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The present study reports on the effectiveness at one-year follow-up of an after-school prevention program targeting 6(th) grade African American youth residing in high-risk urban areas. The program, conducted on-site over the school-year period, involved a group mentoring approach emphasizing remedial education and an appreciation of African American cultural heritage in promoting school bonding, social skills development, and greater academic achievement. Behavioral and adjustment outcome data were obtained from two participating middle-school sites (intervention and comparison, involving 237 and 241 students, respectively) serving essentially equivalent urban communities. Results of the study revealed significant effects for academic achievement and behavior in terms of grade point average and teacher ratings that favored students at the intervention site. At this site, greater participation of parents in the intervention program was found to be positively related to improvement of the children in grade point average. No differential site-related changes in negative behavior were observed.

This paper presents background, implementation, and feasibility findings associated with planning and conducting an after-school intervention program in an alternative education setting designed to prevent the initiation and escalation of violence and substance abuse among urban African American youth at high risk for life-long problem behaviors. Evolving from earlier preventive interventions implemented in clinic and school settings, the program, entitled The Village Model of Care, consisted of structured group mentoring, parental support, and community outreach services administered to alternative education students and their primary caregiver(s) during the school year. Over a two-year intake period, 109 youth participated in the present process evaluation study. Findings from the study not only provided relevant demographic information on the characteristics of youth likely to be included in such programs but also indicated the importance of including the family in the rehabilitation effort and the need for school administrative system support for the underlying alternative education approach. The information presented in this report has a direct bearing on the planning of future prevention efforts conducted in similar settings that are aimed at reducing problem behaviors and promoting positive lifestyles among high-risk youth.

This paper reviews research findings on caretaking-related problems associated with the absence of parents from the home following incarceration. It focuses on the impact of incarceration on the welfare and adjustment of urban African American children and on the assumption of caretaking responsibilities by other caretakers, principally maternal grandmothers. Noting the complex situational difficulties involved and the potential burdens associated with surrogate parenting in general, and with this population in particular, the service-provider implications of this parenting arrangement are considered in this review. Findings indicate that problems associated with incarceration of parents tend to be intergenerational and vary considerably in complexity and severity. To the extent that they impact the children involved, these issues should be addressed in coordinated service delivery focusing on prevention.

Although the number of mothers with histories of drug addiction who are incarcerated has grown substantially in recent years, there is little information on their unique characteristics and vulnerability. Undertaken to address this issue, this study examined data on 167 incarcerated drug-abusing mothers from Baltimore City who had volunteered for a parenting program offered at a Maryland correctional facility. Prior to entering this program, mothers who consented to participate completed a battery of assessment measures, which included an extensive interview covering their early developmental and current experiences, along with standardized instruments measuring psychological adjustment and parenting satisfaction. Analyses of these data focused on the link between risk/protective factor information drawn from the early development experiences of the mothers and their current adjustment status. Results revealed significant relationships between higher risk levels and less favorable current adjustment. Implications of the findings of the study for both prevention and clinical intervention efforts targeting both mothers and their children are discussed.

This descriptive study examines the self-reported behaviors of 285 male and female adolescent children (ages 12-17) of narcotic addicts participating in methadone maintenance programs. These children responded to an extensive 2.5-hour interview questionnaire focusing on current and past activities, including criminal activities prior to age 12. The findings revealed that early deviance, assessed by self-report measures of both severity and variety, is related to current adolescent drug and alcohol use, association with deviant peers, a negative view of home atmosphere, and psychological symptomatology. These results are contrasted with the retrospective reports of adolescent behavior obtained from adult male narcotic addicts in a prior study of vulnerability to addiction. The comparability of study results is discussed in the context of developmental risk factors, prevention and treatment strategies, and other considerations specifically related to the development of children of narcotic addicts.

