Psychosocial characteristics of adolescents at risk for violence

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Psychosocial characteristics of adolescents at risk for violence
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Coles, Charlton J., 1968-
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Subjects / Keywords:
Violence -- Adolescent   ( mesh )
Violence -- psychology   ( mesh )
Risk -- Adolescent   ( mesh )
Risk Factors -- Adolescent   ( mesh )
Family   ( mesh )
Anger -- Adolescent   ( mesh )
Risk-Taking   ( mesh )
Adolescent   ( mesh )
Personality -- Adolescent   ( mesh )
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bibliography   ( marcgt )
theses   ( marcgt )
non-fiction   ( marcgt )

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Thesis:
Thesis (Ph. D.)--University of Florida, 1996.
Bibliography:
Includes bibliographical references (leaves 86-91).
Statement of Responsibility:
by Charlton J. Coles.
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Typescript.
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Vita.

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University of Florida
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ocm49016300
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Full Text












PSYCHOSOCIAL CHARACTERISTICS
OF
ADOLESCENTS AT RISK
FOR VIOLENCE




















By

CHARLTON J. COLES


A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL
OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT
OF THE REQUIREMENTS FOR THE DEGREE OF
DOCTOR OF PHILOSOPHY

UNIVERSITY OF FLORIDA


1996














ACKNOWLEDGMENTS


I would like to acknowledge the assistance of my doctoral committee,

Drs. Eileen Fennell. Duane Dede, Gary Geffken, Faye Gary, Anthony Greene.

and David Miller. Acknowledgements are due to Lennie Weiss, Carrie

Roseberrv. Mr and Mrs Webb. John Rickicki. and Dr. Anderson, for assisting

me with sample information. I would like to thank my family, especially my

mother. Nlarian Pitts-Coles. my father. Cleo P. Coles, my sister. Cynthia

Robinson. and my brother, Christopher Coles, for their support throughout

this project and my academic career. I would like to dedicate this project

to my grandmother. Marian Pitts. Acknowledgements are also due to Charles

Isbell. L\ nn Sims. Walter Jacobs, Kerry-Ann Anderson. Samaria Jones. Sonja

Jonas, Cleo and Jane Coles. Yvonne Collins. and Charlene Armstrong for their

continuing support of me and my studies. I would like to thank my paternal

grandparents. Cleo and Louise Coles.


iii








TABLE OF CONTENTS
page

ACKNOW LEDGM ENTS ......... ................................ .. iii

ABSTRACT ..................................................... v

CHAPTERS .............. ............................. .......... I

1. INTRODUCTION ........ .......... ......................... 1
Personality Characteristics of Adolescents At Risk ................. 13
Family Structure and Violence Among Adolescents ................ 20
Anger ........... ................................... 25

2. METHODS .............................................. 34
Subjects ........... .................................. 34
M measures and Procedures ............................. 34
MMPI-A .......................................... 36
STAXI ................................. ......... 40
STAI ......................................... 42
FES ............................................. 43
Hypotheses .......... ................................. 44
Statistical A nalyses ................................. 45

3. RESULTS ........ ........................................ 47

4. DISCUSSION ........................................... 68

APPENDIX ............ ............................... .......... 85

REFERENCES ............................................ ....... 86

BIOGRAPHICAL SKETCH ................ ......................... 92














Abstract of Dissertation Presented to the Graduate School
of the University of Florida in Partial Fulfillment of the
Requirements for the Degree of Doctorate of Philosophy

PSYCHOSOCIAL CHARACTERISTICS
OF
ADOLESCENTS AT RISK
FOR VIOLENCE

By

Charlton J. Coles

December 1996


Chairperson: Eileen B. Fennell
Major Department: Clinical and Health Psychology

The current literature on adolescents suggest that a multitude of

psychological and social factors. including personality, environment and

familial, can interact to place these adolescents at risk for aggression and

violence. It was hoped that this study could provide a heterogeneous

representation of adolescents for violence in terms of psychosocial

factors. The subjects in this study were 119 male adolescents who attended

schools targeted for children with behavioral difficulties. These

adolescents were given four self-report measures which examined

personality, affective and familial variables. A hierarchical,

agglomerative cluster analysis was conducted to see if adolescents at risk








for aggression presented a heterogeneous picture in terms of personality

characteristics. Results of the cluster analysis suggested three clusters

of adolescents at risk. Examination of the three cluster types by anger

expression. family control, trait anxiety and trait anger found

distinctions between groups for anger expression, trait anger and trait

anxiety. This suggests a possible relationship between personality

presentation and affective responding. Further analyses suggested a link

between anger control and the least elevated personality type. A series of

linear regression equations found relationships between high levels of

angry acting-out and the family variables of cohesion and conflict.














CHAPTER 1
INTRODUCTION


Adolescents at risk is a term used to describe sub-populations of

adolescents who are disadvantaged economically and/ or socially. As a

result, these adolescents are at risk for a number of developmental problems

including: juvenile delinquency, teenage pregnancy. sexually transmitted

diseases (STDs), substance abuse, and illiteracy. Current definitions of

adolescents at risk are usually fairly broad. Simply stated, adolescents at

risk are those juveniles who are at risk for poor developmental outcome.

Additionally. risk behavior can encompass a wide number of problems

including illicit substance experimentation/ substance abuse, sexual

promiscuity. and excessive violence. Risk behavior can have both short- and

long- term consequences. The factors that may predispose a youth to these

behaviors are complex and inter-related (Dryfoos. 1990: Ginzberg et al..

1988: Jessor and Jessor. 1977). Social factors may include parents, peers.

societal attitudes and media influences (Hawkins and Weiss, 1985: Dryfoos,

1990). Psychological influences include personality, affect, and

individual attitudes and beliefs (Quay, 1987: Dryfoos. 1990). Biological

factors may include psychiatric, neurological and non-neurological medical

factors. Finally, economic factors include unemployment and living in an










economically impoverished area and/ or a high crime area (Baldus and Tribe.

1978; Siegel. 1981). These at risk adolescents are likely to continue their

inappropriate behavior into adulthood and place additional burdens upon

society. It is difficult for a social science to separate the above

mentioned factors, determine which have the greatest impact on a developing

youth, and produce sufficient programs or interventions to sufficiently

impact these youth. Many theories have been generated to explain the high

prevalence of at risk adolescents in our society. Additionally. many

intervention programs have been developed over the years to impact these

behaviors. However, there exists a need for a larger empirical base about

these behaviors, the factors influencing them and what precipitates at risk

behaviors in order to properly serve this population (Dryfoos. 1990).

The present study was proposed in order to examine factors that may

predispose adolescents towards violent behavior, particularly expressive

violence. Expressive violence is violence that is predicated

interpersonally between individuals or groups. The youths who are prone to

expressive violence include juvenile delinquents, individuals who have

extensive histories of violence in settings such as school or the community.

but have not been officially arrested, and those who live in high crime/

economically impoverished areas. This study explores those factors that

may predispose youth to violence within the psychosocial domain:

personality, affect, and familial elements. This study utilized a more










heterogeneous representation of adolescents at risk in such a way as to

provide for more accurate assessment and possibly better intervention

measures for these adolescents.

Project Purpose


The purpose of this study was to examine psychosociological factors

that may predispose male adolescents to violence. These factors include

personality, affect, and familial elements. By studying a more

heterogeneous group of adolescents at risk, this study was designed to

provide support for those factors in predicting violence in youths at risk.

If personality structure, affective symptoms and family cohesion do predict

increased risk. it may provide an empirical basis for more effective

intervention strategies. This study examined only male adolescents due the

relatively low frequency of female adolescents who are referred to agencies

such as alternative schools or detention centers compared to males.

However, future research may suggest a gender comparison on a number of

different psychosocial variables, including personality, affect and

family, for adolescents at risk for aggression.

Theoretical Rationale


Historically, psychological theories concerning adolescents at risk

were uni-modal in that these adolescents were viewed as a homogeneous group

with the same behavioral presentation (Vedder, 1954; McCann. 1957).










Traditionally, they were viewed as sociopathic with many of the traits

associated with adult sociopaths. Subsequent adolescent personality

theory, such as the adolescent personality theory by Hathaway and Monachesi

(1963), have suggested differential personality characteristics. However,

even today many institutions and individuals still use a uni-modal system to

intervene with adolescents at risk. A common example is the modern-day

school system. Children and adolescents with disruptive behaviors are

commonly classified as "emotionally handicapped (EH)," even though they

have significantly distinct behavioral presentations. personality factors

and familial components.

This study proposed that adolescents at risk are a heterogeneous

group in terms of personality structure. This personality structure is

important because it affects how a child views and interacts with the

outside world. This interaction with the outside world can be expressed

through emotional symptomatology which can be reflected in a child striking

out against the world externally through anger. or conducting harmful.

self-injurious behaviors internally through anxiety. Both of these

behaviors are completely distinct behavioral presentations. but under a

traditional uni-modal system they can simply be labeled as inappropriate

behavioral presentations. This is hypothesized to impair intervention

because no one specific form of symptomatology is targeted. It is further

hypothesized that there are sub-groups of adolescents at risk which have










significant anger and anxiety components occurring simultaneously. In

addition. it is proposed that the personality and behavioral presentations

of adolescents at risk are further affected by familial factors,

particularly those related to issues of attachment and warmth. It is

believed that an inverse relationship exists between low levels of family

cohesion and high levels of affective symptomatology and highly unstable

personality functioning.

The Occurrence of Delinquency


One sub-population of adolescents at risk for violence includes

juvenile delinquents. Juvenile delinquency is defined by a finding of

violation of legal statutes relating to criminal codes, school (truancy)

and other behaviors (eg. runaway, sexual promiscuity. etc.). In many ways.

juvenile delinquency is less complicated to define because it is shaped by

legal statutes and official facts and figures compiled from a variety of

different agencies. One such agency is the United States Children's Bureau.

Since 1927. the U.S. Children's Bureau has circulated estimates on

the number of juvenile offenses committed within the United States. Reports

out of the Children's Bureau have indicated the number of crimes committed

by juveniles has shown a substantial increase every year since the Bureau

began tabulating juvenile offenses (Roberts, 1987, pg. 9).

The U.S. Children's Bureau in the 1930s estimated 200.000 juvenile

offenders in the United States. In 1950, the Bureau estimated the number to










be 435,000 juveniles. and by 1966 the estimate ballooned to over 1,000.000

delinquents arrested in the United States. During the last two decades, the

Federal Office of Youth Development has reported a significant increase in

the number of juvenile offenders. By 1984. the number of arrests for

adolescents less than the age of 18 had exceeded 2.000,000 (actual figure:

2,062.448). Consequently, this growth has significantly exceeded the

growth of the population of children in the 10- to 17-year-old age group.

According to the 1984 data. the delinquent most likely to be arrested was

between the ages of 15 and 18 and the most common offense was larceny/theft

(Roberts. 1987. pg. 10). Roberts (1987) indicated that the majority of the

crimes by juveniles were property-related, although there was a trend

towards violent crimes as the youths became older.

In terms of ethnicity. African-American males are more likely to be

arrested than any other group. Hindelang (198 1) analyzed information that

was collected in the American National Crime Survey. He compiled the data

from crimes against persons including rape. robbery. assault, and theft to

compute the offense rates for different population subgroups. The

estimates indicated that for juveniles aged 12-17. 2.1% of these offenses

were committed by white females, 8.6% by African-American females. 8.0% by

white males, and 43.2% by African-American males. There are various

theories which have been proposed to rationalize the differences in

delinquency rates for African-Americans and whites. The majority of these










theories suggest that ethnicity is not an important causal factor (Quay.

1987) but that. instead. African-Americans and whites differ on a number of

precursors to delinquency. These precursors may include low family income

and poor parental child-rearing practices. It has been argued that because

of the high proportion of black single-parent households, there is less

parental control and supervision in African-American families (Quay.

1987).

For African-American males, black-on-black homicide is the leading

cause of death for males between the ages of 15-34. The chances that an

African-American male will be murdered is roughly ten times that of whites

males. African-American females are five times as likely to be murdered as

white females (Quay. 1987).

These statistics may only represent the "tip of the iceberg" in terms

of actual reporting. Not all delinquent behavior is detected and the acts

which are officially recorded do not represent a random sample of juvenile

acts. Official statistics only provide a limited index of juvenile

delinquents. However, they may be useful in indicating trends or suggesting

trends for research and/ or intervention.

Public Health Responses to Adolescents At Risk For Violence


The conflicts of violent youth have received substantial attention

from the public via mass media. In response to public opinion that

interventions are needed for violence within our youth, the federal










government has responded with a number of programs targeting the youth. An

example of government intervention includes a response by the Centers for

Disease Control.

