Use of the MMPI and MCMI in predicting outcome of lumbar laminectomy

This study compared the abilities of the MMPI and Millon Clinical Multiaxial Inventory (MCMI), using discriminant analyses, to predict outcome after lumbar laminectomy for chronic back pain. Sixty-nine males and 60 females with lumbar discogenic disease completed MMPIs and MCMIs before surgery and were classified as either having good or fair/poor surgical outcomes based on self-reported pain relief, return to work, restriction of activities, and medication use. Results showed both the MMPI and MCMI to have moderate ability to predict surgery outcome. A slightly higher classification hit rate was obtained with both instruments when age, sex, employment status, and presence of compensation/litigation issues also were entered into the prediction equation. Results indicate the need for caution in using either instrument to make predictions of surgery outcome in individual cases.     

The MMPI as a predictor of response to conservative treatment for low back pain.

Studies that used the MMPI to predict the response of chronic low back pain patients to standard medical treatment have not produced definitive results. Patients seen in a university hospital orthopedic back pain clinic were given the MMPI before treatment, and 6 to 12 months later 76 patients completed follow-up forms that indicated their level of intensity during the previous week and their ratings of the success of treatment in relieving their pain as well as in enabling them to return to normal activities. Predictions of poor response were made in terms of either single MMPI scales or code types. Patients with poor outcome on two of the three criteria (level of pain intensity and ability to return to normal activities) had significantly higher scores on the Hs scale. The predicted high risk code types very accurately identified patients with poor response on the same two criteria; however, the code-type procedure overpredicted poor response in the good outcome group.     

MMPI correlates of clinical women who report early sexual abuse

It was predicted from Freud's seduction theory that women who experienced sexual assault early in life would be identifiable by the MMPI. Twenty-six of 51 women treated at a psychotherapy clinic during a 2-year period reported experiencing sexual abuse as a child (RA); 25 made no such claim (NRA). Age, income level, years of formal education, marital status, and k-corrected scores of the MMPI were submitted to a stepwise multivariate discriminant analysis. It was found that the HY, MF, HS, and PD scales constituted a linear function that correctly classified 72.55% of the subjects (Wilkes Lambda = .670785, df 4, p = .0009). These scales correctly identified 73.1% of the RA and 72.0% of the NRA clients.     

The relationship between surgical outcome and MMPI profiles in chronic pain patients

Administered the MMPI as part of a comprehensive pain evaluation to 44 patients who were receiving surgery for low back pain. Surgical outcomes then were determined after 6 to 18 months, and the patients were grouped as surgery success (22) or surgery failures (22). MMPI profiles were examined for each group, and while there was a significant difference on the Hs scale, no other mean scores were discriminative. In contrast, when patients were divided into subgroups based upon MMPI profile configurations, a strong relationship existed between subgroup MMPI profile and surgery outcome. Thus, while these data argue against attempting to use group MMPI profiles to predict surgical outcome in patients who are suffering from pain, subgroup profiles do bear a strong relationship with surgery outcome and appear worthy of further investigation.     

A validity index for the MMPI-2.

There have been numerous methods developed for the detection of valid profiles on the Minnesota Multiphasic Personality Inventory (MMPI)-2. The current study examined a method of combining seven different validity scales of the MMPI-2 into a common weighted method in assessing malingering in chronic pain patients. The weighted method was able to correctly classify 100% of nonlitigants, using a cutoff score of > or =5. The findings of this study suggest that chronic pain patients in litigation produce a different profile on the MMPI-2 validity scales than do nonlitigants. In a group of knowledgeable actors (malingerers), 86% was correctly classified. The overall finding showed 100% specificity and 86% sensitivity. The findings support the need for multiple validity scales to be examined in determining a valid profile. The weighted validity scales method was robust enough to account for "emotional distress" and still identify invalid MMPI-2 performance.     

Psychological factors in the long-term prognosis of chronic low back pain patients.