This retrospective study investigated relationships among early family circumstances, peer associations, and narcotic addiction in a sample of 601 urban males. Results of logistic regression analyses indicated that the extent of deviant behavior among close friends at ages 12-14 and disruption in family structure (parental divorce/separation) prior to age 11 were significantly associated with narcotic addiction. Additional regression analyses indicated that deviant behavior among family members, as well as family disruption, experienced prior to age 11, also increased the probability of association with deviant peers and a negative home atmosphere at ages 12-14. Implications of these findings for preventive interventions and for future research are presented.

This survey study of male and female narcotic addicts participating in methadone maintenance programs examined self-reported retrospective data on parental behavior experienced by addicts during their adolescent years. These findings were contrasted with the addicts' self-report of their current parenting practices with their own adolescent children. Results showed addicts as perceiving their mothers as significantly more functional in their parenting practices than their fathers on indices of parental involvement, attachment, and responsibility. Significant parenting differences between addicts and their parents were reported for the three indices mentioned, as well as for parent discipline and punitive actions, with the addicts rating their current parenting practices as more effective than those of their parents. Reported parenting practices were further analyzed in the context of how the ratings of parental functioning were related to problems of drug and alcohol abuse exhibited in the home. Findings are discussed in terms of the implications for prevention and treatment approaches for addicts and their children.

Providing retrospective self-reports of their activities, perceptions, and experiences during their early adolescent years (ages 12 to 14), 255 narcotic addicts were classified into four distinct types on the basis of a clustering technique applied to risk factor information derived from five major descriptive domains: family; peer deviance; personal deviance; psychological status; and protective factors. Differentiations among the types largely involved the extent of early drug and other behavioral deviance and family dysfunction. The predictive utility of the typology was examined in terms of outcome over the first ten years of the addiction career, including age at first narcotic addiction, amount of time incarcerated, and percentage of time addicted while in the community. The implications of the typology for both substance abuse prevention and treatment are discussed.

This retrospective study examined differences among three groups of urban males in the prevalence of various family risk factors occurring before age 11 and their independent contributions to subsequent deviance. The groups included: narcotic addicts; never-addicted peer controls who were associates of the addicts at age 11; and never-addicted community controls not associated with the addicts. Sixty-four percent of the addicts, compared to slightly under 40% of both control groups, reportedly experienced one or more family risk factors involving deviant behavior among family members and family disruption before age 11. While community controls differed from addicts on both family deviance and disruption in family structure, peer controls differed from addicts only on disruption of family structure. For the total sample, both family deviance and family disruption experienced before age 11 were significantly associated with crime severity level at age 11. Implications of these findings for future substance abuse research and intervention are discussed.

In this study, we examined whether differential perceptions of poor urban neighborhoods may contribute to narcotic addiction in individuals who grow up in these neighborhoods. Three groups of adult males provided retrospective perceptions of the neighborhoods where they lived at ages 12 to 14. The groups, matched on neighborhood, age, and race, were: narcotic addicts, peer controls--a never-addicted control sample of age-11 associates of the addicts, and community controls--a never-addicted control sample of age-11 peers who did not associate with the addicts. Results suggested clear group differences in perceptions of neighborhood deviance, with addicts perceiving the greatest and community controls the least amount of deviance. However, within groups, subjects who lived in more socially deviant areas, as determined by official records, tended to view their neighborhoods as more deviant than did subjects who lived in less deviant neighborhoods.

Evaluating drug abuse treatment within a correctional framework presents unique issues and challenges. Given their respective emphases on rehabilitation and incapacitation, treatment and corrections approaches to incarcerated drug abusers often differ in methods aimed at reducing deviant behavior. Although this results in problems in planning integrative drug abuse intervention strategies, the two approaches are not always incompatible. Corrections can help identify those individuals in need of treatment, and for some of these, treatment can lessen the need for incapacitation. Understandably, gaining a drug-abusing offender's cooperation in monitoring routines and engendering trust in the confidentiality of treatment conducted in criminal justice systems settings, while still ensuring public safety, are not easy tasks. Nevertheless, there are decided advantages, in terms of compliance and retention, to the increased surveillance exercised by the criminal justice system in community-based treatment efforts. In these efforts, therapy coupled with urine monitoring appears particularly promising. Along with the presentation of descriptive and preliminary outcome information, this report provides a discussion of treatment/corrections issues within the framework of an ongoing treatment evaluation study involving drug-abusing parolees in Baltimore City.