In 1991, the Centers for Disease Control (CDC) defined violence among

adolescents as a public health dilemma. This agency worked on establishing

guidelines to help prevent the occurrence and the overall rate of violence

among teenagers. especially those of a minority population. ie. African-

Americans. Hispanics, and Native Americans. The CDC (1991) defined several

underlying assumptions about violence among youth in an effort to help

combat the problem. One of these assumptions was that violence is a learned

behavior that can be changed and prevented. Another assumption by the CDC

was that there is no simple or single solution to the problem of youth

violence. In the third assumption, the CDC indicated that a framework for

violence intervention exists. Within this framework, a community-based

program must have the following characteristics: 1) there must be

coordinated responses for many community organizations and groups: 2)

activities and interventions should be targeted at specific risk groups: 3)

community groups should provide societal support for individual behavioral

change via advocacy and policy development, and 4) it is necessary to apply

multiple methods in multiple settings (CDC, 1991).

The fourth assumption of the CDC centered around the idea that each

active participant in the intervention process be made held accountable for










whom and to whom activities are being directed. The CDC noted that citizens

should be given their own authorization to identify and choose their

priorities, activities, and retain control over what happens in their

communities, a process known as "empowerment." Empowerment is needed in

many of these communities due to the fact that the sense of powerlessness and

lack of control contributes to violence. Clear, conscientious efforts

should be attempted to return community control back to these communities.

Community participation, responsibility and revitalization were viewed as

important ingredients to empowerment (CDC. 1991).

The final assumption of the CDC was that meaningful change in a

complex. multisystemic problem takes a lengthy period of time. The final

measures of success in a program, such as decreases in mortality, injury.

and disability, will not be immediate, and an enduring commitment to provide

resources is critical to achieving these ends (CDC. 1991).

The CDC looked at targeting violence prevention strategies to

populations of adolescents at high-risk for violence. The factors that they

examined as contributing to the high rate of interpersonal violence among

adolescents at risk included unemployment, poverty, low educational

opportunities and achievement, drug/ alcohol abuse, and weapon carrying

(CDC. 1991).

The CDC (1991) identified five groups of high-risk teenagers

considered to be at highest priority. The first of these groups were those










that live in a geographically defined area in which rates of violent deaths.

injury and disability are extremely high. Children growing up in these

areas may be exposed to high rates of violence through such activities as

drug dealing and/ or gang activity. Children growing up in these areas may

be likely to model their self-defense and conflict-resolution skills on

those violent behaviors that they are exposed to on a routine basis.

The second of these groups were those youths who have been targeted as

belonging to a gang or youths that have been targeted as at risk for becoming

gang members. Studies have shown that the rate of violent offenses for gang

members is three times that of adolescents who are not gang members (CDC.

1991). It may be difficult to distinguish those youths who belong to a gang

from those who do not. Gang membership may span several generations within a

family or extended family. Children and adolescents may seek the

companionship, monetary rewards, and sense of belongingness that may be

associated with being in a gang (CDC, 1991).

The third group included those youths who are members of families that

have problems related to violence. The factors associated with this include

unsupervised children, parental drug abuse, child abuse, and the neglect or

absence of a parental role model. Studies (Loeber and Stouthamer-Loeber.

1986: Palmo and Palmo. 1993) have shown that children from violent families

and children with parents who show little affection tend to develop violent

behavior problems (CDC. 1991).










The fourth group consisted of those violent youths who have histories

of extreme violence and who have entered the court system due to their

violent behavior. This group also includes adolescents in the penal system.

Potential strategies to address this group would include skill training in

such areas as conflict resolution and anger management, peer counseling and

mentorships with respected members of the community, and group activities

to help bolster self-esteem. trust, and group support. The final group

includes those who were victims of violence, relatives of violence victims.

and witnesses to violence. It may be difficult to distinguish perpetrators

from victims in a high-risk violent situation.

The recommendations and effort to define groups of adolescents prone

to violence by the CDC are generally positive. However, there are a few

criticisms. One criticism of the CDC's guidelines is that the criteria for

selecting adolescents into groups may be too rigid and narrow. The CDC has

defined groups based on strict environmental factors and failed to examine

others factors which could account for violence. One such factor would be

psychological. The DSM-IV contains many diagnoses to account for acting-

out behavior (ADHD, Intermittent Explosive Disorder, Conduct Disorder,

etc.) and. when coupled with a harsh environment with few resources, could

make a child significantly at risk for aggression. In addition, there are

medical conditions to account for adolescent aggression such as

neurological injuries, genetic and endocrinological irregularities.










Another difficulty with defining groups based on environmental

factors is that one assumes a uni-modal theoretical orientation in which

children in the same category receive the same treatment. It never tests the

theory that within a category adolescents may have different reasons for

acting-out or being aggressive. Also, these adolescents may have different

behavioral or emotional presentations. For instance, one child with

violent tendencies may be violent without the slightest provocation while

another child has rigid controls over his aggression which break down on a

few occasions. However, when this child's control breaks down on those rare

occasions the result is extremely violent. If the theory of heterogeneity

within categories is true. would these two children benefit from the same

treatment?

A third criticism is that the CDC defines groups by external criteria.

ie. by the number of violent incidents and histories of court referrals and

demographic information, such as community orientation and high-risk crime

areas. While such information is important. additional information which

could help target the population further may be missed. Such information

could include knowledge about internal characteristics of these

adolescents, such as the personality and affective states of adolescents at

risk. Moreover, we need to know if there is a relationship between affective

reactivity, personality and violent tendencies. Investigations should

examine the effect of being in these highly stressful environments on a










child's inter- and intrapersonal development. Specifically, we need to

know the functional role of affective reactivity within this population. If

emotional reactivity does serve a functional role, can it be altered?

Lastly, we need to begin to investigate the long-term costs of being

effectively reactive in a child's given environment. These are the

beginning of formulations which have arisen as a result of going through the

CDC guidelines.

In order to fully service the need for intervention, it is vitally

important to have as much comprehensive information about the population to

be treated. This study examines the problem of adolescents at risk by

addressing areas such as personality variables and their interaction with

other variables such as family structure, substance abuse history, and

affective states,. such as anger and depression. This study tests an

hypothesis that adolescents at risk have differing psychosocial

characteristics and behavioral presentations. If this hypothesis is true.

then it may lead to more effective behavioral interventions. Additionally.

it would contribute to a comprehensive picture of these adolescents and how

they interact \\ ith their environment from a number of different factors.

Personality Characteristics Of Adolescents At Risk For Violence


This section will address the literature as to the most appropriate

personality measures for adolescence. The problems confronting

adolescents are generally less well known than those facing adults (Kazdin,










1992). Assessing the behavior and emotions of adolescents is a difficult

chore, and a complicating factor is that for a long time there was

significantly less research with adolescence compared to adults.

The Minnesota Multiphasic Personality Inventory (MMPI) is a well-

known personality measure that has been extensively studied with adult

populations, although it has also been used on adolescents as well. In

general, the research concerning adolescent personality has been extremely

limited and difficulty has arisen over a long number of years. One of the

first research studies to study the MMPI responses reported by adolescents

was a classic study by Hathaway and Monachesi in 1963.

Hathaway and Monachesi (1963) collected MMPIs from approximately

15,000 adolescents in the Minneapolis, Minnesota, area between the years

1945- 1963. In addition to the personality information, they collected

ratings on school adjustment. school conduct. and delinquency. Hathaway

and Monachesi stated that approximately 28.4 percent of the male sample was

delinquent compared to 9 percent of the female sample. Hathaway and

Monachesi placed delinquents on an inhibitory-excitatory continuum. They

concluded that Scales F. 4, 8, and 9 of the MMPI were excitatory scales and

thus successfully predicted high rates of delinquency. Conversely,

Hathaway and Monachesi reported that Scales 2, 3. 7. 0, and 5 were inhibitory

scales and were predictive of lower rates of delinquency. They stated that

the inhibitory scales were predictive of low rates of delinquency due to the










fact that they were "neurotic" scales and individuals who scored high on

these scales had low inclination to conduct delinquent acts. However, they

indicated that when inhibitory scales interacted with excitatory scales.

the excitatory scales served to have a stronger influence. An example is an

adolescent with a two-point code type of "42" or "24". Hathaway and

Monachesi (1963) predict that the constraining effects of depression would

be over-ruled by the stimulatory effects of reported sociopathy. Huesmann,

Lefkowitz. and Efron (1978) commented on Hathaway and Monachesi's (1963)

study and reported that the best predictors of adolescent aggression and

delinquent behavior were Scales F. 4, and 9.

Williams and Butcher (1989) made the argument that age-appropriate

norms may be needed for adolescents who are administered the MMPI.

Frequently. however, adolescent norms are problematic in adolescent age

groups. The major problem with this is that on the MMPI, the adolescent norm

set fails to reach clinical significance (T scores greater than 70).

Subsequently. this led to the suggestion that an adolescent cut-off score of

65, rather than 70 be used to determine clinical significance (Williams et

al., 1986,.

To address the problems of the MMPI with an adolescent sample,

Williams and Butcher (1989a and b) initiated a two-study project designed to

develop a personality inventory for use by adolescents. The first study was

an attempt to determine the empirical validity of the standard MMPI in a










large-scale sample of adolescents in treatment before the instrument was

changed. The second study was an attempt to determine if appropriate.

alternative code type classification procedures would lead to meaningful

descriptors based on adolescent responses.

The first study was conducted with 844 adolescents who ranged in age

from 12 to 18 years of age. This sample consisted of adolescents who were

admitted to several treatment facilities between 1985 and 1988. In general,

the authors stated that the MMPI clinical scales were associated with

clinically relevant behavior in adolescents at risk. They found that Scale

4, 8, and 9 were strongly associated with measures of acting out for both

genders. The authors concluded that Scale 6 may be an excitatory scale for

males.

The Hathaway and Monachesi (1963) and Williams and Butcher (1989)

found similar research findings. For example, adolescents scoring high on

the excitatory continuum. "4. 8, 9." appear to display substantial evidence

for acting- out behaviors. However, the Williams and Butcher study found

additional evidence for adolescents with elevations on Scale 6 (Paranoia)

to have characteristics similar to those with elevations on the

"excitatory" dimension. The similarities in the findings of the two studies

over a 15- year period demonstrate that the inhibitory- excitatory theory of

the MMPI has been durable over the past several decades, although the scales

which contribute to this continuum have varied somewhat.










Weaver and Wootton (1992) conducted a MMPI study with delinquent

adolescents over a three-year time period using MMPI special scales. Their

study had three objectives. The first was to identify the MMPI special

scales that characterized the personality characteristics of delinquent

adolescents. The second objective was to examine whether certain special

scales could be used to discriminate between levels of recidivism, crime

severity, and category of crime committed. The final objective was to

discover whether special scales could be used to predict delinquent

behavior more accurately than the traditional MMPI scales F. 4. 8. and 9.

The subjects were 401 convicted male juvenile offenders who ranged in age

from 13 to 17. The subjects were tested within two weeks of court

conviction. A score was considered significant if it had a T-score of

greater than or equal to 65 or less than or equal to 35. These investigators

found that there was a significant difference between the T scores of the

delinquent and normative groups on the following special scales: Re (Social

Responsibility). MAC (MacAndrew Alcoholism Scale). Pdl (Familial Discord).

Pal (Persecutory Ideas), Ma2 (Psychomotor Acceleration). Si3 (Staid-

Personal Rigidity), and TSC4 (Depression and Apathy). Weaver and Wootton

(1992) also found significant differences between delinquents with high and

low rates of recidivism on 11 of the clinical and supplementary scales: F,

Pd (Psychopathic deviate), Re (Social responsibility), Mal (Amorality), Ma

(Mania). Pd2 (Authority problems), Aut (Authority conflict), MAC










(MacAndrew Alcoholism Scale), Ma3 (Social Imperturbability), Hos (Manifest

Hostility). and Pal (Persecutory Ideas).

Weaver and Wootton (1992) also utilized a crime index used by the

District Juvenile Courts in Utah to discriminate between adolescents who

engage in "serious" crimes from those who engage in less serious crimes. The

MMPI special scales that they reported having the largest differences

between these groups were Re (Social Responsibility), Es (Ego Strength), Cn

(Control). and St (Social Status). The delinquents who engaged in less

serious crimes scored higher on Mf I (Narcissism- Hypersensitivity) and Fam

(Family Conflicts). The authors also tested an hypothesis concerning those

delinquents who had committed assaultive behaviors against persons versus

those who had not. The high assaultive group scored significantly higher on

Re (Social Responsibility), Pdl (Family Discord), and Ma2 (Psychomotor

Acceleration). In contrast. those individuals who were in the low

assaultive group scored significantly high on MAC (MacAndrew Alcoholism

Scale). Mf I (Narcissism-Hypersensitivity). Sc IA (Social Alienation). Fam

(Family Problems). and TSC4 (Depression and Apathy).

