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Coming to Terms With Reality: Predictors of Self-deception Within Substance Abuse Recovery

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Coming to Terms With Reality: Predictors of Self-deception Within Substance Abuse Recovery

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Abstract

It is argued that drug and alcohol addiction centers on denial and self-delusion, and successful recovery depends on coming to terms with such problems. Mutual-help programs for substance abuse recovery (eg, 12-step programs) and self-run recovery homes (eg, Oxford House) might decrease self-deception through emphasis on facing reality, strict abstinence rules, and empowering people to direct their own course of recovery. The present study examined how recovery processes (12-step programs vs. recovery residence), substance use, and race/ethnicity predicted self-deception among adult residents of self-run recovery homes (359 men, 152 women). Twelve-step participation but not recovery home residency significantly predicted decreased self-deception across a 4-month period. In addition, race/ethnicity was a significant predictor of self-deception, with African Americans reporting higher levels of self-deception than participants of other racial groups. It is suggested that substance abusing individuals look to 12-step programs such as Alcoholics Anonymous and Narcotics Anonymous to reduce denial and gain a realistic self-view, critical steps in addiction recovery.

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... In many people with substance use disorders, the lack of self-awareness on how their brains behave to develop cravings and initiate relapse is a complication that hampers efforts for abstinence and delays progress in recovery [52,60]. Given this deficit, this group of patients are well-equipped to manage their cravings, and may deny drug-related problems and underestimate the need for treatment [61,62]. Enhancing self-awareness by training neurocognitive skills to help patients to deal with drug craving and other cognitive consequences of chronic drug use is the aim of this study that was described in detail above. ...
Article
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Background Neurocognitive deficits (NCDs) and associated meta-cognition difficulties associated with chronic substance use often delay the learning and change process necessary for addiction recovery and relapse prevention. However, very few cognitive remediation programs have been developed to target NCDs and meta-cognition for substance users. The study described herein aims to investigate the efficacy of a multi-component neurocognitive rehabilitation and awareness program termed “Neurocognitive Empowerment for Addiction Treatment” (NEAT). NEAT is a fully manualized, cartoon-based intervention involving psychoeducation, cognitive practice, and compensatory strategies relevant across 10 major cognitive domains, including aspects of attention, memory, executive functions, and decision-making. Method/design In a single-blind randomized controlled trial (RCT), 80 female opioid and/or methamphetamine users will be recruited from an addiction recovery program providing an alternative to incarceration for women with substance use-related offenses. Eight groups of 9–12 participants will be randomized into NEAT or treatment-as-usual (TAU). NEAT involves 14 90-min sessions, delivered twice weekly. The primary outcome is change in self-reported drug craving from before to after intervention using Obsessive Compulsive Drug Use Scale. Secondary and exploratory outcomes include additional psychological, neurocognitive, and structural and functional neuroimaging measures. Clinical measures will be performed at five time points (pre- and post-intervention, 3-, 6-, and 12-month follow-up); neuroimaging measures will be completed at pre- and post-intervention. Discussion The present RCT is the first study to examine the efficacy of an adjunctive neurocognitive rehabilitation and awareness program for addiction. Results from this study will provide initial information concerning potential clinical efficacy of the treatment, as well as delineate neural mechanisms potentially targeted by this novel intervention. Trial registration ClinicalTrials.gov NCT03922646 . Registered on 22 April 2019
... It has been shown that, in the clinical population, specifically among drug addicts and emotional dependents, a syndromic profile of self-deception is more pronounced than in the general population [2]. The literature on addiction points out that substance abusers show more self-deception than those who do not abuse [5], which is not surprising since the abuse of drugs and alcohol are disorders characterized by denial, dishonesty and self-deception [6]. As a result, therapeutic intervention has shifted the focus towards the recovery of honesty and the capacity for objectification [7] as substantial elements in the treatment for dependency [8]. ...
Article
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We all need to resort to deception, either with ourselves (denial, self-deception, mystification) or with others (with modalities, such as impression management, social desirability), to a greater or lesser extent. Lies, in their broader meaning, are interpreted as something rather adaptive, useful, and necessary in our socioaffective world. In particular, self-deception is a highly interesting psychological concept in the clinical population, namely, in drug dependents, as it serves as a mechanism for maintaining addiction. The objective of this study was to create and explore the validity and psychometric properties of a short self-deception scale (SDQ-12), derived from the IAM-40 and emphasizing the manipulation and mystification dimensions. Participants in this study included a group of drug dependents (alcoholics and drug abusers) under treatment (n = 417) as well as a group of adults from the general population (n = 124) (total N = 541), selected using simple random sampling. Across the sample, 63% of individuals were male, with a mean age of 38.65 years (S.D. = 10.61). Empirical exploration of the SDQ-12 items using exploratory and confirmatory factor analysis revealed that the instrument has a clear structure matching the theoretically relevant proposed dimensions of mystification and manipulation. Internal consistency was verified (Cronbach’s alpha coefficient = .85), and confirmatory factor analysis revealed that the two-dimensional model provided an appropriate fit to the data. In addition, manipulation was greater in young male individuals, with significant differences found in mystification and manipulation between the general population and alcoholics and drug abusers. Our study supports the clinical and research importance of the SDQ-12 scale, due not only to its diagnostic efficacy but also to its novel nature, its importance, and its relevance. It could be particularly useful for evaluating the substantial components of self-deception in the addict population, thus guiding therapists in their diagnostic and interventional role.
... Often they misinterpret non-verbal signals relying instead on their inner conviction that they are the bad ones or conversely, that the world is a bad place. (McWilliams,1994; Kaplan et al., 2007; Francis et al., 1999; Ferrari et al., 2008; Lesch, 2011). Taking into account the situation in Latvia, having to do with the spread of addiction disorder the influence of treatment methods mainly on the reduction of acute symptoms (excluding the disease's psychosocial part and the research established high social intelligence indicators especially for drug addicts) one must develop a critical attitude to one-self and their environment so essential in working with alcoholics and drug addicts. ...
Article
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Abstract Alcohol and drug addiction is a bio-psycho-social illness that affects a person not only physically but also influences his psyche, thinking and behavior as well as his attitude towards himself and his closest friends and others. In this paper, particular attention is paid to the three components of addiction disorder patients’ social intelligence (SI): social information processing (SIP), social skills (SS) and social awareness (SA). Using the Social Intelligence Test, 241 respondents were questioned; all Riga Center of Psychiatry and Addiction Disorder department patients. The mean arithmetical indicators were statistically relevant and significantly higher for males than females (in SIP factor); drug addict indicators were higher than those of alcoholics in all three SI factors. Male drug addict indicators were statistically relevant and significantly higher in the SIP and SA factors when compared to those of male alcoholics. For female drug addicts and alcoholics the SI factors had no significant statistical difference. In this paper, the research results were analyzed. The results allude to the respondents’ difficulties in adequately and critically assessing their own aptitudes of social intelligence as well as their various ways of responding that are deemed socially acceptable. Key-words: social intelligence, social skills, social information processing, social awareness, alcoholics, drug addicts, substance use disorders, gender.
... If it is viewed from a psychodynamic perspective, it can be seen that for addiction disorder patients certain defense mechanisms of the psyche such as projection, projective identification, denial, ending relationships, which are characteristic of addict disorder patients. Often they misinterpret non-verbal signals relying instead on their inner conviction that they are the bad ones or conversely, that the world is a bad place (McWilliams,1994; Kaplan et al., 2007; Francis et al., 1999; Ferrari et al., 2008; Lesch et al., 2011). Table 1Table 3 ...