This article focuses on the effectiveness of the major drug abuse treatment modalities (methadone maintenance, therapeutic communities, outpatient drug-free programs, and short-term detoxification) in the United States. It includes findings specific to individual clients and to particular modalities. Methadone maintenance, therapeutic communities, and outpatient drug-free treatment are generally effective in reducing illicit narcotic use and the criminal activity that often accompanies narcotic addiction. These effects are usually short-term, however, and more than one treatment episode is often required for long-term recovery. Longer time in treatment, pretreatment employment, and lack of pretreatment criminality are generally associated with favorable outcome regardless of modality. Issues needing further study, such as treatment for nonnarcotic (mainly cocaine) use, matching clients to treatments, and evaluating the cumulative effects of multiple treatment episodes, are discussed, along with the authors' research on the relationship between drug abuse, crime, and treatment in Maryland.

The validity of previously hypothesized predictors of elapse following neuroleptic discontinuation was examined. One hundred sixty-two outpatients, with either Research Diagnostic Criteria schizophrenia or schizoaffective disorder, were discontinued from neuroleptic medication for a 28-day period or until judged to be relapsed. Pre-discontinuation neuroleptic dosage level, the severity of psychotic symptoms, and the presence of dyskinetic movements prior to neuroleptic discontinuation were the predictor variables. Of the 162 patients, 62.7% did not relapse during the study period. There were no differences in the survival rates between the patients withdrawn from oral versus depot neuroleptics. Neuroleptic dosage, but not severity of psychotic symptoms or dyskinetic movements, predicted relapse. These results support the hypothesis that pre-withdrawal neuroleptic dosage level predicts relapse, but fail to validate either severity of psychotic symptoms or presence of dyskinetic movements as predictors of relapse.

A double-blind crossover trial was used to evaluate carbamazepine as the sole maintenance treatment of chronic, nonmanic schizophrenic outpatients whose conditions had been stabilized with the use of neuroleptics prior to study. Criteria of treatment effectiveness included the number of patients relapsing and time to relapse over a 95-day neuroleptic-free period during which either carbamazepine or placebo was administered. Relapse was determined by the concordance of psychiatric ratings and independent clinical judgements indicating significant worsening. Results for 27 patients (13 receiving carbamazepine and 14 receiving placebo) involved in the first phase of this treatment comparison were nondifferentiating. Corroborating descriptive findings in the second phase were available for 14 of these patients. There was no evidence supporting the existence of a treatment-relevant subgroup defined by episodic dyscontrol phenomena.

The authors report on the outcome of treatment of 116 outpatients with chronic schizophrenia who were assigned to a 2-year, single-blind course of treatment with either targeted or continuous medication. These patients were not restricted to those who were good candidates for a medication reduction strategy. Continuous medication was superior to targeted medication in preventing decompensations and hospitalizations and in extent of employment at 2 years. Other measures of psychopathology and functioning at 1 and 2 years did not differentiate the two groups of patients. The targeted approach achieved a substantial reduction in total medication through a reduction in the number of days of medication administration.

This paper presents the background and initial experiences of a treatment evaluation involving self-help techniques and principles as a means of providing aftercare services for stabilized methadone maintenance patients. It describes the Clinically Guided Self-Help (CGSH) model, which focuses on community reintegration and places emphasis on social network components following a period of primary treatment and demonstrated client stability. From our experiences, we have identified needs and issues that are of concern to stabilized clients, and we have distilled a paradigm for responding to these in a self-help group format. The model permits clients to establish their own agenda of interests and, guided by staff, to engage in a process geared toward maximum participation of their part. The model is clinically based in that staff and participants are engaged in working on present adjustment concerns. The overall goal of the investigators is to generate the prerequisite skills for successful adaptation of self-help concepts and techniques to the particular needs and interests of individual methadone maintenance programs and clients.

