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Addiction Research Center Inventory (ARCI):
Measurement of Euphoria and Other Drug Effects
Charles A. Haertzen and John E. Hickey
NIDA Addiction Research Center
c/o Francis Scott Key Medical Center
Baltimore, Maryland 21224
|This paper reviews the evolution of the Addiction Research
(ARCI) into a viable instrument for determining the subjective effects
of drugs. Primary focus is on item selection, scale development, the
of short forms for different objectives, and the use of the ARCI as a
tool. The importance of items and scales of euphoric content in the
The item selection process for both the 550 item inventory and the additional 50 items dealing with classical withdrawal symptoms is described. Discussion of scale development begins with the construction of the empirical scales which distinguished a given drug from placebo and continues through the development of drug-specific scales, those scales that can distinguish between drugs.
The clinical scales, which discriminate between groups, are briefly discussed with emphasis on the appropriate use of the psychopathology scales. In terms of test validity, the effective use which has been made of the drug orientated ARCI short forms and selected scales is discussed in some detail with relevant comment regarding the utility of the total ARCI.
One of the primary reasons for developing the Addiction Research Center Inventory (ARCI) was to measure the subjective effects of a large variety of drugs. Since July of 1958 when the first ARCI was given to an opiate addict, the ARCI has been applied to evaluate the effects of dozens of different psychoactive compounds. A large percentage of the reports on the ARCI are in volumes published by the Committee on Problems of Drug Dependence. The ARCI has received some attention both in the U.S.A. and abroad as it has been translated into German (Battig & Fischer, 1967), French (Pichot, 1964), Spanish (Meketon & Perea, 1967), and Swedish (Sjoberg, 1969b).
Interest in the development of the ARCI as an instrument to measure drug effects, psychopathology, and personality was stimulated by a number of findings. On the negative side, established tests such as the Minnesota Multiphasic Personality Inventory (MMPI) were not uniformly effective in showing drug effects. Thus, it revealed changes for LSD (Belleville, 1956) but not for morphine or pentobarbital (Haertzen & Hill, 1959). In contrast, Beecher (1959) and associates uncovered subjective effects of opiates and other drugs in both opiate addicts and normal subjects with adjective check lists. The utility of several different adjective check lists had been affirmed in other studies of drugs or in studies of stimulating social factors (Clyde, 1960; Nowlis & Nowlis, 1956). Adjective check lists have continued to be used to detect the effects of drugs (Cameron, Specht, & Wendt, 1967; McNair, Lorr, & Droppelman, 1971) and the effects of social factors (Datel, Gieseking, Engle, & Dougher, 1966).
In the 1950 era the LSD questionnaire developed by Abramson (Abramson, Jarvik, Kaufman, Kornetsky, Levine, & Wagner, 1955) was used at the Addiction Research Center for showing acute effects of LSD and other hallucinogens as well as tolerance and cross tolerance to them (Isbell, Belleville, Fraser, Wikler, & Logan, 1956). A preliminary questionnaire developed by Belleville to show the effects of a marijuana compound (dimethylheptyl derivative called CA 101 or SKF-5390) showed a large variety of significant changes (Haertzen, Hill, & Belleville, 1963).
The idea of including indicators of psychopathology and personality in the ARCI was stimulated by theories and findings in the 1950s and before which related drug effects to these determinants. In the 1920s Kolb (1925) came to the conclusion that psychopaths were more likely to obtain euphoria from opiates. The elevation of opiate addicts on the Psychopathic Deviate scale of the MMPI seemed consistent with the Kolb conclusion (Hill, Haertzen, & Glaser, 1960). Also, addicts felt euphoric from opiates whereas normals did not (Beecher, 1959). It was characteristic of the 1950s to speculate about the similarity of psychopathology such as schizophrenia and the psychotomimetic effects of LSD, mania, and drug euphoria or about the possible causes of delirium tremens (Haertzen, 1964; Hoch & Solomon, 1952; Isbell, Fraser, Wikler, Belleville, & Eisenman, 1955; Savage, 1955). More recently the discovery of endorphins has served as fuel for speculations and studies of possible pathophysiology of those with mental disorders and of treatment of these (Feinberg, Pegeron, & Steiner, 1983). In the 1950s Eysenck implicated both psychopathology and personality as determinants of drug effects or drugs affecting personality. Thus, according to Eysenck (1957), central nervous system depressants such as alcohol and barbiturates should increase cortical inhibition, decrease cortical excitation, and thereby produce extraverted behavior patterns.
By simultaneously using items which were believed to reflect psychopathology, personality, and drug effects, it was thought that the study of the interrelation of these variables and the effects of drugs would be expedited. The original study with the ARCI partially permitted some analysis of interrelationships of personality and drug effect dimensions, because the MMPI (Hathaway & McKinley, 1951), the California Personality Inventory (CPI; Gough, 1957), Guilford-Zimmerman Temperament Survey (Guilford & Zimmerman, 1949), and the Sixteen Personality Factor Questionnaire (16 P.F.; Cattell, 1957) were included under a no-drug condition (Haertzen & Miner, 1965).
In selecting a new set of items, there can be no guarantee that valid items will be included, especially in the area of psychopathology, as it has been demonstrated that expert judges have misconceptions about how psychopathological types will answer questions (Gough, 1954). Granting the limitations imposed by judgment, it is thought that the method of generating original items, of classifying the items into content areas, of requiring consensus among the authors to accept an item, and of editing of accepted items led to the ultimate validity of the item pool for the various objectives. Validity of the scales is probably related to use of a large number of subjects and to the methods of scale construction.
The primary means of generating items consisted of having opiate addicts respond to a 200 item sentence completion test when they were under a no-drug condition and when they were under the influence of drugs such as morphine, LSD, pentobarbital, chlorpromazine, a marijuana-like compound (1’-2’- dimethylheptyl cannabinol, SKF-5390), and placebo (Haertzen, Hill, & Belleville, 1963). Sentence completion stems consisted of phrases such as "I feel " and "My appetite is ." The huge corpus of possible items was initially reduced to about 3300 and then to 550 through a judgment process. The list also included MMPI items. If Hill, Haertzen, or Belleville thought that an item was worthy of further consideration, it was checked and committed to a card. At this stage items were categorically eliminated from consideration if the names of drugs were mentioned except in the case of alcohol, cigarettes, and coffee. This exclusion was followed because it was our intent to use the test on many different populations including those who did not use drugs.
