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Alcohol & Alcoholism Vol. 34, No. 3, pp.

370377, 1999


Department of Psychiatry, CB#7175, School of Medicine, University of North Carolina at Chapel Hill,
Chapel Hill, NC 27599-7175, USA

(Received 2 November 1998; accepted 10 December 1998)

Abstract The MyersBriggs Type Indicator (MBTI), a popular personality test, was used to profile the
personalities of in-patient alcoholics/substance-use disorder patients who had, and those who did not have,
a concurrent affective disorder diagnosis. The MBTI divides individuals into eight categories: Extroverts and
Introverts, Sensors and Intuitives, Thinkers and Feelers, and Judgers and Perceivers. Alcohol/substance-use
disorder patients with no affective disorder differed from a normative population only in being significantly
more often Sensing and significantly less often Intuitive single-factor types. The Extroverted/Sensing/
Feeling/Judging four-factor type was also significantly over-represented in this group, compared to a
normative population. In contrast, mood-disordered alcohol/substance-use disorder patients were significantly
more often Introverted, Sensing, Feeling, and Perceiving and significantly less often Extroverted, Intuitive,
Thinking, and Judging single-factor types. They were also significantly more often Introverted/Sensing/
Feeling/Perceiving and Introverted/Intuitive/Feeling/Perceiving four-factor types. Pure alcohol/
substance-use disorder patients differed from alcohol/substance-use disorder patients with a mood
disorder in that they were significantly more often Extroverted and Thinking and significantly less often
Introverted and Feeling single-factor types; and significantly less often were an Introverted/Sensing/
Feeling/Perceiving four-factor type. The above results may have psychogenetic, diagnostic, and psycho-
therapeutic implications.

INTRODUCTION using the five-factor model of personality, a model

which divides personality into Neuroticism, Extro-
Over the years, a number of studies have attempted version, Openness to Experience, Agreeableness,
to profile the characteristic personality or person- and Conscientiousness (Costa and McRae, 1992).
alities of alcoholics. Although a number of per- These latter authors, using the NEO-PI, a five-factor
sonality disorders (i.e. anti-social personality, scale, noted increased Extroversion in elderly
passive-dependent personality, explosive person- individuals having alcohol problems. Also using
ality, etc.) have been extensively studied and asso- the five-factor NEO-PI Scale, Martin and Sher (1994)
ciated with higher risks for the diagnosis of noted that current alcoholics showed increased
alcoholism (Cox, 1979), studies of the relationship Neuroticism, lower Agreeableness, and lower
of underlying personality and temperament, as such, Conscientiousness. Further dividing their sample,
to alcoholism, as well as to other substance-abuse/ Martin and Sher (1994) found female alcoholics to
dependence disorders have occurred less frequently. be more neurotic and agreeable, when compared to
Nevertheless, some studies have shown alcoholics male alcoholics. Co-morbidity with a mood disorder
to have characteristic personality traits. Thus, alco- was associated with relatively greater Neuroticism
holics have been found to be relatively more passive, and lower Extroversion, whereas co-morbidity
impulsive, sensation-seeking, dependent, anxious, with anxiety disorders was correlated with lower
psychopathological, and depressed (Barry III, 1974; Agreeableness.
Cox, 1979; Barnes, 1983). Several studies have Several studies have suggested that pre-
evaluated the personalities of alcoholic patients alcoholics, like alcoholics, appear more neurotic,
impulsive, under-controlled, non-conforming,
dominant, independent, active, aggressive, and
*Author to whom correspondence should be addressed. anti-social (Barnes, 1983; Martin and Sher, 1994).