Poster
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Background: The aim is to clarify which are the Social Intelligence (SI) indicators for addiction disorder patients; are there differences in gender and addiction differences in the SI indicators. Methods: 154 men and 87 women (substance use disorders patients – ICD-10 diagnosis- F10.2–19.2) were questioned. Using The Tromso Social Intelligence Scale, it contains three components: social information processing (SIP), social skills (SS) and social awareness (SA). Findings: The mean arithmetical indicators of SIP were statistically significant and higher for males than females, for drug addicts than alcoholics, for male drug addicts than male alcoholics. SA and SS indicators were statistically significant and higher for drug addicts than alcoholics and for male drug addicts than male alcoholics. For female drug addicts and alcoholics the SI factors had no significant statistical difference. Discussion: The results allude to the respondents’ difficulties in adequately and critically assessing their own aptitudes of social intelligence.
... The individual operating under a positivist discourse can ascribe to herself the objectivity necessary to determine a diagnosis of alcoholism. Thus, the naı¨ve scientist contemplating the significance of her own problem drinking frequently finds herself refuting two characterizations imposed by others: alcoholism and denial (Dare & Derigne, 2009;Ferrari, Groh, Rulka, Jason, & Davis, 2008;Miceli & Castelfranchi, 1998;Wing, 1995). This negotiation of individual identity is an interpersonal struggle conducted within the broader positivist discourse. ...
Article
The advantages of the disease model of alcoholism are well known, but the disadvantages have received little attention. The model's dominance has forestalled consideration of alternative and potentially valuable theories. It reinforces the value of normality even as it marks alcoholics as deviant. It suggests problem drinkers can diagnose themselves. These disadvantages are traceable to narrowly constructed scientific discourses: science-as-positivism, alcoholism-as-disease, and the individual-as-scientist. As a result, problem drinkers pondering a diagnosis of alcoholism emphasize the positivist concepts of central tendency, objectivity, and prediction/control. Positivism reinforces the value of normality even as a disease diagnosis threatens to mark the personal identity as deviant. In this circumstance, continuing to drink while manipulating drinking variables is rational. Alcoholism theory would benefit if researchers extended conceptualizations beyond the disease model. Alcoholism treatment would benefit if treatment professionals challenged social norms, emphasized subjectivity, and determined the parameters of the drinker’s self-control.
... Even though the validity of the self-reported EI measures has been questioned, and the influence of the current affective state or the social desirability effect may possibly bias the results, it has been revealed that self-reported perception of their own skills by AD individuals, was associated with overconfidence in the evaluation of the ability to abstain from alcohol (e.g. Ferrari et al., 2008). To resolve the direction of the revealed association, a randomized control trial, with the prospective assessment of the effects of EI skills training on drinking outcomes should be introduced. ...
Article
Growing data reveals deficits in perception, understanding and regulation of emotions in alcohol dependence (AD). The study objective was to explore the relationships between emotional processing, drinking history and relapse in a clinical sample of alcohol-dependent patients. A group of 80 inpatients entering an alcohol treatment program in Warsaw, Poland was recruited and assessed at baseline and follow-up after 12 months. Baseline information about demographics, psychopathological symptoms, personality and severity of alcohol problems was obtained. The Schutte Self-Report Emotional Intelligence (EI) Test and Toronto Alexithymia Scale (TAS) were utilized for emotional processing assessment. Follow-up information contained data on drinking alcohol during the last month. At baseline assessment, the duration of alcohol drinking was associated with lower ability to utilize emotions. Patients reporting more difficulties with describing feelings drank more during their last episode of heavy drinking, and had a longer duration of intensive alcohol use. A longer duration of the last episode of heavy drinking was associated with more problems identifying and regulating emotions. Poor utilization of emotions and high severity of depressive symptoms contributed to higher rates of drinking at follow-up. These results underline the importance of systematic identification of discrete emotional problems and dynamics related to AD. This knowledge has implications for treatment. Psychotherapeutic interventions to improve emotional skills could be utilized in treatment of alcohol-dependent patients. © The Author 2014. Medical Council on Alcohol and Oxford University Press. All rights reserved.
... One previous study has shown that further stages of recovery from substance dependence relate to decreased self-deception (Ferrari, Groh, Rulka, Jason, & Davis, 2008). Nevertheless, there is scarce research dedicated to the role of self-deception in the treatment of substance-dependent patients. ...
Article
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Background: This study was aimed at: (i) examining levels of self-deception in substance dependent individuals following addiction treatment, and (ii) examining the association between participants’ levels of self-deception and (a) personality disorders, (b) addiction-related beliefs, (c) duration of abstinence, and (d) estimates of craving. Method: We administered self-report questionnaires of self-deception and mixtification, and core beliefs related to addiction and craving. The sample comprised 79 outpatients who were consecutively recruited at the Centro Provincial de Drogodependencias in Granada: 87.3% were males and the mean age was 37.68 years old. Thirty-four percent of participants were diagnosed with comorbid personality disorders. Results: Results showed that individuals with substance dependence exhibit elevated scores of self-deception, particularly in the domains of active denial, selective amnesia, projection, and confabulation. Individuals with comorbid personality disorders display greater levels of self-deception compared to individuals without dual diagnosis. Conclusions: Moreover, there is a significant association between levels of self-deception and addiction-related beliefs and craving. In addition, there is a negative association between levels of self-deception and duration of abstinence.
... On the other hand, as was just explained with the case of addicts, this positive anticipation can come with a drop in prefrontal cortex activation and can thus take precedence over rational cognition. As noted, addicts are more prone to deceive themselves (Ferrari, Groh, Rulka, Jason, & Davis, 2008;Walker, 2010). The decrease of frontal lobe activation in conjunction with the increase in the dopamine system should lead to a neurobiological situation favoring self-deception to its maximum. ...
... For this reason any rehabilitation programme would need to address substance abuse as a priority when working with any other issues, including other psychological problems. As those who abuse substances often deny the extent of their problems (Ferrari et al., 2008; Stein & Rogers, 2008) or normalise these in the context of a particular sub-group (Duff, 2003;, it is not always easy to provide the help required. It was notable that none of those who participated in this research acknowledged currently using hard drugs although they had done so in the past. ...
... Women may have under-reported their previous or current drinking to avoid stigmatisation, or for other reasons such as poor memory, or as a self-deception -a well-recognised phenomenon in heavy drinkers. [53,54] However, our experience was that women were forthcoming about their drinking practices. ...
