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.     

The MMPI-2: A Contemporary Normative Study of Midwestern Family Medicine Outpatients

For more than 60 years it has been known that profiles from the Minnesota Multiphasic Personality Inventory (MMPI), obtained from medical patients, are elevated when scores are plotted using general population norms. These elevations have been most apparent on the neurotic triad (NTd), the first 3 clinical scales on the MMPI profile. More than 45 years have passed since a nonreferred, normative sample of MMPIs was established from 50,000 consecutive medical outpatients. We present comparable but contemporary normative data for the revised MMPI (MMPI-2) based on a nonreferred sample of 1,243 family medicine outpatients (590 women; 653 men). As true for the original MMPI, contemporary medical outpatients have profiles that are significantly different, clinically and statistically, from the general population norms for the MMPI-2. This is particularly evident in elevations on the NTd. New normative tables of uniform medical T (UMT) scores were developed following the procedures used to create the uniform T scores for the MMPI-2. Measures of internal consistency are reported; test-retest reliability was established over a mean of 3.7 weeks, and results characterizing the stability of the validity and clinical scales are presented.     

MMPI profiles of women in codependency treatment.

The Minnesota Multiphasic Personality Inventory (MMPI) profiles of 73 women presenting themselves for treatment of codependency in a 10-day residential setting were examined. Results suggest a significant amount of psychopathology to be present in this population. More than 50% of these individuals produced clinically significant elevations of five or more scales, and 38% produced elevations on six or more scales.     

MMPI Profiles of Women in Codependency Treatment

The Minnesota Multiphasic Personality Inventory (MMPI) profiles of 73 women presenting themselves for treatment of codependency in a 10-day residential setting were examined. Results suggest a significant amount of psychopathology to be present in this population. More than 50% of these individuals produced clinically significant elevations of five or more scales, and 38% produced elevations on six or more scales.     

MMPI Taxonomies of Child Sexual and Nonsexual Offenders: A Cross-Validation and Extension

In a court clinic sample of 107 child sexual and nonsexual offenders, Minnesota Multiphasic Personality inventory (MMPI) profiles did not differ as a function of arrests for sexual versus nonsexual offending. However, a three-group cluster-analytic solution was generated. Two of these clusters replicated those derived by Hall, Graham, and Shepherd (1991). The first duster was unelevated, with Scales 4 and 9 as high points. The second Cluster had MMPI Scales 4, 8, 2, and 7 as the highest scales. The third cluster was even more elevated than the other two clusters, characterized by extreme elevations on MMPI Scales F, 2, 4, 6, 7, and 8. The somewhat different results of this study versus previous studies (e.g., Hall et al., 1991) may be a function of the different populations sampled. The results provide evidence of within-group heterogeneity among sexual and nonsexual offenders that may be as important as between-group differences.     

Viewing the MMPI–2–RF Structure Through the Personality Psychopathology Five (PSY–5) Lens

Ben-Porath and Tellegen (2008) recommend organizing MMPI–2–RF scale interpretive information around 3 broad topics, emotional/internalizing dysfunction, thought dysfunction, and externalizing/behavioral dysfunction, and 3 additional topics labeled somatic complaints, interpersonal functioning, and interests. That organization is based primarily on structural analyses of the Restructured Clinical (RC) scales. This study reviewed the MMPI–2–RF's scale structure when the Personality Psychopathology Five (PSY–5) scales are included. Principal axis factor analyses with oblique rotation were conducted on the Restructured Clinical, PSY–5, and Special Problem (SP) scales in 2 samples, by gender. One sample was an outpatient community health center, the other a large, metropolitan inpatient psychiatric facility. The 6-factor solution evidenced each of the PSY–5 constructs plus a general somatic concerns factor. Implications of this solution in comparison to the 3-factor organizing structure recommended by Ben-Porath and Tellegen are discussed.     

MCMI-II profiles of women with eating disorders: a cluster analytic investigation

A three-factor model of personality pathology was investigated in a clinical sample of 183 female patients in an outpatient eating disorders treatment program. Cluster analysis of MCMI-II personality scales (Millon, 1987) yielded three distinct personality profiles, which were consistent with previous studies. First, 16.9% of the sample comprised a High Functioning cluster, which manifested no clinical elevations on the MCMI-II and had significantly lower scores on the Eating Disorder Inventory (EDI; Garner; 1991) scales than the other two clusters. Second, 49.1% of the sample comprised an Undercontrolled/Dysregulated cluster. Finally, the remaining 34% of the sample comprised an Overcontrolled/Avoidant cluster. This final cluster had significantly higher EDI Ineffectiveness scale scores than the Undercontrolled/Dysregulated cluster group. Cluster membership was not associated with eating disorder subtype, suggesting that there is considerable variance in personality pathology within eating disorder diagnostic categories.     

