Latent Classes based on Clinical Symptoms of Military Recruits with Mental Health Issues and Their Distinctive Clinical Responses to Treatment over 6 Months

Objective

: This study aimed (1) to identify distinct subgroups of psychiatric patients referred for a mental health certificate for military service suitability and (2) to determine whether there is a difference in clinical features such as treatment responsiveness and prognosis among certain subgroups.

Methods

: We conducted latent profile analysis (LPA) using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) clinical profiles of the participants. Linear mixed model analysis was performed to examine changes in the severity of clinical symptoms and functional level according to the treatment period of the latent classes derived from the LPA.

Results

: The results indicated that the best-fitting model was a three-class model, comprising Class 1 (mild maladjustment), Class 2 (neurotic depression and anxiety), and Class 3 (highly vulnerable and hypervigilant). We demonstrated that the three subgroups displayed different characteristics in treatment responsiveness and clinical course based on their Clinical Global Impression-Severity and Global Assessment of Functioning scores over a treatment period of 6 months. While subjects in Classes 1 and 2 significantly improved over 6 months, those in Class 3 showed little or no improvement in our clinical parameters.

Conclusion

: This study has yielded data with clinical implications for treatment planning and interventions for each subgroup classified that were based on MMPI-2 clinical profiles of military recruits who might be maladjusted to serve.

The forensic assessment of dissociation: Distinguishing real from the unreal

Because a wide range of disorders incorporate dissociative symptoms, evaluators should be familiar with evidence-based approaches to evaluating dissociation claims in the clinical and forensic context. This article provides specific guidelines for practitioners when conducting a forensic assessment of individuals who report dissociative symptoms. We review the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition disorders that include dissociation as a symptom, highlight how to distinguish genuine versus atypical symptoms of dissociative identity disorder, and summarize strengths and weaknesses of structured assessments in the evaluation of dissociative claims.

A study supported by the MMPI-2 test

The main function of the medical-psychological assessment to evaluate fitness to drive (FTD) is to safeguard the community against risks posed by drivers who, owing to psycho-physical disease, personality disturbances, abuse of psychotropic substances or drugs, can be a hazard to safety on the roads. In the context of psychodiagnostic investigations, the Minnesota Multiphasic Personality Inventory 2 (MMPI-2) test is the gold standard tool supporting clinical assessments conducted to evaluate a subject's capacity to predict her/his own actions, attitudes, risk propensity, level of conformity to social norms. Other important features of the tool include the specific scales aimed at individuating behaviors adopted with the intent to elude or hide existing personality problems. These behaviors are very frequent in the field of medicolegal, psychological and psychiatric assessments, including FTD evaluations. In this study, the MMPI 2 test was administered to 154 subjects for whom Driving Licence (DL) Medical Commissions based in the south of Italy had required specific personality assessments, compared to a control group of 186 subjects with no clinical or psychodiagnostic problems. The question posed in our study was to understand whether the test was able to detect differences between the personalities of the subjects belonging to the two groups. The results obtained demonstrated significant differences between the experimental group and the controls, shown by the MMPI-2 variables, in particular the clinical Hs scale,the supplementary scales: GF, Re, AAS, APS and the content scales DEP and TRT, as well as the PSY-5 Disc and Nege scales.

Hypnotizability and psychopathology of patients with personality disorders

Assessment of hypnotizability is useful in research and predicting the effects of hypnosis in clinical practice. There are few contemporary scientific reports examining the relationship between hypnotizability and psychopathological personality dimensions. The current study explores the connections between abnormal personality in psychiatric patients and the hypnotizability level. Fifty-five patients with anxiety and personality disorders who previously completed the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) were invited to undergo the Elkins Hypnotizability Scale - Clinical Form (EHS-CF). The hypnotizability scores comprise a normal distribution but shifted toward low scores. Twenty-seven patients were included in the low hypnotizability (LOW) group, and 28 patients in the medium to high (MID-HIGH) group. The number of participants with high scores on the Psychopathic Deviate and Paranoia MMPI-2 clinical scales was significantly higher in the LOW than in the MID-HIGH group. Patterns of associations between hypnotizability and psychopathology differed in the two groups. The results indicate that moderate hypnotizability should be considered a normal trait that has no meaningful relationship with psychopathology, but certain dysfunctional symptoms of personality disorders may entail resistance and a defensive attitude toward the hypnotherapy, resulting in a tendency to obtain lower hypnotizability.

