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

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?

  1. 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.
  2. 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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