International Journal of the Addictions
ISSN: 0020-773X (Print) (Online) Journal homepage: http://www.tandfonline.com/loi/isum19
Problems of Adjustment Reported among a Group of Heroin Addicts Larry Hart & Linda Krogh To cite this article: Larry Hart & Linda Krogh (1975) Problems of Adjustment Reported among a Group of Heroin Addicts, International Journal of the Addictions, 10:3, 433-441, DOI: 10.3109/10826087509026726 To link to this article: http://dx.doi.org/10.3109/10826087509026726
Published online: 03 Jul 2009.
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Date: 17 March 2016, At: 01:53
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The International Journal of the Addictions, 10(3), 433-441, 1975
Problems of Adjustment Reported among a Group of Heroin Addicts* Larry Hartt Services for Traffic Safety Boston, Massachusetts
Linda Krogh Social Systems Analysts Cambridge, Massachusetts
Abstract
Many reports in the literature concerning the heroin addict and his addiction have been related to psychological tests and the personality and behavior among addicts. However, studies have not cited his adjustment problems. Forty-seven narcotic addicts were surveyed to determine their adjustment difficulties by an administration of the Mooney Problem Checklist. The results indicate that the most difficult areas of adjustment were related to
* The term “resident” or “addict” is used throughout this report to include not only those who were physically dependent on heroin but also those who have been psychologically dependent on so-called soft drugs. t To whom requests for reprints should be sent at Services for Traffic Safety, 21 1 Congress Street, Ninth Floor, Boston, Massachusetts 02110. 43 3 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.
434
HART AND KROGH
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personality, self-improvement, the home and family, and occupation. It was concluded that among these participating narcotic addicts, four areas were noted as frequent problems while five additional areas were reported as less of an adjustment difficulty. Throughout the past decade, clinicians and researchers have reported an abundance of information concerning the heroin addict and his addiction. Included are investigators who have reported on the use of the Minnesota Multiphasic Personality Inventory among addicts (Berzins et al., 1971; Sutker, 1971; Sheppard et al., 1969; Haertzen et al., 1968; Gilbert and Lombardi, 1967). Also, researchers have studied the emotional characteristics of addicts in a therapeutic community (Biase, 1971 ; DeLeon et al., 1971), while others have reported on the resident who “splits” the therapeutic community (DeLeon et al., 1972). Furthermore, investigators have reported on the subject of the locus of control among addicts (Berzins and Ross, 1973) and the relationship of sexual behavior to heroin addiction (DeLeon and Wexler, 1973). Additionally, research has been reported that has been concerned with the personality and interpersonal relationships of addicts. In the area of personality, Astin (1959) has noted the hypersensitivity and emotional deprivation of addicts, and Wikler and Rasor (1953) has discussed the personality of young addicts and their families. Among the reports dealing with the issue of interpersonal relationships, Biase (1971) and Kaplan and Meyerowitz (1969) have discussed the addicts inability to relate. Although researchers have concentrated on areas related to the addict and his addiction, they have avoided other areas of importance. One such area pertains to the addicts’ adjustment difficulties as he is involved in the rehabilitation process. If it can be assumed that aiding in the solution of the addicts’ problems will lead to successful rehabilitation, then it is necessary to identify these difficulties and aid in their resolution. The present study was undertaken because of the necessity in understanding the addicts’ perception of his adjustment difficulties and the lack of available literature dealing with the subject. Table 1 abstracts the studies reported in this paper.
METHOD The group to be surveyed were residents of the Marathon House therapeutic communities located in Massachusetts and New Hampshire. Marathon is a residential, self-help, “concept” oriented program which is
1959
1973
1971
1971
1973
1972
Berzins and Ross
Berzins et al.
Biase
DeLeon and Wexler
DeLeon et al.