Characteristics of alcohol use disorder patients based on MMPI-2 profile typology and comorbid disorder

This study investigated the clinical characteristics of alcohol use disorder (AUD) patients using a typology based on the MMPI-2 to compare patients with and without comorbid disorders. A total of 244 patients with AUD at an alcohol specialty hospital were categorized into the two groups. The noncomorbid group (n = 142) had three profile types: a "normal profile type," with normal-range scores on clinical scales; a "depressive and worried profile type," with elevated clinical scales 2, 7, and 4; and a "mild psychological discomfort type," with scores within the normal range on clinical scales and relatively low on defensiveness scales. The comorbid group (n = 102) had two profile types: a "mild psychopathological type," with higher scores on infrequency scales and clinical scales 2, 4, 6, 7, and 8 and relatively lower defensiveness scale scores than type 2; and a "normal profile type" with all scale scores within the normal range. In both groups, the profile types were significantly differentiated on the Addiction Admission Scale (AAS) in the supplemental scales for substance abuse.

Psychological correlates of sexual self-esteem in young women with Mayer-Rokitansky-Küster-Hauser syndrome

BACKGROUND

Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS) is a difference (disorder) of sex development that results from Müllerian duct aplasia in 46,XX females. The diagnosis of MRKHS is usually established in late adolescence. The purpose of the study was to assess the impact of congenital absence of uterus and vagina (CAUV) on a patient's psychosexual functioning.

PARTICIPANTS AND PROCEDURE

Thirty-two women with MRKHS (mean age 22.9 years) and 32 matched healthy controls (mean age 24.75 years) completed three study questionnaires: the Sexual Self-Esteem Inventory for Women, the Rosenberg Self-Esteem Scale, and Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Statistical analysis was performed by IBM SPSS Statistics 22.

RESULTS

There was no difference in global self-esteem between the two study groups. MRKHS females had lower sexual self-esteem and experienced higher intensity of some psychological functioning characteristics (paranoia, psychasthenia, schizophrenia) than their peers. Correlations between sexual self-esteem and results on depression, psychopathic deviate, schizophrenia, social introversion and anxiety scales were observed in patients with MRKHS. Global self-esteem and schizophrenia results were significant predictors of sexual self-esteem in the clinical group. Higher global self-esteem and lower results in the schizophrenia scale were associated with higher sexual self-esteem in patients with MRKHS.

CONCLUSIONS

Psychological and medical counseling of women with MRKHS should address their impaired sexual self-esteem, especially sexual skills and experiences. While the number of diagnostic responses indicating the presence of specific symptoms in MRKHS females is statistically significantly different, the level of scores obtained does not exceed the threshold of clinical pathology.

Understanding MMPI-2 response structure between schizophrenia and healthy individuals

BACKGROUND

Using Minnesota Multiphasic Personality Inventory-2 (MMPI-2) clinical scales to evaluate clinical symptoms in schizophrenia is a well-studied topic. Nonetheless, research focuses less on how these clinical scales interact with each other.

AIMS

Investigates the network structure and interaction of the MMPI-2 clinical scales between healthy individuals and patients with schizophrenia through the Bayesian network.

METHOD

Data was collected from Wuhan Psychiatric Hospital from March 2008 to May 2018. A total of 714 patients with schizophrenia and 714 healthy subjects were identified through propensity score matching according to the criteria of the International Classification of Diseases (ICD-11). Separated MMPI-2 clinical scales Bayesian networks were built for healthy subjects and patients with schizophrenia, respectively.

RESULTS

The Bayesian network showed that the lower 7 scale was a consequence of the correlation between the lower 2 scale and the greater 8 scale. A solely lower 7 scale does yield neither a lower 2 scale nor a higher 8 scale. The proposed method showed 72% of accuracy with 78% area under the ROC curve (AUC), similar to the previous studies.

LIMITATIONS

The proposed method simplified the continuous Bayesian network to predict binary outcomes, including other categorical data is not explored. Besides, the participants might only represent an endemic as they come from a single hospital.

