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This paper considers some recently reported cigarette smoking and drug-use data which indicate teenage smokers have a greater probability of using or becoming involved with illicit drugs than non-smoking peers. It is suggested that the epidemiological concept of high risk groupsbe applied to relationship between the use of socially approved substances like tobacco by young people and subsequent drug experiences because it acknowledges the empirical covariance between these events but does not have as strong causal implications as a “stepping stone” notion. By this, it is implied that a person who begins smoking, for example, at age 10 when his reference group will begin at age 15, may be more likely to become involved with substance abuse. Further suggested the decision to use drugs is an individual one which appears to be influenced by a multiplicity of factors as availability, personal needs, values, peer influences, personality characteristics and previous behavioral tendencies.

Hypothesizing that a relationship exists between personality and occupational choice, the Edwards Personal Preference Schedule was employed to assess need differences for a sample of 33 metropolitan police officers, Edwards' adult male, and male college normative groups. Comparison with the adult male population indicates this police sample score higher on needs for achievement, exhibitionism, and heterosexuality. They score lower on needs for abasement, affiliation, deference, endurance, nurturance, and order. Comparisons with the male college normative population show this sample of police personnel differs in having a lower affiliation need. A discussion of these findings with those of two previous studies was undertaken. The common findings of the three studies suggest that compared to the male general population, police officers have higher needs for exhibitionism and heterosexuality and a lower need for affiliation. Further studies are necessary for clarification.

Among the 15 variables assessed by the EPPS for 59 male and female applicants to a suburban methadone maintenance program the pattern, direction and magnitudes of correlations between need states were significantly different from those of the normative sample. The implications of the tendency of addicts to associate positively a number of incompatible needs for: (1) counseling, (2) generating interpersonal conflict, and (3) understanding the addict as an individual were discussed.

Psychologic tests and psychiatric ratings for 90 elderly long‐term psychiatric patients showed that those who were treated psychopharmacologically (one or more psychotropic drugs) had personality profiles indicative of less control of impulses and less anxiety binding than did those who received milieu (no‐drug) therapy. Since the three groups of elderly patients tested (no‐drug, one‐drug, multiple‐drugs) did not differ significantly from one another on all measures of intellectual functioning, emotional characteristics and individual psychiatric symptoms, it appears that treatment modes may be mediated more on the basis of reactive personality features than on the basis of clinical differences in basic pathology. Thus, although the patients treated with a single drug or multiple drugs did not manifest different symptom profiles qualitatively or quantitatively, when compared to patients who received no drugs they made their symptoms more apparent to the staff.

A questionnaire which included a case history designed to elicit treatment preferences in psychiatric disease was distributed to psychiatrists on the staffs of seventeen state mental hospitals in New York State. Results of the survey, based upon a 45 per cent return, indicate that two of every five respondents selected polypharmacy as the preferred initial treatment regimen for the hypothetical patient described in the questionnaire. Recency of training (residency completion) and fewer private agency affiliations appeared to be the major characteristic of the psychiatrists in this sample, who tended to employ drug combinations. These data are interpreted as being consistent with the hypothesis that polypharmacy may currently be ‘in vogue’ as a therapeutic modality despite the lack of a clear cut rationale for its use or proof of its efficacy.

The relationship between authoritarian attitudes, which reflect the belief that mentally ill persons comprise an inferior class requiring coercive handling, and personal adjustment was examined for 77 female psychiatric aides at a large state mental hospital. Correlations and analysis of variance suggested the lack of a systematic association between the two variables.

The Ravens Progressive Matrices (RPM), a test of intellectual ability, was administered to 396 male narcotic users. Norms are given, and concepts basic to the validity and reliability of the RPM tested. Significant shifts were found in item order in sets A, B, C, and D. Differences were not considered crucial for each set, which was progressively more difficult than the preceding set; thus the total structure of the test was supported by the sample. The discriminative power of most items ranged from good to excellent. In investigating properties of distractors, answer four was chosen significantly more often than other alternatives as the wrong answer in sets C, D and E identifying the possible operation of a positional distractor. Test-retest reliability, content and concurrent validity coefficients were of the order of .8. Correlation of formal education with RPM was of the order of .2. Previously available normative data on patient samples ae extended and use of the RPM as a measure of intellectual performance relatively free from language and cultural bias is supported.

In an attempt to identify the existence of reasoning errors in psychiatric patients, the performance of male narcotic users defined as sociopathic (N= 36) and schizotypic (N= 34) by MMPI profile patterns was analyzed for avoidable errors on the Ravens Progressive Matrices (RPM). An avoidable error was defined as a failure to solve an item whose difficulty level was within the testee's range of ability as measured by his performance. Construct validity was defined in terms of the intercorrelations of Ravens centile and item difficulty levels. Parametric and non-parametric tests of significance indicated that the schizotypic group commit significantly more identifiable reasoning errors than the sociopathic group.

Sutker and Allain (1973) suggest that nonincarcerated heroin addicts who are involved in the “street life style” would tend to obtain elevated scores on the Hs, D, Hyand Pdscales of the MMPI. If these findings were cross-validated, then personality descriptions of addicts would have to be modified accordingly. Also, improvement measured by decreases on the Hsand Hyscales soon after entering a drug-free environment may be a result of milieu differences rather than personality change. Four groups of heroin addicts, two hospitalized, urban drug abusers who were free of drug influence at testing (Hospitalized1and Hospitalized2) were compared with two street addict samples, one from an urban (StreetNARA), the other a suburban (StreetSCNCC) environment. It was hypothesized that both the StreetNARAand StreetSCNCCgroups would score significantly higher than the hospitalized groups and that there would be no differences between the hospitalized groups. As was expected, the street samples scored statistically higher on the Hsand Hyscales. However, data for the Dand Pdscales failed to cross-validate the Sutker-Allain hypothesis. These data suggest that personality characteristics play a more dominant role in MMPI score elevations than the “street life style.” This contention was also supported by test-retest data on the Hospitalized2sample measuring the effect of 90 days of hospitalization in a drug-free environment.