Year
Astin
Researcher
Rotter Internal-External Control Scale MMPI
Male and female hospitalized addicts Male hospitalized addicts
600
Multiple Affect Adjective Check List
Interview
Data collection
Male and female addicts
Maie addicts in a therapeutic community
Male and female therapeutic community residents
31
358
30
200
MMPI
Instrument used or method
Male narcotic addicts
Group surveyed
250
Sample size
Table 1 Abstracted Studies of Narcotic Addicts Results
(continued)
Five identifiable factors emerged after a factor analysis of the MMPI psychopathic deviate scale Opiate addicts showed strong internal expectations, especially on those items referring to personal control Patients appeared to be markedly more egocentric, defensive, sexually confused. and socially maladaptive than the comparison groups Early terminators from treatmen t (splittees) had significantly higher depression scores than those therapeutic community residents who remained in treatment A relationship between changes in sexuality and heroin addiction is discussed. Findings indicate that during periods of heroin addiction there is a loss of sexual activity while during postaddiction periods sexuality recovers Results indicated that the longer the residence in the therapeutic community the greater the reduction in criminal activity among splittees
Downloaded by [Purdue University Libraries] at 01:53 17 March 2016
318 145 322 71
396 40
1968
1969
1968
1971
1953
Haertzen
Kaplan and Meyerowitz
Sheppard et al.
Sutker
Wikler and Rasor
na
40
Although maladjustment existed among the addicts and the comparison group, the addicts tended to have more psychopathic traits, depression, insecurity, and inadequacy MMPI Differences in personal pathology and Addicts Alcoholics personality differ according to the Criminals specific scale and test employed Interview Male institutionDifferent prerelease characteristics indicate various postinstitutional adalized addicts justment among hospitalized and imprisoned addicts Court referred ad- Psychological test Narcotic users with different character battery dicts structures have measurable differences in emotional profiles Unincarcerated MMPI and Shipley Results indicated that there are meaInstitute of Living addicts surable personality differences beNonaddict intween heroin addicts and nonaddict Scale prisoners. especially in respect to mates sociopathy Drug addicts Clinical interpretaThe authors discuss the symptomatopretation logical psychoanalytic and pharmacodynamic formulations regarding the psychiatric aspects of drug addiction Male narcotic addicts
45
1967
Gilbert and Lombardi
Scores on emotionality significantly dropped over time for the residents in the Phoenix House therapeutic community program
Narcotic Addiction Evaluation Program questionnaire from (mood item) MMPI
Male and female therapeutic community residents
1971
DeLeon et al. 95
Results
Instrument used or method
Group surveyed
Year
Researcher
Sample size
Table 1 (continued)
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PROBLEMS OF ADJUSTMENT OF HEROIN ADDICTS
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staffed and administered almost entirely by ex-addicts. The staff employs a variety of reality therapy techniques to resocialize the residents into responsible individuals. The Ss were 30 male (27 White, 3 Black) and 17 female (15 White, 2 Black) addicts who were drug free. The mean age for the residents was 19.9 years (range 15-33). The mean length of residence for these addicts was 6 months (range 6 days-19 months). According to marital status, 37 were single, five were married, three were divorced, one was separated, and one subject did not indicate his or her status. All residents were unemployed, The Ss assembled and received an administration of the adult form of the Mooney Problem Checklist (MPC). The MPC is a group of 288 statements that are concerned with such adjustment problems as Health, Economic Security, Self-Improvement, and Personality. The instrument is designed to identify adjustment difficulties that a person is “willing to express at a given time,” and it has been shown to exhibit “sufficient stability for a group to warrant general program planning on the basis of survey results” (Mooney and Gordon, 1950). An “over-all index of the validity of the check lists would . . . be quite meaningless . . .” because the MPC provides information about “particular people in specific situations” (Mooney and Gordon, 1950). After the Ss assembled, the second author (hereafter referred to as the surveyor) briefly explained the purpose of the checklist. The surveyor explained that the Ss’ responses would remain confidential and then administered the checklist face down. After all the Ss received an MPC, they were instructed to turn the instrument over and to read the directions. Any questions that the Ss had pertaining to the instructions or the survey were answered. The surveyor instructed the Ss to proceed with the checklist. Upon completion, the Ss were instructed to turn the checklist over and to remain seated until everyone had finished. After the Ss had completed the checklist, the surveyor collected the data. Later the checklist was compiled and interpreted.
