Relationship between the Millon Behavioral Health Inventory and the minnesota multiphasic personality inventory (MMPI) in low-back pain patients

The Millon Behavioral Health Inventory (MBHI) is being used with increasing frequency for the assessment of chronic pain, although there is a relative lack of evidence as to its utility, and prior studies have not examined low back pain. This investigation compared the MBHI to the MMPI in a sample of low-back pain patients and analyzed subgroups of pain patients based upon their MBHI responses. Subjects were 60 patients who had been admitted to outpatient multidisciplinary pain clinics of two Chicago-area hospitals. Patients completed both the MMPI and the MBHI and provided demographic information. Results of correlational analyses indicated strong relationships between the MBHI psychogenic attitude, psychosomatic correlate, and prognostic index scales and the validity scales of the MMPI. The MBHI Pain Treatment Responsivity scale (PP) correlated with 16 of the other 19 MBHI scales. PP did not demonstrate specificity with low back pain patients. The results of both the scale comparisons and the exploratory two-group cluster subgroup analysis support the notion that responses to the MBHI are largely affected by the respondent's tendency to deny psychopathology or to admit emotional distress.     

The distribution of repressive coping styles among non-metastatic and metastatic breast cancer patients as compared to non-cancer patients

Abstract

Recent investigations have shown increased disease progression among breast cancer patients with a “repressive” coping style characterized as: passive, conforming, inclined to deny physical symptoms and emotionally unexpressive. The Millon Behavioral Health Inventory (MBHI) scales which delineate three discrete repressive coping styles include the: Introversive, Cooperative and Respectful. Forty-four women recently diagnosed (within four weeks) with non-metastatic (N=32) or metastatic (N=12) breast carcinoma, responded to the MBHI upon admission for treatment of their disease at a cancer treatment unit. All subjects received mastectomy as well as chemotherapy, radiation and/or endocrine therapy. These 44 Cancer patients were compared to 34 control subjects, comprising women who were seen at a colposcopy clinic for follow-up of a suspicious pap smear which was ultimately shown to be benign or consisted of mild dysplasia. Non-metastatic, metastatic and control subjects were compared with respect to coping style and psychological distress. The breast cancer patients were more likely to employ a repressive coping style as compared to non-cancer patients who utilized a “sensitizing” coping strategy predominantly. Cancer patients with the most severe prognosis (metastasis) were the only group within the study to attain a clinically significant mean base rate score on the respectful scale. Results suggest that the incidence of repressive coping styles may be disproportionately high among breast cancer patients.     

Factor comparison of two Minnesota Multiphasic Personality Inventory short forms

A sample of 315 valid Minnesota Multiphasic Personality Inventory (MMPI) protocols were selected from inpatient files and scored for both the MMPI-168 and Faschingbauer Abbreviated MMPI short forms. Each short form was then factor-analyzed by a principal axis strategy with varimax rotation. The six factors extracted from each short form were then compared as to their similarity by use of the s index. This procedure showed five of the six factors in each short form as having a significant relationship of the pattern of salient variables they had in common with the complimentary factors of the other form. These data suggest that both short forms, though based on different construction methodologies, share the same underlying personality attributes. Future research is suggested to replicate these results and extend them to the full MMPI.     

Personality disorder correspondence between the million behavioral health inventory (MBHI) and the minnesota multiphasic personality inventory (MMPI)

The MBHI and MMPI personality disorder scales were analyzed for convergent and discriminant validity. Correlational data demonstrated that six of the eight scales were significantly related, while the remaining two scales approached significance. Further analyses of these data, however, demonstrated that none of the scales correlated significantly better with its convergent scale compared to nonconvergent scales. The MBHI classified significantly more of the sample as personality disordered (93%) compared to the MMPI personality disorder scales (17%). Furthermore, the MBHI tended to describe the sample as falling within the Anxious cluster of personality disorders, whereas the MMPI described them within the Dramatic cluster. Single scale codetype correspondence was found to be 15%, while two-point concordance was 12.5%, indicating very low congruence between personality style codetypes. These two measures do not appear to be measuring the same personality style constructs.     

