Derivation and Implications of MMPI Cluster Groups in Clinically Depressed Inpatient Females

The purpose of this study was to subclassify clinically depressed patients based on a cluster-analytic examination of the MMPI. Subjects were 79 female inpatients with major depression. A cluster analysis of the MMPI validity and clinical scales resulted in three clusters labeled psychotic (287 MMPI profile), hostile (24 MMPI profile), and histrionic (32 MMPI profile) depression. The psychotic group exhibited the greatest depression as measured by the Beck Depression Inventory (BDI). The psychotic and hostile groups, however, did not differ on other associated aspects of depression, such as negative cognitions, nonassertiveness, or personality style. The hostile group reported the fewest physical difficulties and the most excessive alcohol use. The groups, however, did not differ on other aspects of depression history or presentation such as family history of depression or previous hospitalizations. A repeated measures ANOVA for the three cluster groups on the BDI at admission, discharge, and 6 months after discharge indicated that all groups showed improvement at discharge but that only the hostile depressive group continued to show improvement at the 6-month follow-up.     

Personality organization as an aspect of back pain in a medical setting.

The MMPI profiles of 74 low back pain patients who had previously been classified as "functional,"organic," or "mixed" were sorted into six profile groups. The six profile groups were those used by Pichot, Perse, Lekous, Dureau, Perez, and Rychewaert (1972); denial, "conversion V" without defensiveness, "conversion V" with defensiveness, depressed/anxious, psychotic and normal. Results indicate that all six profile types are well represented in the low back pain group. Evidence is also presented which shows that each of the pathological MMPI profile types examined across "functional," "organic," and "mixed" classification is significantly more elevated than a normal profile group on two scales (Lb, DOR) designed to measure functional aspects of pain. Pathological MMPI profile groups did not differ significantly from each other on the "functional" pain scales. The data presented in this study point to the relationship of various forms of psychopathology with "functional pain." The findings of this study would not support a homogeneous "pain personality" for low back pain patients. However, combined "conversion V" profiles accounted for 58% of the "functional" group, 45% of the "mixed" group and 35% of the "organic" group.     

Development and Validation of a Dutch Translation of the Big Five Inventory (BFI)

The MMPI profiles of 74 low back pain patients who had previously been classified as "functional," "organic," or "mixed" were sorted into six profile groups. The six profile groups were those used by Pichot, Perse, Lekeous, Dureau, Perez, and Rychewaert (1972); denial, "conversion V" without defensiveness, "conversion V" with defensiveness, depressed/anxious, psychotic and normal. Results indicate that all six profile types are welt represented in the low back pain group. Evidence is also presented which shows that each of the pathological MMPI profile types examined across "functional," "organic," and "mixed" classification is significantly more elevated than a normal profile group on two scales (Lb, DOR) designed to measure functional aspects of pain. Pathological MMPI profile groups did not differ significantly from each other on the "functional," pain scales. The data presented in this study point to the relationship of various forms of psychopathology with "functional pain." The findings of this stud v would not support a homogeneous "pain personality" for low back pain patients. However, combined "conversion V" profiles accounted for 58% of the "functional" group, 45% of the "mixed" group and 35% of the "organic" group.     

An MMPI typology of cocaine abusers.

Three types were found in a cluster analysis of scores on the Minnesota Multiphasic Personality Inventory (MMPI) of 100 men voluntarily presenting for treatment of cocaine abuse. Type 1 (n = 59) had a mean MMPI profile consistent with the hypothesized grouping of persons who self-medicate with cocaine as a means of overcoming depression. The relatively normal mean MMPI profile obtained by Type 2 (n = 37) suggested little indication of significant psychopathology. Type 3's (n = 4) mean MMPI profile suggested either severe disturbance or profile invalidity. Types were found to differ in the nature of drug use, reactions to cocaine, education level, and social class, but not on the scales of the Adjective Check List.     

An MMPI Typology of Cocaine Abusers

Three types were found in a cluster analysis of scores on the Minnesota Multiphasic Personality Inventory (MMPI) of 100 men voluntarily presenting for treatment of cocaine abuse. Type 1 (n = 59) had a mean MMPI profile consistent with the hypothesized grouping of persons who self-medicate with cocaine as a means of overcoming depression. The relatively normal mean MMPI profile obtained by Type 2 (n = 37) suggested little indication of significant psychopathology. Type 3's (n = 4) mean MMPI profile suggested either severe disturbance or profile invalidity. Types were found to differ in the nature of drug use, reactions to cocaine, education level, and social class, but not on the scales of the Adjective Check List.     