Preprint
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Background: Fetal Alcohol Spectrum Disorders (FASD) is a common, important and under-recognised health burden in South Africa. There is a limited understanding of why pregnant women drink in the South African context. Existing qualitative research leaves significant knowledge gaps regarding pregnant women in rural settings, where prevalence of FASD is highest. Objective: To provide a qualitative assessment of factors that influence drinking in pregnant women in a rural community in the Northern Cape province of South Africa Methods: A descriptive phenomenological approach was undertaken to explore the perceptions and experiences of pregnant women who drink, in a purposive sample of 8 women from a rural ante-natal clinic. A semi-structured interview was conducted with each participant and thematic analysis was conducted. Results: Participants appeared more aware of FASD than described in other study populations. Most reduced drinking after pregnancy recognition, although both recognition and cessation were often delayed. Participants described barriers and facilitators of alcohol abstinence. Barriers included social pressure, life stressors, and cravings and habits. Facilitators included desire to avoid FASD, relationships that were supportive without being stigmatising, availability of other “occupations” especially friendships and relationships not centred on drinking, specific body cues such as nausea, and a sense of personal agency. Conclusion: Various personal and contextual factors can act as barriers or facilitators of alcohol abstinence during pregnancy. Addressing barriers at structural, community and individual levels may aid women in reducing harmful drinking during pregnancy. Facilitators of abstinence should be leveraged to effect change in drinking behaviours, and thereby limit the burden of FASD.
... Even though the validity of the self-reported EI measures has been questioned, and the influence of the current affective state or the social desirability effect may possibly bias the results, it has been revealed that self-reported perception of their own skills by AD individuals, was associated with overconfidence in the evaluation of the ability to abstain from alcohol (e.g. Ferrari et al., 2008). To resolve the direction of the revealed association, a randomized control trial, with the prospective assessment of the effects of EI skills training on drinking outcomes should be introduced. ...
... It may be of greater importance to determine the role of negative associations in identity reformation and catharsis, particularly with a disorder that involves high degrees of selfdeception, denial, and blame, such as SUD. This may be particularly true of 12-step members who often adopt such labels as a form of self-truth or honesty as a means of counterbalancing against self-deception (Ferrari, Groh, Rulka, Jason, & Davis, 2008). Thus, negative associations do not necessarily translate to negative effects for the individual if the negativity serves an identity function and is a plausible divergent explanation for our results. ...
Article
Full-text available
Background: Labels such as “addict” and “substance abuser” have been found to elicit implicit and explicit stigma among the general public previously. The difference in the levels of this bias among individuals in recovery and those employed in the health profession has not yet been identified, however. The current study seeks to answer this question using measures of implicit bias. Methods: A subset sample (n = 299) from a previously completed study (n = 1,288) was selected for analysis. Mixed-model ANOVA tests were completed to identify variance between d-prime automatic association scores with the terms “addict” and “substance abuser” among individuals in recovery and those identified as working in the health professions. Results: Individuals in recovery did not have lower negative associations with either term, whereas individuals employed as health professionals had greater negative associations with the term “substance abuser” but did not have greater negative associations with the term “addict”. Conclusions: Results provide further evidence that previously identified stigmatizing labels have the potential to influence medical care and medical practitioner perceptions of individuals with substance use disorders and should be avoided. Results also suggest that previously identified terms (e.g., "substance abuser" and "addict") are also negatively associated to individuals in recovery. Further exploration into the role negative associations derived from commonly used labels have in the individual recovery process are needed to draw appropriate recommendations.
... Se ha evidenciado que en población clínica, en concreto en drogodependientes y dependientes emocionales, se obtiene un perfil sindrómico de autoengaño más acusado que en población general [2]. La literatura sobre adicciones advierte de que las personas que abusan de sustancias muestran más autoengaño que las que no lo hacen [5], lo cual no sorprende, ya que el abuso de drogas y alcohol son trastornos caracterizados por la negación, la deshonestidad y el autoengaño [6]. Como resultado, la intervención terapéutica ha puesto el foco en la recuperación de la honestidad y la capacidad de objetivación [7] como elementos sustanciales en el tratamiento de la dependencia [8]. ...
Article
Full-text available
Resumen Todos sentimos la necesidad de recurrir al engaño para con uno mismo (negación, autoengaño, mistificación) y hacia los demás (con modalidades como manejo de impresiones, deseabilidad social), en mayor o menor medida. La mentira, en el sentido laxo del término, es interpretada como algo en buena medida adaptativo, útil y necesario en nuestro mundo socioafectivo. Específicamente, el autoengaño es un concepto psicológico de gran interés en la población clínica, más concretamente en drogodependientes, como mecanismo de mantenimiento de la adicción. El objetivo de este estudio es crear y explorar la validez y las propiedades psicométricas de una escala breve de autoengaño (SDQ-12) obtenida a partir del IAM-40, incidiendo en las dimensiones de manipulación y mistificación. Han participado en el estudio un grupo de drogodependientes (alcohólicos y abusadores de drogas) en tratamiento (n = 417), así como un grupo de adultos de la población general (n = 124) (total N = 541), seleccionados mediante muestreo aleatorio simple. De la muestra completa, el 63% son hombres y la edad promedio es de 38.65 años (S.D. = 10.61). A partir de la exploración empírica de los 12 ítems del SDQ-12, mediante técnicas de análisis factorial exploratorio y confirmatorio, se ha comprobado que el instrumento presenta una estructura clara que coincide con las dimensiones propuestas teóricamente relevantes de la mistificación y la manipulación. Se ha comprobado la adecuada consistencia interna (coeficiente alfa de Cronbach = .85) y mediante el análisis factorial confirmatorio se mostró un ajuste apropiado a un modelo bidimensional. Asimismo, se ha confirmado que la manipulación es mayor en varones jóvenes y se han hallado diferencias significativas en mistificación y la manipulación entre la población general y los alcohólicos y abusadores de drogas. Nuestro estudio fundamenta la importancia clínica e investigadora de la escala SDQ-12, no sólo por su eficacia diagnóstica, sino también por su novedad, relevancia y pertinencia, siendo especialmente apropiada para evaluar los componentes sustanciales del autoengaño en la población adicta, lo cual puede orientar al terapeuta en sus labores diagnósticas y de intervención. Palabras clave: Autoengaño, Adicción, Manipulación, Mistificación, Inventario de Autoengaño, Estudio de validación. OPEN ACCESS Citation: Sirvent C, Herrero J, Moral MdlV, Rodr´ıguez FJ (2019) Evaluation of self-deception: Factorial structure, reliability and validity of the SDQ-12 (self-deception questionnaire). PLoS ONE 14(1): e0210815. https://doi.org/10.
... Se ha evidenciado que en población clínica, en concreto en drogodependientes y dependientes emocionales, se obtiene un perfil sindrómico de autoengaño más acusado que en población general [2]. La literatura sobre adicciones advierte de que las personas que abusan de sustancias muestran más autoengaño que las que no lo hacen [5], lo cual no sorprende, ya que el abuso de drogas y alcohol son trastornos caracterizados por la negación, la deshonestidad y el autoengaño [6]. Como resultado, la intervención terapéutica ha puesto el foco en la recuperación de la honestidad y la capacidad de objetivación [7] como elementos sustanciales en el tratamiento de la dependencia [8]. ...
