16 males and 16 females age 18 and older at Morris Village (a SC State Inpatient Treatment Center) participated in a study attempting to use the PAI to predict their number of external excuses for using addictive substances. This research showed several PAI scales by themselves reliably and significantly predicted their number of excuses. Further, several PAI scales together reliably and significantly predicted a large amount of the total variance. There were gender differences in mean number of excuses but an Analysis of Variance failed to show reliability or significance.

Harbin DM, Elder IR (2020) Prediction of the Number of Addicts’ Excuses for Using Addictive Substances. J Subst Abuse Alcohol 7(1): 1082.

There can be many reasons an individual abuses substances, so it is important to understand what substance abusers’ excuses seem to mean. Substance abuse has many faces and can be a misunderstood disease. According to the National Institute on Drug Abuse, addiction has been defined as “a brain disease” according to Hammer, Dingle, Ostergren, Nowakowski & Koenig [1-7]. They also reported that “addiction has been understood in various ways – a sin, a disease, a bad habit - each a reflection of a variety of social, cultural, and scientific conceptions” Baker stated that substance abuse, dependence and addiction continues to be a major issue that neither the community nor the government seems to be able to stop or control. The real question is what drives an individual to use and what excuses are they using to justify the use?

During the many treatments I was able to be a part of in my internship, I had the privilege of listening to different stories and discussing the reasons (excuses) for the substance abuse. I began to hypothesize there was an association between addicts’ excuses and their psychopathology and further hypothesized that if this were true, tests for psychopathology should be able to predict the number of addicts’ excuses. In other words, if increased or decreased number of excuses were associated with differing psychopathology, then these associations should show up in a correlational study.

Subjects

This study randomly selected 32 detoxed inpatient individuals (16 males and 16 females) to participate in the study.

Procedure

The researcher used a random number generator to select the subjects. Prior to the study, the investigator devised an informed consent that all the necessary academic and institutional agencies required to safeguard the participants. The investigators briefed each participant on the study’s purpose and asked them to sign this informed consent giving permission for the study. The investigator used the participants inpatient bed number as their identifier on the consent form, the survey and the PAI. The investigator informed participants this identifier protected their identity during and after the study. No names were ever used in the process or data. The investigator gave each participant a very brief list of excuses commonly used for substance abuse. There were additional lines at the bottom to add any excuses not covered in the survey. (Figure 1).

Figure 1: The table below shows how each of the most significant predictive variables were entered sequentially

This survey took about 1-2 minutes to complete. The investigator also gave each participant a computer administered Personality Assessment Inventory (PAI) to complete that took approximately an hour. The researcher supervised the administration of both surveys and was available for any questions. Participants asked no questions.

A forward stepwise Multiple Regression Analysis of the 32 subjects’ excuses and PAI scales’ numerical elevations showed the following: SEE THE TABLE BELOW: Six scales together (Drug Problems, Alcohol Problems, Antisocial, Paranoia, Infrequency, and Mania) reliably predicted the Number of Excuses’ Variance (p=.000132) and predicted a significant amount of total variance: 52% of the Number of Excuses’ Variance, with an F of 7.07, overall a very powerful finding. Obtaining such results with a small number of subjects suggests very powerful effects. Reliability of course suggests only replicability, but significance suggests the power of the effects---the degree of association of the variables- -and these both reached very high levels with only 32 subjects.

The forward stepwise regression summary below also shows the Alcohol Problems, Drug Problems and Antisocial Scales were reliable single variables in predicting Number of excuses, i.e., the red variables, while Paranoia, Infrequency, and Mania scales were not reliable single variables, but did add some significance (increasing the total amount of predicted variance to 52%), i.e., blue variables.

The table below shows how each of the most significant predictive variables were entered sequentially, in a forward stepwise process, until all variables adding any significance were added to the final regression formula.

The investigators subjected the men’s and women’s mean excuses to an independent t-test and the results showed more excuses for men, that is, 7.18 mean excuses for men, versus 6.93 mean excuses for women. However, this difference was not reliable, t=.19, p =.53. Since the difference was not reliable, it was also not significant.

The most powerful predictors were Drug Problems, Alcohol Problems and Antisocial Scales and these seem to indicate the client is perhaps focusing defensively, psychologically, on their “externalized” problems. In other words, the patients with more excuses appeared to focus more of the problems caused by drugs and alcohol, an external focus. Further, the Antisocial Scale itself predicts “externalization.”

Of course, we cannot presume the relationships are necessary causal, but they do predict. Thus, at the least, the results suggest that those addicts with a high number of excuses for their addictions probably employ more externalization. And clinically they frequently also got diagnoses for Antisocial personality. Thus, psychotherapy will need to address working through this externalization/resistance.

Special thanks to psychology interns Myran Porterfield and Constance Bacon for their effortless involvement in keying in all PAI T-scores and number of excuses reported from the surveys.

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