Finally. Weaver and Wootton (1992) discussed four composite

"personalities." The first of these was the recidivist personality which

was differentiated from the others on the MAC (MacAndrew Alcoholism), Pd

(Psychopathic Deviate). and Re (Social Responsibility) scales. The second

"personality" was termed the property offender. This group was










characterized by high scores on Pd (Psychopathic Deviate). Pd2 (Authority

Problems). MAC (MacAndrew Alcoholism), Re (Social Responsibility), and Mal

(Amorality). The third personality group was the severe offender. This

group was distinguishable from others by high scores on Re (Social

Responsibility), Es (Ego Strength). Cn (Control), and St (Social Status).

The final group was the assaultive personality. The scales that best

discriminated between the high and low assaultive personalities were Ma3

(Imperturbability), Mf (Masculinity-Femininity), and Pa2 (Poignancy).

Weaver and Wootton (1992) stated that the combination of Scales F. 4. 8, and

9 may be the result of proportions of types of subgroups in each study's

delinquent sample. They concluded that this combination was not accurate in

discriminating types of offenders.

The Weaver and Wootton study (1992) was important in that it described

aggressive adolescents as more of a heterogeneous group than has been

reported in the earlier literature. However, the criteria by which they

differentiated groups was based more on results from special scales of the

MMPI rather than from the traditional scales.

In response to the controversies with the traditional MMPI, a more

specialized version was developed in 1991 and was termed the MMPI for

Adolescents (MMPI- A). In part, the MMPI- A developed from a number of

criticisms about the use of the original MMPI with adolescents. These

included the following: the test being too lengthy, the adolescent norms










were too outdated, the reading level may be too high, and, much of the

language may be outdated (Archer. 1984, 1987: Marks, 1974; Williams and

Butcher. 1989a, 1989b). Most of the research on the MMPI- A with adolescents

at risk for violence is still exploratory and speculative. It has been

hypothesized that use of the MMPI- A with aggressive adolescents will be

similar to that of the original MMPI: however, that has yet to be put to

empirical test. The differences between the two measures could account for

additional Scales to be added to the "excitatory" scales. particularly

Scale Pa (Paranoia).

FAMILY STRUCTURE AND VIOLENCE AMONG ADOLESCENTS


There have been a large number of studies over a 50-year period which

have attempted to look at the family structure of violent youths. These

studies have traditionally found that the family variables which contribute

most to aggressiveness and delinquency include parental criminality, poor

parental supervision, cruel or neglecting attitudes, erratic or harsh

discipline, marital conflict, and large family size (Bahr, 1979: McCord and

McCord. 1959; West and Farrington. 1973; Wilson, 1980). Studies have also

examined the role of family interaction patterns and the general emotional

environment of the family as it relates to delinquency. These studies have

tended to conclude that delinquents are more likely to be raised in families

which tend to exhibit more conflict and less stable family interaction

patterns (Alexander. 1973; Faunce and Riskin, 1970). In general, research










has found that the most violent adolescents are more likely to be found in

physically abusive households (Lewis et al., 1989). In fact. a history of

abuse and/ or family violence, were found to be one of the best predictors of

adult violent crimes (Lewis et al., 1989).

The emotional environment of the home is also important in

distinguishing delinquents from nondelinquents (Veneziano and Veneziano.

1992). In general. families of delinquents were more likely than families

of non-delinquents to express rejecting attitudes and to exhibit a lack of

warmth and affection (West and Farrington. 1973). In terms of parental

discipline styles. the parents of delinquents are more likely to be more

punitive, gave more vague commands, and were generally less effective in

stopping children's deviant behavior (Patterson, 1982). Singer (1974)

concluded that a configuration of very restrictive family policy, lax

policing, and lenient punishing were more common among the family of

delinquents.

There has also been a wealth of research on communication pattern

differences between delinquents and non-delinquents. Alexander (1973)

found that delinquent families evidenced higher rates of defensive

communication and lower rates of supportive communication than non-

delinquent families. He further noted that conversations in the families of

delinquents were disjointed and disorganized, and the actual communication










was unevenly distributed, with one member dominating during family

discussions.

A recent study by Veneziano and Veneziano (1992) attempted to examine

the family functioning of male juvenile delinquents using the Family

Environment Scale (FES). The FES. developed by Moos and Moos (1981), is a

90-item psychological measure that asks respondents questions about their

perception of the family environment in a true-false format. This

instrument provides 10 subscales. with means of 50 and standard deviations

of 10. They also attempted to develop a typology of family social

environments using cluster analytic techniques. They examined the

resulting subgroups on a number of dimensions, including intellectual.

personality, and behavioral characteristics, in an attempt to determine if

the groups differed in ways that would have implications for research and

treatment. The subjects in their study consisted of 41 1 institutionalized

male adolescents who were committed as adjudicated delinquents to a state

department of corrections. The only exclusions were those delinquents who

transferred to another facility, or were released before they could

complete the five-workday classification process. Subjects ranged in age

from 11-7 to 16-4. with an average age of 14-9. The ethnic distribution of

the sample was 52% white and 49% African-American. Of these subjects, 67.6%

were serving their first offense and 57.9% were committed for one offense.

Approximately 67% were committed for property offenses, with the second










most common offense being of "probation violations." The resulting

analysis produced seven clusters, which classified 93.9% of the FES

profiles. They discovered that other analyses yielded clusters which were

either too small or too large to be statistically meaningful. They termed

Cluster 1 the Denial of Conflict. These subjects were similar to a norm

group except in the area of the open expression of anger. The subjects in

Cluster I were the oldest group and 95% were first time offenders. Cluster 2

was termed the Repression of Expression and they were consistently low on

measures of anger and hostility. However, they were highest in terms of

being aware of limited opportunity. Cluster 3 was termed the Suppression of

Independence. Families of these delinquents were attempting to establish

strong controls but that independence was discouraged and conformity was

encouraged. This group was the second highest in terms of state and trait

anger and were also high in terms of state and trait anxiety. The Cluster 4

(Unstructured Conflict) had very high Conflict scores and low scores on

other subscales. They were the youngest group and had the highest scores on

measures of anger and impulsivity, and were likely to be the group that

rejected middle-class values. Cluster 5 was termed Structured Conflict and

they had high Conflict Scores but also had high Control Scores and average

scores on the other scales. Cluster 6 was termed Unstructured Control. They

were characterized by little expression of freedom and with little emphasis

on independence outside of the household. Subsequently they typically had










little involvement in activities outside of the house. In addition, the

parental style was characterized by mild attempts at maintenance and

control. Collectively as a group. Cluster 6 fell within the middle of the

scores received in the assessment measures. Finally Cluster 7 was termed

Structured Control and were characterized by a high emphasis on

maintenance, control, and achievement, and low emphasis on expression of

feelings and independence. Cluster 7 had the lowest anger scores, but the

second highest anxiety scores.

Veneziano and Veneziano (1992) summarized that most of the

adolescents had relatively high scores on the scales of Organization and

Control, suggesting that their families were not characterized by an

absence of structure. They imply that the families of delinquents establish

rules and procedures, but they have a hard time implementing these

procedures due to inappropriate or ineffective monitoring and

disciplining. They also found that the subset of delinquents who live in

homes with a higher degree of conflict tend to exhibit more severe

difficulty. These findings are consistent with the literature that found

associations between abusive and/ or violent homes and aggressive behaviors

among delinquent adolescents (Lewis et al., 1988). Veneziano and Veneziano

(1992) concluded that delinquents are not a homogeneous population in terms

of presenting symptomatology, and need a multidimensional assessment

approach when complex constructs such as family dynamics are an issue.










The Veneziano and Veneziano (1992) study is interesting in pointing

out the affective states of the delinquents involved in the study. Many of

the clusters described in their study had abnormally high levels of anger

and anxiety. In terms of anger, the majority of the clusters had chronically

high levels. The researchers described their population well in terms of

heterogeneity, but it would be fascinating to assess how the dimension of

anger and anxiety in these groups differed. We know that anger can be

assessed in a number of distinct dimensions. Examples of differing anger

styles include hostility (trait anger). suppressing angry feelings for fear

of letting others know one is angry, overt anger expression, and frequent

attempts to consciously control the overt expression of anger. Since

Veneziano and Veneziano (1992) found a relationship between affect and

family structure, do these factors interact with personality variables

discussed before in the previous section? The inclusion of variables

assessing both family factors and anger in adolescents at risk in the

present study should help to clarify the potential interaction or role of

these factors in this group.

ANGER:


Anger is considered to be an affective state which can consist of

feelings of irritation, irritability, annoyance, fury. and rage. This

affective state is known to activate the autonomic nervous system (ANS) and

to involve the endocrine system as well (Johnson and Greene, 1992, pg. 25).










It is also known to cause tension in the skeletal musculature, antagonistic

thought patterns, and aggressive behaviors (Johnson and Greene, 1992). The

experience of anger is typically a complex emotional and physiological

pattern that can be elicited in interpersonal and social situations among

individuals who have a strong proneness (trait) to experience anger. When

discussing anger, it is typically important to distinguish between the

experience and expression of anger. Generally the experience of anger can

be characterized by frequency. intensity, and duration. The expression of

anger can be conceptualized as a single. bipolar entity which can range from

suppression of angry feelings to expression of anger through aggressive

behavior towards other individuals or objects in the environment

(Spielberger. 1988). It is important to understand the emotional experience

of anger before one can conceptualize the much broader concept of hostility.

Typically. hostility has been understood to contain angry feelings

but it may also have the added dimensions of negative and destructive

attitudes and beliefs. Thus hostility may motivate aggressive and violent

acts. particularly in interpersonal situations. Aggression is said to

describe destructive and punitive behaviors directed against another. The

feelings of anger often result in hostility and aggression, although anger

is not a necessary precursor in either of these states. Unfortunately, the

concepts of anger, hostility, and aggression are often used interchangeably

in research literature as with the lay public (Johnson, 1990).










Anger has been conceptualized by a model proposed by Spielberger

(1988). The model conceptualizes anger as a psychophysiologic response

that can be elicited in social situations where an individual feels (a) loss

or threat of loss of (b) something felt to be possessed (rights, job,

marriage, or physical objects) through (c) perceived arbitrary, unfair, and

unjustifiable acts by others (people, select groups, or society). The

behavioral manifestations of anger can involve overindulgence or overuse of

alcohol. cigarettes. illicit or over-the-counter drugs, and food.

Hostility Types and Anger-Coping Styles

The social learning theory of aggression proposed by Bandura (1973)

suggests that aversive stimulation can produce a general state of emotional

arousal that can promote a host of accompanying behaviors. Depending on a

person's cognitive appraisal of the situation and the environment, the

accompanying emotional arousal can be interpreted as anger (Hecker & Lunde.

1985. pg. 227). This anger can be expressed as aggressive behavior ranging

from a deviant thought to physical violence depending on an individual's

learned social skills. Usually this anger will dissipate and leave an

individual free for new emotional experiences; however, feelings of anger

can be prolonged or compounded on subsequent occasions by recalling or

focusing on provocative situations. Individuals who frequently become

angry in the absence of distinctive external stimuli may be seen as

exhibiting chronic hostility.










Chronic hostility is not formally recognized as psychopathology

according to the Diagnostic and Statistical Manual of Mental Disorders: 4th

Edition (DSM-IV): although chronic hostility has been implicated in a

number of psychiatric disorders which include Somatization Disorder.

Intermittent Explosive Disorder, Conduct Disorder. Oppositional Defiant

Disorder. Antisocial Personality Disorder. and Borderline Personality

Disorder (American Psychiatric Association, 1994). Common characteristics

of individuals with chronic hostility can include deficits in social

skills: lack of sensitivity in interpersonal situations; failure to

recognize the consequences of their behavior; and, being unable to see a

situation from another person's viewpoint (Spivack, Platt, & Shure. 1976).

The intense emotional arousal from anger-intensive individuals may impair

cognitive appraisal of aversive situations and can help to facilitate

impulsive behavior (Zillman. 1983).

The etiology of chronic hostility is largely unknown. Role-models

such as parents can influence the development of attitudes and behavior

patterns. Among these also would be unstable family patterns including but

not limited to abusive families or neglectful families. Other factors

influencing chronic hostility could include feelings of inadequacy or

insecurity,. unrealistic views and expectations, and insufficient skills

for dealing with stressful situations (Hecker & Lunde, 1985).