RESULTS The Ss reported adjustment problems in all categories: on Health, 14% of 1692 items were noted; Economic Security, 16% of 1692 items; Self-Improvement, 39% of 1692 items; Personality, 390,; of 3384 items; Home and Family, 22% of 1692 items; Courtship, 25% of 846 items; Sex, 22% of 846 items; Religion, 210,/, of 846 items; and Occupation. 25% of 846 items. Table 2 is a list of the 15 most frequently checked items.
’
438
HART A N D KROGH
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Table 2 The 15 MPC Items Most Often Marked by 47 Addicts Number of times marked
Percent of Ss marking item
39 36 35 33 32 32 31 30 30 30 30
83 11 74 70 68 68 66
29 29 28 27
62 62 60 51
Feelings too easily hurt Want more personal freedom Lacking self-confidence Confused as to what I really want Worrying how I impress people Being envious or jealous Worried about a member of my family Wanting love and affection Wanting to be more popular Would rather be doing other kind of work Bothered by thoughts running through my mind Needing more outdoor air and sunshine Wanting very much to travel Wanting to improve my mind Not seeing parents often enough
64
64 64 64
It is not surprising to find that these therapeutic community residents are concerned about issues related to personality and self-improvement; the two categories with the largest percentage of items checked. Of the most frequently marked items, seven were related to personality, four were related to self-improvement, three were related to the home and family, and one was related to occupation. These findings suggest that these resident addicts are concerned about adjustment related to their personality, self-improvement, familial, and occupational situations.
DISCUSSION Clearly, these residents of the Marathon therapeutic community report difficulties in adjustment in the nine categories of the MPC. While the adjustment areas of Personality, Self-Improvement, Home and Family, and Occupation are of utmost concern to these participating residents, other areas, such as Courtship, Sex, and Religion, are held in high regard. One might expect to obtain similar findings from nondrug abusers in the same age group. It is interesting to note that the category of Occupation had response rate identical to the categories of Courtship and Sex; however, these latter categories did not have an item appear among those
Downloaded by [Purdue University Libraries] at 01:53 17 March 2016
PROBLEMS OF ADJUSTMENT OF HEROlN ADDICTS
439
most frequently marked. The categories of Health and Economic Security appear to be of less concern than the previously mentioned categories. These addicts reported seven Personality items among the 15 items most frequently marked. Among these, the addicts have indicated concern with such statements as : “feelings too easily hurt, lacking self-confidence, confused as to what I really want, and worrying how I impress people.” These difficulties in personality adjustment aie consistent with those reported by other researchers: Kaplan and Meyerowitz (1969), who have reported on the addict’s antisocial behaviors, identity, and feelings of rejection, and Gilbert and Lombardi (19671, who have discussed the addict’s difficulties in formulating emotional relationships and their severe feelings of inadequacy. The residents reported four Self-Improvement items among the 15 items most frequently marked. Among these, the addicts have indicated their concern with the following statements : “wanting more personal freedom, needing more outdoor air and sunshine, wanting very much to travel, and wanting to improve my mind.” It is not surprising to find indications from these residents that they desire to be involved in outside activities and to travel. The therapeutic community acts as a pressure cooker which serves to force residents to exhibit their interpersonal problems to each other. Consequently, the day-to-day interpersonal stress tends to reach high levels with an outlet via encounter groups. These residents reported three Home and Family items and one Occupation item that appeared among those 15 most frequently marked. Among items in the Home and Family category, the Ss indicated concern on