1999 Medical Council on Alcoholism


These studies generally did not exclude patients Subjects were divided as to whether or not they
with antisocial personalities. In addition, Cloninger had a concurrent mood disorder. The subjects were
et al. (1988) have noted that the heritable child- divided into two groups; one included 50 alcohol/
hood traits of high Novelty Seeking and low Harm substance-use disorder patients [33 males, 17
Avoidance on the Tridimensional Personality females; mean age ( SD) was 39.5 14.2 years]
Questionnaire (TPQ) were highly predictive of with an affective disorder, consisting of either major
subsequent alcohol abuse. Schuckit (1983), using depressive disorder, bipolar disorder, dysthymia, or
the Eysenck Personality Inventory, initially found a diagnosis of another affective disorder (i.e. ad-
no personality differences in non-alcoholic sons justment reaction with depression, schizo-affective
of alcoholics when compared to non-alcoholic sons disorder, etc.), and the other consisted of 40
of non-alcoholics. Later, however, at follow-up, patients (26 males, 14 females, aged 33.8 7.4
Schuckit et al. (1994) did find that those who years) who had an alcohol/substance-use disorder
ultimately became alcoholics had been more without an affective disorder (i.e. were pure
Extroverted at baseline on the Eysenck Personality alcohol/substance-use disorder patients). Of the
Inventory than those who did not (a finding which 50 subjects with an alcohol/substance-use disorder
lost statistical significance when the Bonferroni diagnosis plus an affective disorder, 25 had an
correction was applied). Importantly, Schuckit alcohol-use disorder diagnosis plus one or more
(1983) and Schuckit et al. (1994) excluded all sub- other substance-use disorder diagnoses (i.e.
jects who had a diagnosable anti-social personality. cocaine, cannabis, opioid, or polydrug dependence
One of the most common discrepancies between or abuse), 16 had an alcohol-use disorder diagnosis
studies of underlying personality in patients with alone and nine had a substance-use disorder diag-
alcoholism is that some report increased Extro- nosis without an alcohol-use disorder diagnosis.
version, and others report decreased Extroversion Of the 40 pure alcohol/substance-use disorder
(increased Introversion) in their subjects. Since patients, 20 had an alcohol-use disorder diagnosis
many alcoholic patients are depressed, and depres- plus one or more other substance-use disorder diag-
sion is often associated with Introversion (Akiskal nosis, nine had an alcohol-use disorder diagnosis
et al., 1983), we postulated that whether or not a alone, and 11 had a substance-use disorder diag-
given alcoholic patient was also concurrently nosis without an alcohol-use disorder diagnosis. A
suffering from a mood disorder might discriminate number of patients in both groups had an Axis II
between Introverted and Extroverted individuals personality diagnosis in addition to the alcohol-
respectively. The purpose of this study was to use substance-use disorder diagnoses as described above.
the MyersBriggs Type Indicator (MBTI), a widely
used popular personality test, to profile the per- Materials
sonalities of in-patient alcoholics (with or without Each of the patients filled out a copy of the
a concurrent other substance-use disorder) who had 166-item MBTIForm F. The MBTI divides
or did not have a concurrent affective disorder individuals into eight dichotomous preferences:
diagnosis. Extroverted vs Introverted, Sensing vs Intuitive,
Thinking vs Feeling, and Judging vs Perceiving
(Myers and McCaulley, 1985). Extroverted
SUBJECTS AND METHODS individuals tend to relate to the outside world of
people, whereas Introverted individuals relate to
Subjects their own inner thoughts. Extroverts are sociable,
The study subjects were 90 in-patient alcohol/ interactive, externally oriented, enjoy multiple re-
substance-use disorder patients (i.e. patients who lationships, and are gregarious, whereas Introverts
were admitted to the acute adult psychiatric wards are internally oriented, intensive, territorial, enjoy
of the University of North CarolinaChapel Hill limited numbers of relationships, are reflective, and
Hospitals). A final DSM-III-R diagnosis (American are energy conservative. Sensing individuals deal
Psychiatric Association, 1987) was assigned at the with the concrete and the here and now, whereas
time of discharge by the patients in-patient psych- Intuitive individuals tend to look toward future
iatrist. Most of the subjects were either unemployed possibilities. Sensors tend to rely on experience,
or were working at relatively low income jobs. are realistic, hard-working, actually oriented, down
372 D. S. JANOWSKY et al.

