MMPI predictors of mania among psychiatric inpatients

MMPI data from 64 patients with a diagnosis of manic-depressive illness, manic type, were compared with MMPI data from patients in two comparison groups--64 patients with a psychotic diagnosis other than manic-depressive illness, and 64 patients with a variety of psychiatric diagnoses. Manic patients had higher Ma scale scores for MMPI scales that assess personal distress and interpersonal difficulties (e.g., D and Si). Discriminant analysis, with the Ma, D, and Si scales as predictors, correctly classified as manic or not manic 82.5% of the patients in the derivation sample and 74.2% of the patients in the cross-validation sample. Two high-point pairs, Sc-Ma/Ma-Sc and Pa-Ma/Ma-Pa, occurred in the MMPI profiles of almost half of the manic patients but were rarely found among the profiles of other patients. The results of this study support the use of the MMPI in identifying manic patients, particularly when discriminating between mania and other types of psychosis.     

Sex differences in mortality rates among long-stay psychiatric inpatients

Study of the sex ratio of mortality rates among three categories of long-term psychiatric inpatients suggests a trend toward equalization of death rates between the sexes by specific cause of death, given the constant inpatient environment. The most dramatic example of this equalization was the virtual parity of death rates for ischemic heart disease among younger schizophrenic patients of both sexes in contrast to a three- to fourfold male excess in the general population. An exception to this equalization was seen for neoplasm deaths, which showed a female excess in all three patient groups in contrast to the male excess seen in the general population. Further study of chronically hospitalized psychiatric patients seems indicated to delineate patterns of death associated with biologic variation in a relatively constant environment.     

MMPI validity scales and behavioral disturbance in psychiatric inpatients.

Sixty psychiatric inpatients were assigned to one of three groups on the basis of F and K MMPI validity scales. Staff ratings of patient behavior and recorded incidents of "acting-out" behavior were obtained for patients with: (a) "plea for help" validity profiles, (b) hyper-defensive profiles, and (c) average profiles. Patients with "plea for help" profiles were perceived as "acting-out" more frequently and engendering more feelings of frustration than patients in the other groups. These patients account for 77% of the incidents of inappropriate, destructive behavior and 83% of the seclusions in the patients sampled. Although the "plea for help" profile is considered invalid in some scoring systems, results suggest that this validity profile may be useful in treatment planning.     

Kinetic Family Drawings and MMPI diagnostic indicators in adolescent psychiatric inpatients

Correlations among Kinetic Family Drawings and MMPI indicators of depressive, anxiety, behavioral, and thought disorders and diagnostic category were estimated for a group of 52 adolescent psychiatric inpatients. No statistically significant values were found between test indicators and corresponding MMPI scales or diagnoses, although MMPI D and Sc scales were significantly related to diagnosis. Results do not support the concurrent or construct validity of the drawings.     

The construct validity of the MMPI alexithymia scale with psychiatric inpatients

Relatively few studies have addressed the issue of the Minnesota Multiphasic Personality Inventory (MMPI) alexithymia scale's construct validity. In this study, the validity of the scale is supported by the finding of a significantly lower percentage of alexithymic individuals in a large sample of psychiatric inpatients than in samples of patients with a variety of physical disorders (i.e., migraine headaches, asthma bronchitis/emphysema, and hypertension). Validity of the scale is further supported through a comparison of the alexithymic and nonalexithymic psychiatric inpatients on a series of Rorschach and MMPI variables. As predicted, alexithymics were less verbally productive, displayed less ability to fantasize, and demonstrated greater defensive pseudonormality. Results suggest the measure may be of value in studies of psychiatric patients as well as those with physical disorders.     

Substance use among Iranian psychiatric inpatients.

This study evaluated substance use among a sample of 205 psychiatric inpatients (70 women and 135 men) chosen randomly. The subjects (who had schizophrenia or mood disorders) were evaluated on a confidential questionnaire by interview. Their mean age was 35 yr. (SD= 10.4, range 16 to 69). Of these participants, 76% of the 135 men and 34% of the 70 women admitted use of substances: cigarettes (74% of men, 31.4% of women), opiates (31.9% of men, 4.3% of women), alcohol (23.7% of men, 4.3% of women), hashish (8.9% of men, no women), marijuana (3.7% of men, no women), and cocaine or LSD by none. Only 27% of the women and 63% of the men reported still using substances regularly; some reported using more than one substance. Of the current users, 61.8% of the schizophrenics, 20% of unipolar depressed, and 37.5% of bipolar patients reported current use. The reasons for substance use in order of frequencies of mention were release of tension, seeking pleasure, and need (to avoid withdrawal symptoms) by men and habit, seeking pleasure, and need by women.     