The present study, involving 132 narcotic addicts with multiple periods of addiction, examines trends in criminal activity and drug use over successive periods of addiction and successive periods of nonaddiction during an average 15-year addiction career. Significant decreases over successive addiction periods were found for four (of five) categories of crime: theft, violence, drug distribution, and "other" crime (primarily gambling). These results appear to be accounted for by a disproportionately high level of crime during the first addiction period. Criminal activity, most notably theft and violence, decreased over successive periods of nonaddiction, though not significantly. Although more evidence is needed, a particularly large addiction vs nonaddiction disparity in crime rates for Hispanic addicts revealing a low propensity for crime when not addicted suggests that crime reduction may be a reasonable objective in the treatment of these individuals. With regard to drug use over the addiction career, the most dramatic increases over time were found for illicit methadone and cocaine. Rates of heroin and marijuana use declined. Generally, nonnarcotic drug use, other than use of cocaine and Valium, tended to decrease progressively over time regardless of addiction status. These results, along with findings relevant to the "maturing out of addiction," are discussed.

Undertaken in the context of a controlled drug trial involving newly admitted psychiatric hospital patients, this study compared the effectiveness of a "Doctor's Choice" (DC) method of administering psychotropic drugs versus an experimentally determined treatment regimen employing random assignment and double-bline procedures. The 32-day drug trial sought to determine the comparative effectiveness of thioridazine-placebo, thioridazine-chlordiazepoxide, and thioridazine-imipramine, with the daily dosage of openly administered thioridazine ranging from 100 to 900 mg and dosages for chlordiazepoxide and imipramine, administered in a double-blind fashion, fixed at daily dosages of 30 and 75 mg, respectively. DC medication, consisting of a choice (by a research physician) of any of the three experimental medications determined on the basis of judged clinical need, was added as a fourth treatment category for present purposes. Criteria of effectiveness included standarized psychiatric rating scales and global measures of imporvement completed by research team members and ward physicians. Outcome results for the DC group compared to those for a single control group made up of individuals matched with DC patients on the basis of drug assignment indicated an essentially similar clinical effectiveness under both DC and control treatment conditions. Generalization of the finding was limited by the fact that the main treatment effect, attributable to thioridazine, overshadowed the more subtle action of the ancillary drugs.

As an introduction into a clinical study of one of a new group of compounds having neuroleptic potential, the background and characteristics of the gamma carbolines, particularly flutroline, are cited in the general context of a review of the use of antipsychotic drugs in psychiatry. In the four-week double-blind trial involving dosages of 1, 5, 10, 20 and 100 mg, 48 hospitalized schizophrenic patients were given the tryptoline derivative flutroline on a once-a-day basis. Outcome criteria obtained weekly, including the incidence of side effects, standardized psychiatric ratings, and clinical global impressions of psychopathology, indicated that flutroline was a safe and effective antipsychotic drug. Data suggested that dosages of 20 mg and above offered the best potential for optimal clinical effectiveness.

MMPI-168 profiles were obtained on 225 male narcotic addicts who were attending methadone maintenance clinics in Baltimore and New York City during 1983 and 1984. Data were collected on Black and White (Anglo, other than Hispanic) addicts in Baltimore and on Black, Hispanic, and White addicts in New York City. In general, the profiles indicated high levels of psychopathology, with particularly high elevations on the F, D, PD, PT, and Sc scales. Consistent across cities and in agreement with earlier findings, profiles of Whites indicated somewhat more maladjustment than those for Blacks, while the profiles of Hispanics displayed essentially the same levels of disturbance as those for Whites. Comparisons by city revealed greater deviance for New York City subjects, a finding more evident among Whites than among Blacks.

