Influence of the Flushing Response in the Relationship between Alcohol Consumption and Cardiovascular Disease Risk

Evaluating the Measurement Invariance of MMPI-2-RF Restructured Clinical Scale 4 (Antisocial Behavior) between American and Korean Clinical Samples: Exploring Cultural and Translation Issues Affecting Item Responding

Establishing the cross-cultural measurement invariance of psychometric scales is considered an essential step before scale means are compared across cultures. Although the MMPI instruments have been extensively researched, few studies have examined the measurement equivalence of MMPI scales in cross-cultural research. This study examined the measurement invariance of MMPI-2-RF Restructured Clinical Scale 4 (RC4; Antisocial Behavior) using multi-group confirmatory factor analysis with American and Korean clinical samples by (a) comparing a rationally-derived four-factor model (School Problems, Substance Abuse, Family Problems, and Violation of Social Norms) with a one-factor model, and (b) examining the measurement invariance of the RC4 four-factor model. After adjusting for age and gender, partial scalar invariance was achieved, and six non-invariant items were identified, most of which centered around substance abuse. Results support the generalizability of the four factors across cultures; however, special attention is needed when using substance abuse items with Korean clinical populations. Plausible sources of item non-invariance were explored in the context of translation challenges and observed patterns of relationship with external measures.

A comparative evaluation of Korean MMPI-A and MMPI-A-RF Substance Abuse Scales

OBJECTIVE

The purpose of the present study was to compare psychometric properties of the Substance Abuse (SUB) Scale on the Korean Minnesota Multiphasic Personality Inventory-Adolescent-Restructured Form (MMPI-A-RF) with those on the Korean MMPI-A (the Alcohol/Drug Problem Acknowledgment Scale [ACK]), the Alcohol/Drug Problem Proneness Scale [PRO], and the MacAndrew Alcoholism Scale-Revised Scale [MAC-R]).

METHOD

Participants consisted of 237 Korean adolescent psychiatric patients whose scores on these measures were compared in terms of internal consistency and predictive validity.

RESULTS

Scores on SUB exhibited superior internal consistency to that of the MMPI-A substance abuse scales. Further, scores on SUB predicted substance abuse more accurately than did the optimal combination of scores on the MMPI-A substance abuse scales.

CONCLUSION

Results provide strong support for the use of the Korean MMPI-A-RF SUB scale when assessing substance abuse in Korean youth.

Korean Alcohol Guidelines for Moderate Drinking Based on Facial Flushing

This study investigated advantages and potential risks associated with drinking alcohol in Koreans based on the alcohol flush reaction. Our investigation reviewed published studies and examined moderate-drinking levels for Koreans based on modified National Institute on Alcohol Abuse and Alcoholism guidelines. Fourteen articles out of a total 198 publications were searched using PubMed, EMBASE, KoreaMed, and RISS (Research Information Sharing Service) databases and selected for review. Individuals without alcohol flush reaction (non-flushers) exhibited lower risks associated with insulin resistance, metabolic syndrome, and hyperhomocysteinemia and their 10-year cardiovascular disease risk when alcohol consumption was ≤8 drinks/wk. Conversely, risks associated with insulin resistance, metabolic syndrome, high blood pressure, prediabetes or type-2 diabetes, and high intraocular pressure and increases in carbohydrate-deficient transferrin, gamma glutamyl transferase, and blood glucose levels were present when >8 drinks were consumed. For individuals with flushing reaction (flushers), advantages were reported in relation to risks of hyperhomocysteinemia when alcohol consumption was ≤4 drinks/wk, whereas consumption of >4 drinks/wk increased the risk of insulin resistance, metabolic syndrome, high blood pressure, pre-diabetes or type-2 diabetes, high-risk colorectal adenoma, and high intraocular pressure and increased carbohydrate-deficient transferrin, gamma glutamyl transferase, and blood glucose levels. The moderate drinking level for Koreans is ≤8 drinks/wk for men aged ≤65 years and ≤4 drinks/wk for men aged over 65. For women, these limits should be half of those for men. Furthermore, individuals with flushing reaction should maintain an alcohol consumption level half of that for non-flushers.