Specificity of MMPI cluster types to chronic illness

Abstract

Cluster analysis derived MMPI profile types were compared for three distinct illness populations: chronic low back pain (CLBP), mixed headache (HA), and cardiac disease (CD). Results replicated previous findings in the chronic pain and cardiac literatures. Differences between diagnostic groups and genders were found for the prevalence of the derived MMPI profile types. Results indicated that, in males, the two chronic pain groups had similar profile types and similar relative frequencies of these types, but both differed from the CD sample. The chronic pain groups tended to have a greater number of patients with pathological and distressed MMPI profile types and a lesser representation in the subclinical profile type compared to the CD sample. Similar findings were obtained for females, though the CLBP group tended to have a higher frequency of highly distressed, pathological profiles than either the HA or CD groups. Results suggested that the MMPI may be a measure of response to illness rather than reflecting predisposing personality types for any given illness and that the higher frequency of highly distressed profiles in the chronic pain samples reflects the increased suffering of those populations compared to other illnesses.     

Clinical Considerations in the Conjoint Use of the Rorschach and the MMPI

Contemporary clinical and research findings concerning the Rorschach and the Minnesota Multiphasic Personality Inventory (MMPI) indicate that (a) objectivity and subjectivity are relative and not categorical dimensions of these two instruments; (b) apparent contradictions between Rorschach and MMPI results are generative and not invalidating; (c) within limits, false negative findings are not cause for concern in the clinical application of Rorschach and MMPI variables; and (d) differences between the Rorschach and the MMPI in how they are structured and what they measure demonstrate considerable advantage in using them in complementary fashion to support clinical inferences.     

Clinical considerations in the conjoint use of the Rorschach and the MMPI

Contemporary clinical and research findings concerning the Rorschach and the Minnesota Multiphasic Personality Inventory (MMPI) indicate that (a) objectivity and subjectivity are relative and not categorical dimensions of these two instruments; (b) apparent contradictions between Rorschach and MMPI results are generative and not invalidating; (c) within limits, false negative findings are not cause for concern in the clinical application of Rorschach and MMPI variables; and (d) differences between the Rorschach and the MMPI in how they are structured and what they measure demonstrate considerable advantage in using them in complementary fashion to support clinical inferences.     

Psychological and social correlates of the back pain classification scale

The Back Pain Classification Scale (BPCS) identifies patients whose low back pain reflects a primary psychological disturbance. BPCS scores were related to the MMPI, State-Trait Anxiety Inventory, Multiple Affect Adjective Check List, and Social Readjustment Rating Scale scores; to distribution, intensity, and activities affecting pain; and to social characteristics of 116 patients. High scores on the BPCS (psychological disturbance) are associated with elevated MMPI profiles, and with more widely distributed and more intense pain. Stepwise multiple regression solutions indicate that the MMPI Hypochondriasis (Hs) scale accounts for 15.5% of the variance. No other variable accounts for as much as 3% of the variance. Scores on Hs relate primarily to words in the BPCS psychologically disturbed pole, supplying convergent validity to the BPCS. BPCS scores are unrelated to social characteristics, implying usefulness with the variety of patients seen for evaluation of low back pain.     

Detection of a Psychiatric Diagnosis in Heart Transplant Candidates with the MBHI

The utility of the Millon Behavioral Health Inventory (MBHI) in screening for the formal diagnosis of a psychiatric disorder was investigated in a sample of 90 heart transplant candidates, a population at risk for psychiatric disturbance. Psychiatric disorders were identified in 71% of patients, the majority being adjustment disorder. Sensitivity and specificity rates of >70% were determined in discriminant function analyses, for presence or absence of a psychiatric condition. When Axis I conditions were differentiated as mild (adjustment reaction only) or severe (all other Axis I conditions, including comorbid Axis II disorders), the MBHI correctly identified every severe case as a probable psychiatric diagnosis. The rate of clinically significant elevations on certain MBHI scales and severity of Axis I psychiatric condition was also significantly associated. These findings suggest that the MBHI may have potential utility in identifying high-risk patients with diagnosable psychiatric conditions and help justify mental health consultation referrals at a time when managed care entities are vigorously rationing ancillary services with medically ill populations.     

The Rorschach Concept Evaluation Technique

The Back Pain Classification Scale (BPCS). identifies patients whose low back pain reflects a primary psychological disturbance. BPCS scores were related to the MMPI, State-Trait Anxiety Inventory, Multiple Affect Adjective Check List, and Social Readjustment Rating Scale scores; to distribution, intensity, and activities affecting pain; and to social characteristics of t 16 patients. High scores on the BPCS (psychological disturbance) are associated with elevated MMPI profiles, and with more widely distributed and more intense pain. Stepwise multiple regression solutions indicate that the MMPI Hypochondriasis (Hs) scale accounts for 15.5% of the variance. No other variable accounts for as much as 3% of the variance. Scores on Hs relate primarily to words in the BPCS psychologically disturbed pole, supplying convergent validity to the BPCS. BPCS scores are unrelated to social characteristics, implying usefulness with the variety of patients seen for evaluation of low back pain.     