Over the past several decades, psychopharmacological treatments in psychiatry have been subjected to intensive methodological scrutiny in the continual assessment of their efficacy and safety. Although one of the most dramatic and controversial therapeutic approaches in psychiatry, electroconvulsive therapy (ECT) has not received the same concentrated, systematic attention. Through a comprehensive literature search, the present authors have attempted to provide answers relating to the efficacy and the safety of conventional ECT and some of its more prominent variations. Although specific discernible trends are reported in the text, results of the survey are too disparate for a simplistic summary statement to be made regarding efficacy in all diagnostic categories. As with most somatic treatments in psychiatry, bilateral ECT does present some apparent risk, reduced but not entirely eliminated by precautionary techniques, which must be weighed against the possible benefits to be derived in a given case. Other variations of ECT offer promise of fewer side effects but must be accepted as standard clinical practice.

The counterbalanced design in a bioequivalent study of haloperidol indicated an absence of any clinical difference between a new 20-mg dosage form and two 10-mg tablets of haloperidol (Haldol). This impression was supported by the absence of any significant behavioral changes during the four weeks when either form of the once-a-day fixed dose of 20 mg haloperidol was administered. This impression was substantiated by experiences with the dopamine receptor blocking assay, since results with this procedure also indicated the lack of any significant difference in the plasma neuroleptic equivalence of either dosage form. On the basis of present findings the assay would appear to offer promise for clinical application in the adjusting of the dosage of neuroleptic drugs, as well as in the monitoring of drug usage.

This is a presentation of the results of pilot and controlled research on the effectiveness of the contingent (upon narcotic drug use) administration of 500-2,000 mg daily, of the narcotic antagonist, naloxone (N-allylnoroxymorphone), to paroled narcotic addicts enrolled in a urine monitoring program conducted in a metropolitan-based outpatient clinic. Criteria of effectiveness, which include clinic attendance, the extent of narcotic drug usage, and final disposition at the end of a 6-month treatment period, are viewed in relation to already established baseline results with a sample of patients processed through the same clinic over a 5-year period prior to the introduction of naloxone treatment. Although results of the pilot study are encouraging, indicating longer patient involvement and less reinstitutionalization than baseline values, the results of the controlled evaluation reveal no benefit from contingently administered naloxone beyond placebo reactivity, which appears to be substantial in the contingent approach. The results are discussed in terms of given sample characteristics, and suggestions are offered regarding the development of new narcotic antagonist treatment approaches.

Factor analysis of data from a general survey of attitudes and opinions concerning narcotic addiction and its treatment revealed 10 major dimensions, five of which were likely to have significant implications for drug abuse intervention strategies. For these latter dimensions, differences were determined among clients and staff according to type of treatment clinic (three types involving the provision of methadone maintenance in various combinations with other treatments and one involving the use of abstinence only). The most pronounced differences were between the methadone clinics and those offering abstinence only. Both the clients and staff of abstinence clinics were more skeptical concerning treatment effectiveness, were more negative regarding the use of narcotic drugs, and were more disposed to the use of ex-addict counselors and group procedures in treatment.

Considerable progress has been made in increasing the formal correctness of outcome research in schizophrenia by employing strict methodologic standards. However, based on a recent review of the literature, the authors note that insufficient attention has been directed toward the meaningfulness of such research. The interest of a particular study derives from its application beyond the specific patients treated; lack of attention to meaningfulness encourages the researcher to posit unjustified or overly generalized conclusions, resulting in the widespread adoption of questionable treatment strategies or the dismissal of potentially useful ones. Increased attention to meaningfulness will make the conclusions of this type of research more valuable, both from pragmatic and theoretical standpoints.

