1.

Table 1: Summarized scores and statistical analysis.

Scale

Group 1

Group 2

 

 

Aver. score

SD

Aver. score

SD

Diff

" t " (*)

p

Validation scales

L

1.90

1.19

4.05

5.00

-2.15

-4.192

.0009

F

11.05

3.15

15.4

5.39

-4.35

-3.174

.003

K

4.09

1.92

4.95

2.22

-0.86

-1.329

.192 NS

 

Scales of Depression / Lack of mental energy

D

14.97

1.93

18.06

2.76

-3.38

-4.563

.0009

Pt

22.33

3.83

23.75

3.73

-1.42

-1.2°2

.237 NS

 

Psychotic scales

Hy

13.19

2.24

14.25

2.79

-1.06

-1.347

.186 NS

Pd

17.90

2.09

17.45

3.97

.45

.457

.650 NS

Pa

14.86

3.12

16.30

3.03

 

-1.589

.139 NS

Sc

20.76

3.58

23.35

4.96

-2.59

-1.924

.062 NS

 

Scales of social behaviour

Mf

14.33

2.98

14.50

3.17

-0.17

-0.177

.860 NS

Si

16.04

2.99

18.00

2.12

-1.96

-2.410

.021

A

28.14

3.17

24.85

5.00

3.29

2.529

.016

(*) with 39 degrees of freedom.

As you can see in Table 1:

  • psychotic subject says significantly more lies;
  • psychotic subjects have an Ego form and thoughts significantly more involved;
  • psychotic subjects significantly suffer from depression;
  • psychotic subjects have a strong trend towards schizophrenic answers, although not significantly.
  • psychotic subjects have significantly more social introversion;
  • Ex-drug addicts show significantly more attitudes of aggression.
  • No significant differences between the two groups as for psychotic scales.

We made graphics of the four groups of scales (Graphics 1-4).


Discussion

What we observed found confirmation. Formerly opiate drug addicts, living in therapeutic community and abstinent from the drug since at least one year, gave psychotic answers to MMPI related scales like do psychotic inpatients.

We did not find any significant difference as for scales Hy (Hysteria), Pd (Deviation towards sociopathy or psychopathy), Pa (Paranoia), Sc (Schizophrenia).

This fact suggests that drug addicts have a psychosis-oriented personality, instead of drug addiction as the way to elicit psychotic traits, even present after one-year abstinence. To pay attention to the MMPI other scales, leads us to see something equally interesting.

The three scales used to validate the test presented slight difference in using defence mechanisms (scale K) between the two groups. Psychotic inpatients are more prone to lie (scale L) and to have a form of the Ego and of the thought more involved (Scale F).

It is not easy to explain well the L scale increased in psychotics.

Anybody who had experience with drug addicts knows well how perverse is their ability for lying to mask their addiction or to justify otherwise money spent for the drug.

At least one year in the community and overall the abstinence can lead to such a result? Or can we better think that, somehow, they can more use the normal half-brain dominance, previously impaired by the drug? (Cocchi, 1994)

On the other hand, the reduced F scale in ex-drug addicts is fully understandable and, we can say it, consequent. While the psychotics were suffering from a current illness, ex-drug addicts were given psychotherapic intervention, aiming to strength the Ego since first days of their community staying. As for depression/inhibition behaviour (scales D and Pt) psychotics show increased scores, but significantly for depression.

Perhaps different environments - more activated in the community, lesser in the hospital - and the acute phase of the illness in psychotics can differently act.

Also behaviour socially linked (scales Mf, Si, A) showed different scores. Sex oriented behaviour did not present any significant difference.

There is an opposition as for the other two behaviours, with significantly more aggression in ex-drug addicts and significantly more introversion or social inhibition in psychotics. We deal with so trivial data that further explanation is useless.

To come back to psychotic traits of ex-drug addicts, we think they could have used the drug as a bad self-medication. This is what one of us suggested about 25 years ago. (Cocchi and Tornati 1977)

Somehow the drug could allow the control of a half-brain unstable dominance that otherwise should have driven to heavier risks. We know that substances of abuse like alcohol can act on the half-brain dominance, and increase opposition answers, a clear sign of the not dominant half-brain use. (Cocchi 1994; Cocchi, 1999).

A review on schizophrenia exactly suspected a clean unbalance between the two half-brains (see: Crow, 1993), with a separation between emotionality and rationality. The right half-brain mainly controls the former, while the left one does so for the latter. In schizophrenic people the decreasing of the gray matter of the temporal lobe, as found after CAT, MNR and post-mortem examinations could have a definite signification (Crow, 1983)

 

Conclusions.

The analysis and comparison of the answers given by a group of ex-drug addicts and by a group of hospitalized psychotics to the MMPI did not show any significant difference as for the scales linked to psychotic behaviour (namely scales Hy, Pd, Pa, Sc).

The psychotics had significantly increased scores as for depression and social inhibition (scales D and Si) while ex-drug addicts had significantly increased scores as for aggression (scale A).

Previous difficulties in maintaining a normal half-brain dominance could have benn causal factors in both groups.

Formerly drug addicts could have used opiates as a bad self-medication to fight somehow a possible psychotic outcome.

 

References

Cocchi R. Defective hemispheric dominance and cognitive behaviour: Speculative considerations lt. J. lntellect. lmpair. 1994, 7: 19-27.

Cocchi R.: The re-analysis of the wrong answers at Raven's Coloured Matrices by alcoholics: A final overview. It. J. Intellect. Impair 1999, 12: 49-57

Cocchi R., Tornati A.:: Psychic dependence? A different formulation of the problem with a view to the reorientation of therapy for chronic drug addicts. Acta Psychiat. Scand. 1977, 56: 337-346.

Crow T.J: Sexual selection, Machiavellian intelligence, and the origins of psychosis" Lancet 1993, 342: 594-598.

.Hataway S.R., McKinley S.C. MMPI, University of Minneapolis 1951. (Forma Abbreviata, a cura di R. Nencini, OS, Firenze 1976).

 

 First published on Internet on 15 July 2001, copyright by R. Cocchi, 2001


Author address: Renato Cocchi via Rabbino, 3
42 100 Reggio Emilia (Italy)

renatococchi@libero.it

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