The Depressive Experiences Questionnaire: Validity and Psychological Correlates in a Clinical Samples

This study sought to compare the original and revised scoring systems of the Depressive Experiences Questionnaire (DEQ) and to assess the construct validity of the Dependent and Self-critical subscales of the DEQ in a clinically depressed sample. Subjects were 103 depressed inpatients who completed the DEQ the Beck Depression Inventory (BDI), the Hopelessness Scale, the Automatic Thoughts Questionnaire (ATQ), the Rathus Assertiveness Schedule (RAS), and the Minnesota Multiphasic Personality Inventory (MMPI). The original and revised scoring systems of the DEQ evidenced good concurrent validity for each factor scale, but the revised system did not sufficiently discriminate dependent and self-critical dimensions. Using the original scoring system, self-criticism was significantly and positively related to severity of depression, whereas dependency was not, particularly for males. Factor analysis of the DEQ scales and the other scales used in this study supported the dependent and self-critical dimensions. For men, the correlation of the DEQ with the MMPI scales indicated that self-criticism was associated with psychotic symptoms, hostility/conflict, and a distress/exaggerated response set, whereas dependency did not correlate significantly with any MMPI scales. Females, however, did not exhibit a differential pattern of correlations between either the Dependency or the Self-criticism scales and the MMPI. These findings suggest possible gender differences in the clinical characteristics of male and female dependent and self-critical depressive subtypes.     

The Depressive Experiences Questionnaire: validity and psychological correlates in a clinical sample

This study sought to compare the original and revised scoring systems of the Depressive Experiences Questionnaire (DEQ) and to assess the construct validity of the Dependent and Self-Critical subscales of the DEQ in a clinically depressed sample. Subjects were 103 depressed inpatients who completed the DEQ, the Beck Depression Inventory (BDI), the Hopelessness Scale, the Automatic Thoughts Questionnaire (ATQ), the Rathus Assertiveness Schedule (RAS), and the Minnesota Multiphasic Personality Inventory (MMPI). The original and revised scoring systems of the DEQ evidenced good concurrent validity for each factor scale, but the revised system did not sufficiently discriminate dependent and self-critical dimensions. Using the original scoring system, self-criticism was significantly and positively related to severity of depression, whereas dependency was not, particularly for males. Factor analysis of the DEQ scales and the other scales used in this study supported the dependent and self-critical dimensions. For men, the correlation of the DEQ with the MMPI scales indicated that self-criticism was associated with psychotic symptoms, hostility/conflict, and a distress/exaggerated response set, whereas dependency did not correlate significantly with any MMPI scales. Females, however, did not exhibit a differential pattern of correlations between either the Dependency or the Self-Criticism scales and the MMPI. These findings suggest possible gender differences in the clinical characteristics of male and female dependent and self-critical depressive subtypes.     

The Beck Depression Inventory: item order and the impact of response sets

The lack of subtle content in the item groups of the Beck Depression Inventory (BDI) and the consistency in the ordering of the items from least to most pathological make this instrument unduly susceptible to either defensive or malingering response sets. Two experimental forms were developed for the BDI: a backwards version (a simple reversal of the order of items within each group) and a random-order version. These forms, together with the original item order, were given to college undergraduate women along with the Depression scale from the MMPI and the Burks-Martin Questionnaire covering recent life changes and current stressful situations. The random order BDI results in a significantly higher depression score than did either the original or backwards version. Correlations with the other instruments were comparable for all three forms. The random order of items within each set appears to break up a response set to endorse either the first or last item and is, therefore, recommended.     

The Beck Depression Inventory: Item Order and the Impact of Response Sets

The lack of subtle content in the item groups of the Beck Depression Inventory (BDI) and the consistency in the ordering of the items from least to most pathological make this instrument unduly susceptible to either defensive or malingering response sets. Two experimental forms were developed for the BDI: a backwards version (a simple reversal of the order of items within each group) and a random-order version. These forms, together with the original item order, were given to college undergraduate women along with the Depression scale from the MMPI and the Burks-Martin Questionnaire covering recent life changes and current stressful situations. The random order BDI results in a significantly higher depression score than did either the original or backwards version. Correlations with the other instruments were comparable for all three forms. The random order of items within each set appears to break up a response set to endorse either the first or last item and is, therefore, recommended.     

Depression: Psychological Referrals in Nursing Homes

Studies in nursing homes have consistently shown the presence of mental health disorders. We assessed 300 nursing home residents (referred for psychological testing) to provide preliminary data on referral patterns, assess the cognitive and affective patterns of residents with different diagnoses, and present psychometric data on depression measures, including the Beck Depression Scale (BDI) (as a bivariate index) and the Mood Scale (a shortened version of the Geriatric Depression Scale). Results show that the referrals involved a compromised group of residents, both cognitively and affectively. Despite obvious mean differences, a MANOVA revealed that Major Depressive Disorder did not differ significantly from the Adjustment Disorder and Dementia groups on the bivariate BDI and Mood Scale; the dementia group was lower than the depression and adjustment groups on the MMSE. Patterns on depression inventories also identified a correct classification score of 4 on the BDI (89%) and 3 on the Mood Scale (79%). Discussion endorsed use of the bivariate BDI and addressed depression in these facilities.     