to earth, factual, practical, and sensible. Intuitives substance-use disorder group with the alcohol/
are future-oriented, trust hunches, are speculative, substance-use disorder group with co-existing
inspirational, ingenious, imaginative, fantasize, affective disorder using a t-test procedure. Since
and are active. Thinking individuals prefer to use the Centre for the Application of Psychological
their cognitive processes to engage in decision- Type provides categorical data, but does not pro-
making, whereas feeling individuals relate to their vide continuum scores for its normative data, we
relationships with others. Thinking individuals were unable to compare our alcohol/substance-use
are thus objective, policy-oriented, legalistic, firm, disorder group and subgroups with normative data
impersonal, justice-oriented, analytical, and adhere using non-categorical comparisons.
to standards. Feeling individuals are subjective, All statistical tests were non-directional (two-
intimate, use persuasion, are personable, humane, tailed), with level of significance set at = 0.05.
harmony-oriented, sympathetic, and devoted. Because of the exploratory nature of the study, a
Judging individuals enjoy coming to judgements Bonferroni correction for the number of analyses
and decisions rapidly. Perceiving individuals like to was not applied.
keep things open. Thus, Judgers are settled, decided,
fixed, like to plan ahead, are decisive, believe in
deadlines, and enjoy closure. Perceivers adapt as RESULTS
they go, like to keep their options open, are open-
minded, are tentative, dislike deadlines, and have a Total patient groupnormative group comparisons
wait and see attitude (Myers and McCaulley, 1985). As shown in Table 1, individuals with Intro-
verted, Sensing, Feeling, and Perceiving single-
Data analysis factor MBTI preferences respectively were
The alcohol/substance-use disorder patient groups significantly over-represented among the overall
with and without an affective disorder respectively group of 90 alcohol/substance-use disorder patients,
were compared with each other and with normative when compared to the normative population data.
data that were derived from a total of 55 971 in- Individuals with Extroverted preferences were
dividuals (32 731 females and 23 240 males) who significantly under-represented, as were those with
had taken the MBTIForm F (Macdaid et al., Intuitive, Thinking, and Judging preferences. As
1986). The MBTI was scored and data were ana- shown in Table 2, the overall patient group sig-
lysed for the eight one-factor, 24 two-factor, and 16 nificantly more often consisted of Introverted/
four-factor personality preference and type dis- Perceiving, Sensing/Feeling, Sensitive/Perceiving,
tributions (i.e. Introverted, Introverted/Feeling, Feeling/Perceiving, Introverted/Sensing, and Intro-
Introverted/Intuitive/Feeling/Judging) using the verted/Feeling two-factor types, relative to the
Selection Ratio Type Table (SRTT) computer pro- normative population. Also, as shown in Table 2,
gram (Granade et al., 1987). This program uses 2 Sensing/Thinking, Intuitive/Thinking, Intuitive/
and Fisher exact tests to compare percentages of Judging, Thinking/Judging, Extroverted/Intro-
subjects in each group who fall into a given cat- verted, Extroverted/Thinking, and Introverted/
egory. In addition, MBTI data can also be calculated Thinking two-factor types in the overall patient
as a continuum score measuring the degree of group were significantly under-represented, when
preference for the poles of a given dichotomy (i.e. compared to the normative population. With respect
a continuum from Extroversion to Introversion) as to four-factor MBTI types as shown in Table 3, a
described by Myers and McCaulley (1985). significantly greater percentage of the overall
We compared the pure substance-use disorder, patient group was over-represented as being Intro-
the mood disorder/substance-use disorder and total verted/Sensing/Feeling/Perceiving and Introverted/
subject groups with normative data (see above) and Intuitive/Feeling/Perceiving types, when compared
the pure substance-use disorder group with the to the normative population.
mood disorder/substance-use disorder group using
the SSRT computer program (Granade et al., 1987). Dual diagnosis groupnormative group
All results were rounded off to the nearest per- comparisons
centage. We also compared the continuum scores Table 1 compares the 50 dual diagnosis alcohol/
(Myers and McCaulley, 1985) of the pure alcohol/ substance-use disorder patients with an affective

Table 1. MBTI single-factor distributions of 40 pure, 50 mood-disordered, and 90 total alcohol/substance-use disorder
patients compared to normative data

Normative Pure Mood disorder Total

distribution (%) substance-use disorder (%) substance-use disorder (%) subjects (%)
Preference (n = 55 971) (n = 40) (n = 50) (n = 90)

Extroversion (E) 54 63 26*** 42*

Introversion (I) 46 37 74*** 58*
Sensing (S) 56 72* 72** 72*
Intuitive (N) 44 28* 28* 28**
Thinking (T) 47 40 16*** 27***
Feeling (F) 53 60 84*** 73***
Judging (J) 60 50 38** 43**
Perceiving (P) 41 50 62** 57**

MBTI, MyersBriggs Type Indicator.