Predicting treatment preferences for agoraphobia

Fifty-one university students completed two questionnaires: (1) The Millon Behavioral Health Inventory (MBHI) and (2) a questionnaire evaluating Ss' ratings of acceptability and effectiveness of five treatments for agoraphobia (Norton, Allen and Hilton, 1983a). The results showed that the Ss rated the three psychological treatments as more effective and acceptable than the two drug treatments. A discriminant function analysis, using the coping style measures of the MBHI and the Ss' ratings of acceptability and effectiveness of tranquilizers as predictor variables, correctly classified 78% of the Ss as to which psychological treatment they rated as more acceptable and effective for agoraphobia.     

Racial identity and the MMPI in African American male college students

The relation of the Minnesota Multiphasic Personality Inventory (MMPI) to the Racial Identity Attitude Scale--Black, Short Form (RIAS-B) was examined among 50 African American male college students in a reanalysis of unpublished MMPI data described in R. H. Dana (1993). This permitted study of relationships between MMPI scores and specific psychological variables hypothesized to produce cultural differences among African Americans. Results indicated RIAS-B scale scores functioned as predictors of MMPI scale scores. Similar research with the MMPI-2 incorporating larger samples that more adequately represent African American heterogeneity is needed. Methodological implications of these findings for MMPI-2 research with ethnic and racial groups are discussed, emphasizing the importance of research to depathologize African American racial and cultural identity.     

The MMPI and Jesness Inventory as measures of effectiveness on an inpatient conduct disorders treatment unit

There is a paucity of research on the effectiveness of inpatient treatment of conduct disorders. The purpose of the present study was to determine what effect a locked behavioral/cognitive treatment setting would have upon the Minnesota Multiphasic Personality Inventory (MMPI) and Jesness Inventory scores of adolescent inpatients. Fifty consecutive admissions (30 males, 20 females) to a conduct disorders unit were administered the MMPI and Jesness Inventory pre- and posttreatment. Statistically significant changes were found on both inventories. Males responded to treatment more favorably than did females. Improvement on the test scores could not conclusively be linked to the treatment due to the absence of a control group; however, combined with previous research, the results indicate areas of improvement in the sample's pathology.     

MMPI correlates of Exner's Egocentricity Index in an adolescent psychiatric population

This research examined the relationship between Exner's Egocentricity Index (EI) and Minnesota Multiphasic Personality Inventory (MMPI) Scales 2, 4, and 9 in an adolescent psychiatric population. Subjects with a low EI had significantly higher MMPI Depression (D) scale elevations compared to those with a high EI. Furthermore, of the adolescents who had Scale 2 scores in the clinical range, 68% also had an EI in the bottom half of the distribution. There was no relationship between the EI and MMPI scales 4 and 9. These findings are discussed in light of the generally poor correlations between MMPI and Rorschach variables.     

Relations Between Minnesota Multiphasic Personality Inventory–A Scales and Rorschach Variables With the Scope and Severity of Maltreatment Among Adolescents

This study examined preexisting Rorschach (Exner, 2001) and Minnesota Multiphasic Personality Inventory–A (MMPI–A; Butcher et al., 1992) profiles to determine if selected MMPI–A scales and Rorschach variables would jointly associate with the number and severity of maltreatment subtypes (physical abuse, sexual abuse, neglect, and emotional maltreatment) of 157 adolescents (ages 14–17) with documented maltreatment histories. The Maltreatment Classification System was used to systematically code the maltreatment attributes. Six Rorschach variables (MOR, PER, Afr, SumY, SumC’, Human Content) were significantly correlated with the number of maltreatment subtypes, but none of the anticipated MMPI–A scales were related. MMPI–A Scale 7 and Rorschach variables Ego, MOR, and PER were jointly associated with physical abuse severity. MMPI–A Scale 0 and Rorschach variables MOR, PER, SumY, SumC’, PTI, Human Content, and Texture jointly associated with sexual abuse severity. This study supports the potential for certain MMPI–A scales and Rorschach variables to reflect the impact of adolescents’ maltreatment experiences in terms of the number and severity of types of maltreatment experienced. Because both instruments captured different aspects of adolescents’ maltreatment experiences, clinicians should consider using both when evaluating the impact of maltreatment on adolescents.     

