Millon Behavioral Health Inventory norms for chronic pain patients

Millon Behavioral Health Inventory Scores of Patients With Chronic Pain Associated with Myofascial Pain Syndrome

OBJECTIVES

Normative data for the coping styles and psychogenic attitudes of the Millon Behavioral Health Inventory (MBHI) for male and female chronic pain patients (CPPs) with mixed pain diagnoses have previously been reported and compared with normative MBHI manual data. However, results from other studies have suggested that CPPs with myofascial pain syndrome (MPS) may need to be considered as a distinct group in psychiatric/psychological studies. The purpose of the present study was then to provide normative data for each MBHI scale for male and female CPPs with MPS and to compare these data with MBHI manual norms for similarities and differences.

SETTING

Multidisciplinary pain facility.

PATIENTS

CPPs with an associated diagnosis of MPS.

OUTCOME MEASURE

MBHI base rate scores.

METHODS

CPPs with an associated diagnosis of MPS were first broken down into two groups: males and females. Analyses were then performed using the MBHI base rate scores of these two groups. For each group, the percentages of CPPs who had a base rate of 75 or above were calculated for each individual coping style and psychogenic attitude. These percentages were then compared by chi square with percentages of patients with base rate scores of 75 or above for each coping style and psychogenic attitude to the MBHI Manual normative sample.

RESULTS

Female CPPs with MPS differed from MBHI Manual normative counterparts on two of the six psychogenic attitude scales (future despair and somatic anxiety); no differences were found in any of the eight coping style scales. Male CPPs with MPS differed from MBHI Manual normative counterparts on one coping style scale (sociable) and three psychogenic attitude scales (premorbid pessimism, future despair, and somatic anxiety).

CONCLUSIONS

The pattern of the results indicated that CPPs with MPS, especially males, differ from the MBHI Manual normative data counterparts. These differences appear to be greater than those for CPPs with mixed pain diagnoses. Differences in MBHI scale scores between CPPs with MPS and MBHI Manual normative data counterparts may be related to a number of issues, such as whether differences in state factors reflecting depression and anxiety might affect trait factors purportedly measured by the MBHI.

Self-report evaluation of health behavior, stress vulnerability, and medical outcome of heart transplant recipients

OBJECTIVE

The purpose of this study was to explore the value of patient self-report assessment in heart transplant candidacy evaluation, utilizing the Millon Behavioral Health Inventory (MBHI). Patient's MBHI measures were related to important pretransplant patient characteristics and posttransplant measures of health behavior, medical morbidity, and mortality.

METHOD

Ninety heart patients with end-stage cardiac disease completed the MBHI during pretransplant candidacy evaluations, and also were interviewed concerning their coping effectiveness, support resources, and compliance history. Postransplant follow-up of 61 living and 29 deceased patients included measures of survival time, postsurgical medical care, rejection and infection episodes, and nurse ratings of medication compliance and problematic interpersonal health behaviors.

RESULTS

The MBHI coping scales were found to significantly discriminate good and poor pretransplant compliance, and interview judgments of good and poor coping and support resources, with modest accuracy. The MBHI also was superior to these interview judgments in predicting posttransplant survival time and medical care used. Certain scales were also positively associated with physical parameters of pretransplant and posttransplant status.

CONCLUSIONS

Patient self-report with the MBHI can contribute to identification of patients at risk for a problematic outcome with transplant, by providing information pertinent to clinical decision making and outcome management analysis with this special population of cardiac patients.

Personality disorder correspondence among the MMPI, MBHI, and MCMI

MMPI, MBHI, and MCMI personality disorder scales were analyzed for convergent and discriminant validity. Friedman's ANOVA indicated that there were no significant differences among the sample's averaged scale scores. Further analyses of these data, however, demonstrated that the Millon instruments classified significantly more of the sample as personality disordered when compared to Morey's MMPI personality disorder scales. In addition, codetype correspondence among the three instruments was only 4 to 6%. When the instruments were analyzed in a pair-wise fashion, codetype correspondence increased to approximately 10 to 20%. These data indicate that these personality disorder scales do not demonstrate construct equivalence, particularly at the level of the individual profile.