This study appraised the significance of psychological factors in the long-term prognosis of patients with chronic low back pain (LBP). The MMPI ratings of 80 long-term sick-listed LBP patients were set in relation to their disability pension status 6 to 12 years later. The number of elevated scales, in combination with the level of certain scales (HS and HY), proved to be a better predictor than profile patterns, advocated in some studies. Moreover, in a review of prognostic studies, the HS and HY scales appeared most frequently as significant predictors. That result also was confirmed in this study of long-term prediction of overall functional level. The results are discussed in relation to the concepts of pain-fear and sick role.     

Separation of brain-damaged from psychiatric patients with the combined use of an ability and a personality test: a validation study with a Puerto Rican population

The purpose of this study was to validate the results obtained by Watson, Gasser, Schaefer, Buranen, and Wold (1981) by utilizing the Smith Symbol-Digit Modalities Test (Form W) and the MMPI (Psychiatric-Organic) scale in combination. Forty recently admitted/readmitted male patients were given both the SDMT and the MMPI (P-O) at a point in their hospitalization in a private inpatient psychiatric hospital in Puerto Rico. The combined use of the Smith and the P-O scale, with the criteria originally developed by Watson et al. (1981), provided a modest level of discrimination by correctly identifying 80% of the brain-damaged sample (organic group) and 55% of the functional sample (psychiatric group) subjects. This combination of tests yielded an overall mean hit rate of 67.5%. These results moderately support the findings obtained by Watson et al. (1981).     

The assessment of denial and physical complaints: the validity of the Hy scale and associated MMPI signs

Little and Fisher (1958) have demonstrated that the MMPI Hysteria (Hy) scale consists primarily of items that address the denial of psychological problems (the DN scale) and items that involve the admission of physical problems (the AD scale). The traditional interpretation of an elevated Hy score implies that both DN and AD subscales are elevated significantly. Using samples of psychiatric (N = 1,246), medical (N = 330), and chronic pain patients (N = 126), the effectiveness of the HY scale and of various combinations of MMPI scales as predictors of the simultaneous occurrence of these two characteristics was evaluated. The results suggest that when the 13 standard MMPI scales were used, simultaneous elevations on scales K, HS, and HY proved to be the best indicator of the denial of psychological factors associated with a physiological disorder. It was found unwarranted to suggest the presence of hysteroid features on the basis of an elevated HY score unless scales K and HS also were elevated. The value of the HY scale as a measure of psychological denial associated with physical complaints must be considered questionable.     

Multivariate discriminant function analysis of neurologic,pain, and psychiatric patients with the MMPI

The ability of the MMPI to classify five well-defined patient groups was investigated (N = 394; control, neurologic, psychiatric, chronic pain, and random). Clinical inspection and discriminant function analyses of basic clinical and research scales could not classify groups correctly, but discriminant function analyses of 37 variables loaded with CNS items (Cripe Neurologic Symptom items) correctly classified the groups with 78% overall accuracy (70% of neurologic, 62% of psychiatric, 81% of pain, 84% of controls, and 100% random). Results indicate that differential diagnosis is not possible with clinical inspection of scales, but complex statistical analysis of the MMPI is potentially useful in diagnosis and decision making. A method for applying the discriminant function analysis to individual cases is provided.     

The use of the Minnesota Multiphasic Personality Inventory with low back pain patients.

The MMPI was administered to 36 male low back pain patients at the Seattle Veterans Administration Hospital. The patients were divided into three groups of 12 each. The organic group contained patients who had an organic basis for their pain. The functional group contained patients who had no organic basis for their pain. The mixed group contained patients who had some organic basis for their pain, but one that was thought to be insufficient to account for the pain they were reporting. The mixed and functional groups differed significantly from the organic group on the Hs, Hy, Pt, Sc, Hy-O, D-O, and DOR scales. The mixed and functional groups differ significantly from each other only on the Hy-O scale. The special low back pain scales of Lb and DOR were found to have little utility when used separately. When used in conjunction, however, the scales discriminated correctly 75% of the time.     