CONCLUSION

This study identified MMPI-2 clinical scales correlation and built separated Bayesian networks to investigate the difference between patients with schizophrenia and healthy people. These differences may contribute to a better understanding of the clinical symptoms of schizophrenia and provide medical professionals with new perspectives for diagnosis.

Childhood Obesity and Maternal Personality Traits: A New Point of View on Obesity Behavioural Aspects

The epidemic spread of childhood obesity in Western society has interested many researchers, who agree in defining it as a multifactorial disease in which not only eating habits and sedentary lifestyle play a role, but also genetic predisposition. The aim of this study was to analyze the personality profile of a group of mothers of children with obesity and to compare this profile to that of a group of mothers of children without obesity. A total of 258 mothers participated in the study (126 mothers of children with obesity and 132 mothers of children without obesity). Weight and height were measured and the body mass index was calculated. The Minnesota Multiphasic Personality Inventory second edition (MMPI-2), evaluating personality and psychological disorders, was used to evaluate the personality profile. The results suggested that mothers of children with obesity score higher than the mothers of children without obesity in all MMPI-2 subscales. In most of these subscales, the differences between the two groups of mothers were statistically significant and with a medium to high effect size. These data suggest a new perspective on childhood obesity, identifying it as a multifactorial pathology that requires a multimodal and multidisciplinary approach that also takes care of caregivers to ensure optimal therapeutic efficacy.

The Influence of Rehabilitation on Quality of Life in Breast Cancer Survivors: A Clinical Study

Background: Breast cancer survivors report negative impacts of cancer, augmented by specific vulnerabilities to body changes, negative self-assessment, and quality-of-life concerns. The main objective of our work was to test the effect of a rehabilitation program on breast cancer patients by evaluating the change in their physical well-being during an outpatient rehabilitation setting and, subsequently, in a home rehabilitation setting, considering the individual personality profile. Methods: Patients who underwent total mastectomy with breast prostheses or tissue expanders were enrolled. Outcome assessments (Pain, Quality of Life, Personality traits for the Minnesota Multiphasic Personality Inventory-2) before treatment (T0), at the end of the rehabilitative treatment (T1 = 10 sessions 2/week, one hour/each), and after two months of follow-up (T2) were performed. Results: The data of 38 included patients were analyzed. The quadratic trend of the Visual Analogue Scale can be explained by the fact that patients have a strong reduction in the perceived pain immediately after rehabilitation in the clinic. This reduction remains constant for the home period of the rehabilitation. The personality profiles of all the participants were substantially valid. Only three patients obtained scores higher than 65 points. Conclusions: The study evidenced that in the initial phase of the rehabilitation, psychological traits such as anxiety, depression, and preoccupation could have a strong association especially with the autonomous functions and the perceived physical symptoms. However, during the therapeutic process, this association decreased and these decrements were higher when patients performed their rehabilitation at home, in a more familiar and comfortable setting.

Can the MMPI Predict Adult ADHD? An Approach Using Machine Learning Methods

(1) Background: Adult attention-deficit/hyperactivity disorder (ADHD) symptoms cause various social difficulties due to attention deficit and impulsivity. In addition, in contrast to ADHD in childhood, ADHD in adulthood is difficult to diagnose due to mixed psychopathologies. This study aimed to determine whether it is possible to predict ADHD symptoms in adults using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) with machine learning (ML) techniques; (2) Methods: Data collected from 5726 college students were analyzed. The MMPI-2-Restructured Form (MMPI-2-RF) was used, and ADHD symptoms in adults were evaluated using the Attention-Deficit/Hyperactivity Disorder Self-Report Scale (ASRS). For statistical analysis, three ML algorithms were used, i.e., K-nearest neighbors (KNN), linear discriminant analysis (LDA), and random forest, with the ASRS evaluation result as the dependent variable and the 50 MMPI-2-RF scales as predictors; (3) Results: When the KNN, LDA, and random forest techniques were applied, the accuracy was 93.1%, 91.2%, and 93.6%, respectively, and the area under the curve (AUC) was 0.722, 0.806, and 0.790, respectively. The AUC of the LDA method was the largest, with an excellent level of diagnostic accuracy; (4) Conclusions: ML using the MMPI-2 in a large group could provide reliable accuracy in screening for adult ADHD.