Some approaches to address the problem of chronic hostility have been

proposed (Novaco, 1975: Novaco. 1985; Glick & Goldstein, 1987). Usually

these approaches have addressed the issues of correcting behavioral and

cognitive deficits that may underlie chronic hostility. In addition,

relaxation training and systematic desensitization are used to manage the

physiological correlates of emotional arousal (Novaco. 1985). However,

chronically hostile individuals do not represent a clinically homogeneous

group. Although all chronically hostile individuals should be able to

benefit from stress inoculation training, the authors propose that

treatment should be tailored to meet the specific needs of individuals

(Hecker & Lunde. 1985).

Typology of Chronic Hostility:


Individuals prone to chronic hostility have been conceptualized by

Hecker and Lunde (1985) as belonging to three main types. each of which can

be further divided into two subtypes. The three main groups have been termed

the Uncontrolled Anger Type (Type I). the Overcontrolled Anger Type (Type

2), and the Suppressed Anger Type (Type 3).

The first type (Uncontrolled Anger) has been described as

experiencing anger emotionally and readily translating their angry

feelings into violent or aggressive behavior. These types were originally

described by Megargee (1966, 1982) as having weak inhibitions against

aggressive behaviors and exerting little or no control over instigation










towards aggression. This type was divided into two subtypes: the Impulsive

Undercontrolled Type and the Deliberate Undercontrolled Type.

The Impulsive Undercontrolled type experiences anger emotionally and

acts impulsively with little or no deliberation. When they are provoked.

this type will react quickly and many times will disregard personal safety

and impulsively cause accidents that may cause injuries to others or

themselves. For example, an adolescent may become angry at another and will

commence a "drive-by" accident with innocent bystanders in the line of fire.

The Deliberate Undercontrolled type experiences anger that does not

directly lead to aggressive behavior. They do not usually behave

impulsively, but will instead plan for aggressive behavior to be carried out

later. Because the aggressive behavior is separated in time from the angry

event, the aggressor is able to act anonymously (Hecker & Lunde. 1985).

Typical deliberate acts performed by them include conspiring with others to

defeat a competitor. plagiarism. embezzlement, and homicide.

The second main type (Overcontrolled Anger) commonly experiences the

emotion of anger, but their angry feelings are strongly suppressed and not

translated into aggre,,i e behavior. Megargee (1966: 1982) described this

type as having strong inhibitions against aggressive behavior; they exert

enormous control over provocations to aggression. This type can be further

divided into two subtypes: Stable or Unstable Overcontrolled types.










The Stable Overcontrolled type traditionally have strong controls

over the engaging of aggressive behaviors. Even under conditions of extreme

stress, they manage to control their responses to nearly every provocation

to aggression. When challenged, an individual of this type may adopt a

passive stance or withdraw so as to avoid an unpleasant emotional exchange.

However, the emotionally provoking incident is likely to be remembered for a

long time. The Stable Overcontrolled type have a tendency to become

preoccupied with their unexpressed thoughts and feelings that they may

neglect their health by smoking or eating too much, exercising too little,

or ignoring the early symptoms of physical disorders.

The Unstable Overcontrolled type also has strong inhibitions against

displaying emotionality yet. under conditions of extreme stress, the

inhibitions against aggression may fail for reasons which are not clearly

understood. Extremely violent criminal behavior may result, including

multiple homicides. Individuals who commit these crimes are usually

remorseful afterward, and are able to reconstruct their former. unstable

inhibition,,.

The third chronically hostile type has been termed the Suppressed

Anger type. The research suggests that this type does not experience anger

directly but rather the anger is suppressed and functions as a source of

anxiety. pain. or other maladaptive behavior (Hecker & Lunde. 1985). Since

their cognitions are separate. these individuals are usually surprised when










others around them call them angry or hostile. Their tendency may be to

suppress other emotions too, and their general responses to common

situations may lack genuine, appropriate affect. The two subtypes of the

Suppressed Anger type can be differentiated on the basis of whether or not

their interpretations of reality are normal or psychotic.

The Normal Suppressed type is a hostile type that will become anxious

and engage in unproductive behavior when confronted by a difficult or

frustrating situation. To obtain a sense of relief from their psychological

distress. these individuals may engage in unnecessary work or leisure-time

activities that will keep them constantly busy.

The second suppressed anger type is the Psychotic Suppressed anger

type. These individuals often present with a distorted perception of

reality, and their responses to situations and events are often

inappropriate. This may be present in psychotic depression or

schizophrenia. where one has to infer the presence of overt hostility.

It is believed that adolescents at risk are a heterogeneous group in

terms of personality and anger presentation. The three major hostility

types (Undercontrolled. Overcontrolled. and Suppressed) are hoped to be

found in adolescents at risk. The Undercontrolled Anger Types.

theoretically. would be the easiest to identify due to their frequent

presentations of anger. Particularly, they would be easy to identify by

self- report measures given the low energy invested to contain anger.










In contrast to the Undercontrolled Anger Types. the Overcontrolled

and Suppressed Anger Types would be more difficult to separate out on self-

report measures compared to normal adolescents. On self- report measures,

it is hypothesized that the Overcontrolled Anger Type. Suppressed Anger

Type and normals would all score within normal limits. To assist in further

dividing these groups into accurate subgroups would require additional

assessment devices, such as semi- structured or structured interviews. In

addition. retrieving information from secondary sources. ie. school

officials or parents. would be invaluable in providing an accurate portrait

of anger presentation over a period of years. For instance, one would

predict that the Overcontrolled Anger Type would have only a few instances

of violent presentations: however, these presentations would be extremely

violent in general and well out of proportion to the individual's usual

presentation. The Suppressed Anger Type could be hypothesized to have

frequent anger demonstrations, but would not attribute their outburst to

anger. For the Suppressed Anger Type. an interview could also provide

information about an individual's verbal display, such as verbal

stylistics. to better verify the existence of this anger type. Although

information, such as interview data, will not be gathered in this study.

hopefully the results of this study will guide the way for more expansive

research.














CHAPTER 2
METHODS


Subjects


Subjects were 119 male adolescents between the ages of 13 to 18 years

old. who were currently enrolled in alternative schools for behaviorally

disruptive children and juvenile detention centers located in the regions

of North Central Florida. South Central Alabama and Atlanta, Georgia. This

study collected self-report data from the students. After the data records

were collected the sample was classified according to demographic

information such as age. ethnic affiliation, family organization (single

parent. dual parent, etc.) and occupation of parent. The last 20 subjects

only have demographic information and completed MMPI-As. They were missing

the STAXI. STAI and the FES. A description of the demographic questionnaire

is included in Appendix A.

Procedures


Prior to testing. the proper administration protocol and the nature

of the tests were explained to the subjects in a group format. If students

had difficulty understanding the official procedures detailed above, it was

explained to them on an individual basis. Support was obtained from the

34










identified schools and detention centers in the Florida, Alabama. and

Georgia areas prior to testing. All test procedures were scrutinized by an

Institutional Review Board (IRB) at the University of Florida before

testing commenced.

The tests involved in this research project were administered in a

small group setting at a child's school. Subjects were assigned into groups

based on reading levels, which was accessed in a student's academic record

or by consultation with the child's teacher. Those research subjects with a

reading level above the sixth grade level were administered the tests in

their usual. standardized format. However, for those subjects with a

reading level below the sixth grade level, an audio-taped version of the

test measures was administered. The time required to finish all of the test

procedures was between 60 minutes to 120 minutes. Those children who

completed all of the test measures received a five-dollar gift certificate

for use at the McDonald's restaurant.

Test Measures:


There were four assessment measures employed in this study. They were

the Minnesota Multiphasic Personality Inventory for Adolescents (MMPI- A),

the State- Trait Anger Expression Inventory (STAXI). the State- Trait

Anxiety Inventory (STAI), and the Family Environment Scale (FES).










Minnesota Multiphasic Personality Inventory- Adolescents (MMPI- A):


The MMPI-A was developed in 1989 in order for adolescents to have a

personality instrument that better reflected their outlook on life and

stage of human development than the original MMPI. It has been noted by

previous authors (Archer. 1984, 1987: Marks, 1974: Colligan and Offord.

1989: Williams and Butcher. 1989a. 1989b) that the original MMPI had a

number of limitations when the instrument was used by adolescents. One of

these limitations was the fact that many felt as though the item content was

inappropriate for use with adolescents: partly due to the fact that they

were written for adults. The problems may be subtle such as the verb tense

being inappropriate or there were was not enough content suitable for young

people. Another complaint was that there appeared to be a lack of content or

research scales suitable for adolescents. A third limitation concerned the

fact that many adolescents have a characteristic high responding on some

scales. such as the F Scale on the MMPI, which may in part reflect their

feeling of alienation or identity diffusion (Archer. 1984, 1987). The F

Scale in itself may be developmentally unsuitable for this group. A final

problem concerned the problem of selecting which norms to use with

adolescents since the MMPI uses both adult and adolescent norms. The

adolescent norms were developed by Dahlstrom, Welsh, and Dahlstrom (1972)

and Marks et al. (1974). Both of the adolescent norm sets were T-scale

conversion tables for adolescent scores. Authors have shown that the use of










adult norms tended to over-psychopathologize typical adolescents.

Colligan and Offord (1989) concluded that adolescent responding to the MMPI

was decidedly different from adult responding.

The committee to develop the MMPI- A was formed in 1989. The committee

was termed the MMPI Adolescent Project Committee and was appointed by

Beverly Kaemmer of the University of Minnesota Press. The committee had two

recommendations. The first recommendation the University of Minnesota

Press publish a separate form of the MMPI with separate norms for

adolescents. The second recommendation was that the MMPI- A have the same

standard scales as the MMPI.

The original form of the MMPI- A (Form TX) contained 704 items. The

704 item booklet was used for the adolescent normative data collection and

in a clinical sample described by Williams and Butcher (1989a. 1989b).

The committee recognized the need to reduce the total number of items

to make the instrument more appealing to adolescents. The final version of

the test had items comprising the original validity indicators L and K. new

indicators Fl and F2. the original clinical scales, new Content Scales.

existing supplementary scales MAC- R, A, and R. and a new scale. IMM

(Immaturity). were included in the MMPI- A. The final version that resulted

contained 478 items arranged such that all of the items on the basic scales.

as well as a number of items of new uniquely adolescent items. Content










Scales, and supplementary scales are not obtainable in the first 350 items,

but require administering the full MMPI- A.

MMPI- A Validity Indicators:


The MMPI- A Lie scale consists of 14 items and it was designed to

measure naive attempts by teenagers to put themselves in a favorable light.

The MMPI- A F scale is divided into a 33-item Fl scale and a 33-item F2

scale. This scale was developed to measure the frequency of endorsement of

infrequently used items. The Fl scale covers those items that occur in the

first 350 items of the test and F2 covers those that appear later in the test.

It was generated in this way to possibly identify adolescents who have

changed his or her test-taking approach in the later stages of the testing

administration.

The MMPI- A K scale consists of 30 items and is thought to be a measure

of defensiveness.

NMMPI- A Clinical Scales:


Scale 1 (Hs: Hypochondriasis): This scale consists of 33 items that

were selected to identify clients with a history of symptomatology

characteristic of hypochondriasis.

Scale 2 (D: Depression): The D scale is composed of 60 items that have

been chosen to reflect general feelings of dissatisfication, hopelessness,

and possibly suicidal ideation.










Scale 3 (Hy: Hysteria): This scale is comprised of 60 items that were

selected to identify individuals who respond to stress with hysterical

reactions that include sensory and motor impairment without an organic

basis.

Scale 4 (Pd: Psychopathic Deviate): This scale consists of 49 items.

It is developed on the basis of responses from adolescents with patterns of

lying, stealing, sexual promiscuity, and alcohol abuse.

Scale 5 (Mf: Masculinity-Femininity): The Mf scale is a measure of

stereotypic masculine or feminine interests.

Scale 6 (Pa: Paranoia): This scale is comprised of 40 items. It is

used to identify patients with a high degree of paranoid symptomatology.

Scale 7 (Pt: Psychasthenia): This scale was developed in order to

measure symptoms related to obsessive-compulsive disorder including

anxiety and rumination. It is composed of 48 items.

Scale 8 (Sc: Schizophrenia): This scale has 77 items. It is used to

reflect those individuals who endorse bizarre thought processes, peculiar

perceptions, social isolation, disturbances in mood and behavior, and

difficulties in impulse control.

Scale 9 (Ma: Hypomania): This scale consists of 46 items designed to

identify patients manifesting hypomanic symptoms.

Scale 0 (Si: Social Introversion): This is a scale designed to

measure scores on social relationship problems.