MMPI与MMPI-2对精神分裂症患者的一致性测试

目的:考察精神分裂症患者的MMPI与MMPI-2结果的一致性程度,以便为MMPI-2的使用者参考MMPI临床与研究经验提供更多的实证依据.方法:采用MMPI与MMPI-2复合问卷,对97名精神分裂症患者在临床量表上的测试结果进行统计分析.结果:单一量表分数的相关分析以及量表编码类型的符合率分析结果提示,尽管MMPI-2对临床量表项目内容作了一定的修改,但MMPI-2与MMPI对应临床量表分数仍具有很高的相关;另外,MMPI-2与MMPI间编码类型的总体符合率达到93.8%,其它多点编码符合率也都达到了美国人所报告的同类符合率水平,如两点编码符合率为62.9%,若给以限制性定义,则该符合率可达80.8%.结论:中文版MMPI-2的临床量表与MMPI具有较高的延续性,在精神分裂症患者群体的临床使用上具有一定的类推性.     

Associations Between Minnesota Multiphasic Personality Inventory‐2‐Restructured Form (MMPI‐2‐RF) Scores,Workers' Compensation Status,and Spine Surgery Outcome

This study examines whether workers' compensation (WC) patients respond more poorly to spine surgery than non‐WC patients and whether poorer outcome is associated with individual differences in personality and emotional variables, as assessed by the Minnesota Multiphasic Personality Inventory‐2‐Restructured Form (MMPI‐2‐RF). Three‐hundred eighty‐two patients underwent presurgical psychological screening that included a diagnostic interview and psychometric testing. Pain level, functional ability, work status, medication use, and emotional distress were assessed at baseline and at an average of 6 months postoperative. WC patients showed significantly poorer response to spine surgery than did non‐WC patients on measures of pain level, functional ability, work status, medication use, and emotional distress. MMPI‐2‐RF scales assessing demoralization, somatic complaints, and low positive emotions were found to be incrementally associated with diminished surgery results.     

MMPI short forms as predictors of response to conservative treatment for low back pain.

This study (N = 115) compared the abilities of the Faschingbauer Abbreviated Minnesota Multiphasic Personality Inventory (FAM), the Midi-Mult, and the standard MMPI to predict response to conservative medical treatment for low back pain, as assessed by patient ratings of pain intensity 6 to 12 months later. The results indicated that all three inventory formats yielded significant correlations between the Hypochondriasis, Depression, and Hysteria scales and follow-up pain ratings. Less consistent findings were obtained with other scales and indices. The results provide tentative support for the clinical and research utility of these abbreviated MMPIs in substituting for the standard MMPI in outcome studies with back pain patients.     

Personality profiles of the morbidly obese

Personality characteristics of 150 morbidly obese patients (100 pounds or more over ideal weight) were investigated. The patients were given the Minnesota Multiphasic Personality Inventory (MMPI) and a new, self-report personality disorder inventory. The study attempted to determine whether particular personality variables could predict success or failure at weight loss six months post-surgery. Multivariate analyses of variance revealed no significant differences on any of the personality variables when the patients were divided into "good," "fair," and "poor" success categories. Rank order MMPI scale profiles and personality disorder profiles are presented and implications discussed.     

中文MMPI与MMPI-2临床量表一致性研究

目的：考察MMPI与MMPI-2临床量表的一致性程度。方法：采用MMPI与MMPI-2复合问卷，对236名被试进行测试，其中含186名精神科住院患者(精神分裂症、心境障碍、神经症)和50名正常被试。结果：相关分析提示两问卷间各对应量表具有高相关性；对于236名被试，编码总符合率达到90．3％，其中单点编码符合率81．6％，两点编码符合率65．8％，三点编码符合率49．2％，高分编码符合率为64％；那些两点编码不符合的问卷中，96．4％具有同一个编码量表。给以限制性定义以后，两点编码符合率达到82，8％。新常模的使用及T分形式的改变，对于两问卷编码类型符合率没有显著影响。结论：可以推论，中文MMPI与MMPI-2临床量表具有较高程度的延续性，中文MMPI与MMPI-2在临床使用上具有一定的可比性。     