Items were classified according to the categories in Table 1. To prevent exclusion of items in content areas, items were judged for acceptability only within a common subcategory. Content of a particular category is generally larger than the table suggests as some categories are potentially very broad. For example, items indicative of euphoria or anxiety which are broad dimensions were classified under other categories such as attitudes toward people. In contrast with the content of personality tests, many items of the ARCI concern alterations in motivation and mood, in sensation and perception, and in reportable physiological processes (Haertzen, Hill, & Belleville, 1963). Selected items were edited through consideration of the Thorndike-Lorge word counts (1944) so that the most difficult word in an item was below the sixth grade level. Items were predominantly phrased in the present tense rather than the past tense because drug effects were more commonly found on items that were phrased in the present tense. The final form of the ARCI contained 550 items including 30 items which were repeated exactly or in logically opposite form. The repeated items were used to form a Carelessness scale to evaluate the validity of responses in individual subjects (Haertzen & Hill, 1963). The original 550 items (Hill, Haertzen, & Belleville, 1958) have been retained to the present time. All of the 39 basic recommended scales can be scored with this set of items.
The middle 1960s permitted the testing of subjects undergoing opiate
withdrawal (Haertzen & Hooks, 1969; Haertzen, Meketon, & Hooks,
1970). Since no sentence completion tests were given to subjects under
any withdrawal condition, including opiates, it seemed desirable to
some classic withdrawal symptoms described chiefly by Himmelsbach
For this reason 50 additional questions were added. In this set of
rules about using drug names and Thorndike-Lorge word count criteria
suspended. It may be parenthetically noted that most drug names
infrequently in print or not at all. The added part is called
Questionnaire Number 4. It need not be given to subjects who are not
abusers. The use of drug names may give clues about the possible
of the test.
|1. General Information||a. Family
|2. Interests and Drives||a. Interests in activity now
c. General interests (occupation)
|3. Sensation and Perception||a. Hearing
b. Internal sensations
c. Kinesthetic sensations
|4. Bodily Symptoms and Processes||a. Head
b. Nose and lungs
c. Body image
d. Muscular coordination
e. Mouth, throat, stomach
l. Excretion and genitals
|5. Feelings and Attitudes||a. Ability
1) general discouragement or confidenceb. Reactions toward the test
c. Attitudes toward people
d. Attitudes toward institutions
e. Content of thought
f. Character traits
1) empathy, sympathyg. Schizophrenia
1) affecth. Expression
1) fearsj. Guilt
1) guiltk. Mood
1) state of feelingl. Interpersonal relations:
much overlap with other categories
n. Philosophy of life
Note: a, N = number of items. Table 1 was originally adapted from a dissertation (Haertzen, 1961). A complete list of items for each category is also given.
Scale development on the ARCI has gone through many phases. Several hundred scales have been constructed for the ARCI, but 39 scales are recommended including the Carelessness scale (Haertzen, 1974a). Scale development on the ARCI was influenced by the empiricism associated with the MMPI (Hathaway & McKinley, 1951) and California Personality Inventory (CPI; Gough, 1957) but also by the factor analytic methodology associated with tests such as the Guilford-Zimmerman Temperament Survey (Guilford & Zimmerman, 1949) and Sixteen Personality Factor Questionnaire (16 P.F.; Cattell, 1957), Cattell’s theories of causation (Cattell, 1952, 1957; Haertzen, 1966a), and Eysenck’s (1950) criterion analysis (Haertzen, 1962, 1969b). In addition Martin and colleagues developed an amphetamine scale based on dose-effect relationships (Martin, Sloan, Sapira, & Jasinski, 1971). Other investigators have also developed scales (Cole, Orzack, Beake, Bird, & Bar-tal, 1982; Resnick, Kestenbaum, & Schwartz, 1977).
The first set of published scales were empirical drug scales that applied to drugs included in the initial ARCI drug study (Hill, Haertzen, Wolbach, & Miner, 1963a, 1963b). The full item content for each scale is listed in the Appendix for ready reference. The drugs or conditions included in the study included no-drug, placebo, amphetamine, pentobarbital, chlorpromazine, alcohol, LSD, and pyrahexyl. More than one dose of some drugs was given. In the empirical scale development phase, we were interested in the question of whether the drug-placebo differences in responses on items would be maintained under cross validation. Hence, the sample of 100 subjects was divided into two equal parts for a test group and a cross validation group. A so-called significant scale for a particular drug consisted of those items which differentiated responses for a drug condition from a placebo condition at the 0.05 level or less for both the test group and cross validation group. LSD at a 1.5 mg/kg oral dose yielded the greatest number of significant changes. There were 67 items which met the cross validation criterion. LSD produced a huge assortment of changes from anxiety and difficulty in thinking to perceptual changes and hallucinations.
A second type of empirical scale is called a marginally significant scale and consisted of those remaining items which differentiated a placebo condition and drug condition using an N of 100. There were a total of 174 items in the combined significant and marginally significant LSD scales. Studies showed that the correlations between responses for the significant items were higher than that between the marginally significant items (Haertzen, 1966a). However, in spite of the fact that the differentiations of drugs and placebo were greater on individual items of the significant scale, the differentiations using total scores for significant and marginally significant scales were comparable (Hill, Haertzen, Wolbach, & Miner, 1963a). Therefore, if empirical scales are used, it is advisable to obtain just a score for the combined total. The significant scale items, however, may be considered under some circumstances as a short scale (Angrist, Rotrosen, & Gershon, 1974; Battig & Fischer 1965, 1966, 1968; Ehlers, 1966; Gold, Pottash, Sweeney, & Kleber, 1979, 1980a, 1980b).
The content of empirical scales overlaps with pattern or group variability drug scales which measure the more specific effects of various drugs. This is true in terms of items of euphoric content. Recently a naive subject rated ARCI items for euphoric content. When the overlap of items selected was determined for empirical scales, Benzedrine and Morphine scales were found to be high in euphoric content while the Chlorpromazine scale was very low (one item). Between these two extremes were scales for pyrahexyl, pentobarbital, LSD, and alcohol showing decreasing but measurable levels of euphoria. This variation in euphoric content on empirical scales is consistent with the findings of Hill, Haertzen, Wolbach, and Miner (1963a). Similarly when the overlap of items was determined for the more drug specific scales, euphoria items were found to be most concentrated in the Morphine-Benzedrine (MBG) scale and least in Chlorpromazine (CS) scale, which is consistent with the findings of Haertzen (1966b).
Empirical drug scales have the virtue of showing the variety of changes produced by a drug. The chief disadvantage is that empirical scales show general as well as more specific effects of a drug. Items which refer to feeling different or weird or to having a dry mouth or a lump in the throat are general effects. Empirical scales are less powerful for differentiating drugs than the pattern scales to be mentioned (Haertzen, 1966b).