issues related to “worrying about a family member, wanting love and affection, and not seeing parents often enough.” It seems that these addicts may be concerned with their relationship and membership with their families while they are residents at the therapeutic community. This appears to be a need for self-satisfaction to know one still “has a family” and that, despite his psychological difficulties and social problems, he, as an individual, is still loved and accepted. The residents have indicated a statement in the category of Occupation which requires additional comment. These residents have indicated a desire to do “another kind of work.” They are noting that their daily tasks are dissatisfying and are considered an “adjustment problem.” Much of the work within the therapeutic community is routine and boring; many times residents perform the same tasks for months before their job is changed. This dissatisfaction with one’s job and desire to do more satisfying work appears to be an area of considerable frustration to the residents; one may wonder
Downloaded by [Purdue University Libraries] at 01:53 17 March 2016
440
HART AND KROGH
if this dissatisfaction and routine work is not debilitating to the rehabilitation process. In summary, these residents of the Marathon House therapeutic community have reported their difficulty in adjustment related to the Personality, Self-Improvement, Home and Family, and Occupation categories on the MPC. The most outstanding issues of adjustment in each of these four categories were related to their feelings which are too easily hurt, their desire for greater personal freedom, their concern about a family member, and that they would rather be doing another kind of work. The remaining five categories of Health, Economic Security, Courtship, Sex, and Religion were reported to be less of an adjustment difficulty. ACKNOWLEDGMENTS
The authors would like to express their appreciation to J. Germano, L. Ajar, R. Filiault, and T. Danforth for their help in implementing this research. REFERENCES ASTIN, A. A factor study of the MMPI psychopathic deviate scale. J . Consult. Psychol. 23(6): 550-554, 1959. BERZINS, J., and ROSS, W. Locus of control among opiate addicts. J . Consult. Clin. Psychol. 40(1): 84-91, 1973. BERZINS, J., ROSS, W., and MONROE, J. A multivariate study of the personality characteristics of hospitalized narcotic addicts on the MMPI. J . Clin. Psychol. 27: 174-181 1971. BIASE, D. Adolescent Heroin Abusers in a Therapeutic Community. Paper presented at the meeting of the National Research Council Committee on Problems of Drug Dependence, Toronto, February 1971. DELEON, G., and WEXLER, H. Heroin addiction: Its relationship to sexual behavior and sexual experience. J . Abnormal Psychol. 81(1): 36-38, 1973. DELEON, G., HOLLAND, S., and ROSENTHAL, M. Phoenix House-Criminal activity of dropouts. J . Amer. Med. Assoc. 222(6): 686-689, 1972. DELEON, G., ROSENTHAL, M., and BRODNEY, K. Therapeutic community for drug addicts, long-term measurement of emotional changes. Psychof. Rep. 29: 595-600, 1971. GILBERT, J. and LOMBARDT, D. Personality characteristics of young male narcotic addicts. J . Consult. Psychol. 31(5): 536-538, 1967. HAERTZEN, C., HILL, H., and MONROE, J. MMPI scales for differentiating and predicting relapse in alcoholics, opiate addicts, and criminals. Intern. J . Addictions 3(1): 91-106, 1968. KAPLAN, H., and MEYEROWITZ, J. Psychosocial predictions of postinstitutional adjustment among male drug addicts. Arch. Gen. Psychiut. 20: 278-284, 1969.
PROBLEMS OF ADJUSTMENT OF HEROIN ADDICTS
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MOONEY, R., and GORDON, L. Manual of the Mooney Problem Checklists, Adult Form. New York: Psychological Corp., 1950. SHEPPARD, C., FIORENTINO, D., COLLINS, L., and MERLIS, S. Comparison of emotional profiles as defined by two additional MMPI profile types in male narcotic addicts. J. Clin. Psychol. 25(2): 186-188, 1969. SUTKER, P. Personality differences and sociopathy in heroin addicts and nonaddict prisoners. J. Abnormnl Psychol. 78(3): 247-251, 1971. WIKLER, A., and RASOR, R. Psychiatric aspects of drug addiction. Amer. J . Med. 1953, 14: 566570, 1953.