Can Demographic Variables Be Disregarded?

The driver’s personality is a key human factor for the assessment of the fitness to drive (FTD), affecting driving decisions and behavior, with consequences on driving safety. No previous study has investigated the effectiveness of Minnesota Multiphasic Personality Inventory (MMPI)-2 scales for predicting the FTD. The present study aimed to compare two MMPI-2-based models of normal and pathological personality traits (i.e., Inventory of Driving-related Personality Traits (IVPE)-MMPI vs. Personality Psychopathology Five (PSY-5) scale) in predicting the cognitive FTD. One hundred young and eighty-seven adult active drivers completed the MMPI-2 questionnaire as a measure of personality and a computerized driving task measuring for resilience of attention (Determination Test (DT)), reaction speed (Reaction Test (RS)), motor speed (MS), and perceptual speed (Adaptive Tachistoscopic Traffic Perception Test (ATAVT)). The effects of age, gender, and education were also controlled. Results showed that the models controlled for demographics overperformed those neglecting them for each driving outcome. A negative effect of age was found on each driving task; the effect of gender, favoring males, was found in both the RS and the MS, and the effect of education was found on the DT and the ATAVT. Concerning personality traits, significant effects were found of sensation seeking (IVPE-MMPI) on each outcome; of anxiety (as a measure of emotional instability; IVPE-MMPI) and introversion (PSY-5) on the measures of MS; and of psychopathic deviation (as a measure of self-control; IVPEMMPI) on the DT. The study confirmed the key role of demographic factors in influencing the FTD, further suggesting the usefulness of some MMPI2-based personality scales in the assessment of driving-related personality determinants.

Clinical and Psychological Characteristics of Young Men with Military Adaptation Issues Referred for a Psychiatric Evaluation in South Korea: Latent Profile Analysis of Minnesota Multiphasic Personality Inventory-2 and Temperament and Character Inventory

OBJECTIVE

To investigate clinical and psychological characteristics of young men referred for a psychiatric evaluation due to expected unsuitability for military service and identify their heterogeneous subgroups based on the profiles of MMPI-2 and TCI.

METHODS

We conducted a latent profile analysis of 348 men using MMPI-2 and TCI and then a comparative analysis of four latent classes in relation to sociodemographic, clinical, and IQ variables.

RESULTS

We identified four classes with distinct clinical and psychological features: Class 1 (nonclinical: n=68), Class 2 (internalized: n=129), Class 3 (externalized: n=60), Class 4 (confused: n=91). Class 1 showed no significant psychiatric symptoms and relatively adaptive temperament and characteristics. Class 2 showed relatively higher harm avoidance and introverted traits indicating vulnerability to internalizing disorder. Class 3 was related to higher novelty seeking, impulsivity, and bipolarity. Class 4 showed the most severe clinical symptoms including psychotic experiences with extremely unstable temperament and immature personality. In total, 50-70% participants reported clinically significant depression, anxiety, and suicidal idea. Participants showed lower processing speed index (M=85.9, SD=16.6) than the general population.

CONCLUSION

The results suggest that clinical conceptualization and therapeutic intervention considering distinctive features of young men with adaptive problems related to military service are needed.

Psychological profiles of irritable bowel syndrome patients with different phenotypes

BACKGROUND/AIMS

Abnormal psychological profiles are frequently found in patients with functional gastrointestinal disorders (FGIDs). The present study aimed to evaluate the psychological profiles of FGID patients with irritable bowel syndrome (IBS), and IBS phenotypes.

METHODS

In 608 FGID patients, including 235 with IBS, have filled a Rome III questionnaire and the French version of the Minnesota Multiphasic Personality Inventory 2. Data analysis was performed using univariate analysis and multivariate logistic regression.