Normal range MMPI-A profiles among psychiatric inpatients

The present study examined the base rates of normal range Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A) profiles in an inpatient sample and examined the differences between adolescents with apparently valid normal range profiles (all clinical scale T-scores < 60) and those with elevated profiles on prior interventions, reported internalizing and externalizing symptoms, and MMPI-A validity scale scores and other indexes of underreporting. Normal range profiles cannot be adequately explained by a less pathological history prior to hospitalization or by defensiveness. Thirty percent of male and 25% of female adolescents produced valid MMPI-A profiles in which none of the clinical scales were elevated. Both male and female adolescents with normal range profiles were generally less likely to report internalizing symptoms than those with elevated profiles, but both groups report externalizing symptoms. Neither the standard MMPI-A validity scales nor additional validity scales discriminated between profile groups. Clinicians should not assume that normal range profiles indicate an absence of problems.     

MMPI and Rorschach indices of schizophrenic and depressive diagnoses among adolescent inpatients

Although adolescent norms have been developed for the MMPI (e.g., Marks, Seeman, & Haller, 1974) and Rorschach (e.g., Exner, 1986a), little is known regarding the discriminate diagnostic validity of these measures with adolescents. This study investigated the usefulness of these measures in the detection of depression and schizophrenia among adolescent inpatients. Subjects (mean age = 15.3) consisted of 134 adolescents who received Rorschach and MMPI administrations at hospital admission. Clinical diagnoses resulted in the following groupings for this sample: schizophrenia = 15, dysthymic disorder = 41, major depression = 26, conduct disorder = 28, personality disorder = 18. MMPI scale Sc elevation was found to be the most effective single predictor of schizophrenic diagnoses, with a hit rate of .76, sensitivity of .62, and specificity of .78. Neither MMPI scale D scores nor Rorschach DEPI scores were found to be significantly related to patients' diagnoses. Results were interpreted in terms of prior findings in adult psychiatric populations and in relation to implications for the clinical assessment of adolescents.     

MMPI differences among mild and severe insomniacs and good sleepers

Past research has attempted to delineate personality differences between insomniacs and good sleepers but has failed to control for type of insomnia or severity of the disorder. The purpose of this study was to compare MMPI scores of mild and severe sleep onset insomniacs with a control group of noninsomniacs . Results demonstrated that sleep onset insomniacs, regardless of degree of severity, differed significantly from noninsomniacs ; and that mild and severe insomniacs differed from each other on only one MMPI scale.     

Validity and clinical scale comparisons between the MMPI and MMPI-2 with psychiatric inpatients.

This study was designed to investigate the comparability of the original MMPI (1950) and the MMPI-2 (1989) with a psychiatric patient population. 34 male and 3 female patients, shortly after admission to one of two acute psychiatry units, completed the old and revised versions of the MMPI. Paired t tests indicated but scant differences for raw scores, while many more differences were found among T scores for validity, clinical, and supplemental scales. Analyses, however, showed all scales on the two forms to be highly correlated. Analysis of the high-point and two-point codes across the two administrations also showed relative stability, although the proportion of Scales 2 (Depression) and 8 (Schizophrenia) decreased, while those for Scales 6 (Paranoia) and 7 (Psychasthenia) increased markedly in the MMPI-2 protocols. Examination of each version's discriminability among mood- and thought-disordered subsamples suggested that the MMPI provides slightly better delineation between diagnostic classes. Discriminant function analyses showed that there were essentially no differences between the two forms in the accurate classification of clinical and nonclinical groups. The findings reported here provide support for the MMPI-2; despite modification, the newer form retains the advantages of the original MMPI. Differences found here may be unique to psychiatric patients and their patterns of MMPI/MMPI-2 equivalence and may not generalize to other special populations.     

Sex differences on use of associative and dissociative cognitive strategies among male and female athletes

This study assessed whether men and women differed in using associative and dissociative cognitive strategies during athletic performance. Athletes (31 men, M age = 23.2 yr., SD = 3.9 and 29 women, M age = 22.9 yr., SD = 4.3) who practiced endurance activities (running, swimming, and cycling) were considered high-level performers because they participated in national or international competition. The athletes were interviewed, and Schomer's 1986 method of measurement was used to evaluate and quantify two cognitive strategies. Most specifically, categories of association concerned the way the athlete paid close attention to bodily signals, and categories of dissociation described how the athlete shunned sensory inputs. Analysis of variance and the t test showed that women tend to be more dissociative than men and men more associative than women. The results suggest that pain perception in these sports may be a function of sex.     

