Implications
of Personality Profiles
for Batterer Treatment
Reviewed by
Priscilla Schulz, LCSW
from an article of the same title by:
Robert J. White & Edward W. Gondolf, Mid-Atlantic Addiction Training
Institute, Indiana University of Pennsylvania
Published:
Journal of Interpersonal Violence, V. 15 (5), May 2000, 467-488
What is the scope of this study?
It is widely accepted that a client's personality should be considered
when choosing or tailoring an appropriate treatment. With regard to the
treatment of men who abuse their intimate partners the Millon Clinical
Multiaxial Inventory (MCMI) has been increasingly used to identify and
classify personalities of batterers. This study explores the appropriateness
of different batterer treatment approaches for different types of batterers
based on individual personality and psychopathology profiles. The authors
present a "profile grouping procedure" that closely follows MCMI recommendations
for interpreting scores, and explore implications for treatment. They
describe how group cognitive-behavioral treatments might be adapted to
accommodate typical batterer personalities and suggest other theoretical
implications for treatment. A table summarizes both tendencies and treatment
implications for different groups of batterers.
What is the Millon Clinical Multiaxial
Inventory (MCMI)?
The Millon Clinical
Multiaxial Inventory is a 28-scale, 175-item inventory in a true/false
format that takes between 20 and 30 minutes to complete. The MCMI assesses
personality traits of respondents, from exaggerated or rigid styles to
severe personality pathology, and clinical syndromes including substance
abuse, mood and thought disorders. MCMI scores are best understood when
all 28-subscale scores for each individual are interpreted as a whole.
How was the study conducted?
Researchers administered
the MCMI to the 840 men who appeared for intake at batterer treatment
programs in four American cities, Pittsburgh, Houston, Dallas and Denver.
From this large sample researchers selected 100 cases (25 cases from each
site) as a "stratified random subsample" to use for the analysis of personality
profiles. The demographics and MCMI responses of the 100 cases approximated
those of the total (840 men) sample.
Study participants' MCMI responses
were first grouped according to apparent severity of dysfunction (i.e.,
"low", "moderate" or "severe"). Researchers then divided each of these
three groups into two subgroups whose membership was determined by a person's
most pronounced personality trait as indicated by a high score within
a personality pattern scale of the MCMI and other MCMI-based criteria.
The resulting six groups were discussed in terms of MCMI treatment recommendations.
What were the study's
findings?
- Interpretations of MCMI responses resulted
in researchers classifying 84% of study participants into 6 groupings
(see table below). Researchers judged that existing group batterer treatment
programs would most likely address the needs of men in the first three
groups. However, the severity of personality disorders among men in
groups 4 through 6 might preclude them from group treatment without
prior and ongoing psychiatric care and individual therapy.
- MCMI responses of the remaining 16%
of study participants revealed atypical personality profiles and could
not be classified.
Summary of MCMI Personality
Profiles and Treatment Implications
(Adapted
from White & Gondolf, 2000)
| Grouping
and Percent
of Sample |
Profile
Tendencies |
Treatment Implications |
| 1.Narcissistic-Conforming
32% of subjects |
Defensive, self-centered,
confident, controlling |
Tactful confrontation
of denial, explicit goals and expectations, empathy training |
| 2.
Avoidant - Depressive
21% of subjects |
Withdrawn, anxious, dissatisfied |
Patient, nonthreatening
stance, collaboration, reassurance, role plays, reinforcement |
| 3.
Antisocial Disorder 11%
of subjects |
Competitive, confident,
guarded, vindictive, intimidating, aggressive |
Firm, consistent limit-setting,
straight talk, treatment framed in terms of self-interest, substance
abuse screening |
| 4.
Narcissistic Disorder
7% of subjects |
Explosive, confident,
hypervigilant, reactive, arrogant, self-involved |
Compliance framed in terms
of self-interest, cognitive techniques and group feedback to address
self-image distortions |
5.
Paranoid Disorder
9% of subjects |
Suspicious, distrustful,
hypersensitive, bitter, anxious |
Open, honest communication,
gradual engagement, problem-solving framed in self-interest |
6.
Borderline Disorder
4% of subjects |
Impulsive, self-punitive,
resentful, moody |
Clear structure and interventions,
tolerate and interpret moods, confront reality distortions, screen
for substance abuse and suicidality |
Discussion of results and implications
for batterer treatment
- Narcissism and avoidance play important
roles in the personalities of batterers; 64% of study participants showed
tendencies of narcissistic and avoidant personalities.
- Group cognitive-behavioral treatment,
the most common treatment approach used with batterers, was determined
to be theoretically most appropriate for this population:
- Cognitive-behavioral approaches
in general include elements that deal with self-image distortions
commonly associated with avoidant and narcissistic personality problems.
- Less than one-sixth of study participants
could be classified as having severe personality dysfunction not
suitable for standard group treatments.
- Particularly beneficial aspects of group cognitive-behavioral treatment
would include relationship skills training, corrective feedback of group
members regarding self-image and behavior, sex role exploration and
reevaluation by group members, and activities that increase empathy
for women.
- Researchers suggest that a prudent approach to treatment would be
a therapeutic style that is firm, clear and encouraging. Case studies
presented by the authors suggest that both highly confrontative styles
and overly supportive styles have undesirable outcomes, the latter actually
seeming to promote abusive behavior.
What are the study's limitations?
The personality profiles described and analyzed in this study are based
on the results of one instrument. Other aspects of batterers' past and
current lives ought to be considered in clinical settings when determining
treatment approaches. In addition, treatment implications in this study
are not based on empirical findings but rather on theory and previous
treatment research.
Reviewed
by Priscilla Schulz, LCSW, Center
for Trauma Recovery, University
of Missouri - St. Louis, July
28, 2000
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