ISSN: 0020-773X (Print) (Online) Journal homepage: http://www.tandfonline.com/loi/isum19
Problems of Adjustment Reported among a Group of Heroin Addicts Larry Hart & Linda Krogh To cite this article: Larry Hart & Linda Krogh (1975) Problems of Adjustment Reported among a Group of Heroin Addicts, International Journal of the Addictions, 10:3, 433-441, DOI: 10.3109/10826087509026726 To link to this article: http://dx.doi.org/10.3109/10826087509026726
Published online: 03 Jul 2009.
Submit your article to this journal
Article views: 2
View related articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=isum19 Download by: [Purdue University Libraries]
Date: 17 March 2016, At: 01:53
Downloaded by [Purdue University Libraries] at 01:53 17 March 2016
The International Journal of the Addictions, 10(3), 433-441, 1975
Problems of Adjustment Reported among a Group of Heroin Addicts* Larry Hartt Services for Traffic Safety Boston, Massachusetts
Linda Krogh Social Systems Analysts Cambridge, Massachusetts
Abstract
Many reports in the literature concerning the heroin addict and his addiction have been related to psychological tests and the personality and behavior among addicts. However, studies have not cited his adjustment problems. Forty-seven narcotic addicts were surveyed to determine their adjustment difficulties by an administration of the Mooney Problem Checklist. The results indicate that the most difficult areas of adjustment were related to
* The term “resident” or “addict” is used throughout this report to include not only those who were physically dependent on heroin but also those who have been psychologically dependent on so-called soft drugs. t To whom requests for reprints should be sent at Services for Traffic Safety, 21 1 Congress Street, Ninth Floor, Boston, Massachusetts 02110. 43 3 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.
434
HART AND KROGH
Downloaded by [Purdue University Libraries] at 01:53 17 March 2016
personality, self-improvement, the home and family, and occupation. It was concluded that among these participating narcotic addicts, four areas were noted as frequent problems while five additional areas were reported as less of an adjustment difficulty. Throughout the past decade, clinicians and researchers have reported an abundance of information concerning the heroin addict and his addiction. Included are investigators who have reported on the use of the Minnesota Multiphasic Personality Inventory among addicts (Berzins et al., 1971; Sutker, 1971; Sheppard et al., 1969; Haertzen et al., 1968; Gilbert and Lombardi, 1967). Also, researchers have studied the emotional characteristics of addicts in a therapeutic community (Biase, 1971 ; DeLeon et al., 1971), while others have reported on the resident who “splits” the therapeutic community (DeLeon et al., 1972). Furthermore, investigators have reported on the subject of the locus of control among addicts (Berzins and Ross, 1973) and the relationship of sexual behavior to heroin addiction (DeLeon and Wexler, 1973). Additionally, research has been reported that has been concerned with the personality and interpersonal relationships of addicts. In the area of personality, Astin (1959) has noted the hypersensitivity and emotional deprivation of addicts, and Wikler and Rasor (1953) has discussed the personality of young addicts and their families. Among the reports dealing with the issue of interpersonal relationships, Biase (1971) and Kaplan and Meyerowitz (1969) have discussed the addicts inability to relate. Although researchers have concentrated on areas related to the addict and his addiction, they have avoided other areas of importance. One such area pertains to the addicts’ adjustment difficulties as he is involved in the rehabilitation process. If it can be assumed that aiding in the solution of the addicts’ problems will lead to successful rehabilitation, then it is necessary to identify these difficulties and aid in their resolution. The present study was undertaken because of the necessity in understanding the addicts’ perception of his adjustment difficulties and the lack of available literature dealing with the subject. Table 1 abstracts the studies reported in this paper.