In an effort to isolate the major dimensions of attitude and expectation regarding narcotic addiction and its treatment and to compare different groups of addict/clients and agency staff on these factors, a comprehensive questionnaire was administered to 900 addict/clients and 237 agency personnel in 25 drug treatment clinics in six states. Results of a factor analysis, which used questionnaire data from all of the 1137 subjects so that direct group comparisons could be made, indicated the presence of 10 major dimensions of attitude and expectation. Results also suggested considerable variation, particularly by status (client vs. staff) and ethnic group, on these dimensions. An additional analysis of staff attitudes and expectations revealed correlations with years of education, ex-addict status, and years of work experience. Such findings suggest the need to consider client/staff characteristics and attitudes in the planning of treatment services for narcotic addicts. An abbreviated (53-item) attitude and expectation questionnaire was developed for this purpose.

Open-trial reports of substantial clinical improvement in most schizophrenic patients on hemodialysis for their psychiatric condition prompted the present study to determine the efficacy of hemodialysis under double-blind, controlled conditions. Fifteen schizophrenic outpatients were randomly assigned to either a real-sham or sham-real dialysis treatment sequence. Presented in detailed, graphic form, results of repeated measurement and other analyses of symptom and behavioral data collected initially, at crossover, and at the end of treatment revealed no differential effects between real and sham dialysis. These results provide important experimental evidence of the lack of therapeutic efficacy of hemodialysis in schizophrenia.

Detailed interview data from 250 male narcotic addicts attending methadone maintenance treatment centers in Baltimore and New York City were used to confirm and extend previous findings regarding the frequency of nonnarcotic drug abuse among relevant addict subgroups. Consistent with earlier results, abuse of nonnarcotic drugs in general, and particularly cocaine, was higher during periods of addiction than during periods of nonaddiction. Overall, marijuana and cocaine were the two main drugs of abuse, but variations were present according to addiction status period, city, and ethnic group membership. Relationships between cocaine use and specific types of criminal activity were also examined. It was found that there were high associations between cocaine use and several different kinds of crime.

A controlled, double-blind study of the comparative effectiveness of the narcotic antagonists, cyclazocine and naloxone, was undertaken in a metropolitan narcotic clinic offering an abstinence program involving urine monitoring and ancillary counseling services. Seventy male addict parolees were randomly assigned to 6-month treatment with either cyclazocine, 4 mg administered on a daily basis, or naloxone, 500-2,000 mg administered on a locally developed and researched 'contingent' basis, i.e., whenever there was indication of narcotic drug use (daily and contingent placebos were utilized to preserve the double-blind). Criteria of treatment effectiveness included narcotic drug usage, clinic attendance, length of participation in the program, disposition at 6 months, and incidence of side effects. The two subsamples of 35 individuals were similar with respect to relevant demographic characteristics. Examination of comparative effects revealed little to no significant differences between the two groups in terms of measures of program adherence, treatment outcome, and personal and social adjustment. Side effects were more prevalent among cyclazocine patients. Typically, these included moderately severe somatic effects and perceptual and cognitive disturbances.

There is growing interest in deficit symptoms in studies of the course and treatment response of schizophrenia. However, existing clinical assessment instruments focus primarily on productive symptoms. The authors describe the Quality of Life Scale (QLS), a 21-item scale based on a semistructured interview designed to assess deficit symptoms and thereby fill an important gap in the range of instruments now available. Data regarding reliability and training in the use of the QLS are presented. A factor analysis of the items yields results compatible with the conceptual model on which the scale is based. The factor analysis was also performed separately by sex and was fundamentally similar for men and women.