A test-retest was conducted on normative sample of 154 subjects.

These subjects completed one complete test questionnaire and then were

asked to complete the same questionnaire a week later. Pearson Product-

Moment test-retest correlations for the sample were calculated. The

correlations ranged from values of .65 to .84 for the three validity scales

and the ten clinical scales.

The State- Trait Anger Expression Inventory (STAXI):


The State- Trait Anger Expression Inventory (STAXI) is a measure

designed by Spielberger (1988) that is used to assess the experience and

expression of anger. One of the primary reasons the STAXI was developed was

to provide a technique to evaluate the components of anger that can be

utilized for evaluations of normal personalities and personality disorders

(Spielberger. 1988).

The STAXI is composed of 44 items. With these 44 items. one can derive

six major scales and two sub- scales. The six major scales are State Anger

(10 items r. Trait Anger (10 items). Anger- In (8 items). Anger- Out (8

items). Anger Control (8 items), and Anger Expression (24 items). The sub-

scales are Angry Temperament (4 items) and Angry Reaction (4 items).

The State Anger scale was designed to measure the magnitude of anger

felt at the time of testing. The Trait Anger scale assesses an individual's

disposition to experience anger in different situations. Subscales to the

Trait Anger Scale are Angry Temperament and Angry Reaction. Angry










Temperament is a measure of a general predisposition to experience anger

with little or no provocation. Angry Reaction assesses subject differences

in the experience of anger when unfairly evaluated or treated harshly by

other individuals.

Anger- In measures the frequency at which an individual is likely to

restrain angry feelings because the individual is uncertain of what to do

with the angry affect. Conversely. Anger- Out is an anger expression scale

which assesses how an individual expresses anger to other people or objects

in the environment. Anger Control professes to measure an individual's

frequency to control the feelings of anger.

Finally. Anger Expression is a general measure of the frequency at which

anger is expressed. Anger Expression assesses general angry affect

regardless of the direction of the expression.

Information about the internal consistency of the STAXI scales was

gathered from different samples (Spielberger. 1988). These samples

consisted of male and female college undergraduates. adolescents, adults

who were not college students and Navy recruits in the Tampa. FL area. For

all scales. Cronbach's coefficient alphas ranged from .70 to .87 reflecting

a high degree of internal consistency. Test-retest correlations of all of

the scales ranged from .58 to .75.










The State- Trait Anxiety Inventory (STAI):


The State- Trait Anxiety Inventory (STAI) was a measure designed by

Spielberger (1983) to evaluate an individual's experience of anxiety. The

measure wvas designed to be self- administering and may be administered

either individually or in groups. Completion time for the STAI ranges from

10 to 20 minutes. The STAI assesses two indices of anxiety: State- Anxiety

(S- Anxietvy) and Trait- Anxiety (T- Anxiety). S- Anxiety consists of 10

items. conversely T- Anxiety is composed of 11 items.

When administered. Spielberger recommends that the S- Anxiety Scale

should be administered first, followed by the T- Anxiety Scale, due to the

fact that the S- Anxiety scale is sensitive to the conditions by which the

test is administered and can be influenced by feelings created by the T-

Anxiety Scale.

Each STAI item is given a weighted score of 1 to 4. A rating of 4

suggests high anxiety while a rating of I implies low levels of anxiety.

Norms for the STAI were collected on working adults, college students, high

school students. and military recruits. The high school sample consisted of

424 tenth-grade students who were tested in their schools (Spielberger.

1983). Cronbach's coefficient alphas for the high school sample .90 for the

State and the Trait Anxiety scales. Test-retest reliability coefficients

were calculated for both scales and the values ranged from .65 to .75

(Spielberger. 1983).










The Family Environment Scale (FES):


The Family Environment Scale (FES) (Moos & Moos, 1994) is a 90- item

test that was designed to assess three dimensions of family functioning.

The first of these dimensions is relationships. The relationship dimension

is global and attempts to reflect several areas such as belonging, pride.

open expression, and conflict. Another dimension is personal growth and

development. Central to this theoretical dimensions are such areas as

autonomy, academics. competitions. family activities, and religious

emphasis. The final dimension is system maintenance which deals with

centers around the structure and organization of the family. The system

maintenance dimension also examines the amount of perceived control

exercised over each member. The FES is a self-report device which can be

given independently to individual family members. The ten subscales of the

FES are represented as T scores with means of 50 and standard deviations of

10. Internal consistencies were calculated for the ten scales of the FES

based on a normative sample of 591 individuals (Moos & Moos. 1994).

Cronbach's coefficient alphas ranged from .61 to .78. Test-retest

reliabilities were calculated at two-month intervals and values for the ten

scales ranged from .68 to .86.










Hypotheses:


1) The first hypothesis proposed that adolescents at risk are a

heterogeneous group in terms of personality presentation. It was predicted

that these adolescents will fall into four distinct personality groups

based on MNMPI scale scores. These personality groups could be postulated as

falling along the "inhibitory- excitatory" continuum originally proposed

by Hathaway and Monachesi (1963). One can expect an "inhibitory" group with

elevations on many of the inhibitory scales, an "excitatory" group with

elevations on many of the excitatory scales, a mixed group with features of

both and a non-elevated group.

2) The personality cluster groups which have been discussed in the

first hypothesis were postulated to differ on the following four variables:

anger expression, trait anxiety, maternal control, and trait anger. It was

proposed that each personality cluster group would have distinctive

patterns of responding to each of these variables. This is related to the

research in the literature of heterogeneous patterns of responding to

family environment and affective data which was influenced by the work of

Veneziano and Veneziano (1992).

It was further hypothesized that the personality groups would have

differing responses on the dimensions of anger-in, anger-out and anger

control.










3) The third hypothesis proposed that there is a distinct

relationship between high levels of chronic anger (hostility), levels of

perceived family conflict, family cohesion, and delinquency. This

hypothesis seeks to help define the assessment and evaluation of the

Undercontrolled Hostility Type.

Statistical Analyses:


1) The first analysis consisted of a cluster analysis with the

following scales of the MMPI- A: F. 2. 3. 4. 5, 6. 7. 8, 9. 0. There were five

"inhibitory" scales that were investigated and they were 2. 3. 5, 7. and 0.

In addition, there were five "excitatory" scales and they consisted of F. 4.

6, 8. and 9. A hierarchical, agglomerative cluster analysis (Centroid

linkage method), which utilized squared Euclidean distances between scale

items. was conducted to maximize heterogeneity among cluster groups. This

followed the hypothesis which stated that adolescents-at-risk for violence

are a heterogeneous group in terms of personality presentation.

2) The second analysis consisted of running several one-way ANOVAs to

verify the evidence provided in the cluster analysis with personality

cluster group as the independent variable. Differences in the four

dependent variables (anger expression, trait anxiety, maternal control.

and trait anger) were examined. It was predicted that individual cluster

groups can be differentiated by the four dependent variables listed above.








46

Additional analyses were conducted with anger-in, anger-out and

anger control as dependent variables. Personality cluster group remained

the independent variable.

3) The third analysis was a series of independent linear regression

equations with Trait Anger. Anger-In, Anger-Out, and Anger Control as the

dependent variables. Maternal care, family conflict, and delinquency were

entered as independent variables.














CHAPTER 3
RESULTS


Subject Characteristics


Sample information collected is described below. Information was collected

from subjects (N = 119) from a number of testing sites in northwest Florida

(Alachua and Marion counties), central Alabama (Eufaula. AL), and northeast

Georgia (Atlanta. GA). The average age of the collection sample was 16 years

old (N= 119. standard deviation = 1.04). The minimum age was 13 years old and

the maximum age was 18 years old. The average grade level for the subjects

was 10th grade with a standard deviation of 1.2. From information collected

in the sample. 60.9 % of the sample described themselves as African-

American. 31.5 % of the sample as White. 5.2 % of the sample as Latino. 1.1 %

as Native American and 1.1 % as "Other." In addition. further breakdowns of

the sample revealed that 22.8 % of the sample resided with their biological

parents. 31.5 % resided with one biological parent and a step-parent. 33.6 %

with a single-parent (29.3% were single mothers). and 12 % had "Other"

arrangements. These other arrangements included additional family members

including grandparents, aunts or uncles, or frequently children were wards

of the state.










Of those children who lived with at least one of their biological

parents. 80.4% of the parents were employed and 19.6 % were described as

unemployed. Lastly. 84.8 % of the sample indicated that they had an arrest

history and 15.2 % had no arrest history. Subject characteristics are

described in Table 1.


Table 1: Mean subject characteristics (N= 119)

Mean


Age

Grade Level

Ethnicity

African-American

White

Latino

Native American

Other

Family Structure
Both biological parents

Biological parent and step-parent

Single parent

Other arrangements

Parental Employment Status
Yes

No


16

10


Range
13-18

8-12


60.9%

31.5%

5.2%

1.1%

1.1%


22.8%

31.5%

33.6%

12.1%


80.4%

19.6%










Table 1 Cont.


Arrest History
Yes 84.8%

No 15.2%


Information from the MMPI-A is described below (See Table 2).


Table 2: Mean MMPI- A scores for the entire sample


Mean Standard Deviation


61.64

56.73

52.39

61.29

46.08

60.50

54.29

57.54

57.26

50.56


11.23

10.38

9.72

10.14

7.65

13.44

9.55

12.15

12.20

8.13


Minimum Maximum

88

81

82

99

64

107

78

92

100

67


F Scale

Scale 2

Scale 3

Scale 4

Scale 5

Scale 6

Scale 7

Scale 8

Scale 9

Scale 10

(N = 119)













The cut-off score for the MMPI-A was based on average subject scores


based on a normative sample. Information from Table 2 shows that no scale


had a clinical elevation (T score > 65) compared to the normative sample.


However, it should be noted that many of the highest scales had the greatest


standard deviations. Information on the mean sample MMPI-A distribution is


illustrated in Figure 1.


Figure 1: MMPI-A Mean Profile For Entire Sample (n= 1191


65 T
A
60 +

55 +

50-

4- S5 -

-0 -


F 3 4 5 6 7 9 10
MMPI-A Scales










Data was collected on the STAXI. Table 3 displays the mean score, standard

deviation and percentile rank for the STAXI. The percentile rank

comparisons for these scores were based on average subjects in a normative

sample.


Table 3: Mean STAXI scores for the entire sample

Mean Standard Deviation

State Anger 17.50 7.41

Trait Anger 22.47 6.12

Trait Anger/ Temperament 8.30 3.16

Trait Anger/ Reaction 9.66 3.04

Anger-In 17.77 4.13

Anger-Out 18.12 4.59

Anger Control 21.17 4.94

Anger Expression 30.78 8.89

N=99


Percentile Rank


77th

45th

52nd

62nd

57th

71st

37th

67th


On the STAXI there were clinical elevations (percentile rank > 75) on State

Anger only when the present sample was compared to a normative sample.

However. Anger Out and Anger Expression were substantially elevated as

well.

Tables 4 and 5 illustrate the results of the STAI and the FES respectively.













Table 4: Mean STAI scores


State Anxiety

Trait Anxiety

N = 99


Mean Standard Deviation

41.68 10.97

43.71 9.85


Both State and Trait Anxiety scores for the subject group fell within

the normal range. The means for both the STAI and the FES were based on a

normative sample.


Table 5: Mean FES scores


Mean

Family Cohesion 44.09

Family Conflict 52.46

Family Control 52.25

N= 99


Standard Deviation

12.65

9.48

10.36


T-tests were conducted between the normative sample means and standard

deviations and the means and standard deviations of our sample for the FES.

All t-tests were significant. Family cohesion was found be significantly

lower than the normative sample [t,,, 98 = -5.09]. Family Conflict [t 0, 98 =










2.83] and Family Control [to0, 98 = 2.36] were found to be significantly

higher than the normative sample.

MMPI-A Scores and Ethnicity


The majority of subjects within this sample were African-American.

Previous research on the MMPI has suggested differences between certain

validity and clinical scales by ethnicity. Comparison tests were conducted

between MMPI-A scales F. 2. 3. 4. 5. 6. 7. 8. 9. 0 and ethnicity (African-

American and White). See Table 6 below.



Table 6: NIMPI-A scores by ethnicity (African-American and White) N= 119

Scale African-American White Significance Level

Mean SD Mean SD

Scale F 61.78 10.37 60.79 10.37 .25

Scale 2 55.88 10.28 56.45 11.21 .94

Scale 3 51.61 9.40 52.38 10.09 .82

Scale 4 60.10 9.34 62.28 11.70 .35

Scale 5 45.72 8.50 45.73 6.42 .07

Scale 6 58.99 10.67 61.21 18.55 .00

Scale 7 53.07 7.70 54.38 12.50 .00

Scale 8 57.54 11.00 56.55 15.80 .02

Scale 9 58.06 11.53 55.79 14.23 .67

Scale 10 50.00 7.56 49.62 9.92 .06













According to this analysis. Whites were significantly higher than African-

Americans on Scale 6 (Paranoia) and Scale 7 (Psychasthenia). African-

Americans were significantly higher on Scale 8 (Schizophrenia).