METHOD The group to be surveyed were residents of the Marathon House therapeutic communities located in Massachusetts and New Hampshire. Marathon is a residential, self-help, “concept” oriented program which is
1959
1973
1971
1971
1973
1972
Berzins and Ross
Berzins et al.
Biase
DeLeon and Wexler
DeLeon et al.
Year
Astin
Researcher
Rotter Internal-External Control Scale MMPI
Male and female hospitalized addicts Male hospitalized addicts
600
Multiple Affect Adjective Check List
Interview
Data collection
Male and female addicts
Maie addicts in a therapeutic community
Male and female therapeutic community residents
31
358
30
200
MMPI
Instrument used or method
Male narcotic addicts
Group surveyed
250
Sample size
Table 1 Abstracted Studies of Narcotic Addicts Results
(continued)
Five identifiable factors emerged after a factor analysis of the MMPI psychopathic deviate scale Opiate addicts showed strong internal expectations, especially on those items referring to personal control Patients appeared to be markedly more egocentric, defensive, sexually confused. and socially maladaptive than the comparison groups Early terminators from treatmen t (splittees) had significantly higher depression scores than those therapeutic community residents who remained in treatment A relationship between changes in sexuality and heroin addiction is discussed. Findings indicate that during periods of heroin addiction there is a loss of sexual activity while during postaddiction periods sexuality recovers Results indicated that the longer the residence in the therapeutic community the greater the reduction in criminal activity among splittees
Downloaded by [Purdue University Libraries] at 01:53 17 March 2016
318 145 322 71
396 40
1968
1969
1968
1971
1953
Haertzen
Kaplan and Meyerowitz
Sheppard et al.
Sutker
Wikler and Rasor
na
40
Although maladjustment existed among the addicts and the comparison group, the addicts tended to have more psychopathic traits, depression, insecurity, and inadequacy MMPI Differences in personal pathology and Addicts Alcoholics personality differ according to the Criminals specific scale and test employed Interview Male institutionDifferent prerelease characteristics indicate various postinstitutional adalized addicts justment among hospitalized and imprisoned addicts Court referred ad- Psychological test Narcotic users with different character battery dicts structures have measurable differences in emotional profiles Unincarcerated MMPI and Shipley Results indicated that there are meaInstitute of Living addicts surable personality differences beNonaddict intween heroin addicts and nonaddict Scale prisoners. especially in respect to mates sociopathy Drug addicts Clinical interpretaThe authors discuss the symptomatopretation logical psychoanalytic and pharmacodynamic formulations regarding the psychiatric aspects of drug addiction Male narcotic addicts
45
1967
Gilbert and Lombardi
Scores on emotionality significantly dropped over time for the residents in the Phoenix House therapeutic community program
Narcotic Addiction Evaluation Program questionnaire from (mood item) MMPI
Male and female therapeutic community residents
1971
DeLeon et al. 95
Results
Instrument used or method
Group surveyed
Year
Researcher
Sample size
Table 1 (continued)
Downloaded by [Purdue University Libraries] at 01:53 17 March 2016
Downloaded by [Purdue University Libraries] at 01:53 17 March 2016
PROBLEMS OF ADJUSTMENT OF HEROIN ADDICTS
437
staffed and administered almost entirely by ex-addicts. The staff employs a variety of reality therapy techniques to resocialize the residents into responsible individuals. The Ss were 30 male (27 White, 3 Black) and 17 female (15 White, 2 Black) addicts who were drug free. The mean age for the residents was 19.9 years (range 15-33). The mean length of residence for these addicts was 6 months (range 6 days-19 months). According to marital status, 37 were single, five were married, three were divorced, one was separated, and one subject did not indicate his or her status. All residents were unemployed, The Ss assembled and received an administration of the adult form of the Mooney Problem Checklist (MPC). The MPC is a group of 288 statements that are concerned with such adjustment problems as Health, Economic Security, Self-Improvement, and Personality. The instrument is designed to identify adjustment difficulties that a person is “willing to express at a given time,” and it has been shown to exhibit “sufficient stability for a group to warrant general program planning on the basis of survey results” (Mooney and Gordon, 1950). An “over-all index of the validity of the check lists would . . . be quite meaningless . . .” because the MPC provides information about “particular people in specific situations” (Mooney and Gordon, 1950). After the Ss assembled, the second author (hereafter referred to as the surveyor) briefly explained the purpose of the checklist. The surveyor explained that the Ss’ responses would remain confidential and then administered the checklist face down. After all the Ss received an MPC, they were instructed to turn the instrument over and to read the directions. Any questions that the Ss had pertaining to the instructions or the survey were answered. The surveyor instructed the Ss to proceed with the checklist. Upon completion, the Ss were instructed to turn the checklist over and to remain seated until everyone had finished. After the Ss had completed the checklist, the surveyor collected the data. Later the checklist was compiled and interpreted.