*P < 0.05, **P < 0.01, ***P < 0.001, all comparisons with normative data.

P < 0.05, P < 0.001, all comparisons between pure substance-use disorder and mood-disordered substance-use disorder

Table 2. Two-factor MBTI type distributions in 40 pure, 50 mood-disordered, and 90 total alcohol/substance-use
disorder patients compared to normative data

Normative Pure substance-use Mood disorder Total

population (%) disorder (%) substance-use disorder (%) subjects (%)

I/P 18 23 50*** 38***

S/T 28 28 10** 18**
S/F 25 45* 62*** 54***
I/T 19 13 6* 9*
S/P 16 30* 38*** 34***
E/J 31 35 14** 24
I/J 21 8* 4** 6***
T/J 30 20 10** 14**
F/P 25 30 56*** 44***
E/I 26 13 8*** 10***
I/S 27 23 54*** 40**
E/S 29 50**, 18 29
E/T 25 28 4*** 14*
I/F 23 25 62*** 46*
I/T 22 13 12 12*

Abbreviations are as in Table 1. No significant differences were noted for E/P, N/F, S/J, N/P, T/P, F/J, N/I, and E/F.
*P < 0.05, **P < 0.01, ***P < 0.001 comparing the sustance-use disorder groups with normative data.

P < 0.05, P < 0.01, P < 0.001, comparing the pure alcohol/substance-use disorder group with the mood-disordered and
alcohol/substance-use disorder group.

disorder with the normative population with re- Sensing/Feeling, Sensing/Perceiving, Feeling/
spect to single-factor preferences. Dual diagnosis Perceiving, Introverted/Sensing, and Introverted/
patients more frequently had Introverted, Sensing, Feeling two-factor types. Conversely, they were
Feeling, and Perceiving preferences respectively. As significantly less often Extroverted/Judging,
shown in Table 2, these dual diagnosis patients, Sensing/Thinking, Intuitive/Thinking, Intuitive/
when compared to the normative population, were Judging, Thinking/Judging, Extroverted/Intuitive,
significantly more often Introverted/Perceiving, and Extroverted/Thinking two-factor types. Dual
374 D. S. JANOWSKY et al.

Table 3. Distribution of alcohol/substance-use disorder patients among 16 four-factor MBTI types compared
to normative data

Normative Pure Mood disorder Total

Four-factor distribution (%) substance-use disorder (%) substance-use disorder (%) subjects (%)
types (n = 55 971) (n = 40) (n = 50) (n = 90)

I/S/T/J 10 2 6 5
I/S/F/J 9 8 16 12
I/S/T/P 4 5 2 3
I/S/F/P 5 8 30*** 20***
I/N/F/J 4 3 0 1
I/N/T/J 5 3 2 2
I/N/F/P 6 8 16** 12*
I/N/T/P 4 3 2 2
E/S/T/P 3 8 0 3
E/S/F/P 5 10 2 8
E/S/T/J 10 13 2 7
E/S/F/J 9 20* 10 14
E/N/F/P 10 5 4 4
E/N/T/P 5 5 2 3
E/N/F/J 6 0 2 1
E/N/T/J 6 3 0 1

Abbreviations are as in Table 1.

*P < 0.05, **P < 0.01, ***P < 0.001, comparing alcohol/substance-use disorder groups with normative data.

P < 0.05 comparing pure alcohol/substance-use disorder group with mood-disordered alcohol/substance-use disorder

diagnosis patients were significantly more often except for Extroverted/Sensing/Feeling/Judging