Group Variability Scales and Drug Correction Scales
Some of the second set of scales called the group variability or drug correction scales are recommended (Haertzen, 1974a). Group variability refers to the pattern of the percentage of true responses found for opiate addicts for the various drugs mentioned (Haertzen, 1966b). Figure 1, upper panel, gives an example of a group variability pattern for the question 201 "I feel anxious and upset." It will be noted that the maximum true percentage was obtained for the highest dose of LSD of 1.5 mg/kg and that the second highest percent was obtained for the low dose of 1.0 g/kg of LSD. This pattern is referred to as the LG pattern, L is for LSD and G is for group variability. The recommended scale is called LSD. Items in the pattern include anxiety, restlessness, and perceptual changes (see Appendix, Scale 5 in List 116). The items contained in the LSD short form will be presented later.
In the pattern indicated by item 3, "I feel as if I would be more popular with people today" (see Figure 1, lower panel), it can be seen that the maximum percentages of true responses were found for Benzedrine and morphine. Relative to placebo, modest increases in true responses were found for other drugs except chlorpromazine. In this pattern called MBG, M is for morphine, B is for Benzedrine, and G is for group variability. The items which correlate highly with the MBG pattern suggest well being, euphoria, and optimal functioning.
The third common pattern is PCAG and refers to the common effects of pentobarbital, chlorpromazine, and alcohol. The marker for this pattern is item 66 "I feel drowsy" (see Figure 2, upper panel). The three drugs in the pattern name produced the highest effect. Morphine and pyrahexyl had a modest but significant effect on this item also. Items in this category suggest sedation, sluggishness, and low motivation.
A fourth pattern for Benzedrine (see Figure 2, lower panel) is marked by item 548 "Answering these questions was very easy today." Benzedrine produced a strong effect relative to other drugs such as LSD, pentobarbital, and alcohol. Feeling of intellectual efficiency or wakefulness are most specific to amphetamine (BG).
Several other patterns were found. The symptom of itching is relatively specific for morphine (MG; Haertzen, 1966b). A need to urinate and a high feeling similar to that produced by alcohol are specific to alcohol (AG). A feeling of excitement is common to LSD and amphetamine and to a lesser extent to morphine (Ex).
Scales were constructed to represent these various patterns. Simply stated these group variability marker patterns were correlated with the patterns for all other items and then factor analyzed by the diagonal (Fruchter, 1954) or profile method (Haertzen, 1963b). Items were selected which correlated highly with a pattern and showed some differentiation of drugs.
Space does not permit a full description of some of the remaining
(Haertzen, 1965a, 1965b, 1970; Haertzen & Meketon, 1968; Sharp,
& Haertzen, 1967) nor of the methods used to reduce the vast number
of scales. The number of scales were reduced from 200 to 39 by
function analyses (Haertzen, 1974a). Table 2 presents the names of the
38 recommended scales with the exception of the Carelessness scale.
drug scales covering the effects of narcotic antagonists and of opiate
and alcohol withdrawal and so forth along with factor analytic scales
as Impulsivity and Reactivity, and clinical scales such as Psychopathy
and Social Withdrawal.
Figure 1: Percentage of "true" responses on ARCI items 201 (upper panel) and 3 (lower panel). The treatment conditions are listed on the abscissa. The drugs and routes of administration were morphine (20 mg, im), pentobarbital (200 mg, im), chlorpromazine (Day 1, 25 mg, oral, qid; Day 2, 50 mg, oral, qid; Day 3, 75 mg, oral at 8 a.m. only), LSD-25 (1.0 mg/kg, oral), LSD-25 (1.5 mg/kg, oral), pyrahexyl (60 mg, oral), pyrahexyl (90 mg, oral), and alcohol (3.0 ml/kg of 30% alcohol). See Appendix, ARCI column for guide to items.
Figure 2: Percentage of "true" responses on ARCI items 66 (upper panel) and 548 (lower panel). The treatment conditions are listed on the abscissa. See Figure 1 caption for drugs and routes of administration. See Appendix, ARCI column for guide to items.
Some brief attention needs to be given to the clinical scales. The development of these scales required the use of clinical groups such as alcoholics (Haertzen & Fuller, 1967), criminals (Haertzen & Panton, 1967), other opiate addicts (Haertzen, Meketon, & Hooks, 1970), the mentally ill (Haertzen, Long, & Philip, 1964), and normal subjects contributed by Grupp (Haertzen, 1974a). Additional groups such as neurotics would have been desirable.
The clinical scales were developed through a modification (Haertzen, 1974a) of Eysenck’s criterion analysis (Eysenck, 1950). Criterion analysis consists of selecting items which differentiate criterion conditions in a manner similar to that defined by the correlation of responses to an individual difference factor or scale, holding criterion conditions constant. A good scale via criterion analysis is one in which the pattern of differentiation between a pair of criterion conditions agrees with the pattern of correlations between the response to an item and a whole scale. The Alcohol Withdrawal scale (AWS) is the best scale according to this definition (Haertzen, Hooks, & Hill, 1966).
One of the principal clinical scales is the Psychopathy scale (Haertzen, 1974a). The original form of the scale (Haertzen & Panton, 1967) and the revised form (Haertzen, 1974a) highly differentiated alcoholics, opiate addicts, and criminals from the mentally ill and normal subjects. In a fairly recent study of alcoholics, opiate addicts, and normal subjects, the Psychopathy scale differentiated the groups better than the MMPI scales including Pd or the newly developed scales for the Psychopathic State Inventory (Haertzen, Martin, Hewett, & Sandquist, 1978). Ottomanelli (1973, 1977, 1978; Ottomanelli & Halloran, 1982) has used the Psychopathy scale in a variety of treatment oriented studies.