Correspondence of the MMPI and MMPI-168 among incarcerated female felons

This study was designed to assess the correspondence between the MMPI and MMPI-168 for a sample of adult incarcerated female felons. The results indicated a high degree of agreement, median correlation of .79, between corresponding validity and clinical scales of the MMPI-168 and the full MMPI. The MMPI-168 significantly overestimated scales L, F, and D, while it underestimated scales K, Hy, Pd, and Mf. Configural correspondence between the two instruments in terms of profile high points was somewhat less than has been reported for psychiatric populations. However, the MMPI-168 appeared to be a useful short screening instrument for incarcerated female felons with respect to accurate assessment of profile validity, configural correspondence to the full MMPI, and correlations between corresponding scales. Its utility in these respects far exceeds prior attempts to employ the Mini-Mult with a similar sample of incarcerated females.     

Concordance of the MCMI-II, the MMPI, and Axis I discharge diagnosis in psychiatric inpatients.

Discriminant functions of the MMPI and the MCMI-II were compared in a sample of 166 hospitalized psychiatric patients with discharge diagnoses of affective disorder (63), schizophrenia (26), substance abuse (35), and other disorders (42). Of special interest was the comparative diagnostic utility of the two instruments in regards to DSM-III-R Axis I diagnoses. Both tests performed reasonably well in the discriminant function analyses; however, the MCMI-II achieved a somewhat superior overall hit rate with this sample of inpatients (79% to 68%). This difference was tied to greater accuracy of the MCMI-II for identifying the affective disorders group.     

Stability of the Millon Clinical Multiaxial Inventory among psychiatric inpatients

This study investigated the stability of the Millon Clinical Multiaxial Inventory (MCMI) in a sample of psychiatric inpatients over a longer time period and from different perspectives than previous reliability studies. Test-retest reliability was assessed from three perspectives: correlation/regression, equivalence of dimensional structures across testings upon different admissions, and stability of personality style across testings. Some stability from a correlational perspective was found, with higher stability estimates indicated for the basic personality scales in comparison with the clinical symptom scales which is consistent with Millon's theory. The internal structure of the MCMI was essentially identical across testings. Although source of reinforcement and instrumental or coping style were stable across testings beyond chance, the MCMI profiles of a considerable number of subjects were inconsistent across testings. Correspondingly, clinicians should be cautious in using the MCMI to make categorical decisions regarding personality style with inpatients who are tested at admission and who have had repeated hospitalizations.     

Empirical correlates of common MMPI-2 two-point codes in male psychiatric inpatients

Empirical correlates of common Minnesota Multiphasic Personality Inventory-2 (MMPI-2) 2-point codes were identified for a sample of 1,213 inpatient men. A comprehensive standardized review of the hospital record was undertaken, and clinically relevant demographic, diagnostic, and behavioral information was extracted from intake summaries obtained prior to administration of the MMPI-2. Nonmutually exclusive psychiatric diagnoses found in the sample included substance abuse or dependence, schizophrenia, depression, bipolar affective disorder post-traumatic stress disorder, and other anxiety disorders as well as personality disorders. Subsamples consisting of the five most frequently obtained well-defined 2-point code types were selected, and empirical correlates of each code type were then identified and described. Remarkable consistency was found between the empirical correlates of the code types obtained in this study and the correlates of the same code types described by other investigators 40 years ago.     

Examining attitudes about and influences on research participation among forensic psychiatric inpatients

Although a growing body of research has examined various types of coercive practices that may occur among psychiatric patients over the years, almost no attention has been given to coercive influences that may occur specifically in the context of recruitment into research projects. Particularly for those who are institutionalized (e.g., in-patient insanity acquittees), there are significant concerns that their autonomous decision-making to consent or not may be significantly impaired due to the highly restrictive and controlled environment in which they live. This exploratory study sought to examine patients' perceptions of coercive influences by presenting them with hypothetical research vignettes regarding possible recruitment into either a biomedical or social-behavioral research project. Among 148 multi-ethnic male and female participants across two facilities, participants reported relatively minimal perceptions that their autonomous decision-making would be impacted or that various potentially coercive factors (e.g., pressures from staff) would impair their free choice to participate (or not) in such research. To the extent that such perceptions of coercion did occur, they were moderately associated with patients' more general personality traits and attitudinal variables, such as alienation and external locus of control. Limitations of this study and their implications for future research are discussed.     

Mexican-American male batterers on the MCMI-III

This study examined personality characteristics of Mexican-American male batterers. 60 Mexican-American male batterers (M = 33.6 yr.) in the court system in South Texas took the MCMI-III and their MCMI-III scores were compared with the scores of a community sample of 45 Mexican-American individuals (M = 30.4 yr.). The batterers frequently scored higher than the nonbatterers on the Avoidant and Passive-Aggressive scales, while nonbatterers frequently scored higher on the Histrionic scale. The batterers scored significantly higher on 18 out of 24 MCMI-III scales, while nonbatterers scored significantly higher on two scales.