The MMPI was completed by 74 applicants to a Suffolk County methadone maintenance program. All had measurable psychopathology as reflected in Tscores of 70 or above on one or more of the original clinical scales. Data demonstrated heterogeneity in MMPI protocol code types, character structure, and psychopathological indications. Comparisons with previously reported data for addict samples committed to federal and state treatment units indicates fewer neurotic and sociopathic, but more schizotypic, incipient schizophrenic, or schizophrenic personality types applying to the methadone maintenance clinic. The most prevalent code type seen (842'), however, was identical with that reported for a sample of 117 patients seen at a VA methadone maintenance clinic.

The possibility of defining an emotion profile consistent with personality type was examined in this cross-validational study. The procedure contrasted a sample of newly admitted acute paranoid schizophrenic patients, who were identified by clinical procedures and judgment, with a group of narcotic users who were defined as paranoid personality types on the basis of their responses to self-report inventories. When the resulting Emotions Profile Index scores were compared for these two groups, they showed high similarity. This suggests the possibility of identifying emotion profile types which are consistent with underlying personality types.

The Raven Progressive Matrices protocols of 88 narcotic addicts, divided into four MMPI profile pattern groups, were scored for avoidable errors. Ss having psychotic-like profiles (428′ and 987′) made significantly more avoidable reasoning errors than Ss with sociopathic patterns (42′ and 49′). These data were interpreted as evidence of the sensitivity of avoidable error measures to disturbances in consistency and accuracy of comparative and analogical reasoning performance. It was suggested that avoidable error indices might be used to (a) judge the effects of pathological ideation upon complex reasoning, (b) estimate potential level of intellectual functioning in clinical populations, and (c) serve as a criterion for treatment efficacies.

The efficacy of anabolic steroid therapy has often been challenged because of equivocal clinical evidence of weight gain. In view of this challenge, 21 chronically underweight, geriatric patients in a state hospital were chosen for a study to determine the effect of a new synthetic anabolic preparation, norbolethone. Long‐term weight charts were used to determine confidence limits. After a one‐month placebo trial, placebo responders were identified; then the active preparation was given for fourteen weeks. The data indicated that spurious results can be obtained if strict criteria are not used for changes in body weight. Of the 21 study patients, as many as 18 could have been reported as showing a weight gain if only a short pre‐study period had been used for the baseline. However, when the placebo responders and yearly weight fluctuations were accounted for, only 4 patients showed significant gains in weight, and only 2 of these maintained their gains until the completion of the anabolic phase of the study.

Barbiturate withdrawal has long been a subject of controversy, even in the confines of locked psychiatric hospital wards, and certainly never a technic to be attempted on a casual outpatient basis. This report will describe a phenobarbital substitution technic for barbiturate withdrawal on an outpatient basis, which we have utilized with good results in the treatment of over 50 patients at the Haight-Ashbury Free Medical Clinic. This outpatient technic was developed for the very practical reason that much of our drug abusing population simply refuse hospitalization in the available state or county hospital facilities.

1970 is now known as the year of the emergence of the "middle-class junkie" (young, white, with a short-term habit). At the Haight-Ashbury Medical Clinic (in the traditional center of the "drug scene"), we have seen and treated over 1,000 drug addicts (predominantly heroin addicts) since 1969. On reviewing 773 of these cases, three distinct groups were found: The "new junkie" who has lately gone to heroin as his drug of choice; the "transition junkie," who was first a "flower-child" and "mind-expander," and later changed to heroin after multiple-drug experimentation; and the "old style junkie" who fits the traditional picture of being ghetto-bred, and who has a long-term, heavy habit. These subsegments of our patient population are examined in terms of prior drug use and patterns of drug use as well as race, sex, family status, etc.Drug patterns have, in the past, begun in the Haight-Ashbury and other drug abuse centers, and then have spread outward in a "ripple" effect to involve the rest of the country. It appears that the pattern of rapidly increasing heroin addiction will follow this pattern also, and it is hoped that this classification will serve as a useful guide to the types of addicts being seen and eventually as a criterion for treatment modalities.

Narcotic addicts comprising 2 diagnostic groups as defined by MMPI profile types (49′ sociopathic and 468′ paranoid) were selected to test the validity of emotion profiles gleaned from affective differential ratings, the affective differential methodology and the assumption that patients with different character structures have measurable differences in emotion profiles. Comparisons were made between the patient groups and between profiles gleaned from clinicians' ratings and the patients' self-reports. Emotion profile differences were demonstrated between paranoid and sociopathic patient groups. The clinicians' ratings tended to exaggerate the intensity of the emotions, making differences between profile types greater than those differences observed from patient self-reports. The results supported the hypothesis that persons with different character structures have different emotion profiles but not to the degree first reported by clinicians.

Examination of the therapeutic regimens used in treating 89 long‐term hospitalized male psychiatric patients in two groups (age 60 or older, and age 59 or younger) indicated that fewer psychotropic drugs were used in the older group (N = 45) even though both groups presented the same symptom picture, qualitatively and quantitatively, in interview and self‐report situations. This tendency to prefer a non‐drug treatment regimen in the older group did not appear to be due to the presence of a greater incidence of somatic illness, as both groups showed an equal frequency of concurrent physical illness. The data are interpreted as indicating that older patients are treated differently because they are perceived differently by the staff, most likely as a result of energy depletion and the diminished ability to act out their symptoms, associated with increasing age.