The ARCI answer sheet is in true-false format. In scoring all scales
except Carelessness, one point is given for each response which agrees
with the scoring direction on a scale (Haertzen, 1974a). In some
items for a particular subject were excluded when the response under
was in accord with the scoring on a scale (Rosenberg, Wolbach, Miner,
Isbell, 1963). This procedure is not recommended for several reasons.
scale length differs for each individual. It denies the possibility
scores on a scale can go down as well as up. Others have used linear
or multiple choices (Battig & Fischer, 1965). The principal
of the multiple choice format is that standard T-scores cannot be
The principal advantage of multiple choice format is realized in item
because more powerful parametric tests can be used. A large N is
needed to achieve significance at the item level when chi square is
on true-false responses.
|No.||Abbr.||Full Name||Mean Raw Score
General Drug Predictor
General Drug Effect #3
Impulsive Factor Analytic
Pent, CPZ, Alc GV
LSD Drug Correction
Alcohol Withdrawal Specific
Weak Opiate Withdrawal
Most significant WOW
Severe Opiate Withdrawal
Alcohol Withdrawal greater
Sense of Humor
Note: GV means Group Variability; Pent means pentobarbital; Alc means Alcohol; CPZ means chlorpromazine. The mean for the total is based on the average raw scores from sums for the mentally ill (conditions 26, 27), normal (28), alcoholic (86, 87, 88), criminal (94), and opiate addicts (170, 173) (see Clinical Scales and Scoring). The standard deviation within groups is based on the within-conditions variance of the above conditions. These condition numbers are given in the manual (Haertzen, 1974).
In most studies raw scores are used. In statistical analyses some
such as a log transformation may make variation under placebo and drugs
more comparable. This is true for scales such as PCAG in which the
of scores is skewed with many low scores under the placebo condition.
empirical scales (Hill, Haertzen, Wolbach, & Miner, 1963a) and
variability scales (Haertzen, 1966b), a normalized T-score
is provided. This transformation tends to equalize variance under
drug conditions. The ARCI manual gives a T-score transformation that
a normal distribution (Haertzen, 1974a). This transformation is
for reporting averages. Table 2 presents the average raw scores and
conditions standard deviations for the five clinical groups used for
purposes. To make scores on one scale comparable to scores on another
the scores are converted to T-scores. Using this derived T-score, the
for the standardization sample is set at 50 and the standard deviation
is set at 10. The raw scores are converted to T-scores by the formula:
|Ti = 50 + (Xi - Meani) x||10
where X is the raw score of a subject on the ith scale. Mean
is the average raw score of standardization on sample on the ith
scale. SD is the standard deviation within for the ith scale.
example, the T-score of a raw score of 59 on Reactivity is
|T = 50 + (59 - 34.96) x||10
|= 50 + 10.86 = 61|
The manual also gives corrected T-scores which correct for variation on scales such as the Psychopathy scale. This transformation should be used only for making drug or clinical diagnoses. Averages based on corrected T-scores are not recommended because the effect of corrections is extremely large.
In reporting results, uncorrected averages for groups are recommended as this form permits comparisons of magnitude and change using variability estimates based on the standardization sample. Difference scores, though useful as an adjunct, obscure the position of a sample on a scale. Percentage or ratio scores based on a placebo reference point are not recommended as the scales are not ratio scales.
To obtain significance between drugs, statistics for groups rather than individuals are recommended. For example, in one study it was noted that monotonic increases in PCAG as a function of the dose of pentobarbital were found in all five subjects, but that significance was obtained in only two subjects (Griffiths, Bigelow, Liebson, & Kaliszak, 1980). It was added that a group analysis would have been more sensitive to such effects. Using the same type of analysis, no significant effects from secobarbital were found in each of six subjects (Stitzer, Griffiths, Bigelow, & Liebson, 1981). Using group statistics, dose effects have been found for secobarbital (Jasinski, 1973).
The main focus of use of the ARCI has been with short forms or whole single scales. Martin (1967) and Jasinski, Martin, and Hoeldtke (1971) used items from PCAG (scale 452), MBG (scale 453), and LSD (scale 454) in their short form (Haertzen, 1974a). These items are presented in the Appendix. In the typical Addiction Research Center study of acute drug effects, the short form is given, but it is supplemented by other ratings in the Single-Dose Questionnaire such as liking of a drug, adjective check lists, similarity with common drugs, and physiological measures such as pupillary diameter (Jasinski, 1977; Martin, Jasinski, Haertzen, Kay, Jones, Mansky, & Carpenter, 1973a). To determine the degree of equivalency of drugs, drugs are usually given in multiple doses to determine dose effects or by different routes to study the mode of administration. Also some standard drug in the same class as an experimental drug is included. Observations are taken at hourly intervals. The paper by Henningfield, Johnson, and Jasinski, in this volume illustrates the variety of scales used to measure these parameters. Thus, for example in a study by Martin et al., (1973a), subcutaneously administered morphine and methadone were about equally potent. However, subcutaneously administered methadone is about twice as strong as orally administered methadone. Methadone was regarded as having a longer duration of action than morphine. MBG or euphoric effects in these drugs were regarded as having a shorter latency to onset than pupil diameter.
Chronic and withdrawal effects of 100 mg of oral methadone were also evaluated. Thus, during the chronic phase tolerance occurs for euphoria (MBG), but sedative-like effects (PCAG) increase. Another laboratory using a lower maintenance dose has found that euphoria (MBG) manifests itself when a high dose of hydromorphone is administered (McCaul, Stitzer, Bigelow, & Liebson, 1981, 1982, 1983). During withdrawal from methadone, lethargy, weakness, and tiredness (PCAG) increase as do the classic opiate withdrawal symptoms (WOW, SOW). Euphoria (MBG) and other indicators of efficiency (Ef) decrease. As compared with withdrawal under morphine or heroin (Haertzen & Hooks, 1969), withdrawal on methadone is more prolonged.
Classification of drug effects is possible using the full ARCI (Haertzen, 1974a, 1974b). Space does not permit a full description of the diagnostic system of the ARCI. Briefly, the system involves converting raw scores on 38 scales into corrected T-scores. An index of similarity between these scores and standard profiles as for drugs or withdrawal conditions is calculated based on differences squared between the test profile and the standard drug profiles. Classification is based on the lowest sum of differences squared. Correctness of the classification is contingent on the dose level and the number of subjects used in the sample. Correct classifications are most possible with a high dose. Distinctions are probably blurred at lower doses because of a general drug effect. Effects of sampling have not been determined with all drugs, but an N of about 10 for morphine has been found adequate to achieve correct hits.
In this system of classification, the magnitude of differences squared are partially a function of the sample size. If the hypothesis of a study is to determine whether a drug is producing a new pattern, a much larger N than 10 is required.
Separate diagnostic systems are applicable for making clinical and drug diagnoses. The actual scales involved for clinical and drug diagnoses do not overlap to a great degree. It should be added here that a computer is necessary to convert raw scores into corrected T-scores and to do the differences-squared analysis. A program is available for the Apple II+.