RESULTS

This study shows that IBS patients have abnormal psychological profiles with more significant symptom exaggeration and decreased test defensiveness than non-IBS patients. They have a significantly higher score for all clinical scales. Logistic regression analysis showed in IBS patients a decrease of body mass index (P= 0.002), and test defensiveness score K (P= 0.001) and an increase of Hypochondriasis (P< 0.001) and Masculinity-Femininity scale (P= 0.018). By comparison with non-IBS patients, IBS-constipation, IBS-diarrhea, and mixed IBS patients have increased Hypochondriasis value and Depression score, mixed IBS patients have higher Psychasthenia score and higher Hypomania score. No item was significantly different in the IBS-unspecified group.

CONCLUSIONS

This study shows that IBS patients have different psychological profiles than other FGID patients and that psychological characteristics are associated with IBS phenotypes except for patients with unsubtyped IBS.

Body image, personality profiles and alexithymia in patients with polycystic ovary syndrome (PCOS)

Aim: Polycystic ovary syndrome (PCOS) is a common endocrine-metabolic disorder. It affects women's physical well-being and leads to great psychological distress. Indeed, women with PCOS show a compromised quality of life as well as impaired emotional well-being. The aim of this study is to assess personality characteristics, body image and alexithymia in women with PCOS. Materials and methods: A total of 59 women with PCOS and 38 healthy controls were administered the Toronto Alexithymia Scale (TAS), the Body Uneasiness Test (BUT) and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Results: The PCOS group showed higher values of alexithymia and a higher body uneasiness. They also showed higher values on many clinical, content and supplementary scales of the MMPI-2. Discussion: It seems that physical appearance and bodily function have a central place in the minds of women with PCOS, as well as in their relationships. However, it is a body they find it hard to feel and with which they mostly feel uncomfortable. Their approach to the outside world seems to be characterized by a certain degree of immaturity, anger, hostility and distrust. Low self-esteem also seems to be connected to a certain tendency toward introversion and withdrawal. This leads to problems in social, professional and intimate relationships.

Fibromyalgia: heterogeneity in personality and psychopathology and its implications

The fibromyalgia syndrome (FM) is a chronic widespread pain condition whose etiology remains unknown and no treatment has satisfactory levels of success. A meta-analysis has identified a distinct Minnesota Multiphasic Personality Inventory-2 (MMPI-2) clinical profile between FM female patients and healthy controls, and differences between FM and other chronic pain condition with clear etiology have also been found. However, heterogeneity in this population has been suggested in several studies. We aim to assess clinical aspects in FM patients, based on personality psychopathology characteristics, in order to explore heterogeneity and the existence of core common aspects. In this cross-sectional study, a relatively homogeneous sample of 56 female FM patients (M _age = 45.95, SD _age = 9.39) was assessed through MMPI-2. A K-Means cluster analysis identified two clusters, one (n = 24) with clinically significant levels in Negative Emotionality and Introversion scales. Subsequent MANOVAs identified important features of this cluster on several MMPI-2 dimensions. Moreover, several dimensions are clinically elevated in both clusters. In conclusion, the combination of psychopathological negative emotionality, interpersonal isolation, and low hedonic capacity, in a group of patients, has implications for the daily living and treatment of FM patients, and several core aspects of FM need to be addressed.

Clinical and psychological characteristics of patients with globus

BACKGROUND/AIMS

Psychological factors are involved in many functional gastrointestinal disorders including globus. The aim of the present study was to assess the clinical and psychological correlates associated with globus.

PATIENTS AND METHODS

707 patients (69% female, 45.2 ± 16.5 years, BMI 27.2 ± 11.7 kg/m²) filled an MMPI-2 questionnaire and a standard Rome III clinical questionnaire and were included in this cross sectional study. Data analysis was performed using a univariate analysis and a multivariate logistic regression with a backwards selection procedure on significant scales after a univariate analysis.