Additionally. there was a trend towards African-Americans being higher on

Scale 5 (.Masculinity-Femininity) and Scale 10 (Social Introversion).

Cluster Analysis:

Centroid Method


The first analysis consisted of a cluster analysis with the following

scales of the MMPI-A: F. 2, 3, 4. 5. 6, 7, 8. 9. 10. A hierarchical cluster

analysis (Centroid linkage method) which utilized squared Euclidean

distances between individual scale items was used. The Centroid linkage

method xwas utilized due to the nature by which it can maximize compact

clusters composed of similar cases. The Single linkage method was excluded

due to the fact that it has a tendency to form long, elongated clusters

(Aldenderfer & Blashfield. 1984. pg. 39). Consequently. Ward's method was

not utilized because it has difficulty when sample size exceeds 100 cases

and it generates solutions that are strongly influenced by profile

elevation, Aldenderfer & Blashfield, 1984. pg. 44). Squared Euclidean

distances %were utilized in order to maximize the dissimiliarity of unlike

clusters. The analysis was run on SPSS-Windows Version.










A dendrogram of the initial cluster analysis results strongly

suggested a three-cluster solution to the sample. Moreover, an inspection

of the fusion coefficients (the numerical value at which various cases merge

to form a cluster) suggested a trend in which there was a substantial "jump"

in the value of the coefficients at the three-cluster solution. However,

both of these methods are highly subjective and susceptible to experimenter

bias (Aldendefer & Blashfield, 1984. pg. 54). Mojena (1977) and Mojena and

Wishart (1980) developed a procedure to objectively evaluate the optimal

partition of a hierarchical clustering procedure. Their equation examines

the value of the fusion coefficient at a given stage of the clustering

process (z,,). the mean value of the fusion coefficients (z), the standard

deviate (k). and the standard deviation of the fusion coefficients (s,). For

the standard deviate, Mojena (1977) suggested a value of 3.00 to test for

significance. The equation is illustrated below.

Z > z + ks,

Based on the results of the initial cluster analysis, the following values

were derived: Z,+ (Z,,1)= 3189.87: z= 621.78: k= 3.00: sz= 631.16. The null

hypothesis would be a cluster of one if the value of Z,,, can not exceed the

value of [ z + ksz].

Z,,116 > z + ks

3189.87 > 621.78 +(3)(631.16)

3189.87 > 2515.27










Utilizing the information available in this equation, the best solution

suggested was the three cluster solution. Therefore, the null hypothesis

was rejected.

Table 7: Age and educational level for personality cluster types.



Cluster I Cluster 2 Cluster 3
(N= 58) (N= 25) (N= 36)

Age 16 16 16

Educational Level 10 10 10




There were no statistical differences between the three personality cluster

types on age or level of education.

MANOVA and MMPI- A Variables:


To determine if there was an effect of cluster type among MMPI- A

variables, a MANOVA was conducted with the MMPI- A scales as dependent

variables and cluster type as an independent variable.

Table 8: MANOVA of MMPI- A Variables and Cluster Type

Scale F-Score Significance Level

F Scale 4.98 .01

Scale 2 2.56 .08

Scale 3 8.19 .00

Scale 4 10.14 .00










Table 8 Cont.

Scale F-Score Significance Level

Scale 5 2.96 .06

Scale 6 3.52 .00

Scale 7 6.39 .00

Scale 8 6.35 .00

Scale 9 9.72 .00

Scale 10 .58 .56

N= 119



The results of the MANOVA suggest that overall there was an effect for MMPI-

A scales and cluster type. Only Scale 2. Scale 5 and Scale 10 failed to reach

the .05 level of significance. To determine if there were further

differences between MMPI-A scales and cluster type. post-hoc comparisons

were conducted utilizing Bonferroni critical value to control for uneven

pair-wise comparisons. One-way ANOVAs were run with the MMPI-A scales as

dependent variables and personality cluster type as independent variables.

Differences are illustrated in Table 9. The three groups are statistically

distinct from one another on the F Scale. Scale 1 (Hypochondriasis), Scale 2

(Depression), Scale 6 (Paranoia), Scale 7 (Psychasthenia), and Scale 8

(Schizophrenia).













Table 9: Mean MMPI-A Scale T-scores for individual cluster types


F Scale


Depression
Scale 2


Hysteria
Scale 3


Psychopathic Deviate
Scale 4

Masculinity-Fernininity
Scale 5


Cluster 1
(N= 58)

M 61.91b
SD 8.61

M 56.05'
SD 9.16

M 51.73
SD 9.61

M 63.86'
SD 8.56


Cluster 2
(N= 25)

M 78.07'
SD 8.68

M 71.27'
SD 9.15

M 61.07b
SD 7.80

M 63.73b
SD 13.27


Cluster 3
(N= 36)

M 52.52a
SD 6.30

M 50.67"
SD 5.59

M 48.93'
SD 7.44

M 54.59"
SD 8.48


M 46.22 M 48.00 M 44.33
SD 7.94 SD 6.40 SD 7.50


Paranoia
Scale 6


Psychasthenia
Scale 7

Schizophrenia
Scale 8


Hypomania
Scale 9


Social Introversion
Scale 10


M 61.13
SD 10.11

M 55.71'
SD 7.94

M 57.82
SD 8.42

M 59.22"'
SD 11.25

M 51.453
SD 7.45


M 78.00' M 48.59'
SD 12.35 SD 5.49

M 65.20k' M 45.19'
SD 7.00 SD 5.86

M 75.47' M 47.48'
SD 10.56 SD 7.92


M 63.60'
SD 14.09

M 56.07'
SD 6.43


M 50.47'
SD 9.07

M 45.04"
SD 7.59


N= 119


(Note:) Different superscripts denote significance at the .05 level.















A further illustration of the cluster types is provided in Figure 2.


Figure 2: MMPI Scale Profile for Cluster Types


Fig 2: Mean Validity Scales


S--- Cluster 2

- Cluster 3


2 3 4 5 6
MMPI-A Scales


MANOVA and STAXI variables:


-~


7 8 9 10


A MANOVA was conducted with selected variables of the STAXI as


dependent variables and the three cluster types as independent variables.


The results are illustrated in Table 10.













Table 10: MANOVA and STAXI variables


Variable

State Anger

Trait Anger

Anger-In

Anger-Out

Anger Control

Anger Expression


F -Ratio

4.99

7.30

2.20

2.36

4.23

7.66


Significance Level

.01

.00

.12

.10

.02

.00


The results indicate a significant effect for anger variables with the

exception of Anger-In and Anger-Out.

Cluster Type and Dependent Variables:


To address the second hypothesis that the individual cluster types

would be distinct on a number of affective and familial variables, a series

of one-w ay ANOVAs were run with cluster type as an independent variable. The

first one-way ANOVA was conducted with anger expression as a dependent

variable and cluster type (3-Cluster Solution) as an independent variable.

The results indicated that there was a statistically distinct difference

between the personality cluster types and the amount of anger expression,

[F(2. 96) = 7.65. p < .05]. Both Cluster Group 1 and 2 were significantly










elevated when compared to Group 3. However. Group 1 and 2 appear to not be

significantly distinct from each other.

A one-way ANOVA was conducted with Trait Anger as a dependent variable

and personality cluster type as an independent variable. The results

appeared to show a relationship between the personality cluster types and

Trait Anger. [F(2. 96) = 7.42. p < .05]. Groups 1 and 2 appear to be

distinctly elevated compared to Group 3. However, Group 1 and 2 are not

statistically distinct from each other in terms of elevation.

A one-way ANOVA was conducted with family control as a dependent

variable and personality cluster type as an independent variable. The

results suggested that there is not a strong relationship between the

personality cluster types and differing perceived levels of family control.

[F(2. 96) = .0911. p > .05]. The means for all three groups on family control

were statistically similar.

A one-way ANOVA was conducted with Trait Anxiety as a dependent

variable and personality cluster type was an independent variable. The

resulting analysis suggests a strong relationship between the personality

cluster type and the perception of anxiety, [F(2. 96) = 20.68. p < .05].

Group 1 and 2 are significantly elevated when compared to Group 3 in terms of

anxiety. However. Group 1 and 2 are not elevated when compared to each

other. The results to this analysis are provided in Table 11.










Table 11: Means for the Personality Cluster Types on Four Dependent
Variables


Cluster 1 Cluster 2 Cluster 3

Anger Expression M 33.02b M 32.54b M 25.283
SD 7.52 SD 10.40 SD 8.62

Trait An2er M 23.92b M 23.85' M 18.723
SD 5.31 SD 7.08 SD 5.81

Family Control M 51.92 M 52.08 M 53.00
SD 10.30 SD 10.14 SD 10.97

Trait Anxiety M 46.08b M 50.77" M 35.12"
SD 8.39 SD 7.04 SD 8.34

N=99

(Note:) Different superscripts denote differences at the .05 level of

significance.

Cluster T\ oe and Anger Variables:

To fully investigate the relationship between anger expression and

personality\ cluster type. separate one-way ANOVAs were run with Anger-In.

Anger-Out and Anger Control as dependent variables. When Anger-In was

entered a.s a dependent variable with personality cluster type as an

independent variable, the resulting analysis was non-significant for the

relationship between suppressing angry feelings and personality cluster

type. [ F(2. 96) = 2.13. p > .05]. The means for all three groups were

statistically similar.










A one-way ANOVA was conducted with Anger-Out as a dependent variable

and personality cluster type as an independent variable. The resulting

analysis was non-significant for the relationship between expressing angry

feelings outwardly and personality cluster type, [F (2, 96) = 2.40. p > .05].

Finally. a one-way ANOVA was conducted with Anger Control as a

dependent variable and personality cluster type as an independent variable.

The resulting analysis was significant for the relationship between Anger

Control and personality cluster type. [ F(2, 96) = 4.23. p < .05]. Group 3

was statistically elevated compared to Group 1: however. Group 3 was

statistically non-distinct compared to Group 2.

Table 12: Means for the Personality Cluster Types on Three Anger Variables


Cluster 1 Cluster 2 Cluster 3

Anger-In M 18.40 M 17.92 M 16.36
SD 3.86 SD 4.09 SD 4.51

Anger-Out M 18.77 M 18.77 M 16.44
SD 3.86 SD 5.99 SD 4.93

Anger Control M 20.27' M 20.15b' M 23.52b
SD 4.21 SD 4.34 SD 5.93

(Note): Different superscripts denote significance at the .05 level










Regression Analyses:


The third analysis was a series of independent linear regression

equations with various measures of the STAXI as dependent variables and

family cohesion and family conflict as independent variables.

When Trait Anger was entered as a dependent variable with family

cohesion and family conflict as independent variables, the regression

equation revealed a significant interaction for both independent

variables. [ F(2. 96) = 11.62. p < .05 ]. Further analysis indicated that

family cohesion had a negative, significant relationship with Trait Anger.

[ Beta = -.2313. t= -2.290. p < .05]. Consequently, family conflict had a

positive. significant relationship with Trait Anger [ Beta = .3271. t =

3.24, p < .05].

Anger-In was entered as a dependent variable with family cohesion and

family conflict entered as independent variables. The resulting regression

equation showed a non-significant relationship with either variable. [ F(2.

96) = 17. p > .05]. Further analysis demonstrated a negative, non-

significant relationship with family cohesion as a independent variable and

Anger-In as a dependent variable. [ Beta = -.0475, t= -.419, p > .05].

Additionally. family conflict displayed a positive, non-significant

relationship with Anger-In as a dependent variable, [ Beta = .0286, t= .252.

p > .05].










Anger-Out was entered as a dependent variable with family cohesion

and family conflict as independent variables. The resulting regression

equation showed a significant relationship with both independent variables

contributing significantly, [ F(2, 96) = 8.13. p < .05]. Further analysis

suggested that family conflict had a positive, significant relationship

with Anger-Out [ Beta = .2597. t = 2.49, p < .05]. Further analysis also

suggested a negative, significant relationship with Anger-Out and family

cohesion [ Beta = -.2258. t = -2.16. p < .05].

Anger Control was entered as a dependent variable with family

cohesion and family conflict as independent variables. The regression

equation suggested a significant relationship with one of the independent

variables contributing significantly. [ F(2, 96) = 4.35. p < .05]. Further

analysis suggests that family conflict had a positive, non-significant

relationship with the Anger Control. [ Beta = .0505. t = .46. p > .05].