Use of the MMPI to predict effective hotline workers

The present study investigated the use of the MMPI to discriminate between two groups of hotline volunteers: those who after training would become effective interviewers and those who would not. Effective interviewers were defined as those who emitted 40% or more good responses when they were responding to a crisis call. The criterion measure employed was the Therapist Error Checklist. When a specification equation based on standard MMPI scales was used, 91% of effective interviewers and 90% of ineffective interviewers were identified correctly.     

Validity of a back pain classification scale for detecting psychological disturbance as measured by the MMPI

Constructed a Back Pain Classification Scale (BPCS) to detect serious psychological disturbance in low back pain patients, validated against the MMPI. One hundred and twenty patients with low back pain were classified as functional or organic on the basis of BPCS scores. The group identified as psychologically disturbed (functional) had significantly higher MMPI elevations on Scales F, HS, D, HY, PD, MF, PA, PT and SC. None of their scale scores was significantly lower than the group identified as organic. T-scores above 70 were present only on Scales 1 and 3, which suggests a high incidence of essentially neurotic disorders in patients classified as functional. The use of the BPCS as a viable alternative to the MMPI in the medical setting was discussed.     

Application of the somatization factor of the MMPI-168 with low back pain patients.

The usefulness of the Somatization factor of the MMPI-168 with low back pain patients was examined in two separate studies. In study 1, 58 male veteran low back pain patients who had been divided into organic and mixed groups served as Ss. MMPI protocols were rescored for the five factors of Overall, Hunter, and Butcher (1973). The organic and mixed groups differed only on the Somatization factor. A cutting score of raw greater than or equal to 8 (T = 75) was determined to classify the sample correctly 74.5% of the time. In study 2, a second sample of 48 male veteran low back pain patients was divided into mixed, organic, and functional groups. The mixed group was subdivided further into a mixed-pain group who still were having pain and were seeking treatment and a mixed-relief group who were experiencing a reduction of pain and were returning to vocational activities. The functional and mixed-pain groups differed from the organic and mixed-relief groups on the Somatization and Depression factors. The cutting score determined in the study 1 correctly classified patients 83% of the time.     

Chronic pelvic pain: Psychological features and laparoscopic findings

One hundred three consecutive patients referred for treatment of chronic pelvic pain underwent MMPI testing, and 60 had diagnostic laparoscopy. A physical cause for the pain was found in 45 (75%) of the 60. However, three fourths (34) of patients with an organic cause for the pain also had evidence of psychopathology on the MMPI. Reassurance and education as to the role of stress in causing or exacerbating pain complaints appeared helpful. Most patients improve without major surgery.     

MMPI results: A comparison of trauma victims,psychogenic pain,and patients with organic disease

Made comparison using MMPI T scores on three private psychiatric subpopulations: Post-trauma patients, patients with organically based illness, and patients with psychogenic pain (complaints functional in origin) (N = 78). The standard 3 validity and 10 clinical scales were used to evaluate possible differences among the groups. Differences were presented among the groups on scales 3 (HY), 9 (MA), and (F). Individual profiles also were assessed. In patients with a 1-3/3-1 profile, the psychogenic group had significantly higher elevation over the post-trauma and organic groups. In patients with 8 (SC) or 9 (MA) high both with and without 1-3/3-1 high, differences were found; the post-trauma and organic groups showed marked elevation over those in the psychogenic group. Results indicate the MMPI to be a viable aid in distinguishing between patients with post-trauma stress disorder vs. those with functional disorders. The data suggest that MMPI profiles of patients with post-trauma stress disorder more closely resemble the MMPI profiles of patients who have organic disease with pain caused by organic pathology than the profiles of patients with psychogenic pain and/or hypochondriasis.