RESULTS

140 patients (20%) reported suffering from globus. Globus appeared to be associated with older age (P = 0.001; OR = 1.022; 95% CI = [1.009-1.035]), increased BMI (P = 0.007; OR = 1.029; 95% CI = [1.008-1.051]), higher prevalence of regurgitations (P = 0.008; OR = 2.189; 95% CI = [1.228-3.902]), heartburn (P = 0.001 OR = 2.227; 95% CI = [1.406-3.530]), dysphagia (P < 0.001; OR = 2.399; 95% CI = [1.500-3.837]), epigastric pain (P < 0.001; OR = 3.768; 95% CI = [1.880-7.552]) and nonspecific dyspepsia (P = 0.018; OR = 1.786; 95% CI = [1.106-2.881]), and a higher score of hysteria (P = 0.008 OR = 1.034; 95% CI = [1.009-1.059]). By comparison with patients who reported globus and scores of hysteria in the normal range (n = 73), patients complaining of globus associated with high scores of hysteria (n = 67) have high scores of hypochondriasis (P < 0.001; OR = 1.235; 95% CI = [1.142-1.336]), high levels of Psychopathic deviate (P = 0.005; OR = 1.091; 95% CI = [1.026-1.161]) and a higher, but not significant, prevalence of complaints of regurgitation (P = 0.052; OR = 4.022; 95% CI = [0.989-16.351]).

CONCLUSION

Approximately 50% of the patients complaining of globus have a high score of hysteria associated with other personality disorders, and complain more frequently of regurgitation than other patients complaining of globus. These results tend to confirm that globus has a strong, although not systematic, connections with some specific personality disorders.

Identifying non-affective psychosis in first admission patients: MMPI-2, structured diagnostic interview, and consensus lifetime best estimate

PURPOSE

We aimed to evaluate the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) as a potential means of improving on the SCID's diagnostic efficacy.

METHODS

76 first-admission patients were assigned DSM-IV consensus diagnoses by two experienced psychiatrists using all available information, then dichotomized into non-affective psychosis and other mental illness groups. The patients were also given the SCID and the MMPI-2. The diagnostic performance of the MMPI-2 was compared to that of the SCID to assess both diagnostic accuracy and incremental validity.

RESULTS

MMPI-2 scales 8 (Schizophrenia) and BIZ (Bizarre Mentations) correctly identified 58% and 56% respectively of non-affective psychotic patients. The Goldberg Index had an overall correct classification rate of 70%, but only identified 49% of the psychosis group. The SCID had a correct classification rate of 66% but correctly identified only 25% of the non-affective psychosis patients. Three MMPI-2 scales combined with the SCID resulted in an overall correct classification rate of 73%, and identification of 66% of the non-affective psychosis patients.

CONCLUSION

The results suggest that the MMPI-2 may identify early psychosis at least as well as the SCID. Furthermore, using a combination of the MMPI-2 and the SCID shows incremental validity over using the SCID alone.

A clinical guide to assessing level of ego development using psychological testing

This article presents a clinical guide for relating psychological test findings from the Minnesota Multiphasic Personality Inventory-2 and Rorschach Technique to various levels of ego development. The original three validity and 10 clinical scales from the MMPI and a selected group of traditional determinants from the Rorschach are employed. Expected testing results from these instruments are derived from both the authors' clinical experience and the research literature. These results are presented along a continuum of nine levels of ego development and their associated disorders. The nine levels of ego development are "normal" neurotic, neurotic trait, and neurotic symptom organization; high-, mid-, and low-level borderline organization; and affective, cognitive-affective, and cognitive psychotic organization. The relationships between typical testing responses and indices of personality functioning at each level of ego development would hopefully facilitate accurate diagnosis, which in turn would result in more effective treatment planning.

Changes in ego strength in patients with neurotic and personality disorders treated with a short-term comprehensive psychodynamic psychotherapy

OBJECTIVES

Analysis of changes in ego strength in the course of group psychotherapy in patients treated with neurotic and selected personality disorders (F40-F61, ICD-10).

METHODS

82 patients (61 women and 21 men) participated in the study. They underwent intensive short-term group psychotherapy treatment in a day hospital for neurotic and behavioural disorders. The assessment of the patients' personality functioning was carried out at the onset and the end of the psychotherapy. The assessment was reported as a value on the ego strength scale by means of the MMPI-2 questionnaire.

RESULTS

The comparative analysis with the use of the t-Student test for related measurements, which was carried out for the measurement of ego strength values at the onset and the end of the therapy, demonstrated a statistically significant positive change both for the entire examined group and the groups which considered the gender and diagnosis distribution.

CONCLUSIONS

Short-term intensive comprehensive group psychotherapy with elements of individual psychotherapy results in obtaining the desired changes in the personality functioning manifested through the increase in ego strength.