Lastly. analysis revealed a positive, significant relationship with family

cohesion and Anger Control. [ Beta = .3158. t = 2.90. p < .05].

Further. the sample was sorted on arrest history so that only those

with a positive arrest history were analyzed. When Trait Anger was entered

as a dependent variable and family cohesion and family conflict were entered

as independent variables, the overall resulting relationship was

significant. [ F(2. 81) = 10.29. p < .05]. Further analysis suggests that

family conflict had a positive, significant relationship with Trait Anger,










[ Beta = .3007, t = 2.79, p < .05]. Family cohesion had a negative,

significant relationship with Trait Anger. [ Beta = -.2767, t = -2.563. p <

.05].

A regression equation with Anger-In as a dependent variable and

family cohesion and family conflict as independent variables suggested a

non-significant relationship, [ F(2. 81) = .0459, p > .05]. Examining the

variables independently, family conflict had a positive, non-significant

relationship with Anger-In. [ Beta = .1314. t= .352. p > .05]. Family

cohesion had a negative. non-significant relationship with Anger-In. [ Beta

=.0469. t = -. 126. p > .05.

When Anger-Out was entered as a dependent variable and family

conflict and family cohesion, the resulting regression equation suggested a

significant relationship. [ F(2. 81) = 7.11. p < .05]. Examining the

variables independently, family conflict had a positive, significant

relationship with Anger-Out. [ Beta = .2832. t = 2.534. p < .05]. Family

cohesion had a negative. non-significant relationship with Anger-Out:

however, a trend was still indicated, [ Beta = -.2112, t= -1.89. p = .06].

A regression equation was established with Anger Control as a

dependent variable and family cohesion and family conflict as independent

variables suggested a significant relationship, [ F(2, 81) = 4.7123. p <

.05]. Family conflict seemed to have a positive, non-significant

relationship with Anger Control, [ Beta = .0535, t = .463, p > .05]. Family








67

cohesion appeared to have a positive, significant relationship with Anger

Control. [ Beta = .3503. t = 3.034. p < .05].














CHAPTER 4
DISCUSSION


This study was conducted in order to better understand possible

psychopathological personality patterns in adolescents at risk for

violence. In addition, this study sought to better understand the possible

relationships between affective variables, such as anger and anxiety,. and

familial components to these personality patterns in a select sample of

adolescents at risk for violence. Demographic information collected on the

present sample demonstrated that the majority of the sample was African-

American with a previous arrest history. In addition. the majority of the

sample either was raised in a single-family or other non-traditional family

arrangements. such as biological parent and step-parent. For those

children who lived with at least one biological parent. the vast majority of

these parents were employed. Since the majority of the subjects in this

study were African-American. the demographic information suggests a

sampling bias of ethnicity on referrals to alternative schools and

detention center referrals. The extent of this bias on test results is

unknown: however, future research with similar populations may want to

explore in more detail the effects of ethnicity and social class on paper-

and-pencil psychological inventories.










For this study. there were a number of pertinent variables that were

not examined. This variables include questions concerning substance abuse.

gang membership. number of incidences of violence and adolescent parentage.

These variables are important and need to be examined within the population

of adolescents at risk for violence. Future studies of this population

should examine the extent and scope of these variables with these children.

The child's place of residence was not examined in great detail within

the current study. Those children who were not living with a least one

biological parent were placed in an "Other" category. However, within this

category there was a great deal of range. Children could be living with

extended family members. such as aunts or grandparents. or be placed in

foster-care placement. There was not sufficient numbers of children living

in foster-care placement within this sample to conduct a statistical

analysis. However. hypothetical differences between children who live in

extended family situations and those in foster care placements on a number

of affective and familial variables should be examined in a future study.

Within this study. a comparison was conducted between white subjects

and African-American subjects on ten MMPI-A scales (F. 2. 3. 4. 5. 6, 7. 8, 9,

10). Significant differences were found between ethnicity and Scales 6, 7

and 8. Whites in the current sample were found to be higher on Scales 6

(Paranoia) and 7 (Psychasthenia) and African-Americans were found to be

higher on Scale 8 (Schizophrenia). In addition, there was a statistical










trend in whites being higher on Scale 5 (Masculinity-Femininity) and

African-Americans being higher on Scale 10 (Social Introversion). It can

be hypothesized that the white sample elevations on paranoia and

psychasthenia can be the result of coming from a majority culture and being

placed in a situation where they are minorities (ie., detention centers or

alternative schools). The elevation on Schizophrenia for African-

Americans may be explained by subtle cultural differences in language and

socialization. The current differences in MMPI-A scales for ethnic groups

is speculative. This current study suggests that a more detailed analysis

of ethnic differences in different subject populations needs to be

conducted.

For the FES. t-tests were conducted between the sample means and the

means of a normative sample. The analyses showed that compared to a

normative sample. this sample was significantly lower on family cohesion

and significantly higher on family conflict and control. This findings

demonstrates dysfunctional family characteristics for the sample as a

whole. This finding suggests a more detailed study into the family

characteristics of adolescents at risk for violence utilizing more

variables from the FES.

The first hypothesis stated that the overall sample of adolescents at

risk for violence would be heterogeneous in terms of personality data

gathered from the MMPI-A. This hypothesis was tested utilizing a










hierarchical. agglomerative cluster analysis (Centroid linkage method)

with the following scales of the MMPI-A: F. 2, 3, 4, 5, 6, 7, 8, 9, 10.

Distances between clusters were examined using squared Euclidean

distances. A "stopping technique" formulated by Mojena (1977) and later by

Mojena and Wishart (1980) indicated the presence of a three-cluster

solution.

An examination of the three-cluster solution was conducted looking at

the overall MMPI Validity and Clinical Scales. The results were interpreted

based on the scores of a normative sample. Cluster I had no clinical

elevations on any of the validity scales or the clinical scales compared to a

normative sample. However, there were sub-clinical elevations on the F

Scale. Scale 4 (Psychopathic Deviate). and Scale 6 (Paranoia). This is in

direct contrast to Cluster 2. Cluster 2 had clinical elevations (scale

elevation > 65) on the F Scale. Scale 2 (Depression). Scale 6 (Paranoia),

Scale 7 (Psychasthenia). and Scale 8 (Schizophrenia). In addition, there

were sub-clinical elevations on Scale 3 (Hysteria). Scale 4 (Psychopathic

Deviate). and Scale 9 (Hypomania). Lastly, Group 3 had no clinical

elevations on any validity or clinical scales of the MMPI-A. From examining

the results of the means. it appears that the majority of the MMPI-A scales

for Cluster 3 are near the central T-Score mean of 50.

Cluster I had elevated, yet sub-clinical. ( > 60) T-scores on three

Hathaway and Monachesi (1963) "excitatory" scales (F, 4, and 6). For the










purpose of discussion, they were termed the Sub-excitatory group. In

contrast. Cluster 2 had elevated (>65) T-scores on three Hathaway and

Monachesi "excitatory" scales (F. 6 and 8), as well as sub-clinical (>60) T-

scores on two scales (4 and 9). Cluster 2 also had elevated T-scores on two

"inhibitory" scales (2 and 7). They were termed the Mixed group. Finally.

Cluster 3 had no clinical or sub-clinical elevations on any scale. They were

termed the Non-elevated group. Based on the original model suggested by

Hathaway and Monachesi. one would have expected an excitatory group to have

higher T-scores and hypothesized the presence of a purely Inhibitory group.

Since Hathaway and Monachesi (1963) and Williams and Butcher (1989) posited

that excitatory scales would have a greater influence over inhibitory

scales. one would predict that Cluster 2 would have high rates of acting-

out. Since Group 1 had minor elevations on excitatory scales. one would

predict higher rates of acting out than Group 3. which according to the

model, would have low rates of acting out. Acting-out was not measured

directly in this study by examining rates of violent behavior, although it

was examined in-directly by looking at the self-report of anger styles. One

would hypothesize that Group 1 and Group 2 would have higher Trait Anger

(Hostility) and Anger-Out scores compared with Group 3.

In examining the available personality cluster types, the only one

that clearly distinguishes itself is Cluster 2. See Figure 2 in the Results










Section. However, one-way ANOVAs were conducted to verify the separations

of the three personality cluster types.

One limitation of the first analysis is the use of a cluster analysis.

The majority of cluster analysis methods are heuristics which do not involve

a great deal of statistical reasoning (Aldenderer & Blashfield. 1984).

Different clustering techniques (Wards. Average Linkage. Single Linkage.

Centroid. etc.) have been known to generate different solutions to the same

data base (Aldenderer & Blashfield. 1984). While it is true that the

Centroid linkage method generated a three-cluster solution, it may have

been possible to generate a different result utilizing a different

technique. Researchers should be aware of the bias that accompany the

presentation and description of groups created by clustering techniques.

A number of one-way ANOVAs were conducted with a series of dependent

variables anger expression, trait anger, trait anxiety, and family

control) and personality cluster type as the independent variable. The

results indicated a significant relationship between anger expression and

personality cluster type in which Cluster Groups I and 2 were substantially

elevated compared to Group 3. However, the anger expression mean score was

not statistically distinct for Group 1 and 2. The same result occurred with

Trait Anger as a dependent variable and personality cluster type as an

independent variable. Cluster Groups I and 2 were statistically elevated

compared to Group 3. but not statistically elevated when compared to each










other. Trait Anxiety had a statistically significant relationship with

personality cluster type and Groups I and 2 were statistically elevated when

compared with Group 3. However, Groups 1 and 2 were not statistically

distinct from each other. Lastly, Family Control did not demonstrate a

statistically significant relationship with personality cluster type and

upon visual inspection of their means, all three personality cluster groups

were remarkably similar.

Theoretically, it is interesting that Group 1 and 2 were distinct on

personality variables yet similar on affective variables (anger

expression, trait anger, and trait anxiety). If compared to a normative

sample. Group 1 and 2 would be at the 69th and 65th percentile for anger

expression. One would expect that the personality cluster group with the

highest and greatest number of clinical elevations to have the highest anger

expression score. However, for this study this is not the case.

Hypothetically,. this could be explained in that the behavioral

manifestations of anger expression may be different for the two groups.

This would mean that Group I may have more socially acceptable outlets for

their anger than Group 2. This hypothesis could be developed further by

examining the groups in terms of a structured interview designed to gather

information about ways individuals react to situations when angry or upset.

Gathering behavioral information (such as voice characteristics, speech

patterns or eye contact) from each group could contribute more information










about possible distinct manifestations for groups with high levels of anger

expression.

Group 3 was relatively similar to Group 1 in terms of personality

presentation but distinct when it came to anger expression. Group 3 was low

on the majority of measures but had a degree of defensiveness as measured by

Scale K. It could be that the low anger expression scores could be the result

of defensiveness. Again additional information, such as information

provided in an interview would be able to examine if this hypothesis is

valid. The interview could tease out information about verbal style or

reactions to angry situations. Another possibility is that Group 3 is

indeed low on anger expression and that other factors present in a given

child's environment (poverty, poor role models, etc.) placed the child in an

unfortunate situation where they came to the attention of legal

authorities.

Trait Anger was entered as a dependent variable and found to have a

significant relationship with the personality cluster types. Groups I and 2

were distinct from Group 3 but not dissimilar from each other. Trait Anger

is espoused to be a measure of hostility (sustained angry feelings over a

substantial period of time). Hypothetically, it would be interesting if

Group 1 and Group 2 differ in their presentations of hostility.

Specifically, does one group deal with angry feelings in differing, more

socially appropriate ways than the other. Questions arise as to why one










group that readily reveals psychological distress and no group in no

particular distress have the same level of affective responding to paper and

pencil inventories. If this question is asked then the other question would

be that how can two groups so similar in terms of personality variables have

such different levels of affective responding.

To examine the relationship more fully between anger, hostility and

personality cluster type. more analyses were conducted with Anger-In.

Anger-Out and Anger Control. Anger-In was examined to test the Suppressed

Anger Type hypothesis. Analyses were conducted with Anger-Out to test the

Uncontrolled Anger Type hypothesis. Finally. Anger Control was entered to

test the Overcontrolled Anger Type. Both Anger-In and Anger-Out proved to

be non-significant which was surprising given the differences in Trait

Anger and Anger Expression. Anger Control proved to be significantly higher

for Group 3 than for Group 1 or 2. This leads to a theory of Group 3 being an

Overcontrolled Anger type. Group 3 was found to be a more defensive group

than Group 1 or 2 just based on defensiveness (Scale K of the MMPI). For this

theory to be substantiated more. one would expect Group 3 to have higher

Anger Expression scores than it demonstrated. Also, one would have to get

behavioral samples for each of the three groups to test out theories of

Overcontrolled. Uncontrolled and Suppressed Anger Types. One might also

want to get bio-behavioral information as well as observer reliability

before confirming the hypothesis.