Recent research conducted by independent investigators concerning the relationship between crime and narcotic (primarily heroin) addiction has revealed a remarkable degree of consistency of findings across studies. The major conclusion supported by the majority of these studies is that narcotic addicts commit a vast amount of crime and that much of this is directly related to the need to purchase drugs. A large proportion of the crimes committed does not consist merely of drug sales or possession, but involves other criminal behaviors including serious crimes. The strongest evidence of a causal relationship between narcotic drug use and crime is derived from longitudinal studies in which the amount of crime committed during periods of active addiction far exceeds that committed during periods of nonaddiction. Much of this crime goes unreported, although addicts, under conditions of strict confidentiality, have provided information that permits realistic estimates of criminal activity. Use of this methodology has permitted the identification of different types of addicts, especially with respect to the amounts and types of crimes in which they are engaged. The implication of these findings is that although addicts as a group commit a great amount of crime, they cannot be regarded as a homogeneous class. Some addicts commit many crimes, regardless of current addiction status, whereas others commit relatively few, and these are obviously related to their need to purchase drugs. There is a discernible impact of treatment on narcotic drug use and criminality. Although the relationships between addict characteristics and treatment response have yet to be fully determined, extensive prior criminal involvement is associated with a negative outcome.

An open comparative trial was conducted involving 42 schizophrenic outpatients randomly assigned to one of two methods of drug administration: continuous medication (N = 21) and targeted medication plus psychosocial intervention (N = 21). The results, which suggest an extensive similarity with respect to outcome for the two treatments over a 2-year period, argue for the continuation of research on the relative effectiveness of the targeted drug approach, particularly in cases judged suitable for drug reduction strategies.

Prompted by previous reports of substantial clinical improvement in most schizophrenic patients given hemodialysis for their psychiatric condition, we studied the efficacy of hemodialysis in 15 schizophrenic outpatients, under double-blind, controlled conditions. The patients were randomly assigned to either a real-sham or sham-real sequence of dialysis treatment. Results of repeated measurement and other analyses of data on symptoms and behavior that were collected before study treatment, at crossover, and at the end of treatment revealed no difference between the effects of real and sham dialysis. These results provide important experimental evidence of the lack of therapeutic efficacy of hemodialysis in schizophrenia.

A comparison of a chemical analytic technique (gas chromatography/mass spectrometry) with that of the dopamine receptor blocking assay in a study involving seven schizophrenic patients being administered a fixed dosage of haloperidol (20 mg) demonstrated a high degree of correspondence in the quantification of the plasma levels of the neuroleptic.

The authors treated 12 schizophrenic patients who had overt hallucinatory symptoms with intravenously administered naloxone hydrochloride, a narcotic antagonist purported to have antihallucinatory properties. They found no evidence of the effectiveness of naloxone in preventing hallucinations over that of placebo when administered in a randomized, double-blind fashion.

Flutroline hydrochloride, a gamma carboline manifesting neuroleptic activity, was administered in a double-blind fashion in single daily dosages of 1, 5, 10, 20, and 100 mg to 48 hospitalized schizophrenic patients over a period of four weeks. During this period, weekly evaluations were made of response employing standardized psychiatric ratings. Plasma prolactin (PRL) levels were obtained at the termination of previous neuroleptic medication and at two-week intervals during treatment with the investigational compound. Examination of the initial PRL levels indicated that they could be grouped into those above, within, and below the normal range. Comparisons of these initial levels with those following the administration of flutroline suggested an improved methodology for determining optimal neuroleptic dosage.

Using self-report information provided by 250 male admissions to methadone maintenance/detoxification clinics in Baltimore and New York City, separate criminal typologies were derived for prior periods of addiction and nonaddiction in the community. Although far more crime was committed during periods of addiction, comparison of the typologies indicated highly consistent individual patterns regarding the kinds of crime that were committed over periods of addiction and nonaddiction. The association between early deviant behavior and later criminal involvement over an addiction career was determined by relating preaddiction characteristics to both the addiction and nonaddiction typologies. It was found that crime patterns established before addiction, although intensified by addiction, tended to persist throughout the addiction career. Correspondence between the present typology results and those found in an earlier Baltimore sample of 354 addicts was high with respect to both the number and descriptive characteristics of the types derived. Implications of this research with regard to the early identification of the most criminally prone individuals are discussed.