Article
Full-text available
Resumen Todos sentimos la necesidad de recurrir al engaño para con uno mismo (negación, autoengaño, mistificación) y hacia los demás (con modalidades como manejo de impresiones, deseabilidad social), en mayor o menor medida. La mentira, en el sentido laxo del término, es interpretada como algo en buena medida adaptativo, útil y necesario en nuestro mundo socioafectivo. Específicamente, el autoengaño es un concepto psicológico de gran interés en la población clínica, más concretamente en drogodependientes, como mecanismo de mantenimiento de la adicción. El objetivo de este estudio es crear y explorar la validez y las propiedades psicométricas de una escala breve de autoengaño (SDQ-12) obtenida a partir del IAM-40, incidiendo en las dimensiones de manipulación y mistificación. Han participado en el estudio un grupo de drogodependientes (alcohólicos y abusadores de drogas) en tratamiento (n = 417), así como un grupo de adultos de la población general (n = 124) (total N = 541), seleccionados mediante muestreo aleatorio simple. De la muestra completa, el 63% son hombres y la edad promedio es de 38.65 años (S.D. = 10.61). A partir de la exploración empírica de los 12 ítems del SDQ-12, mediante técnicas de análisis factorial exploratorio y confirmatorio, se ha comprobado que el instrumento presenta una estructura clara que coincide con las dimensiones propuestas teóricamente relevantes de la mistificación y la manipulación. Se ha comprobado la adecuada consistencia interna (coeficiente alfa de Cronbach = .85) y mediante el análisis factorial confirmatorio se mostró un ajuste apropiado a un modelo bidimensional. Asimismo, se ha confirmado que la manipulación es mayor en varones jóvenes y se han hallado diferencias significativas en mistificación y la manipulación entre la población general y los alcohólicos y abusadores de drogas. Nuestro estudio fundamenta la importancia clínica e investigadora de la escala SDQ-12, no sólo por su eficacia diagnóstica, sino también por su novedad, relevancia y pertinencia, siendo especialmente apropiada para evaluar los componentes sustanciales del autoengaño en la población adicta, lo cual puede orientar al terapeuta en sus labores diagnósticas y de intervención. Palabras clave: Autoengaño, Adicción, Manipulación, Mistificación, Inventario de Autoengaño, Estudio de validación. OPEN ACCESS Citation: Sirvent C, Herrero J, Moral MdlV, Rodr´ıguez FJ (2019) Evaluation of self-deception: Factorial structure, reliability and validity of the SDQ-12 (self-deception questionnaire). PLoS ONE 14(1): e0210815. https://doi.org/10.
... In addition, substance use may provide pleasure, social connection, and/or relief of negative feelings; thus, many will feel highly conflicted about giving up what they deem to be an acceptable way of coping with life's problems. While these explanations for client deception about substance abuse seem reasonable, with rare exception (e.g., Ferrari, Groh, Rulka, Jason, & Davis, 2008) The respondents in these two studies endorsed a high degree of dishonesty on the topic of substance use. In the first study (N = 547), in which respondents were simply asked, "Have you ever lied about this [topic] in therapy?" 29% reported having been dishonest about their use of drugs and/or alcohol at some point in their treatment, making it one of the most commonly endorsed topics. ...
Article
Full-text available
Findings from a large sample of therapy clients indicate that substance use is among the most widely reported topics of dishonesty; that the primary motives for this dishonesty are shame, fear of being judged by one's therapist, and concern about real‐world consequences of disclosure (e.g., being sent to a rehabilitation facility); and that the most widely held client beliefs about what might facilitate greater honesty about substance use include feeling reassured that a therapist would not overreact nor be judgmental. The case report here reflects many of these themes. Discussion focuses on the ways in which therapists might deal with clients who struggle to be consistently forthcoming about their substance use issues, for example, by asking direct questions and by discussing the parameters and consequences of client disclosure on this topic.
... These results suggest that inmates expressed their psychological problems outwardly rather than viewed their psychological problems as an inner conflict. For inmates, the correct perceptions of their problems may be especially important for treatment [25]. Treatment programs should be implemented not only for patients but also for inmates. ...
Article
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The present study assessed problems in Japanese prisoners (inmates) who abused methamphetamine. Fifty-two male inmates were assessed in 2005-2007 using the Addiction Severity Index-Japanese version and compared with 55 male methamphetamine abusers in hospitals and recovery centers. The chi(2) and Mann-Whitney-Wilcoxon tests showed that the inmates had a significantly lower education level, more frequently had full-time jobs, had more experience living with a sexual partner, and more frequently had a history of juvenile delinquency and criminal records than patients. Although psychiatric symptoms, such as depression, anxiety, and hallucinations, were not common among inmates, suicidal behavior and trouble controlling violence were common in both groups.
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Using a self-defining memory task, this work studies the exact moment in which abstinent alcoholics perceived themselves as addicted. Phenomenological variables involved in the memory were obtained asking participants to evaluate their cognitions, perceptions and emotions associated with that self-defining memory. The sample consisted of 12 female and 31 male ex-alcoholics, with abstinence ranging from 6 months to 23 years. Mean age was 52.91 years. Our findings showed that awareness of the alcoholic self emerges in the context of uncontrolled consumption or an ultimatum from family members. This type of memory had a positive valence for most of the participants, regardless of the memory perspective (actor versus spectator). Those who remembered from an actor perspective, perceived the event as providing higher growth and personal learning. These results show the importance of exploring situations of uncontrolled consumption and family dynamics in the self-recognition of alcohol dependence. In addition, reinforcing an actor perspective compared to a spectator perspective might results in higher levels of personal enrichment, which may help maintain a patient’s long-term recovery. These results support the use of autobiographical memory techniques to enhance awareness of the addicted self, and suggest the need to include these interventions in rehabilitation programmes.
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Objective: This study aims at testing (a) the association between locus of control and socio-demographic, drug use, and treatment-related variables in patients with drug addiction following rehabilitation, and (b) whether locus of control may account for physical and mental health status also controlling for social desirability responding. Methods: Seventy-eight participants were recruited within therapeutic communities for drug rehabilitation treatment. They completed measures of locus of control (LCB), health-related status (SF-12) and social desirability responding (BIDR-6 short form) and provided further socio-demographic, drug use, and treatment-related information. T-tests, Pearson’s correlations, and hierarchical regression analyses were conducted. Results: Education and treatment duration represent the only two meaningful factors potentially favoring higher internal locus of control. Locus of control results to be a predictor of mental health status, explaining for about 6.5% of the outcome variance. However, when considering the potential influence of social desirability responding such a relationship does not remain statistically significant anymore. Conclusion: The study provides some insights about the relationship between locus of control and individual and treatment-related variables, that could be further explored to promote treatment success in rehabilitation programs. As well, social desirability arises as a major concern to be handled when dealing with substance use populations.
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The presented model of operations capacity planning allows obtaining quantitative dimensions of the service system parameters for Administrative Services Center. A methodology for the practical application of this model has also been presented here. The present paper aims at offering support for operations managers in the service sector for decision making regarding the operations capacity.
Preprint
Background: Neurocognitive deficits (NCDs) and associated meta-cognition difficulties associated with chronic substance use often delay the learning and change process necessary for addiction recovery and relapse prevention. However, very few cognitive remediation programs have been developed to target NCDs and meta-cognition for substance users. The study described herein aims to investigate the efficacy of a multi-component neurocognitive rehabilitation and awareness program termed ‘Neurocognitive Empowerment for Addiction Treatment’(NEAT). NEAT is a fully manualized, cartoon-based intervention involving psychoeducation, cognitive practice, and compensatory strategies relevant across 10 major cognitive domains, including aspects of attention, memory, executive functions, and decision-making.Method/design: In a single-blind randomized controlled trial (RCT), 80 female opioid and/or methamphetamine users will be recruited from an addiction recovery program providing an alternative to incarceration for women with substance use related offenses. Eight groups of 9-12 participants will be randomized into NEAT or treatment-as-usual (TAU). NEAT involves 14 90-min sessions, delivered twice weekly. The primary outcome is change in self-reported drug craving from before to after intervention using obsessive compulsive drug use scale. Secondary and exploratory outcomes include additional psychological, neurocognitive and structural and functional neuroimaging measures. Clinical measures will be performed at five time points (pre- and post- intervention, 3-, 6-, and 12-month follow-up); neuroimaging measures will be completed at pre- and post-intervention.Discussion: The present RCT is the first study to examine the efficacy of an adjunctive neurocognitive rehabilitation and awareness program for addiction. Results from this study will provide initial information concerning potential clinical efficacy of the treatment, as well as delineate neural mechanisms potentially targeted by this novel intervention. Trial registration: This trial was registered in clinicaltrials.gov on 22 April 2019 with NCT03922646 as clinicalTrials.gov identifier.