Introverted/Sensing/Feeling/Perceiving and Intro- (Table 3).
verted/Intuitive/Feeling/Perceiving four-factor types,
than were subjects in the normative group, as
shown in Table 3. Dual diagnosispure patient group
Table 1 compares the 40 alcohol/substance-
Pure patient groupnormative group use disorder patients without an affective disorder
comparisons (the pure patients) with the 50 alcohol/substance-
Table 1 compares the 40 alcohol/substance- use disorder patients with an affective disorder (the
use disorder patients without an affective disorder dual diagnosis patients). Significantly more pure
diagnosis (i.e. the pure patients) with the norma- substance-use disorder patients showed Extro-
tive population with respect to single-factor verted and Thinking single-factor preferences, and
preferences. These pure patients were generally were significantly under-represented as having In-
very similar to the normative population, although troverted and Feeling preferences when compared
they significantly more often had a Sensing prefer- to the dual-diagnosis patients. In addition, as shown
ence. As shown in Table 2, they were significantly in Table 2, pure alcohol/substance-use disorder
more often Sensing/Feeling, Sensing/Perceiving, patients were significantly more often Extroverted/
and Extroverted/Sensing two-factor types, when Judging, Extroverted/Thinking, and Extroverted/
compared to the normative population. The Sensing types, and were significantly less often
Intuitive/Judging two-factor type was signifi- Introverted/Perceiving, Feeling/Perceiving, Intro-
cantly under-represented in the pure substance- verted/Sensing, and Introverted/Feeling types,
use disorder group. No differences between the when compared to the dual diagnosis patients.
pure patients group and the normative popu- With respect to MBTI four-factor types, as shown
lation existed with respect to the four-factor types, in Table 3, pure alcohol/substance-use disorder

patients were significantly less often the Intro- et al., 1983; Martin and Sher, 1994) have differ-
verted/Sensing/Feeling/Perceiving type than were entiated subjects by whether or not an affective dis-
those in the dual diagnosis patient group, who order diagnosis also existed. However, since
had both an alcohol/substance-use disorder and an chemically dependent individuals frequently have
affective diagnosis. an affective disorder diagnosis, a differentiation by
Finally, we also compared our 40 pure affective disorder status with respect to personality
alcohol/substance-use disorder patients without an profiling appears warranted.
affective disorder with the 50 dual diagnosis alco- Our findings are similar to the results of several
hol/substance-use disorder patients with an affect- other investigators who have explored the under-
ive disorder, using a t-test procedure. We found that lying personality profiles of alcohol and substance-
the pure patients scored as significantly more use disorder patients using the MBTI. Like our
Extroverted on the Extroverted to Introverted con- results with the overall patient group, Roszell et al.
tinuum (pure patients = 97.2, dual diagnosis (1983) found that heroin addicts maintained on
patients = 117.4, t = 4.38, d.f. = 88, P < 0.0001) methadone were statistically more likely to be
and significantly more Thinking on the Thinking to Introverted, to have a Sensing preference, and to be
Feeling continuum (pure patients = 102.3, dual numerically more likely to have a Feeling prefer-
diagnosis patients = 113.4, t = 2.63, d.f. = 88, ence. These latter authors did not measure Judging
P < 0.01). and Perceiving preferences. Interestingly, those
heroin addicts who were introverted more often were
found to have abnormal Minnesota Multiphasic
DISCUSSION Personality Inventory (MMPI) profiles. Roszell
et al. (1983) also found Introverted/Sensing and
The above results may help clarify discrepancies Introverted/Feeling two-factor types to be pre-
which have appeared in the substance misuse dominantly composed of patients who had depres-
literature concerning the underlying personality sion complaints and who saw themselves as
structure of alcoholics and/or other substance physically ill. Patients characterized by MMPI data
abusers. Significant differences in personality indicating isolation of affect, inappropriate be-
profiles, as measured by the MBTI, were noted haviour, anxiety, chronic worrying, vulnerability to
between patients who had an affective disorder plus threat, and poor interpersonal relationships were
an alcohol/substance-use disorder and those who more evenly divided among the various introversion
had only an alcohol/substance-use disorder but no two-factor subtypes, being Introverted/Sensing,
affective disorder. Alcohol/substance-use disorder Introverted/Feeling, as well as Introverted/Intui-
patients who had no affective diagnosis tended tive, and Introverted/Thinking types. Significantly,
to have profiles which were quite similar to those heroin addicts with normal MMPI profiles gen-
found in the normative population. erally had an Extroverted preference. MBTI data
Alcohol/substance-use disorder patients who from our overall patient group, like that of Roszell
also had an affective disorder had MBTI profiles et al. (1983), showed an over-representation of
very much like those we have noted in individuals alcohol/substance-use disorder patients who had
who have an affective disorder not associated with Introverted, Sensing, and Feeling preferences. This
an alcohol or other substance disorder. The affec- finding was exaggerated in our alcohol/substance-
tive disorder patients were comparatively over- use disorder patients with an affective disorder.
represented as having Introverted, Sensing, Feeling, Emanuel and Harshen (1989) administered the
and Perceiving preferences, and were significantly MBTI to 3342 chemically dependent patients.
over-represented as being Introverted/Intuitive/ As with our overall patient group, these authors
Feeling/Perceiving and Introverted/Sensing/ found over-representation of Introverted, Sensing,
Feeling/Perceiving types (Janowsky et al., 1998). and Feeling preferences. Unlike us, they did not find
The above results may explain why some studies over-representation of the Perceiving preference.
have shown alcoholics and other substance-use They found under-representation of Extroverted,
disorder patients to be predominantly Extroverted, Intuitive, and Thinking preferences. Their results
whereas others have shown them to be Introverted. showed commonality with ours in that there was
To our knowledge, only a few studies (Roszell significant over-representation of the Introverted/
376 D. S. JANOWSKY et al.