Exploring gait adaptations to perturbed and conventional treadmill training in Parkinson’s disease: Time-course,sustainability, and transfer

BackgroundGait impairment is a major motor symptom in Parkinson’s disease (PD), and treadmill training is an effective non-pharmacological treatment option.Research questionIn this study, the time course, sustainability and transferability of gait adaptations to treadmill training with and without additional postural perturbations were investigated.Methods38 PD patients (Hoehn & Yahr 1–3.5) were randomly allocated to eight weeks of treadmill training, performed twice-weekly for 40 min either with (perturbation treadmill training [PTT], n = 18) or without (conventional treadmill training [CTT], n = 20) additional perturbations to the treadmill surface. Spatiotemporal gait parameters were assessed during treadmill walking on a weekly basis (T0–T8), and after three months follow-up (T9). Additional overground gait analyses were performed at T0 and T8 to investigate transfer effects.ResultsTreadmill gait variability reduced linearly over the course of 8 weeks in both groups (p < .001; Cohen’s d (range): −0.53 to −0.84). Only the PTT group significantly improved in other gait parameters (stride length/time, stance-/swing time), with stride time showing a significant between-group interaction effect (Cohen’s d = 0.33; p = .05). Additional between-group interactions indicated more sustained improvements in stance (Cohen’s d = 0.85; p = .02) and swing time variability in the PTT group (Cohen’s d = 0.82; p = .03) at T9. Overground gait improvements at T8 existed only in stance (d = -0.73; p = .04) and swing time (d = 0.73; p = .04).DiscussionTreadmill stride-to-stride variability reduced substantially and linearly, but transfer to overground walking was limited. Adding postural perturbations tended to increase efficacy and sustainability of several gait parameters. However, since between-group effects were small, more work is necessary to support these findings.     

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.     

On the stability and relevance of the exercise heart rate–music-tempo preference relationship

ObjectivesTo examine the stability of the cubic (two points of inflection) exercise heart rate–music-tempo preference relationship found by Karageorghis et al. (2011) in cycle ergometry using a different exercise modality (treadmill exercise). To advance previous related studies through the inclusion of psychological outcome variables (e.g., state attention and intrinsic motivation) and post-experiment interviews.DesignA mixed-model experimental design was employed with two within-subject factors (exercise intensity and music tempo) and a between-subjects factor (gender). The experiment was supplemented by qualitative data that were analyzed using inductive content analysis.MethodsParticipants (n = 22) exercised at six intensities (40–90% maxHRR) during which they were exposed to music tracks at four tempi and a no-music control. Music preference, affective valence, and perceived activation were assessed during the task. Immediately afterwards, an attentional focus item, the short Flow State Scale-2 and items from the Intrinsic Motivation Inventory were administered. A subsample of participants (n = 8) was interviewed using a schedule of open-ended questions.ResultsResults did not support a cubic relationship but rather a quadratic one (one point of inflection), and there was a weak association between the optimal choice of music tempo and positive psychological outcomes.ConclusionsThe range of preferred tempi for treadmill exercise (123–131 bpm) was narrower than that for cycle ergometry (125–140 bpm). Regardless of its tempo, music reduced the number of associative thoughts by ∼10% across all exercise intensities.     

Optimal Scoring of the Multidimensional Pain Inventory in a Chronic Pain Sample

The Multidimensional Pain Inventory (MPI) is one of the most commonly used self-report instruments in pain settings. The MPI can be used to classify patients into three clusters or its nine scales can be treated as dimensions in efforts to understand patient heterogeneity. Previous research suggests the existence of a fourth cluster, whose members have been labeled ‘repressors,’ that emerges with the addition of a defensiveness scale to the MPI. The current paper compared the abilities of MPI cluster and dimensional models with and without a measure of defensiveness to capture variability in validating variables related to personality, psychopathology, physical functioning, and treatment outcome in a chronic pain sample. Results suggest that dimensional models consistently outperform cluster models in explaining variance in outcome variables, and that the addition of a measure of defensiveness increments the validity offered by the MPI scales. Implications for the assessment of pain patients are discussed.