Article
Background: Denial of an overarching alcohol problem despite endorsement of specific alcohol-related difficulties may be central to development and continuation of alcohol use disorders (AUDs). However, there is limited information about which characteristics of drinkers and which drinking problems relate most closely to that denial. Methods: Using data from two generations of the San Diego Prospective Study (SDPS), we compared AUD subjects who considered themselves non-problematic drinkers (Group 1) with those with AUDs who acknowledged a general alcohol problem (Group 2). Comparisons included demography, alcohol-related patterns and problems, drug use, as well as impulsivity and sensation seeking. Variables were first evaluated as univariate characteristics after which significant group differences were entered in logistic regression analyses. Results: Sixty-seven percent of 94 AUD probands and 82 % of 176 AUD offspring reported themselves as light or moderate social drinkers despite averages of up to 12 maximum drinks per occasion and four DSM problems. Regression analyses indicated deniers evidenced less intense alcohol and drug-related problems and identified DSM-IV criterion items that they were most likely to deny. Conclusions: A large majority of two generations of SDPS participants whose interviews indicated a current AUD did not characterize themselves as problem drinkers. Despite drinking amounts that far exceeded healthy limits and admitting to important life problems with alcohol, these individuals give misleading answers regarding their condition when asked general questions about drinking by health care deliverers. The authors offer suggestions regarding how to identify those drinkers in need of advice regarding dangers of their behaviors.
Article
This study aims at exploring deceptive dynamics (i.e., impression management [IM], self-deception, and emotional manipulation [EM]) and their role in control beliefs and health status reporting in a sample of people treated for substance use disorder. Seventy-eight participants following drug rehabilitation treatment were recruited, who provided background information and completed measures of social desirability responding, EM, locus of control, and health-related status. Moderated-regression analyses and t tests were performed. The results highlight that self-deception is associated with not reporting the use of secondary substances and being in treatment for a shorter time period. IM appears as the main deceptive tendency able to account for internal control beliefs and better mental health. Some interaction effects emerge among the examined deceptive tendencies, which suggest to deepen the role of EM as a risk factor for drug relapse and treatment success.
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As emotion regulation is widely considered to be a primary motive in the misuse of alcohol, our aim in the study was to investigate whether deficits in adaptive emotion-regulation skills maintain alcohol dependence (AD). A prospective study investigated whether emotion-regulation skills were associated with AD and whether these skills predicted alcohol use during and after treatment for AD. Participants were 116 individuals treated for AD with cognitive-behavioral therapy. Emotion regulation and severity of AD symptoms were assessed by self-report. Alcohol use during treatment was assessed by Breathalyzer and urine analysis for ethyl glucuronide; alcohol use during the 3-month follow-up interval was assessed by self-report. Pretreatment emotion-regulation skills predicted alcohol use during treatment, and posttreatment emotion-regulation skills predicted alcohol use at follow-up, even when controlling for other predictors potentially related to emotion regulation. Among a broad range of specific emotion-regulation skills, the ability to tolerate negative emotions was the only skill that negatively predicted subsequent alcohol consumption when controlling for the other skills. Individuals in the AD sample reported significantly larger deficits in emotion-regulation skills than did those in a nonclinical control sample but significantly less than did those in a sample of individuals exclusively meeting criteria for major depressive disorder. Enhancement of general emotion-regulation skills, especially the ability to tolerate negative emotions, appears to be an important target in the treatment of AD.
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The rules and regulations from three US state samples of self-governed, communal-living sites, managed and operated by residents in Oxford Houses (n = 55 sites) were compared to traditional, staff-managed, therapeutic communities (n = 14 sites). Results indicated that both types of facilities did not permit self-injurious behaviors (such as physical self-harm or over medication of drugs). However, the Oxford Houses were more likely than the staff-managed facilities to establish policies restricting setting-destructive behaviors (e.g., disturbing, attacking, threatening, or harming others and playing loud music that annoys others), and permitting residents to engage in personal liberties (e.g., staying out late or overnight and having guests stay at the site) and to have personal possessions (e.g., own TV, stereo, and furniture) within the dwelling. Implications related to establishing social regularities that permit persons in recovery to have personal freedoms within communal-living, safe and sober settings are discussed.
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One research tradition has distinguished self-deception, the tendency to give favorably biased but honestly held self-descriptions from impression management, the tendency to give favorable self-descriptions to others. A 2nd tradition has distinguished enhancement, the claiming of positive attributes, from denial, the repudiation of negative attributes. The 2 distinctions were evaluated jointly in 3 studies with a total of 937 undergraduates. Factor analyses showed that impression management items (both enhancement and denial) loaded together. Self-deception items split up: Enhancement items formed a 2nd factor, whereas denial items fell closer to the impression management factor. Of the 4 types, self-deceptive enhancement best predicted adjustment. These results clarify the constructs of enhancement and denial. The critical distinction is not simply one of keying direction but whether the item content refers to a positive or negative attribute. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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J. Millham and L. I. Jacobson's (1978) 2-factor model of socially desirable responding based on denial and attribution components is reviewed and disputed. A 2nd model distinguishing self-deception and impression management components is reviewed and shown to be related to early factor-analytic work on desirability scales. Two studies, with 511 undergraduates, were conducted to test the model. A factor analysis of commonly used desirability scales (e.g., Lie scale of the MMPI, Marlowe-Crowne Social Desirability Scale) revealed that the 2 major factors were best interpreted as Self-Deception and Impression Management. A 2nd study employed confirmatory factor analysis to show that the attribution/denial model does not fit the data as well as the self-deception/impression management model. A 3rd study, with 100 Ss, compared scores on desirability scales under anonymous and public conditions. Results show that those scales that had loaded highest on the Impression Management factor showed the greatest mean increase from anonymous to public conditions. It is recommended that impression management, but not self-deception, be controlled in self-reports of personality. (54 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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A collective constructionist theory of the self proposes that many psychological processes, including enhancement of the self (pervasive in the United States) and criticism and subsequent improvement of the self (widespread in Japan), result from and support the very ways in which social acts and situations are collectively defined and subjectively experienced in the respective cultural contexts. In support of the theory, 2 studies showed, first, that American situations are relatively conducive to self-enhancement and American people are relatively likely to engage in self-enhancement and, second, that Japanese situations are relatively conducive to self-criticism and Japanese people are relatively likely to engage in self-criticism. Implications are discussed for the collective construction of psychological processes implicated in the self and, more generally, for the mutual constitution of culture and the self.