Pain-related correlates of MMPI profile subgroups among back pain patients

The MMPI profiles of 96 male and 218 female patients attending a back pain clinic in a private university-affiliated, orthopedic hospital were analyzed by a hierarchical clustering procedure. The clustering procedure produced four male and four female profile subgroups. The subgroups were compared with one another on the basis of patients' responses to the Cornell Medical Index and revised McGill Pain Assessment Questionnaire. Within the male and female patient cohorts it was found that profile subgroups featuring elevated clinical scales showed greater disruptions of daily activities than did subgroups with relatively unelevated profiles. However, profile subgroups with elevations primarily on the neurotic triad scales reported greater affective disturbance and disruption of daily activities than did subgroups with elevations on both the neurotic triad and relatively psychotic scales. In addition, profile subgroups with subclinical elevations on the neurotic triad scales appeared to have adjusted to their pain experience more poorly than did subgroups that featured scores on nearly all clinical scales that were within one standard deviation of the mean. Suggestions are provided for the use of the MMPI in assessing chronic pain patients and future research regarding cluster analyses of patients' MMPI profiles.     

MMPI configural interpretation as applied to posttraumatic stress disorder in Vietnam veterans

This study investigated the systems of Minnesota Multiphasic Personality Inventory (MMPI) configural interpretation of Skinner and Jackson (1978) and Kunce (1979) with Vietnam veterans with posttraumatic stress disorder (PTSD). MMPI profiles of four groups differing in combat exposure were compared on four MMPI configural variables from Kunce (1979) and Skinner and Jackson (1978). The four groups were (a) PTSD sufferers, (b) Vietnam combat veterans without PTSD, (c) Vietnam noncombat veterans, and (d) Vietnam era veterans. All groups were further divided into hospitalized versus nonhospitalized subgroups. Dependent variables were Skinner and Jackson's (a) sociopathic modal profile, (b) neurotic profile, (c) psychotic profile, and (d) Kunce's emotional expression (enthusiastic-reserved) dimension. Results indicated that hospitalized PTSD subjects had significantly higher scores on Skinner and Jackson's neurotic profile; both hospitalized and nonhospitalized PTSD subjects had higher scores on the psychotic profile and were more "reserved" on Kunce's emotional expression dimension. Results were interpreted in terms of configural MMPI interpretation systems and the adjustment of Vietnam veterans with PTSD. PTSD was viewed as exhibiting cognitive, somatic, and affective features.     

Long-term consequences of childhood physical and psychological maltreatment

This study assessed whether some of the correlates of learned helplessness—depression, low self-esteem, and a maladaptive attributional style—are long-term consequences of child abused. In this study, 260 subjects were identified as physically abused, psychologically abused, both physically and psychologically abused, or nonabused, based on responses to the Child Abuse Questionnaire (CAQ). Subjects were tested for levels of nonclinical depression via the Beck Depression Inventory (BDI), for levels of self-esteem via the Rosenberg Self-Esteem Scale (RSE), and for the adaptiveness of attributional style via the Attributional Style Questionnaire (ASQ). It was hypothesized that each of the three abuse groups would differ from the control group on the three dependent measures; differences among the three abuse groups were also explored. Three one-way analyses of variance indicated that (1) BDI scores reflected a greater tendency toward depression in subjects reporting both types of abuse than in nonabused subjects or in subjects reporting either psychological or physical abuse, (2) subjects reporting psychological abuse only or both psychological and physical abuse showed lower self-esteem than did nonabused subjects, and (3) abused subjects did not seem to exhibit a more maladaptive attributional style than that of nonabused subjects. In addition, multiple linear regression analyses pointed to psychological abuse as a critical variable in predicting levels of depression, self-esteem, and attributional style, when physical abuse effects were controlled. Controlling for the effects of psychological abuse, however, indicated that physical abuse did not significantly contribute to the variance in these variables. Implications for the learned helplessness model and for future research are discussed. © 1992 Wiley-Liss, Inc.     