RESULTS The Ss reported adjustment problems in all categories: on Health, 14% of 1692 items were noted; Economic Security, 16% of 1692 items; Self-Improvement, 39% of 1692 items; Personality, 390,; of 3384 items; Home and Family, 22% of 1692 items; Courtship, 25% of 846 items; Sex, 22% of 846 items; Religion, 210,/, of 846 items; and Occupation. 25% of 846 items. Table 2 is a list of the 15 most frequently checked items.
’
438
HART A N D KROGH
Downloaded by [Purdue University Libraries] at 01:53 17 March 2016
Table 2 The 15 MPC Items Most Often Marked by 47 Addicts Number of times marked
Percent of Ss marking item
39 36 35 33 32 32 31 30 30 30 30
83 11 74 70 68 68 66
29 29 28 27
62 62 60 51
Feelings too easily hurt Want more personal freedom Lacking self-confidence Confused as to what I really want Worrying how I impress people Being envious or jealous Worried about a member of my family Wanting love and affection Wanting to be more popular Would rather be doing other kind of work Bothered by thoughts running through my mind Needing more outdoor air and sunshine Wanting very much to travel Wanting to improve my mind Not seeing parents often enough
64
64 64 64
It is not surprising to find that these therapeutic community residents are concerned about issues related to personality and self-improvement; the two categories with the largest percentage of items checked. Of the most frequently marked items, seven were related to personality, four were related to self-improvement, three were related to the home and family, and one was related to occupation. These findings suggest that these resident addicts are concerned about adjustment related to their personality, self-improvement, familial, and occupational situations.
DISCUSSION Clearly, these residents of the Marathon therapeutic community report difficulties in adjustment in the nine categories of the MPC. While the adjustment areas of Personality, Self-Improvement, Home and Family, and Occupation are of utmost concern to these participating residents, other areas, such as Courtship, Sex, and Religion, are held in high regard. One might expect to obtain similar findings from nondrug abusers in the same age group. It is interesting to note that the category of Occupation had response rate identical to the categories of Courtship and Sex; however, these latter categories did not have an item appear among those
Downloaded by [Purdue University Libraries] at 01:53 17 March 2016
PROBLEMS OF ADJUSTMENT OF HEROlN ADDICTS
439
most frequently marked. The categories of Health and Economic Security appear to be of less concern than the previously mentioned categories. These addicts reported seven Personality items among the 15 items most frequently marked. Among these, the addicts have indicated concern with such statements as : “feelings too easily hurt, lacking self-confidence, confused as to what I really want, and worrying how I impress people.” These difficulties in personality adjustment aie consistent with those reported by other researchers: Kaplan and Meyerowitz (1969), who have reported on the addict’s antisocial behaviors, identity, and feelings of rejection, and Gilbert and Lombardi (19671, who have discussed the addict’s difficulties in formulating emotional relationships and their severe feelings of inadequacy. The residents reported four Self-Improvement items among the 15 items most frequently marked. Among these, the addicts have indicated their concern with the following statements : “wanting more personal freedom, needing more outdoor air and sunshine, wanting very much to travel, and wanting to improve my mind.” It is not surprising to find indications from these residents that they desire to be involved in outside activities and to travel. The therapeutic community acts as a pressure cooker which serves to force residents to exhibit their interpersonal problems to each other. Consequently, the