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The Balanced Inventory of Desirable Responding (BIDR; Paulhus, 1994) is a widely used instrument to measure the 2 components of social desirability: self-deceptive enhancement and impression management. With respect to scoring of the BIDR, Paulhus (1994) authorized 2 methods, namely continuous scoring (all answers on the continuous answer scale are counted) and dichotomous scoring (only extreme answers are counted). In this article, we report 3 studies with student samples, and continuous and dichotomous scoring of BIDR subscales are compared with respect to reliability, convergent validity, sensitivity to instructional variations, and correlations with personality. Across studies, the scores from continuous scoring (continuous scores) showed higher Cronbach's alphas than those from dichotomous scoring (dichotomous scores). Moreover, continuous scores showed higher convergent correlations with other measures of social desirability and more consistent effects with self-presentation instructions (fake-good vs. fake-bad instructions). Finally, continuous self-deceptive enhancement scores showed higher correlations with those traits of the Five-factor model for which substantial correlations were expected (i.e., Neuroticism, Extraversion, and Conscientiousness). Consequently, these findings indicate that continuous scoring may be preferable to dichotomous scoring when assessing socially desirable responding with the BIDR.
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The role of confrontation in the treatment of substance misuse problems is widely debated in the field. Historically, confrontation of denial has been important in treatment, particularly in residential programs. However, confrontation has also been criticized as counterproductive. Miller et al. colleagues have found that confrontation from treatment professionals is correlated with poor outcome. This paper reviews the literature supporting and criticizing confrontation. It is suggested that confrontation is not a monolithic concept. Rather, it is contingent upon clinical contextual factors that current research has not addressed, such as the treatment setting, treatment philosophy, client characteristics, the client's view about their relationship with confronter, the extent to which the client views the confrontation as legitimate, the client's perception of the confronter's motivation, and the level of emotional intensity involved in the confrontive exchange. Confrontation from multiple sources requires more focus, including confrontation from treatment peers, family members, the workplace, the legal system, social welfare workers, and medical professionals.
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A new social desirability scale was constructed and correlated with MMPI scales. Comparison was made with correlations of the Edwards Social Desirability scale. The new scale correlated highly with MMPI scales and supported the definition of social desirability. Ss need to respond in "culturally sanctioned ways."
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Research suggests that collectivists are more likely to engage in deception and socially desirable responding to maintain good relationships with others. In contrast, individualists are portrayed as candid and sincere because individualism encourages people to "be yourself." The authors propose that people with both types of cultural orientations or backgrounds engage in desirable responding, albeit in distinct ways. In Study 1, respondents from the United States compared with those from Singapore, and European Americans compared with Asian Americans, scored higher on self-deceptive enhancement (SDE)-the tendency to see oneself in a positive light and to give inflated assessment of one's skills and abilities- but lower on impression management (IM) by misrepresenting their self-reported actions to appear more normatively appropriate. In Studies 2 to 4, horizontal individualism as a cultural orientation correlated with SDE but not with IM, whereas horizontal collectivism correlated with IM but not with SDE. Further analyses examining (a) individual differences in the tendency to answer deceptively and (b) responses to behavioral scenarios shed additional light on the culturally relevant goals served by these distinct types of socially desirable responding.
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The current study found that African American residents of Oxford House (OH) used Narcotics Anonymous (NA) at high rates, and that both OH and NA strongly contributed to abstinent social networks. Having siblings and other family members in one's network predicted substance use among network members, whereas spouses, parents, and children did not have an effect on the rate of substance use. These findings suggest that OH and NA may be effective sources of abstinent social support for African Americans recovering from substance abuse. However, family members are well represented in the support networks of African Americans in OH.
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The interior and exterior physical characteristics of substance abuse recovery program dwellings (11 woman, 44 men) from three geographic sections of the United States were assessed at creating a "house-as-home" for residents. Although each house was independently governed and operated by residents, results indicated vast similarities among the interior characteristics, amenities, and structural aspects. These rented dwellings also had similar well-maintained exterior characteristics, despite their geographic locations. Follow-up interviews of former residents indicated that these house characteristics and amenities helped create a sense of home not found in traditional institutional facilities. Results suggested that residents of self-governed independently operated recovery houses may create and maintain safe and sober settings that elicit a sense of home among residents.
Article
The culture movement challenged the universality of the self-enhancement motive by proposing that the motive is pervasive in individualistic cultures (the West) but absent in collectivistic cultures (the East). The present research posited that Westerners and Easterners use different tactics to achieve the same goal: positive self-regard. Study 1 tested participants from differing cultural backgrounds (the United States vs. Japan), and Study 2 tested participants of differing self-construals (independent vs. interdependent). Americans and independents self-enhanced on individualistic attributes, whereas Japanese and interdependents self-enhanced on collectivistic attributes. Independents regarded individualistic attributes, whereas interdependents regarded collectivistic attributes, as personally important. Attribute importance mediated self-enhancement. Regardless of cultural background or self-construal, people self-enhance on personally important dimensions. Self-enhancement is a universal human motive.
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Denial, which is viewed here as a composite phenomenon, is the major obstacle to treatment for the alcoholic and the significant others in his life
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With two studies, the authors sought to clarify how alcoholism relates to beliefs about drinking control and self-esteem by varying the stage of alcohol involvement. The stages were active abuser, commitment to change, early recovery, and late recovery. As hypothesized inStudy 1, long-term recovering abstainers had greater drinking-related internal locus of control, self-efficacy about abstaining, and self-esteem than those in detoxification. Unexpectedly, active abusers did not differ from the long-term recovering abstainers. Study 2 successfully discriminated these extreme groups with a measure of self-deception. Active abusers' positive beliefs about drinking control and self-esteem were associated with high self-deception. Self-beliefs at commitment to change were negative, but self-deception was still high. Early and late recovery was associated with positive self-beliefs and significantly lower self-deception.
Article
The authors developed a model of the relationships between racial identity development and socially desirable responding, using a sample of African American undergraduate students. Instruments used were the Racial Identity Attitude Scale‐Long Form (J. E. Helms & T. A. Parham, 1996) and the Balanced Inventory of Desirable Responding (D. L. Paulhus, 1991). The results challenge previous research conclusions regarding social desirability and racial identity development. Implications of findings for researchers, instrument developers, and counselors are included.
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Under this heading are brief reports of studies that provide comparable data from two or more societies, using a standard measuring instrument. These Notes consist of a summary of the study's procedure and as many details about the results as space allows. Additional details concerning the results can be obtained by communicating directly with the author.
Article
As part of a larger investigation of response effects on organizational surveys, the present study compared the responses of Hispanic and non-Hispanic U.S. Navy recruits on the Balanced Inventory of Desirable Responding (BIDR). The inventory contains two measures of socially desirable responding: impression management, the deliberate tendency to over-report desirable behaviors and under-report undesirable ones, and self-deceptive enhancement, the tendency to give overly positive but honest self-reports. Hispanic recruits had significantly higher scores than non-Hispanic Whites on impression management; the two groups did not, however, differ on self-deceptive enhancement. These findings suggest that Hispanics may be more likely than non-Hispanic Whites to present a positive picture of themselves to others but do not differ from non-Hispanic Whites on the amount of positive self-deceptive enhancement they engage in. The results were interpreted with reference to the Hispanic cultural value of simpatia.