Psychopathological characteristics of adjustment disorder among outpatients with and without work related stress

OBJECTIVES

Study's objective is to assess psychopathological profiles in outpatients with a diagnosis of Adjustment Disorder (AD) who had positive evaluations of work related stress (AD-W) versus those exposed to other stressful life events (AD-O).

METHODS

The participants were 70 outpatients with AD-W, compared to 71 outpatients with AD-O, admitted at the Unit of Psychiatry and Occupational Medicine, Sant'Andrea Hospital, Rome. Patients completed the Hamilton Rating Scale for Depression (HRSD), the Hamilton Anxiety Rating Scale (HAM-A), the Minnesota Multiphasic Personality Inventory - 2 (MMPI-2), and the Rorschach test.

RESULTS

The emerged data underline that patients with AD-W scored significantly higher than patients with AD-O in the MMPI-2 scales D, Pd, Pa, FAM, and in the Rorschach anxiety scale (Sum Y).

CONCLUSIONS

Finally patients with AD-W showed greater levels of psychopathology compared to patients with AD-O. Further studies assessing the harm associated with stress might allow a better understanding of the diagnosis and therapeutic implications of AD.

Fake bad scale: the case of the missing construct, a response to Larrabee, Bianchini, Boone, and Rohling (2017)

The 'Commentary' of Drs. Larrabee, Bianchini, Boone, and Rohling (2017) attributes to us a view of the Fake Bad/Symptom Validity Scale (FBS/FBS-r) that is wholly erroneous, a view we do not hold and have never taken. In doing so, the authors have confused the thrust of our article with the assertions made in an earlier article which preceded publication of the FBS. This earlier article held that many physical and cognitive symptoms/complaints observed in personal injury plaintiffs are most parsimoniously understood as manifestations of the stresses that may routinely accompany plaintiffs' involvement in such litigation. In this response, I therefore, wish to clarify this misunderstanding and to elaborate upon several of the issues raised in our article.

Onset of dieting in childhood and adolescence: implications for personality, psychopathology, eating attitudes and behaviors of women with eating disorder

PURPOSE

This study examined the MMPI-2 and EDI-2 scores of 205 Korean women with eating disorders to identify difference between early and adulthood onset of dieting groups.

METHODS

101 women had started dieting in their childhood to adolescence (EARLYdieting group) and 104 had started dieting in their adulthood (ADULTdieting group).

RESULTS

Both of the MMPI-2 and EDI-2 scores were significantly different between the two groups before and after adjusting for the duration since the onset of eating disorder. EARLYdieting group scored higher in the MMPI-2 clinical scales 1, 3, 0 and the EDI-2 bulimia scale. EARLYdieting group tended to use a more varied dieting strategy.

CONCLUSIONS

The findings suggested that starting to diet early in life may be related to more severe psychopathology and dieting behaviors in adulthood.

Personality traits are potentially associated with the presence of chronic temporomandibular joint pain in patients without effusion as determined by T-2 weighted magnetic resonance

OBJECTIVE

The study aimed at investigating personality traits in chronic temporomandibular joints (TMJ) pain patients with and without joint effusion.

METHODS

Two groups of chronic TMJ pain patients were recruited. The TMJ pain control group was composed of patients showing magnetic resonance imaging (MRI) signs of TMJ effusion, while the TMJ pain test group included patients with chronic TMJ pain seemingly not justified, due to the absence of MRI-detected disorders. A third set of pain free individuals was selected as a comparison group. All patients completed a personality assessment with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) instrument, and the between-group differences were assessed for significance by performing an analysis of variance test.

RESULTS

Patients of the TMJ pain test group had higher scores than subjects belonging to the TMJ pain and pain-free control groups in almost all of the MMPI-2 clinical scales. A significant difference was shown for the scales related to concerns about physical health (Scale 1-Hs; F = 7.74; p = .001) and physical symptoms (Scale 3-Hy; F = 8.43; p = .001).

CONCLUSIONS

Chronic TMJ pain patients without MRI-detected TMJ effusion have a different personality profile than patients with TMJ effusion and pain-free individuals, regarding high levels of concerns about physical health and physical symptoms.