Although this writer considers classifications of drugs based on the total ARCI to be most robust, many distinctions among drugs can be made with the short form which includes MBG, PCAG, and LSD scales if adequate doses are given (Fischman & Schuster, 1980, 1981; Jasinski, Martin, & Hoeldtke, 1971; Martin, et al., 1971; McClane & Martin, 1976). However, additional distinctions may be possible if scales for opiate withdrawal (SOW), efficiency (Ef) or amphetamine effects (BG or A), drunkenness (Dr), excitement (Ex), and morphine effects (MG) are included. The short form called ARCI List 116 covers these areas. This list has been used by Cole and his group (Cole, Orzack, Beake, Bird, & Bar-tal, 1982; Cole, Pope, LaBrie, & Pioggia, 1978; Orzack, Cole, Pioggia, Beake, Bird, Lobel, & Martin, 1982). The items are presented in the Appendix with the direction of scoring.
Table 3 gives an estimate of the patterns for different drugs. The elevations shown for Ef and SOW are estimates since these scales were not included in most studies. Generally a range of -- to ++ is adequate. However, the range of withdrawal symptoms is extremely large; modest levels of withdrawal may suggest dysphoria. Probably the average for a group should be at least a standard deviation from the control value before it is considered as withdrawal. The average T-scores of drugs are presented in the ARCI manual (Haertzen, 1974a).
Stimulants such as amphetamine and cocaine are placed on top of the table. Both of these drugs (Fischman & Schuster, 1980; Haertzen, 1966b, 1974a; Resnick, Kestenbaum, & Schwartz, 1977; Van Dyke, Jatlow, Ungerer, Barash, & Byck, 1978) as well as other drugs in the stimulant class such as d-methamphetamine, l-ephedrine, dl-phenmetrazine, methylphenidate (Martin et al., 1971) and diethylpropion (Jasinski, Nutt, Griffith, 1974) had an effect on Efficiency or equivalents of it (e.g., BG or the Martin A scale). The MBG effect of stimulants occurs regularly. Procaine did not have an MBG effect (Fischman, Schuster, & Rajfer, 1983) though it did produce a slight "high" effect. An LSD effect from amphetamine has not been consistently found (Henningfield & Griffiths, 1981). In the Martin et al. (1971) study of stimulants, it was only at the highest dose that LSD scores exceeded those of placebo. Cocaine did produce LSD effects at higher doses (Fischman & Schuster, 1980; Fischman, Schuster, Resnekov, Schick, Krasnegor, Fennell, & Freedman, 1976). In simulations of cocaine, LSD-like effects are evident (Haertzen, 1974a). Simulations require that subjects answer the questions as they have felt while under the influence of a drug. Simulations are done under a no-drug state.
The MBG effect is marked for opiates. These effects have been
reviewed (Jasinski, 1977). The PCAG effect of opiates is not great but
can be shown if the N is sufficiently large (Haertzen, 1966b). The
for partial opiate agonists range from being quite similar to opiates
drifting toward narcotic antagonists at higher doses. A shift towards
antagonists is indicated by a decrease in Efficiency and an increase in
PCAG and LSD effects (Jasinski & Mansky, 1972; Jasinski, Martin,
Hoeldtke, 1970). This shift was found for pentazocine. The pattern of
shown for opiates is for the immediate effects. From 12 to 72 hours
the administration of morphine, methadone, or buprenorphine, the PCAG
is evident (Jasinski, Pevnick, & Griffith, 1978). The simulated
of opiates are similar to the acute effects. Surprisingly, subjects
ascribe euphoria to the chronic phase (Haertzen, 1974a). Tolerance to
occurs during chronic administration (Haertzen & Hooks, 1969;
et al., 1973a). Interestingly, acupuncture increases euphoria or MBG
& Heyder, 1981; Toyama, Popell, Evans, & Heyder, 1980).
Opiates—heroin, morphine, methadone
Partial opiate agonists—pentazocine, nalbuphine
Narcotic antagonists—nalorphine, cyclazocine
Inactive—zomepirac, loperamide, bupropion
Opiate withdrawal—morphine, heroin, methadone
Simulated barbiturate withdrawal
Simulated alcohol withdrawal
Simulated opiate withdrawal
Simulated pep pill come down
Simulated cocaine come down
Ef = Efficiency or BG (Benzedrine group variability)
MBG = Morphine-Benzedrine group
PCAG = Pentobarbital, chlorpromazine, and alcohol group
LSD = LSD group or drug correction
SOW = Strong opiate withdrawal
The characteristics of effects of marijuana-like compounds is less certain. Subjective effects have been found in various studies (Hollister & Gillespie, 1973, 1975; Hollister, Overall, & Gerber, 1975; Kiplinger, Manno, Rodda, & Forney, 1971; Manno, 1970). Interpretation is hampered by the fact that the marijuana scales were not supplemented with other scales such as MBG. Pyrahexyl, a weak marijuana-like compound, produced a PCAG effect (Haertzen, 1966b). LSD-like effects have been found for THC (Hollister & Gillespie, 1975; Isbell, Gorodetsky, Jasinski, Clausen, Spulak, & Korte, 1967; Isbell & Jasinski, 1969; Jasinski, Haertzen, & Isbell, 1971). Valid assays of LSD and delta-9-THC were possible using Abramson’s psychotomimetic scale and the ARCI General Drug Effect scale but not on the ARCI Marijuana or LSD scales. On the last two scales, the drugs could not be distinguished. THC and LSD were different on pupil diameter and knee jerk (Isbell & Jasinski, 1969). In a recent study (Boren, personal communication), THC, nabilone, and marijuana cigarettes produced euphoria; PCAG effects were found for marijuana cigarettes and nabilone but not THC. LSD effects were increased for THC and nabilone. Using simulations in opiate addicts, the profile of marijuana effects was indicative of euphoria (MBG), Efficiency, and Excitement but not PCAG or LSD (Haertzen, 1974a). In simulations of marijuana effects, normals who have not used marijuana overdramatized symptoms (Fabian & Fishkin, 1982).
Barbiturates, minor tranquilizers, and alcohol have some effects in common by being high on PCAG, intermediate on MBG, and low on Efficiency (Cole, Orzack, Beake, Bird, & Bar-tal, 1982; Fraser & Jasinski, 1977; Haertzen, 1966b; Jasinski, 1973; McClane & Martin, 1976). A small group of alcoholics showed an MBG effect from alcohol, but they failed to show a PCAG effect with alcohol and pentobarbital up to a dose of 400 mg oral (Henningfield, Chait, & Griffiths, 1984); they showed a PCAG effect at 600 mg of pentobarbital. Alcohol effects have been found in normal, alcoholic and heroin addicts (Battig & Fischer, 1965, 1966, 1968; Henningfield et al., 1983; Hill et al., 1963a). Buspiron (dopaminergic anti-anxiety drug) had sedative but no euphoric effects (Cole, Orzack, Beake, Bird, & Bar-tal, 1982).