What do the MMPI scales fundamentally measure? Some hypotheses

I consider the question of whether all psychopathological behaviors can, on an evolutionary foundation, be considered as positive adaptations. I proposed that higher functions can be differentiated from their associated emotional modulations at simultaneous subjective, behavioral, and neural levels and that organizing analyses in this way will enable us to fill in our understanding of both the effects and relief of traumatic experiences. I then present each of the 8 clinical scales of the MMPI (Hathaway & McKinley, 1943) as a dimension of positive adaptation with simultaneous cognitive-emotional, operant-classical, and neocortical-limbic elements. A variety of life-experience paradigms are then offered to explain the factors that operate to increase MMPI scale elevations as well as countermeasures that can operate to reduce such elevations. Understanding all such behaviors as adaptive leads to a notable enhancement of empathy.     

Frequency of scale elevations and factor structure of the Behavior Rating Inventory of Executive Function (BRIEF) in children and adolescents with intractable epilepsy.

The Behavior Rating Inventory of Executive Function (BRIEF) is a standardized rating scale that provides information about the nature and extent of executive function deficits displayed by children and adolescents in daily life. BRIEF protocols completed by parents of 80 children with intractable epilepsy were evaluated with respect to prevalence and severity of scale elevations in the sample, and also with respect to factor structure. Overall, the sample was rated as having significantly more executive function problems than healthy children in the BRIEF standardization sample; elevations on the Working Memory and Plan/Organize scales were most frequently seen. Fully 36% of the sample had four or more significantly elevated scales. However, 31% of the sample had no clinically elevated scales, indicating that executive difficulties, though frequent, are not necessarily characteristic of all children with severe epilepsy. As in the validation studies reported in the manual, a two-factor solution emerged from a principal factor analysis of BRIEF scales. However, the factor structure as given in the manual was not entirely replicated; specifically, the Monitor scale was found to load equivalently on both factors. The results of this study suggest that a substantial proportion of children with intractable epilepsy display significant executive function deficits in daily life. Research into the relationship of BRIEF scores to other measures of executive functioning in children with epilepsy is needed to further clarify its clinical utility.     

Frequency of Scale Elevations and Factor Structure of the Behavior Rating Inventory of Executive Function (BRIEF) in Children and Adolescents With Intractable Epilepsy

The Behavior Rating Inventory of Executive Function (BRIEF) is a standardized rating scale that provides information about the nature and extent of executive function deficits displayed by children and adolescents in daily life. BRIEF protocols completed by parents of 80 children with intractable epilepsy were evaluated with respect to prevalence and severity of scale elevations in the sample, and also with respect to factor structure. Overall, the sample was rated as having significantly more executive function problems than healthy children in the BRIEF standardization sample; elevations on the Working Memory and Plan/Organize scales were most frequently seen. Fully 36% of the sample had four or more significantly elevated scales. However, 31% of the sample had no clinically elevated scales, indicating that executive difficulties, though frequent, are not necessarily characteristic of all children with severe epilepsy. As in the validation studies reported in the manual, a two-factor solution emerged from a principal factor analysis of BRIEF scales. However, the factor structure as given in the manual was not entirely replicated; specifically, the Monitor scale was found to load equivalently on both factors. The results of this study suggest that a substantial proportion of children with intractable epilepsy display significant executive function deficits in daily life. Research into the relationship of BRIEF scores to other measures of executive functioning in children with epilepsy is needed to further clarify its clinical utility.     

Correlates of the Egocentricity Index in Child and Adolescent Outpatients

This study examined the Rorschach and MMPI covariates of Exner's Egocentricity Index, 3γ + (2): R, in a sample of child and adolescent outpatients (n = 46). Consistent with previous findings on adult psychiatric inpatients (Barley, Doff, & Reid, 1985), significant positive correlations were obtained between the Index and M, FM, χ + %, and D when controlled for the number of protocol responses. The Egocentricity Index was negatively associated with lambda and, in a subsample of adolescents (n = 19), depression scores. The index bore no significant relationship to either Minnesota Multiphasic Personality Inventory (MMPI) validity or clinical scales, also congruent with earlier investigations. Implications for the interpretation of childrens' Egocentricity Indices are discussed.     

Attention and Memory in Children with Brain Tumors

The Rey Auditory Verbal Learning Test was utilized to examine attention, learning, and memory abilities in 42 children with cerebellar (N?=?18) and third ventricle tumors (N?=?24). Children with cerebellar tumors exhibited significant auditory attentional impairments and displayed adequate encoding and retrieval across subsequent learning and memory trials. In contrast, children with third ventricle tumors exhibited average auditory attentional abilities, but they displayed mild encoding deficits across trials 2–5. Furthermore, the third ventricle group's compromised performance on the delayed recall trial and average performance on the delayed recognition trial is suggestive of underlying retrieval deficits.     

Relationships between MMPI codetypes and MAC scale elevations in adolescent psychiatric samples.

