Changes in antisocial aggressiveness during treatment in a hierarchical therapeutic community. A prospective study of personality changes.

Thirty-six consecutive substance abusers were examined at intake and after 1 year of residency in a hierarchical therapeutic community using the personality instruments Million Clinical Multiaxial Inventory (MCMI) and Basic Character Inventory. Two antisocial aggressiveness subgroups were identified: a no-increase group (n = 11) that had high intake scores on MCMI antisocial aggression, small changes during the stay and a high dropout rate (45%) as outpatients; and an increase group (n = 25) with lower scores at intake and a low dropout rate (20%). A high level of antisocial aggressiveness at intake was related to dropout in the no-increase group, and a high degree of increase in antisocial aggressiveness was related to dropout in the increase group. The results show the importance of monitoring antisocial aggressiveness during treatment.