Obsessive-compulsive disorder and the five-factor model of personality: distinction and overlap with major depressive disorder

Research on individual differences in obsessive-compulsive disorder (OCD) has focused largely on analogue models with participants experiencing sub-clinical obsessions and/or compulsions. Few studies have examined the association between normal, dimensional personality traits and obsessive-compulsive symptomatology in a clinical sample. The purpose of this study was to examine personality differences in patients with a primary diagnosis of OCD (n = 98) or major depression (n = 98) using the domains and facets of the five-factor model of personality (FFM). Patients completed the self-report version of the Revised NEO Personality Inventory (NEO PI-R). When contrasted with community controls (Revised NEO Personality Inventory (NEO-PI-R) and NEO Five-Factor Inventory (NEO-FFI) professional manual, Psychological Assessment Resources, Odessa, FL, 1992), participants with OCD were found to differ across the domains (and facets) of neuroticism, extraversion, and conscientiousness and the facets of openness and agreeableness. Further, when compared to depressed participants, those with OCD were found to be more extraverted, agreeable, conscientious and less neurotic. With the exception of the conscientiousness domain (and facets), these significant differences were maintained even after controlling for depression severity. These results highlight the unique associations between trait domains and facets of the FFM and OCD.     

The detection of feigned uncoached and coached posttraumatic stress disorder with the MMPI-2 in a sample of workplace accident victims

In this study research participants completed the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) under standard instructions and then were asked to fake posttraumatic stress disorder (PTSD) when completing the MMPI-2 for a 2nd time in 1 of 4 conditions with different instructions on how to fake PTSD: (a) uncoached, (b) coached about PTSD symptom information, (c) coached about MMPI-2 validity scales, or (d) coached about both symptoms and validity scales. These MMPI-2 protocols were then compared with protocols of claimants with workplace accident-related PTSD. Participants given information about the validity scales were the most successful in avoiding detection as faking. The family of F scales (i.e., F, FB, FP), particularly FP, produced consistently high rates of positive and negative predictive power.     

Can the MMPI-2 validity scales detect depression feigned by experts?

Major depression is one of the most frequently presented disorders for claims of psychiatric disability. Evidence also suggests that many individuals making claims of disability exaggerate or even fabricate mental illness. These facts suggest that the detection of feigned depression is an important task in psychiatric disability claim assessments. In this study, the capacity of a number of MMPI-2 validity scales and indicators to detect feigned depression was examined. Twenty-three mental health professionals with specific expertise and significant experience in assessing and treating major depression were asked to complete the MMPI-2 as if they were suffering from major depression. The MMPI-2 protocols of this sample were compared to those of a sample of patients diagnosed with major depression. Results indicated that the validity scales F, back F (FB), and the Dissimulation scale (Ds) were highly successful at distinguishing MMPI-2 protocols of feigned depression from bona fide depression. Replicating results from previous studies, however, FB proved most effective, outperforming all other validity scales and indicators, including F and Ds. These findings suggest that even experts are unable to feign major depression successfully on the MMPI-2, and that the FB scale might be the most effective indicator for detecting feigned depression.     

The Structure of Internalizing Disorders in Middle Childhood and Evidence for Personality Correlates

The current multi-method multi-informant investigation compared the fit of three competing models of internalizing problems in middle childhood: (1) a unitary factor model, (2) a two-factor model corresponding to the DSM-IV Anxiety/Depression distinction, and (3) a two-factor model corresponding to the Fear/Distress distinction observed in structural studies of adult psychopathology (Krueger Archives of General Psychiatry, 56:921-926, 1999); Slade and Watson Psychological Medicine, 36:1593-1600, 2006). In total, 346 youths (mean age = 9.51, SD = .78) and their adult caregivers (344 mothers, 227 fathers) reported on childhood internalizing symptoms and personality traits. Confirmatory factor analyses revealed adequate to good fit indices for all three models, although the unitary factor model provided the most parsimonious summary of the data. Although the structural analyses suggested that internalizing symptom subfactors were not clearly differentiated in middle childhood, hierarchical regression analyses revealed that personality dimensions uniquely predicted the Anxiety/Fear and Depression/Distress disorders. These results suggest that personality correlates differentiate childhood psychopathology structure before it is manifest at the symptom level.     