Major tranquilizers differ from barbiturates by not producing euphoria (Haertzen, 1966b). In normal subjects 75 mg of oral chlorpromazine had little effect (Davis, Evans, & Gillis, 1968). In another study of normals, a PCAG effect was shown with 100 mg (Stitzer, Griffiths, Bigelow, & Liebson, 1981). It is of some interest to note that the effects of lithium were most similar to chlorpromazine. Lithium also reduced euphoria feelings on MBG (Jasinski, Nutt, Haertzen, Griffith, & Bunney, 1977).
Narcotic agonist-antagonists produced a strong effect on the LSD and the Strong Opiate Withdrawal scales (Haertzen, 1974a, 1974b; Jasinski & Mansky, 1972; Jasinski, Martin, & Haertzen, 1967). It should be remembered here that withdrawal is characterized by symptoms of anxiety, tension, cognitive difficulty, and tiredness as well as by symptoms such as cramps that are more specific to withdrawal (Haertzen & Hooks, 1969; Haertzen, Meketon, & Hooks, 1970; Himmelsbach, 1941). Opiate withdrawal and narcotic antagonists are quite distinguishable (Haertzen, 1974a). Narcotic antagonists such as naloxone or naltrexone which are devoid of agonist activity do not have effects on these scales (Martin, Jasinski, & Mansky, 1973b). However, in one study naltrexone produced a slight MBG effect (Gritz, Schiffman, Jarvik, Schlesinger, & Charuvastra, 1976). This result could be considered tentative because the subjects disclaimed a drug effect.
LSD is different from narcotic antagonists in showing some euphoria and excitement. Euphoria is more evident at lower doses. Psychotomimetic effects may occur at lower doses (Haertzen, 1966b; Isbell & Jasinski, 1969; Rosenberg, Isbell, & Miner, 1963; Rosenberg, Wolbach, Miner, & Isbell, 1963). LSD produced a very large range of changes (Martin & Sloan, 1977). Mescaline, psilocybin, psilocin (Martin & Sloan, 1977), and DOM (Angrist, Retrosen, & Gershon, 1974) produced effects like LSD.
Scopolamine has effects most similar to narcotic antagonists (Haertzen, 1974a). Scopolamine as well as the narcotic antagonists are different from opiate withdrawal chiefly on the differences in the magnitude of withdrawal symptoms. Scopolamine produced some symptomatic changes, such as blurred vision, which are much greater than other drugs. The larger print on the inventory was helpful in this respect, but subjects at the highest dose frequently required the examiner to read and to record responses.
Little has been done with antidepressants. The effects of bupropion were similar to those of placebo and were different from amphetamine (Miller & Griffith, 1983) on MBG, BG, LSD, and PCAG. Miller and Griffith cite studies with rats and monkeys which indicate bupropion has some similarity with stimulants.
Some other drugs which are inactive according to ARCI scales are zomepirac (Johnson & Jasinski, 1982; Johnson, Jasinski, & Kocher, 1983) and loperamide (Jaffe, Kanzler, & Green, 1981). Placebo effects have been found on the first trial relative to later trials (Haertzen, 1969a). MBG decreased under placebo over weeks (Gritz, Schiffman, Jarvik, Schlesinger, & Charuvastra, 1976).
Opiate and alcohol withdrawal reduced efficiency and increased PCAG and opiate and alcohol withdrawal symptoms by a great margin (Haertzen & Fuller, 1967; Haertzen & Hooks, 1969; Martin et al., 1973a). It will be noted that opiate withdrawal symptoms for simulated withdrawal for alcohol, barbiturates, and opiates were very strong (Haertzen, 1974a), especially when the simulation occurs after a no-drug condition (Haertzen & Hooks, 1971). The pattern shown in Table 3 does not fully indicate the distinctiveness of withdrawal types. The profiles of actual and simulated alcohol-withdrawal deviate so much from the standards that alcohol withdrawal becomes a needed additional standard. In studies of alcohol or barbiturate withdrawal, the alcohol withdrawal scale should also be included.
The similarity of classifications based on subjective reports in humans and animals has been noted in several ways. Thus, internal stimuli which account for drug discrimination in animal studies has been likened to the occurrence of subjective experiences (Colpaert, 1978, this volume; Shannon & Holtzman, 1976). Overton and Batta (1979) suggest that drugs may be more sharply distinguished in animals by the discrimination model than in man by subjective reports with the ARCI. More human experimentation needs to be done to see if humans can sharpen their discriminations. Using the self-administration model, Griffiths and Balster (1979) found concordance between conclusions derived from subjective report and self-administration. The occurrence of euphoria probably accounts for some of the concordance as animals are more likely to self-administer those drugs which produce an MBG effect in man (Schuster, Fischman, & Johanson, 1981).
MBG effects, as for opiates, are in substantial agreement with other indicators of reinforcement such as liking when drugs are administered acutely. However, during chronic administration of opiates, MBG effects are first attenuated and then disappear (Haertzen & Hooks, 1969; Martin et al., 1973a; Schuster et al., 1981). Opiate addicts, nevertheless, attest that they would like to take the drug every day (Martin & Fraser, 1961). Similarly on an Appetite Rating scale in which subjects are asked to rate their current appetite (from absolute necessity to refusal of the drug if it were offered) or projected appetite for the experimental drug (morphine or heroin), appetite for the experimental drug increased during the course of the chronic phase (Haertzen & Hooks, 1969). During the phase of increasing doses of methadone, opiate addicts rode an exercise bicycle to supplement their methadone dose with Dilaudid. This behavior was extinguished in some subjects when they obtained 100 mg of methadone orally (Martin et al., 1973a). During opiate withdrawal opiate addicts significantly agreed to ARCI Q 587 "A shot of morphine or heroin would help to settle my system" (Haertzen, Meketon, & Hooks, 1970). At this phase MBG was below the normal no-drug state. During withdrawal of morphine or heroin, the appetite for these experimental drugs decreased (Haertzen & Hooks, 1969). This decrease is interpreted as indicating that they disparaged the amount or quality of the drug given during withdrawal.