Sensing/Feeling/Perceiving four-factor type and disorder-related reason, an alcohol/substance-use

numerical over-representation of the Introverted/ disorder reason, or both. A number had made
Intuitive/Feeling/Perceiving and the Introverted/ suicide attempts and/or had seriously considered
Sensing/Feeling/Judging types. Their significant suicide and were admitted for that reason. Others
under-representation of the Extroverted/Intuitive/ were admitted primarily for short-term detoxifica-
Thinking/Judging type was numerically concordant tion from substances of abuse. Therefore, our
with our results, as was their and our concordance population may not represent the usual population
of Extroverted/Intuitive/Thinking/Perceiving, Extro- of alcohol/substance-use disorder patients who
verted/Intuitive/Feeling/Perceiving, Extroverted/ seek treatment for their substance-related problems
Sensing/Thinking/Judging, and Introverted/Intui- as such. Second, our subjects had MBTI profiles
tive/Thinking/Perceiving types. obtained while acutely symptomatic, and/or being
In another study of chemical dependency, using detoxified. Although there is evidence to suggest
the MBTI, Dawes (1991) found that, for 1537 that significant changes in MBTI preferences and
participants in a chemical dependency programme, types do not occur over time (Myers and McCaulley,
similar to those in our patient group, their patients 1985), and/or are not changed by mood states, the
were over-represented as having Introverted and possibility exists that, as patients remit from their
Perceiving preferences and under-represented as depression and/or alcohol/substance-use disorder,
having Extroverted and Judging preferences. their profiles might change.
Concordant with our results, their Introverted/ Clinically, our results may have therapeutic
Intuitive/Feeling/Perceiving type was significantly implications. For example, it may be useful to work
over-represented, their Introverted/Sensing/Feel- with introverted patients in small groups, or on a
ing/Perceiving type numerically over-represented, one-to-one basis, rather than in conventional,
and their Extroverted/Intuitive/Thinking/Judging relatively large self-help groups. Self-help groups
type numerically under-represented. often require considerable extroversion, and an
Finally, Bisbee et al. (1982) found a significant ability to tolerate self-revelation, often a problem
over-representation of substance-abuse patients for introverts. In addition, much has been written
with a Sensing preference. These results are con- about individuals with various MBTI personality
cordant with ours. Differing from our results, profiles, and how these people relate to people with
Bisbee et al. (1982) found no overall significant the same or other profiles. These books also describe
over-representation of Introverted, Feeling, or Per- the circumstances under which a given individual
ceiving preferences, and indeed found numerical with a specific MBTI personality type is able to
over-representation of patients who had Extro- perform optimally. It may be that this knowledge,
verted and Judging preferences. Numerical con- now generally applied to normal individuals, may
cordance of under-representation of Extroverted/ be applicable to dual diagnosis patients, alco-
Intuitive/Thinking/Judging, Extroverted/Intuitive/ holics, and other substance-use disorder patients
Feeling/Judging, Introverted/Intuitive/Thinking/ who are receiving treatment.
Perceiving, Introverted/Intuitive/Thinking/Judging,
and Introverted/Intuitive/Feeling/Judging types Acknowledgements This work was supported by a grant from
the Richard King Mellon Family Foundation and NIMH
were also noted between our results and those of MHCRC Grant # MH 33127.
Bisbee et al. (1982). The results of Bisbee et al.
(1982) more resembled those patients in our pure
alcohol/substance-use disorder group, who did
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