day-to-day interpersonal stress tends to reach high levels with an outlet via encounter groups. These residents reported three Home and Family items and one Occupation item that appeared among those 15 most frequently marked. Among items in the Home and Family category, the Ss indicated concern on issues related to “worrying about a family member, wanting love and affection, and not seeing parents often enough.” It seems that these addicts may be concerned with their relationship and membership with their families while they are residents at the therapeutic community. This appears to be a need for self-satisfaction to know one still “has a family” and that, despite his psychological difficulties and social problems, he, as an individual, is still loved and accepted. The residents have indicated a statement in the category of Occupation which requires additional comment. These residents have indicated a desire to do “another kind of work.” They are noting that their daily tasks are dissatisfying and are considered an “adjustment problem.” Much of the work within the therapeutic community is routine and boring; many times residents perform the same tasks for months before their job is changed. This dissatisfaction with one’s job and desire to do more satisfying work appears to be an area of considerable frustration to the residents; one may wonder
Downloaded by [Purdue University Libraries] at 01:53 17 March 2016
440
HART AND KROGH
if this dissatisfaction and routine work is not debilitating to the rehabilitation process. In summary, these residents of the Marathon House therapeutic community have reported their difficulty in adjustment related to the Personality, Self-Improvement, Home and Family, and Occupation categories on the MPC. The most outstanding issues of adjustment in each of these four categories were related to their feelings which are too easily hurt, their desire for greater personal freedom, their concern about a family member, and that they would rather be doing another kind of work. The remaining five categories of Health, Economic Security, Courtship, Sex, and Religion were reported to be less of an adjustment difficulty. ACKNOWLEDGMENTS
The authors would like to express their appreciation to J. Germano, L. Ajar, R. Filiault, and T. Danforth for their help in implementing this research. REFERENCES ASTIN, A. A factor study of the MMPI psychopathic deviate scale. J . Consult. Psychol. 23(6): 550-554, 1959. BERZINS, J., and ROSS, W. Locus of control among opiate addicts. J . Consult. Clin. Psychol. 40(1): 84-91, 1973. BERZINS, J., ROSS, W., and MONROE, J. A multivariate study of the personality characteristics of hospitalized narcotic addicts on the MMPI. J . Clin. Psychol. 27: 174-181 1971. BIASE, D. Adolescent Heroin Abusers in a Therapeutic Community. Paper presented at the meeting of the National Research Council Committee on Problems of Drug Dependence, Toronto, February 1971. DELEON, G., and WEXLER, H. Heroin addiction: Its relationship to sexual behavior and sexual experience. J . Abnormal Psychol. 81(1): 36-38, 1973. DELEON, G., HOLLAND, S., and ROSENTHAL, M. Phoenix House-Criminal activity of dropouts. J . Amer. Med. Assoc. 222(6): 686-689, 1972. DELEON, G., ROSENTHAL, M., and BRODNEY, K. Therapeutic community for drug addicts, long-term measurement of emotional changes. Psychof. Rep. 29: 595-600, 1971. GILBERT, J. and LOMBARDT, D. Personality characteristics of young male narcotic addicts. J . Consult. Psychol. 31(5): 536-538, 1967. HAERTZEN, C., HILL, H., and MONROE, J. MMPI scales for differentiating and predicting relapse in alcoholics, opiate addicts, and criminals. Intern. J . Addictions 3(1): 91-106, 1968. KAPLAN, H., and MEYEROWITZ, J. Psychosocial predictions of postinstitutional adjustment among male drug addicts. Arch. Gen. Psychiut. 20: 278-284, 1969.
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