Depending on the drug, linear acute-dose effects and time-related effects have been found with MBG, with liking a drug, and with getting high from it. On the other hand appetite for "more of a drug right now" is curvilinear with respect to dose. That is, subjects recognized a satiation effect even with opiates. Projected appetite (how much appetite for a drug is likely to occur on other days) is dose related. It is possibly more immune to a time effect; subjects may retain an idea of an appetite for a desired drug even after the effect has worn off. Feeling that a drug has utility (to settle one’s system) is correlated with the severity of opiate withdrawal or is dependent on the level of the disturbance (withdrawal).
Liking of the acute effects of a drug is more indicative of a general drug effect than might be expected considering other criteria. That is, liking of drug effects in acute experiments occurs even for drugs such as barbiturates (McClane & Martin, 1976) which have no great appeal for opiate addicts in a no-drug condition (Haertzen & Hooks, 1969; Haertzen, Hooks, & Ross, 1981). There is some comparative basis for liking pentobarbital, since subjects liked both diazepam and pentobarbital, but they chose pentobarbital over diazepam in a choice situation (Griffiths, Bigelow, & Liebson, 1981; Griffiths, Bigelow, Liebson, & Kaliszak, 1980). Some drugs are liked to some degree under acute administration but not under chronic administration. This is true for orally administered propoxyphene, codeine, and morphine (Fraser, Kay, Gorodetzky, Yeh, & Dewey, 1978). It was speculated that the change in liking was due to the accumulation of nor-metabolites. Opiate addicts liked cyclazocine or nalorphine when moderate doses were given (Martin, Fraser, Gorodetzky, & Rosenberg, 1965), but in chronic studies subjects would not tolerate nalorphine at a dose above 130 mg (Isbell, 1956) and did not show drug-seeking behavior upon withdrawal of cyclazocine (Martin et al., 1965).
Liking for varied drugs after acute administration may suggest that the frame of reference or baseline for the rating of liking is indefinite or floats depending on the drug. It would be interesting to alter the baseline for rating of liking a drug by having subjects rate the experimental drug against standards such as heroin, marijuana, or alcohol. Such ratings have not been tried. If a reference were made to heroin, it is postulated that the degree of liking for barbiturates, minor tranquilizers, and narcotic antagonists would be significantly downgraded. Also a rating of drug liking obtained a day after the drug administration may provide an estimate which reflects perceived advantages or disadvantages of a drug. Changes in liking ratings during chronic administration, as for opiates, may be due to other factors such as nor-metabolites (Fraser et al., 1978).
Ratings of liking, high, or MBG reveal the transitory nature of drug effects. In contrast measures of addiction which refer to past experiences with a drug or which imply a diagnosis of addiction appear to be more resistant to drug effects (Haertzen, 1978; Haertzen & Hooks, 1969). The strength of the verbal habit for a drug, marked by a tendency to associate many drug relevant words or experiences with a drug, is regarded as more malleable in those subjects who have not had extensive experience with it. Opiate addicts given chronic methadone developed a verbal habit for it. Furthermore, the habit was maintained after withdrawal was completed (Haertzen, Hooks, & Pross, 1974).
As indicated, a considerable portion of work has been devoted to showing drug similarity to characterize drug effects. Scales have been used for a variety of other experimental purposes. Thus, the Weak Opiate Withdrawal scale has been used to follow the treatment efficacy of agents to reduce opiate withdrawal. For example, following clonidine administration, methadone-abstinence symptoms were reduced within 120 minutes (Gold, Pottash, Sweeney, & Pottash, 1980a; Kleber, Gold, & Riordan, 1980). In another study clonidine suppressed autonomic signs more than morphine (Jasinski, Haertzen, Henningfield, Johnson, Makhzoumi, & Miyasato, 1982). However, morphine was more effective in reducing the subjective discomfort of withdrawal. In delaying the onset of withdrawal symptoms after placebo substitution, acetylmethadol (LAAM) had a longer duration of action than methadone since withdrawal symptoms on the ARCI withdrawal scale and a symptom check list arose at 36 hours for methadone but not for acetylmethadol (Jaffe, Schuster, Smith, & Blachley, 1970).
Buprenorphine has also been proposed as an opiate detoxification agent and as a maintenance drug (Jasinski, 1982). It has virtue as a maintenance drug because it is long acting and produces very little physical dependence (Jasinski, Pevnick, & Griffith, 1978). As a detoxification agent it reduces withdrawal symptoms of morphine or methadone. However, withdrawal symptoms ascribed to methadone arose again when buprenorphine was discontinued at a time when methadone withdrawal symptoms would be expected to still be present (Jasinski, Henningfield, Hickey, & Johnson, 1983). Opiate withdrawal scales are predictive of the probability of staying in treatment in opiate addicts volunteering for treatment. That is, the stronger the opiate withdrawal symptoms, the shorter the stay (Meketon, 1967).
In an experiment designed to see if opiate addicts would reduce their methadone intake via self-administration, the amount of self-administered methadone varied with a pretreatment dose of methadone. MBG or euphoria scores were greater in those given a 30 mg pretreatment dose of methadone than for those given placebo. There were no differences on the ARCI Weak Opiate Withdrawal scale, but there were differences on the symptom scale devised by the Behavioral Pharmacology Research Unit (BPRU) staff (McLeod, Bigelow, & Liebson, 1982). In another experiment by the same group, those subjects informed of a dose-reduction schedule experienced fewer symptoms with a dose reduction on a BPRU symptom scale than those who were blind to the dose-reduction schedule (Stitzer, Bigelow, & Liebson, 1982).
Evidence for conditioned opiate-abstinence symptoms was found using an ARCI opiate withdrawal scale. Opiate addicts who were shown opiate related stimuli such as the word heroin, an injection of drugs, or a stoned addict subsequently showed greater opiate withdrawal symptoms. On the other hand abstinence symptoms did not increase following exposure to neutral stimuli such as sugar (Teasdale, 1973). Further replication is needed because in an analogous procedure no withdrawal effects were found on the Weak Opiate Withdrawal scale but skin temperature was reduced (Ternes, O’Brien, Grabowski, Wellerstein, & Hayes, 1979) and heart rate increased (Sideroff & Jarvik, 1980). Opiate addicts gave an immediate emotional response to drug-related argot words as measured by pupil diameter (Bernick, Altman, & Mintz, 1972).