Exploring the Hierarchical Structure of the MMPI–2–RF Personality Psychopathology Five in Psychiatric Patient and University Student Samples

In this study our goal was to examine the hierarchical structure of personality pathology as conceptualized by Harkness and McNulty's (1994) Personality Psychopathology Five (PSY–5) model, as recently operationalized by the MMPI–2–RF (Ben-Porath & Tellegen, 2011) PSY–5r scales. We used Goldberg's (2006) “bass-ackwards” method to obtain factor structure using PSY–5r item data, successively extracting from 1 to 5 factors in a sample of psychiatric patients (n = 1,000) and a sample of university undergraduate students (n = 1,331). Participants from these samples had completed either the MMPI–2 or the MMPI–2–RF. The results were mostly consistent across the 2 samples, with some differences at the 3-factor level. In the patient sample a factor structure representing 3 broad psychopathology domains (internalizing, externalizing, and psychoticism) emerged; in the student sample the 3-factor level represented what is more commonly observed in “normal-range” personality models (negative emotionality, introversion, and disconstraint). At the 5-factor level the basic structure was similar across the 2 samples and represented well the PSY–5r domains.     

Psychometric properties of a revised Spanish 20-item Toronto Alexithymia Scale adaptation in multiple sclerosis patients

There have been a small number of investigations of alexithymia in multiple sclerosis (MS) using the 20-item Toronto Alexithymia Scale (TAS-20). However, the TAS-20 factor structure has not yet been evaluated in a MS patient sample, and earlier Spanish translations of this instrument require some improvement. We aimed to evaluate the factorial validity and reliability of an improved Spanish translation of the TAS-20 (the TAS-20-S). The TAS-20-S was completed by 221 MS patients. Confirmatory factor analysis was used to compare the fit of six different factor models. Internal consistency and retest reliability coefficients were also computed. The correlated three-factor model and the higher-order factor model made up of Difficulty Identifying Feelings, Difficulty Describing Feelings, and Externally Oriented Thinking achieved the best fit. Alpha coefficients ranged between .87 and .67; mean inter-item correlations ranged between .48 and .20; and retest correlations after 6 months ranged between .61 and .52. A high degree of alexithymia was present in 18.1% of the sample. Reliability and the traditional three-factor structure were demonstrated for the TAS-20-S, which can now be recommended for assessing an aspect of emotional processing in MS patients.     

Differentiating Bipolar Disorder from Major Depressive Disorder Using the MMPI-2-RF: A Receiver Operating Characteristics (ROC) Analysis

We examined the utility of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) to differentiate patients with lifetime bipolar disorder (BD) from patients with lifetime major depressive disorder (MDD), and to differentiate patients with BD who are currently depressed from patients with current MDD. Sixty-one patients with BD (BD-I n = 51, BD-II n = 10) and 381 patients with MDD were administered the MMPI-2; MMPI-2-RF scale scores were derived from these MMPI-2 protocols. Receiver operating characteristics analysis revealed that the MMPI-2-RF Activation (ACT) scale had the largest Area Under the Curve (AUC), which was 0.74. Using a cut-off score of 4 on the ACT scale resulted in 71% of patients being correctly classified as having BD or MDD (sensitivity = 0.67, specificity = 0.71). An examination of currently depressed patients with BD (n = 29) and a randomly selected sample of MDD patients (n = 29) revealed that the ACT scale correctly classified 72% of patients (AUC = 0.75, sensitivity = 0.69, specificity = 0.76). Implications and limitations of these findings were discussed.     

The validity and utility of the positive presentation management and negative presentation management scales for the Revised NEO Personality Inventory

Schinka, Kinder, and Kremer developed "validity" scales for the Revised NEO Personality Inventory (NEO PI-R; Costa & McCrae) to detect underreporting-the Positive Presentation Management (PPM) Scale and overreporting-the Negative Presentation Management (NPM) Scale. In this investigation, the clinical utility of these scales was examined using the established validity scales from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher et al.) as the referent. The sample was composed of 370 psychiatric patients who completed the NEO PI-R and the MMPI-2 as part of a routine evaluation. Results indicated that response distortion compromised the utility of the NEO PI-R domain scales. Moreover, the PPM and NPM scales and an NPM-PPM index significantly differentiated invalid under-and overreporting groups from a valid responding group. The PPM and NPM-PPM index were adequate in classifying under- and overreporters, respectively.