This study investigated the relationship between subjects' MacAndrew Alcoholism Scale (MAC) elevations and their placement in various codetype classifications. The sample consisted of 1,347 adolescents receiving psychiatric services in Missouri, Virginia, or Texas. The frequency of MAC scores greater than or equal to 24 and greater than or equal to 28 was evaluated, separately by gender, for single-scale and two-point codetypes, containing a minimum of at least 10 subjects. Marked differences occurred in the frequency of MAC scale elevations depending on the adolescent's codetype classification. MAC scores for both genders, for example, were most frequently elevated for the 4-9/9-4 codetype and more rarely elevated for the 2-3/3-2 codetype. Results are discussed in terms of potential measurement overlap which may occur between the MAC scale and several MMPI standard clinical scales, including 4, 6, and 9. It was also noted that the sensitivity and specificity of the MAC scale may vary in relation to subjects' clinical scale profile characteristics.     

Correlations of MMPI Factor Scales With Measures of the Five Factor Model of Personality

Two recent item factor analyses of the Minnesota Multiphasic Personality Inventory (MMPI) classified the resulting factors according to a conceptual scheme offered by Norman's (1963) five factor model. The present article empirically evaluates those classifications by correlating MMPI factor scales with self-report and peer rating measures of the five factor model in a sample of 153 adult men and women. Both sets of predictions were generally supported, although MMPI factors derived in a normal sample showed closer correspondences with the five normal personality dimensions. MMPI factor scales were also correlated with 18 scales measuring specific traits within the broader domains of Neuroticism, Extraversion, and Openness. The nine Costa, Zonderman, McCrae, and Williams (1985) MMPI factor scales appear to give useful global assessments of four of the five factors; other instruments are needed to provide detailed information on more specific aspects of normal personality. The use of the five factor model in routine clinical assessment is discussed.     

MMPI Supplemental Scale Performance of Mexican Americans and Level of Acculturation

Mexican American and Anglo American's performance on the Wiggins Content Scales, Harris-Lingoes subscales, and Serkownek subscales was assessed in a college student population, Level of acculturation (Mexican vs. Anglo orientation), age, and social class were statistically controlled, The results showed statistically significant differences between means of Anglo and Mexican Americans on most of the supplemental scales assessed. These differences were more numerous before scale validity criteria were applied. The number of statistically significant differences were further reduced when level of acculturation and age were statistically controlled, The results showed that level of acculturation is a highly important variable which moderates interpretation of the MMPI scale elevations we measured. Acculturation far outweighted the influence of the well established MMPI moderator variables of age and social class.     

Anxiety and Anger as Predictors of MMPI Elevations in Chronic Pain Patients

Studies utilizing the Minnesota Multiphasic Personality Inventory (MMPI) with chronic pain patients have almost without exception found marked elevations on the Hypochondriasis (Hs), Depression (D), and Hysteria (Hy) scales. The present data reveal that Trait Anxiety was a significant predictor of elevations on all three of these scales for both males and females. Trait Anger emerged as a classical suppressor variable for males only. The implications of these findings are discussed.     

Associations between Symptom Validity Test failure and scores on the MMPI-2-RF validity and substantive scales

This study examined the association between Symptom Validity Test (SVT) failure and the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008), in the Forensic Disability Claimant samples described in the MMPI-2-RF Technical Manual (Tellegen & Ben-Porath, 2008 a, 2008b). SVTs used included the Word Memory Test (Green, 2003), the Computerized Assessment of Response Bias (Allen, Conder, Green, & Cox, 1997), the Medical Symptom Validity Test (Green, 2004), and the Test of Memory Malingering (Tombaugh, 1996). SVT failure was associated with significant elevations throughout the MMPI-2-RF overreporting validity scales and substantive scales. Pairwise contrasts between groups failing 0 and 3 SVTs revealed predominantly large effect sizes for the overreporting validity scales (d = 0.78-1.11), and many of the substantive scales, including the Cognitive Complaints (COG) scale. Results of this study demonstrate an association between SVT performance and elevated scores on the MMPI-2-RF. These results suggest that exaggeration of cognitive symptoms as demonstrated by SVT failure is also associated with overreported emotional, somatic, and neurocognitive complaints on the MMPI-2-RF.     

Psychometric Evaluation of the MMPI–2 Restructured Clinical Scales in Two Dutch Samples

In this article, we evaluate internal validity, internal consistency, and test–retest reliability of the MMPI–2 Restructured Clinical (RC) scales in the Dutch MMPI–2 normative sample (N = 1,244) and a Dutch outpatient psychiatric sample (N = 1,066). We pay special attention to a critique regarding construct drift of RC3 and the redundancy of the RC scales with existing MMPI–2 scales. The results indicate that the RC scales in both samples show comparable or better internal consistencies than the Clinical scales. Also, in both samples, the RC scales demonstrate lower scale-level intercorrelations than the Clinical scales. As to the structural characteristics, principal component analysis of the RC scales provided a clearer pattern than an analysis of the Clinical scales. Furthermore, mean raw scores on the RC scales for men in the Dutch normative sample corresponded highly with those in the U.S. normative sample except for RC2 and RC4. Less correspondence was found for women. Overall, we conclude that the RC scales show satisfactory reliability and promising internal validity in our Dutch samples. We suggest that U.S. validation studies on the RC scales may be generalized to the Dutch-language version of the MMPI–2 RC scales.