MMPI Configural Interpretation as Applied to Posttraumatic Stress Disorder in Vietnam Veterans

This study investigated the systems of Minnesota Multiphasic Personality Inventory (MMPI) configural interpretation of Skinner and Jackson (1978) and Kunce (1979) with Vietnam veterans with posttraumatic stress disorder (PTSD). MMPI profiles of four groups differing in combat exposure were compared on four MMPI configural variables from Kunce (1979) and Skinner and Jackson (1978). The four groups were (a) PTSD sufferers, (b) Vietnam combat veterans without PTSD, (c) Vietnam noncombat veterans, and (d) Vietnam era veterans. All groups were further divided into hospitalized versus nonhospitalized subgroups. Dependent variables were Skinner and Jackson's (a) sociopathic modal profile, (b) neurotic profile, (c) psychotic profile, and (d) Kunce's emotional expression (enthusiastic-reserved) dimension. Results indicated that hospitalized PTSD subjects had significantly higher scores on Skinner and Jackson's neurotic profile; both hospitalized and nonhospitalized PTSD subjects had higher scores on the psychotic profile and were more "reserved" on Kunce's emotional expression dimension. Results were interpreted in terms of configural MMPI interpretation systems and the adjustment of Vietnam veterans with PTSD. PTSD was viewed as exhibiting cognitive, somatic, and affective features.     

Contributions of Discriminant Analysis to Differential Diagnosis by Self-Report

We used discriminant function analyses of the Minnesota Multiphasic Personality Inventory (MMPI; Hathaway & McKinley, 1983), Millon Clinical Multiaxial inventory (MCMI; Milton, 1983), MCMI-II (Millon, 1987), and Symptom Checklist Ninety-Revised (SCL-90-R; Derogatis, 1983) profiles from a heterogenous group of 272 psychiatric inpatients to classify patients as depressed, manic, and/or psychotic, Most functions generated from these tests significantly discriminated depressed, manic (not MCMI-II), and psychotic (not MCMI) subjects from psychiatric controls. However. there was little improvement in diagnostic efficiency over the use of single scale elevations at specified cut scores. Functions derived from the MCMI for mania and the MCMI-II for psychosis show the most promise but require replication. The difficulty of using group profile differences for the diagnosis of individual psychiatric patients is discussed.     

Characteristics of the frequent nightmare sufferer.

Previous research has found that persons who experience frequent nightmares score highly on scales that measure psychotic symptomatology. Neurotic symptoms have also been implicated as correlates of nightmare frequency. In this study, 30 adult lifelong nightmare sufferers were compared with 30 control subjects, matched for age, sex, and socioeconomic status. Subjects were asked to record all dreams for 1 month and to complete the Minnesota Multiphasic Personality Inventory (MMPI) and the Eysenck Personality Questionnaire (EPQ). Nightmare subjects scored significantly higher on the EPQ Neuroticism scale and on 8 MMPI clinical scales than did the control group. These scales also best discriminated between the groups in a direct discriminant analysis. The results are interpreted as a reflection of global maladjustment rather than of specific psychotic symptomatology.     

Association of fake-good MMPI-2 profiles with low Beck Depression Inventory scores

Seventy-nine adolescent mothers (mean age = 18.1 years) were administered the Beck Depression Inventory (BDI) and three validity scales (L, F, and K) of the Minnesota Multiphasic Personality Inventory 2 (MMPI-2). The aim was to determine whether low-BDI mothers were "faking good," or denying their depression. The adolescent mothers were assigned to a low-BDI group (scores = 0, 1, 2), a nondepressed group (scores = 3-9), or a depressed group (scores > or = 13). The depressed group had higher F (Symptom) scale scores than did the nondepressed group, which in turn had higher scores than did the low-BDI group. The low-BDI group, in contrast, had more fake-good profiles than did the two other groups. Discriminant analyses indicated that 90% of the fake-good profiles could be classified correctly based on BDI and K (Defensiveness) scale scores. These data suggest the need for further assessment when individuals have extremely low BDI scores.     

Prototypical profiles of the Brief Psychiatric Rating Scale

Three prototypical profiles of the Brief Psychiatric Rating Scale (BPRS; Overall & Gorham, 1962) were isolated using a Q-type factor-analytic strategy with a sample of homeless men with mental illness (N=165). The 3 profiles--depressed, actively psychotic, and withdrawn--were used to study changes in BPRS profiles over time in a control group and a group that received assertive community treatment (ACT). Over2 time periods (inception to 12 months and 12-24 months), the 2 groups did not differ in terms of changes in profile shape, but they did differ in terms of changes in profile elevation. The ACT group evidenced a decrease in symptom severity during the last 12 months, whereas the control group showed an increase. Although changes in profile shape in both groups did occur, there was a significant tendency for the shape of the BPRS profiles to remain stable from the inception of the study to the 12-month assessment and from that time to the 24-month assessment. We describe the uses of these prototypical profiles and discuss the applicability of this analytical approach to other assessment instruments.