Article
Discusses the therapeutic approach of Alcoholics Anonymous (AA). Areas considered include principles and methods, etiology and treatment, the psychodynamics of recovery, and the expectations of psychotherapy. The work of AA is evaluated based on visits to AA meetings, a review of the literature, interviews with AA members, and interviews with psychiatrists. The shift from a society-centered view of alcoholism to an abuse-centered one is described, along with AA's use of alternate therapies for different types of drinking problems. (57 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Presents an empirical description and evaluation of the validity, reliability, and accuracy of 127 social psychological measures in 9 areas (e.g., self-esteem, locus of control, alienation and anomie, authoritarianism and dogmatism, values, and religious and social attitudes). A review of factors involved in the measurement of life satisfaction and happiness is included. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
disciplines encountered [in this review] included anthropology, sociology, psychology, medicine, theology, and philosophy / participant-observational studies, epidemiological surveys, public opinion surveys, ethnographic investigations, and psychotherapy outcome studies were among the research strategies used in the sources (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The Addiction Severity Index (ASI) is 12 years old and has been revised to include a new section on family history of alcohol, drug, and psychiatric problems. New items were added in existing sections to assess route of drug administration; additional illegal activities; emotional, physical, and sexual abuse; quality of the recovery environment; and history of close personal relationships. No changes were made in the composite scoring to maintain comparability with previous editions. This article discusses the clinical and research uses of the ASI over the past 12 years, emphasizing some special circumstances that affect its administration. The article then describes the rationale for and description of the changes made in the ASI. The final section provides "normative data" on the composite scores and severity ratings for samples of opiate, alcohol, and cocaine abusers as well as drug abusing inmates, pregnant women, homeless men, and psychiatrically ill substance abusers.
Article
The role of social desirability response sets on self-reported marital satisfaction in 143 male alcoholics and their wives was assessed in a factor analytic study of the combined Locke-Wallace Marital Adjustment Scale (MAS) and Edmonds Marital Conventionalization Scale (MCS). Overall, results indicated that alcoholics rated their marriage as significantly more satisfying than did their wives. There was, however, a large amount of covariation between the MAS and MCS for husbands, and factor analyses revealed considerable redundancy between the two measures as evidenced in one dominant factor on which both MAS and MCS items loaded. Although there was also high covariation between the two scales for wives, there was still enough differential responding to MAS and MCS items to identify both a dominant factor and a second factor, the latter loaded on only by MCS items. Results suggest that the self-reported marital satisfaction of male alcoholics may be highly contaminated by social desirability response sets. The results are discussed with respect to the two-component model of socially desirable responding and caution is urged in the evaluation of self-report marital adjustment measures with this population.
Article
Conducted a study (a) to identify the existence of distinct personality types among 282 white male alcoholic psychiatric patients and (b) to relate this empirically derived taxonomy to types from previous research with alcoholic patients and to general psychiatric types. Employing a sequential factor-analytic strategy, 8 bipolar typal dimensions that defined 1 cluster of persons at each pole of each dimension were identified. The 5 clearest bipolar typal dimensions were classified as follows: (a) acute anxiety vs denial and blunted affect, (b) antisocial attitudes vs hypochondriacal preoccupation, (c) hostile-hallucinatory syndrome vs neurotic depression, (d) neurotic disorganization vs hostile paranoid, and (e) emotional instability vs interpersonal conflict and depression. MMPI profiles from prior research with a variety of psychiatric groups showed marked correspondence with MMPI profiles estimated for the 8 common types. (23 ref)
Article
Compared 80 multi-drug-habituated patients with a population of outpatients matched for age and sex using the MMPI and the Interpersonal Check List. The drug abusers emerged as significantly more hostile and critical, idealizing the socially undesirable behaviors of distrust and nonconformity and revealing a significant degree of self-deception. Self-perceptions of the 2 groups were similar and reflected a lack of confidence in their own ability to achieve success, but their reactions to these feelings were markedly different. Both groups perceived their parents as strong, self-reliant, and behaving in a socially desirable manner, although mothers of drug abusers were described as lacking warmth and nurturant behaviors. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Although drinking behavior is clearly a central dependent variable in alcoholism treatment research, the field has reached no consensus on measurement methodology for alcohol consumption. At least four methods for quantifying consumption have been commonly used in outcome studies: quantity-frequency questions, average consumption grids, timeline follow-back and self-monitoring. The Form 90 family of structured interviews was developed by collaboration among the Project MATCH investigators, combining the strengths of prior assessment methodologies. The development, structure, supporting software and training approaches for the Form 90 instruments are described.
Article
Previous research has shown there is significant comorbidity between alcohol abuse and anxiety disorders. However, the prevalence of anxiety disorders in alcoholic samples has been found to be higher than the occurrence of alcohol abuse in anxiety disorder samples. One possibility for this apparent discrepancy involves a social desirability response bias where it may be less socially acceptable to report alcoholism than to report an anxiety disorder. Thus, a high need for social approval may be associated with minimizing alcohol abuse. The relationship between standardized self-reports of alcohol abuse and social desirability was assessed in 51 panic disorder (PD) and 33 social phobia (SP) patients. In male PD patients there was a negative correlation (-0.46) between social desirability and self-reports of alcohol abuse that approached statistical significance, and the prevalence of alcohol abuse was 18%. In male SP patients there was no such inverse relation and the prevalence of alcohol abuse was much higher (47%). In female anxiety disorder patients these patterns were not evident. These results suggest that when there is a strong (negative) relationship between self-reports of alcoholism and social desirability, the alcohol use may be minimized. In general, however, this relationship was not pronounced in most anxiety disorder patients.
Article
Socially desirable responding is the reluctance to admit unpopular beliefs or behavior in order to avoid making a negative impression. It poses a problem for researchers who rely on self-report of heavy drinking and drug use. The Marlowe-Crowne Social Desirability Scale (SDS), which measures socially desirable responding, was administered to 1933 respondents in a general population survey. The relationships between SDS and various self-report measures were examined. SDS was not correlated with gender or race, it increased with greater age and decreased with higher socioeconomic status. With age and socioeconomic status controlled, SDS had a moderate negative relationship with alcohol and drug use, and a strong negative relationship with variables reflecting the expression of anger. Correlations between drinking/drug use and such variables as age, marital conflict, and stressful life events were not substantially changed by controlling for SDS. It was concluded that social desirability response bias probably results in underestimates of rates of heavy drinking and drug use, but does not compromise the study of predictors of heavy drinking or drug use.
Article
Oxford House is a self-help, self-governed, democratic communal-living environment for recovering alcoholics and polysubstance abusers. In this study, 134 male residents (M age = 34 years old) were personally interviewed on their recovery process and, in particular, on their experience with 12-step programs such as Alcoholics Anonymous (AA). Most residents (76%) reported they attended weekly AA meetings to assist in their recovery, mainly to acquire effective techniques to maintain sobriety (72%). Many AA attendees (43%) claimed no sense of spirituality prior to joining AA, and for most of these men (71%), attendance at weekly meetings was not motivated by "spirituality" aspects of the program. In contrast, the majority of residents (53%) attending weekly AA meetings claimed that a sense of fellowship with similar recovering others was their reason for program involvement. It appears that among men living in a communal setting with other recovering addicts, the need for social support for sobriety from similar others continues beyond the confines of their residence.