Changes in mood or feelings as measured by the ARCI are induced by stress factors. College students who were currently under some stress-producing situation obtained greater Reactivity scores (Haertzen, 1974a). College students decreased in MBG (euphoria) and increased in tiredness (PCAG) following the viewing of "Christmas in Appalachia," which is a depressing film showing poverty in that area (Cowan, Kay, Neidert, Ross, & Belmore, 1979, 1980). Scores from other scales from the Profile of Mood States (POMS) such as Depression-Rejection and scales devised by Cowan et al. (1980) for Joylessness increased also. Sleep deprivation increased scores on PCAG and LSD and reduced scores on MBG and BG. Cocaine nullified the 24 hour sleep deprivation effect on MBG and BG (Fischman & Schuster, 1980). Motivational factors affect scores in drug experiments (Sice, Levin, Levine, & Haertzen, 1975).
Emphasis in this paper has been on drug oriented scales and the significance of elevations on these scales for classifying drugs, characterizing drug effects, and rating the abuse potential of drugs. Many studies have been devoted to relating personality and psychopathology to drug abuse (see review by Haertzen, 1978). Psychopathy has been found to be one of the more important nonspecific correlates of drug abuse (Hill, Haertzen, & Glaser, 1960). The degree of psychopathy is correlated with follow-up criteria of drug abuse such as unemployment and arrest records (Ottomanelli, 1977). However, primary measures of psychopathy have been immune to the acute, chronic, or withdrawal effects of drugs such as opiates (Haertzen & Hooks, 1973; Martin, Jasinski, Haertzen, Kay, Jones, Mansky, & Carpenter, 1973a). This may be due to restricted opportunity on closed experimental wards or to the characteristics of psychopathy scales. That is, most psychopathy items, as for example in the MMPI, refer to past behavior. It is hoped that some psychopathy scales from the Psychopathic State Inventory which measures psychopathy as a state will be more susceptible to the measurement of psychopathic episodes (Haertzen, Martin, Ross, & Neidert, 1980; Kay, 1980; Martin, Hewett, Baker, & Haertzen, 1977). Unpublished studies by Monroe, Mathews, and Haertzen of drug abusers in a therapeutic community revealed that several indicators of psychopathy such as hypophoria (depression) reduced with progress in treatment. Within the context of experimental drug studies, only modest attempts have been made to correlate personality or psychopathology with drug effects or to drug-taking behavior. Kolb (1925) thought that psychopaths were more likely to obtain euphoria from opiates. Recent studies have shown the relevance of some characteristics believed to be indicative of psychopathic states in predicting drug-taking behavior. In an experimental drug study, subjects who chose amphetamine over placebo were more egocentric and had a greater desire to become high (de Wit, Johanson, & Uhlenhuth, 1983). Individual differences other than psychopathy have predicted drug-taking behavior. Anxious and depressed subjects were more likely to elect to receive amphetamine in a choice situation (Uhlenhuth, Johanson, Kilgore, & Kobasa, 1981).
These relatively recent studies to develop a more precise understanding of the relationship of psychopathology to drug choice, drug effects, and treatment outcomes represent an important direction for future use of the ARCI or other tests. It is hoped that such work will sharpen the prediction of drug effects and/or drug-taking behavior and contribute to the development of more effective treatment interventions.
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Items From Addiction Research Center Inventory
Short Form (List 116)
|Scale 1 OW: Opiate Withdrawal [ARCI Scale #459]|
|I have sneezing spells
I feel cold all over
My face feels hot
I feel as if I have the flu
Something is making me break out in goose pimples
Some parts of my body ache
My eyes are watering more than usual
I am unusually restless
I have been getting cramps
My nose has been running
I have lost weight within the last week
I have spells of shaking and trembling
I feel weak
I have not been keeping up with my personal appearance
My mouth is watering more than usual
I feel physically ill
I feel like yawning
I feel so miserable that other people must be aware of it
I feel as if I had taken a laxative
I have been feeling some pain in my muscles or joints
My skin feels damp and clammy
|491||27||I am sure I will sleep well tonight|
|Scale 2 MBG: Morphine-Benzedrine Group [ARCI #463]|
|I would be happy all the time if I felt as I
I am in the mood to talk about the feeling I have
I am full of energy
I would be happy all the time if I felt as I do now
Things around me seem more pleasing than usual
I feel less discouraged than usual
I fear that I will lose the contentment that I have now
I feel as if something pleasant just happened to me
Today I say things in the easiest possible way
I feel so good that I know other people can tell it
I feel more clear-headed than dreamy
I can completely appreciate what others are saying when I am in this mood
I feel as if I would be more popular with people today
I feel a very pleasant emptiness
I feel in complete harmony with the world and those about me
I have a pleasant feeling in my stomach
I feel high (Note: This scale [ARCI #463] is exactly like ARCIScale #453 with the exception that #463 contains SQ9 item #614.)
*"I feel high" is probably a good euphoria item, but it also should be a more general drug effect item.
|Scale 3 MG: Morphine Group [ARCI #460]|
|My nose itches
I have been scratching myself
I have had some pins and needles sensations
I have a sentimental feeling
|Scale 4 Ex: Excitement [ARCI #461]|
|I feel like joking with someone
I notice that my heart is beating faster
Some parts of my body are tingling
I feel more excited than sluggish
A thrill has gone through me one or more times since I
|52||I feel more dreamy than lively|
|Scale 5 LSD: LSD Drug Correction [ARCI #454]|
|My hands feel clumsy
I have a weird feeling
I have an unusual weakness of my muscles
Some parts of my body are tingling
I feel anxious and upset
I have a disturbance in my stomach
A thrill has gone through me one or more times since I started the test
I notice my hand shakes when I try to write
I feel an increasing awareness of my bodily sensations
It seems I’m spending longer than I should on each of these questions
|My movements are free, relaxed, and
I would be happy all the time if I felt as I do now
I feel very patient
I feel drowsy
|Scale 6 PCAG: Pentobarbital, Chlorpromazine, Alcohol Group [ARCI #452]|
|I feel dizzy
I feel like avoiding people, although I usually do not feel this way
My speech is slurred
I have a feeling of just dragging along rather than coasting
People might say that I am a little dull today
My head feels heavy
I am not as active as usual
It seems harder than usual to move around
I feel drowsy
I am moody
I feel sluggish
|I am full of energy
A thrill has gone through me one or more times since I started the test
I feel more excited than dreamy
I feel more clear-headed than dreamy
|Scale 7 Dr: Drunk [ARCI #462]|
|I can hardly control my speech
When I stand up, I feel unsteady
I feel dizzy
My head feels light
I would have some difficulty threading a needle
It is somewhat harder to walk in a straight line
I feel drunk
|I would have no trouble walking a chalk
I believe I could stay awake all night driving a car
I seem to be very much aware of the little things that people do
My sense of balance is very good
I feel more clear-headed than dreamy
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