Familial levels of control were not found to be distinct among any of

the three personality cluster groups. The lack of variability suggests that

all three groups perceive the same levels of control. The familial

component of control seems to have little relationship to differing levels

of personality presentation. This result is unexpected given the results of

the Veneziano and Veneziano (1992) study which concluded that most of the

children they tested grew up in households high in control. This study

failed to find the same high levels of control within our sample. The sample

in this study appeared to have relatively consistent levels of control which

were not easily distinguishable from each other. One explanation for the

different findings could be subtle sample differences between this sample

and the sample of he Veneziano and Veneziano (1992) study.

Anxiety appeared to have a statistically significant relationship

with personality cluster type. Groups I and 2 had distinct elevations in

long-standing anxious feelings than Group 3. Coupled with the information

already gathered from anger expression and trait anger, the findings would

suggest that Groups 1 and 2 are effectively reactive and the nature of this

reactivit\ is long-standing.

Hathaway and Monachesi termed the "inhibitory" scales the neurotic

scales and predicted that if a child was elevated on anxiety dimensions, the

rates of acting-out would be lower. However, this study contradicts that

finding in that there are high levels of anxiety and anger for both groups.










This suggests a more complex relationship between anxiety, anger and

acting-out than anxiety being inhibitory and anger meaning expressive. The

results of this study suggest that both contribute to acting-out behavior.

More research needs to be conducted in this area to verify this finding.

One can postulate about the long-term nature of this reactivity in

terms of interpersonal relationships or the health of these children. As a

result of this reactivity would Groups I and 2 have a differing course than

Group 3. It would be interesting to undergo a longitudinal study to examine

if indeed those adolescents who indicated long-standing difficulty with

emotional reactivity had a differing course than those adolescents who did

not indicate such difficulties. This would contribute to the general body

of knowledge concerning the relationship between personality variables.

emotional reactivity and overall health.

Groups I and 2 are distinct on personality variables but not distinct

at all on certain affective variables. Group 1 and 3 are not extremely

distinct on personality variables but are extremely distinct on affective

variables. A conservative view would be that personality variables only

contribute to understanding a sub-group of this population but not the

majority of the population as a whole. Affective variables, particularly

those of a long-standing reactive nature, appear to add more to the nature of

understanding these children.










The final analyses were a series of independent, linear regression

equations which sought to examine relationships between anger and familial

variables. Trait Anger was found to have a negative, significant

relationship with family cohesion. Consequently, Trait Anger had a

positive, significant relationship with family conflict. The variable of

Trait Anger is said to be a reflection of Hostility (frequent experiences of

anger). so that as the variable of family cohesion decreases, the

experiences of anger increases. This result is not surprising in light of

the Veneziano and Veneziano (1992) study. One would suggest that good

family cohesion would somehow be a buffer to anger. Additionally, low

amounts of family cohesion could increase feelings of alienation or

inferiority which could indirectly heighten expressions of anger. This is

demonstrated further by family conflict having a positive relationship with

Trait Anger. Conceptually, high amounts of family conflict suggest a family

situation in which at least one member engages in frequent displays of anger

and/ or arguing, which could influence a child by simply modeling these

behaviors. The converse of family cohesion would be in effect here where

high amounts of family conflict influence frequent experiences of anger.

This finding suggests that a good family bond with average amounts of

conflict have an effect on lowering the experiences of anger.

Anger-Out (the outward expression of anger) was found to have a

negative. significant relationship with family cohesion and a positive.










significant relationship with family conflict. This finding reflects the

previous finding of a relationship between Trait Anger and family conflict

and cohesion. High amounts of family conflict increase the self-report of

anger outwardness. This result may reflect a modeling relationship in which

the child views a parent or guardian frequently engage in outward displays

of anger expressiveness and then follows the same pattern. The opposite

would be true of family cohesion in which a good. perceived bond would

moderate the display of anger. Regression results of the relationship

between Anger-Out and Trait Anger with family components of conflict and

cohesion have important treatment implications for ways to lower hostility

and outward displays of anger.

Anger Control also had a positive, significant relationship with the

variable of family cohesion. This relationship supports the notion of

family bondedness as a moderator of anger displays. The higher the

perceived feelings of family connectiveness the higher the feeling of

frequent emotional control. This may appear to be a positive result at

first. However, intense investment of energy in monitoring and preventing

the expression of anger may result in passivity or depression (Spielberger,

1988). We do not know the nature of the relationship between Trait Anger and

Anger Control for this population. Frequent instances of Anger Control

possibly coupled with Hostility according to Hecker and Lunde (1985) would

suggest the presence of the Overcontrolled Anger type. The evidence is










still tentative if the Overcontrolled Anger type was present in the sample:

however, a possible treatment option may be to encourage the healthy display

of anger to populations who believe that they must over-exert control of

emotional expression.

There did not appear to be much of a relationship between perceived

levels of conflict and frequent attempts to control emotional expression.

In light of the previous finding of a relationship between family conflict

and overt emotional expression, the non-significance of this result appears

to make sense. The relationship appears to be that family cohesion appears

to moderate emotional expression while family conflict appears to escalate

the expression of emotion.

There did not appear to be much of a relationship between Anger-In and

the variables of family cohesion and family conflict within this study.

Anger-In is the suppression of angry feeling for fear that one does not know

what to do with these feelings. It may be that this study did not investigate

this variable fully within this population. More. comprehensive research

should be conducted to test whether the Suppressed Anger type is a viable

theory within an adolescent sample.

Due to the relatively low numbers of subjects without an arrest

history, the sample was sorted on arrest history so that only those who

indicated having a positive arrest history were analyzed. Those with an

arrest history were examined because of a theoretical postulation that










those with an arrest history would have a tendency to act out more and

support the Uncontrolled Anger type theory of Hecker and Lunde (1985).

However, the resulting relationships all maintained their significance and

direction. Again, family cohesion had a positive relationship with family

cohesion suggesting the link between perceived strong family bonds and

emotional control. These findings appear to have strong treatment

implications for adolescents at risk for aggression, especially those with

an arrest history.

Overall. the findings do confirm previous theoretical models that

adolescents at risk for aggression are a heterogeneous group in terms of

personality and affective presentations. However, the variables of

personality for this population did not appear to be as strong as was

indicated by previous experimenters (Hathaway and Monachesi, 1963:

Williams and Butcher. 1989). There was only a minority of subjects who had

extreme clinical elevations with most subjects only having a few clinical

elevations or no clinical elevations. This finding may reflect differences

between the original MMPI and the MMPI-A. The original MMPI was found to

have numerous criticisms including the test being too long, the adolescent

norms being outdated, and the reading level may have been too high (Archer.

1984, 1987: Williams and Butcher, 1989a. 1989b). However for the majority

of children in this sample that they could comprehend and respond to a

lengthy test protocol and respond in appropriate fashion. This is important










for designing treatment options for this population. The majority of these

adolescents may be suitable for a treatment program that is straight-

forward at least comprehensible at the 6th grade level) and relatively

structured.

The findings tentatively suggest the presence of the Uncontrolled and

Overcontrolled Anger type as postulated by Hecker and Lunde (1985).

However, a limitation of this current study is that only self-report

information was used. Further investigations of these Anger types should

include interview information and bio-behavioral measures to verify

utilizing more objective measures the theory of hostility in a population of

adolescents at risk for aggression. However, there was not sufficient

information to ug g:cst the presence of a Suppressed Anger type. Whether

this type can be verified in this population remains to be seen.

The findings as related to affective reactivity suggested that these

adolescen.:s were heterogeneous for emotional presentation as well. There

was evidence of high levels of hostility (Trait Anger) as well as evidence of

overt emouonal expression or stringent monitoring and control of emotional

expression. Future research may want to fully examine the role of emotional

reactivit\ in other behavioral areas such as substance abuse, unprotected

sex, thrill-seeking behavior, suicidality or homicidality.

The findings of this study suggest a treatment model for emotional

reactivit\ in adolescents at risk for aggression and violence. Since










emotional reactivity was found to be a salient variable within this

population, methods to reduce the biological manifestations of emotional

reactivity for this group need to be studied. Hypothetically. one could

study or compare various anxiety and anger reduction methods, such as

progressive muscle relaxation or medication. Other suggestions for

treatment include devising methods of treating elements of dysfunctional

family patterns within this population. A treatment model could be

systematically constructed based on the results of this study. An

examination of the current literature on available treatment methods needs

to be conducted before a treatment model is conceptualized.

Overall, this study suggested that there were differential levels of

anger expression, trait anger and trait anxiety for this population.

Whether or not these affective variables can be treated within a model

remains to be seen. Additionally. it is not known whether the behavior of

these adolescents can be corrected by addressing affective and familial

elements. However. we do know that the rates of adolescents acting out and

being violent is increasing and has been increasing with each subsequent

measurement. A treatment model based on good working hypotheses that can be

evaluated in a component fashion to determine what is effective and what is

ineffective is needed. It is the hope of this study that these treatment

implications can be tested and evaluated and more effective treatment

programs for aggression among adolescents can be found.








APPENDIX
DEMOGRAPHIC QUESTIONNAIRE


Please do not put your name on this form because we want to insure that

your answers are completely anonymous. The information you provide on this

form will be strictly confidential and will not be used against you in any

way. A number will be assigned to you so that feedback on other test results

can be provided.

Assigned number:

1) What is your age?

2) What is your current grade in school?

3) What is your ethnic affiliation?

A) African- American B) Latino C) White D) American Indian E) Other

4) Describe your current family?

A) Both parents B) Mother and Stepfather C) Father and Stepmother

D) Mother only E) Father only F) Other-- Please explain below.



5) What is your parents) employment status?

A) Employed B) Unemployed

6) Please indicate whether or not you have an arrest history?

A) Yes B) No








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BIOGRAPHICAL SKETCH


Charlton James Coles was born in upstate New York on January 8. 1968.

He was the third child of Cleo and Marian Coles. He grew up in the suburbs of

Atlanta. GA. He attended high school at Benjamin E. Mays High School and

graduated on June of 1986. After high school he attended the University of

Georgia for one academic year. From there he transferred credit hours to

Georgia State University in 1987 and graduated with a bachelor's degree in

psychology in 1989. He enrolled in the clinical and health psychology

doctoral program in 1990 and received a Master of Science degree in 1993.

From September of 1995 to August of 1996. he was enrolled at an internship

program in clinical psychology. He completed internship requirements on

August 31. 1996. After completing his Doctor of Philosophy. Charlton is

planning on continuing a postdoctoral fellowship at the Morehouse School of

Medicine and working on professional licensure requirements.







I certify that I have read this study and that in my opinion it conforms to
acceptable standards of scholarly presentation and is fully adequate, in scope and quality,
as a dissertation for the degree of Doctor of Philosophy.


Eileen Fennell, Chair
Professor of Clinical and
Health Psychology

I certify that I have read this study and that in my opinion it conforms to
acceptable standards of scholarly presentation and is fully adequate, in scope and quality,
as a dissertation for the degree of Doctor of Philosophy.


David Miller
Professor of Foundations of
Education

I certify that I have read this study and that in my opinion it conforms to
acceptable standards of scholarly presentation and is fully adequate, in scope and quality,
as a dissertation for the degree of Doctor of Philosophy.


Fay Gary
Distinguished Service Professor of
Nursing

I certify that I have read this study and that in my opinion it conforms to
acceptable standards of scholarly presentation and is fully adequate, in scope and quality,
as a dissertation for the degree of Doctor of Philosophy.


Gary Geflf k 17
Associate Professor of Clinical and
Health Psychology

I certify that I have read this study and that in my opinion it conforms to
acceptable standards of scholarly presentation and is fully adequate, in scope and quality,
as a dissertation for the degree of Doctor of Philophy. \.


Duane Dede
Assistant Professor of Clinical and
Health Psychology







I certify that I have read this study and that in my opinion it conforms to
acceptable standards of scholarly presentation and is fully adequate, in scope and quality,
as a dissertation for the degree of Doctor of Philosophy.


Anthony Greene
Assistant Professor of Clinical and
Health Psychology

This dissertation was submitted to the Graduate Faculty of the College of Health
Professions and to the Graduate School and was accepted as partial fulfillment of the
requirements for the degree of Doctor of Philosophy.


December, 1996 /C- 5 1 /G
Dean, College of Health Professions


Dean, Graduate School










































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