Article
Accounts are statements offered by individuals when explaining questionable behavior. Cultures vary in the kinds of accounts they honor, and individuals who deny a problem with alcohol may be attempting to maintain congruence between self and culture. Within this context, health care professionals who challenge a patient's denial may be causing unnecessary harm. The author presents a concept analysis of alcoholic denial in relation to the concept of accounts to explicate cultural variations in the manifestation of denial. The author integrates findings of her own and others' research to advance an understanding of alcoholic denial and cultural accounts.
Article
This study examined the accuracy of self-reported HIV serostatus for injection drug users and the predictive validity of a measure of social desirability to detect inaccurate self-reports. Participants in the ALIVE study were provided testing for HIV antibodies and counseling every 6 months. In the separate SAFE study, the same volunteers were asked their HIV serostatus. The 348 active injection drug users recruited from the ALIVE study, a longitudinal study of the natural history of HIV among injection drug users, volunteered for an HIV prevention study (SAFE study). The ALIVE baseline interview included a scale to measure "self-deception", a dimension of socially desirable responding. Of one hundred and four HIV seropositive participants, 71 (68%) accurately reported their HIV status, 28 (27%) inaccurately reported their HIV serostatus, and five (5%) reported that they did not know or were not sure about their HIV serostatus. Of 242 HIV seronegative participants, 239 (98%) correctly reported their serostatus. Thus the sensitivity of self-report was 72%, specificity 99%, positive predictive value 97%, and the negative predictive value was 90%. For individuals who scored at or below the median on self-deception, the sensitivity of self-reported HIV serostatus was 81%. The results suggest that high scores on some measures of social desirability may indicate questionable validity of self-reported HIV serostatus.
Article
The culture movement challenged the universality of the self-enhancement motive by proposing that the motive is pervasive in individualistic cultures (the West) but absent in collectivistic cultures (the East). The present research posited that Westerners and Easterners use different tactics to achieve the same goal: positive self-regard. Study 1 tested participants from differing cultural backgrounds (the United States vs. Japan), and Study 2 tested participants of differing self-construals (independent vs. interdependent). Americans and independents self-enhanced on individualistic attributes, whereas Japanese and interdependents self-enhanced on collectivistic attributes. Independents regarded individualistic attributes, whereas interdependents regarded collectivistic attributes, as personally important. Attribute importance mediated self-enhancement. Regardless of cultural background or self-construal, people self-enhance on personally important dimensions. Self-enhancement is a universal human motive.
Article
The relationship of The Paulhus Deception Scales (PDS; ) to the Texas Christian University Drug Screen I was investigated in participants screened for a voluntary in-prison substance abuse treatment program. Mean PDS scores for 35 female and 277 male prison inmates were significantly higher than the inmate norms in the test manual. All three PDS scale scores were negatively related to symptom endorsement and to the diagnosis of drug dependence. Almost 37% of participants produced protocols of questionable validity, with 22% faking-good and 14.7% faking-bad. However, over 90% of participants obtained scores that were not covered by the manual's profile typology. These findings underline the importance of deception to correctional assessment and the need for more information on the psychometrics and operating characteristics of the PDS in correctional settings.
Article
Understanding the role of personal motivation in addiction treatment changed with the advent of the Transtheoretical Model of intentional behavior change, a better understanding of relapse, and a shift in focus from denial to readiness. Motivation is a complex concept that covers many diverse aspects of the process of intentional behavior change. This review examines current perspectives on readiness and the stages of change, criticisms and measurement issues, and clinical applications and future research in this area. Although significant challenges remain, properly incorporating the concepts of readiness and the stages of change into addiction treatment enables providers to address the diverse needs of substance abusers and treatment seekers, supports more proactive interventions, creates a concentration on motivational enhancement, and helps researchers understand the larger process of change where addict and treatment provider meet. Better measurement, more frequent assessments, and a better understanding of the stage subtasks and how they relate to readiness and successful change are needed to deepen our understanding of motivation and its role in the treatment of addiction.
Article
C. Sedikides, L. Gaertner, and Y. Toguchi (2003) reported findings favoring the universality of self-enhancement. S. J. Heine (2005) challenged the authors' research on evidential and logical grounds. In response, the authors carried out 2 meta-analytic investigations. The results backed the C. Sedikides et al. (2003) theory and findings. Both Westerners and Easterners self-enhanced tactically. Westerners self-enhanced on attributes relevant to the cultural ideal of individualism, whereas Easterners self-enhanced on attributes relevant to the cultural ideal of collectivism (in both cases, because of the personal importance of the ideal). Self-enhancement motivation is universal, although its manifestations are strategically sensitive to cultural context. The authors respond to other aspects of Heine's critique by discussing why researchers should empirically validate the comparison dimension (individualistic vs. collectivistic) and defending why the better-than-average effect is a valid measure of self-enhancement.
Article
There is a need to explore the processes of social support and self-efficacy change over time among individuals in recovery homes, and to assess the extent to which residents remain abstinent, obtain and maintain employment, refrain from criminal activity, and utilize health care systems both while within the and after leaving such settings. Residents were recruited and interviewed at an initial baseline phase and then re-interviewed at three subsequent 4-month intervals. Oxford Houses are recovery home residences for individuals with substance abuse and dependence problems who seek a supportive, democratic, mutual-help setting. A national US sample of Oxford House residents (n=897: 604 men, 293 women). Information was gathered on abstinence, social support, self-efficacy, employment, criminal history, and medical care utilization. Change in cumulative abstinence was predicted by support for alcohol use, abstinence self-efficacy, and length of residency in OH (i.e., less than versus >or=6 months), even after controlling for initial time spent in OH. Results suggest that receiving abstinence support, guidance, and information from recovery home members committed to the goal of long-term sobriety may enhance residents' abstinence self-efficacy and enable persons recovering from alcohol and other drug addiction to reduce the probability of a relapse.
Alcoholic denial: self-awareness and beyond Self-awareness Deficits in Psychiatric Patients: Neurobiology, Assessment, and Treatment
  • Kj Sher
  • A Epler
  • B Beitman
  • J Nair
Sher, KJ.; Epler, A. Alcoholic denial: self-awareness and beyond. In: Beitman, B.; Nair, J., editors. Self-awareness Deficits in Psychiatric Patients: Neurobiology, Assessment, and Treatment. W.W. Norton & Company; New York: 2004. p. 184-212.
Addressing denial in the therapy of alcohol problems
  • Berenson
Berenson D, Shrier EW. Addressing denial in the therapy of alcohol problems. Fam Dynamics Addict Q. 1991; 1:21-30.
Within the Wall of Denial
  • R J Kearney
Kearney, RJ. Within the Wall of Denial. Conquering Addictive Behaviors. W.W. Norton and Company; New York: 1996.
Similarities and differences in governance among residents in drug and/or alcohol misuse: self vs. staff rules and regulations. Ther Communities
  • Jr Ferrari
  • Davis La Jason
  • Mi
Ferrari JR, Jason LA, Davis MI, et al. Similarities and differences in governance among residents in drug and/or alcohol misuse: self vs. staff rules and regulations. Ther Communities: Int J Ther Supportive Organizations. 2004; 25:179–192.
Manual for the Balanced Inventory of Desirable Responding (BIDR-7). Multi-Health Systems
  • D L Paulhus
Paulhus, DL. Manual for the Balanced Inventory of Desirable Responding (BIDR-7). Multi-Health Systems; Toronto, Canada: 1998.