CLINICAL IMPLICATIONS

This study has important clinical implications for temporomandibular disorders practitioners, providing suggestions that symptoms in the TMJ area are not only related to a physical disorder. The possible existence of a psychologically modulated condition in patients who refer pain in the TMJ area without signs of effusion should be carefully taken into consideration.

Comparative prediction of nonepileptic events using MMPI-2 clinical scales, Harris Lingoes subscales, and restructured clinical scales

The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) is a psychological testing tool used to measure psychological and personality constructs. The MMPI-2 has proven helpful in identifying individuals with nonepileptic events/nonepileptic seizures. However, the MMPI-2 has had some updates that enhanced its original scales. The aim of this article was to test the utility of updated MMPI-2 scales in predicting the likelihood of non-epileptic seizures in individuals admitted to an EEG video monitoring unit. We compared sensitivity, specificity, and likelihood ratios of traditional MMPI-2 Clinical Scales against more homogenous MMPI-2 Harris-Lingoes subscales and the newer Restructured Clinical (RC) scales. Our results showed that the Restructured Scales did not show significant improvement over the original Clinical scales. However, one Harris-Lingoes subscale (HL4 of Clinical Scale 3) did show improved predictive utility over the original Clinical scales as well as over the newer Restructured Clinical scales. Our study suggests that the predictive utility of the MMPI-2 can be improved using already existing scales. This is particularly useful for those practitioners who are not invested in switching over to the newly developed MMPI-2 Restructured Form (MMPI-2 RF).

Changes in personality functioning as a result of group psychotherapy with elements of individual psychotherapy in persons with neurotic and personality disorders - MMPI-2

AIM

The study of group psychotherapy influence on the personality functioning of patients on treatment for neurotic disorders and selected personality disorders (F4-F6 under ICD-10).

METHODS

The study concerned 82 patients (61 women and 21 men) who underwent intensive short-term group psychotherapy in a day ward. A comprehensive assessment of the patients' personality functioning was carried out at the outset and the end of the psychotherapy utilising the MMPI-2 questionnaire.

RESULTS

At the treatment outset the majority of the study patients demonstrated a considerable level of disorders in five MMPI-2 clinical scales (Depression, Hysteria, Psychopathic Deviate, Psychastenia, Schizophrenia) and moderate pathology in Hypochondria. In the Mania scale most patients obtained results comparable to the healthy population when the treatment commenced. Having undergone the psychotherapy treatment, the majority of the examined were observed to demonstrate positive changes in those areas of personality functioning which were classified as severe or moderate pathology.

CONCLUSIONS

Short-term intensive comprehensive group psychotherapy with elements of individual psychotherapy leads to desirable changes in personality functioning.

A New Index for the MMPI-2 Test for Detecting Dissimulation in Forensic Evaluations: A Pilot Study

This pilot study is the starting point of a potentially broad research project aimed at identifying new strategies for assessing malingering during forensic evaluations. The forensic group was comprised of 67 males who were seeking some sort of certification (e.g., adoption, child custody, driver's license, issuance of gun permits, etc.); the nonforensic group was comprised of 62 healthy male volunteers. Each participant was administered the MMPI-2. Statistical analyses were conducted on obtained scores of 48 MMPI-2 scales. In the first step, parametric statistics were adopted to identify the best combination of MMPI-2 scales that differentiated the two groups of participants. In the second step, frequency-based, nonparametric methods were used for diagnostic purposes.

RESULTS

A model that utilized the best three predictors ("7-Pt", "L," and "1-Hs") was developed and used to calculate the Forensic Evaluation Dissimulation Index (FEDI), which features satisfactory diagnostic accuracy (0.9), sensitivity (0.82), specificity (0.81), and likelihood ratio indices (LR+ = 4.32; LR- = 0.22).

Interpretive Reliability of Six Computer-Based Test Interpretation Programs for the Minnesota Multiphasic Personality Inventory-2

The reliability of six Minnesota Multiphasic Personality Inventory-Second edition (MMPI-2) computer-based test interpretation (CBTI) programs was evaluated across a set of 20 commonly appearing MMPI-2 profile codetypes in clinical settings. Evaluation of CBTI reliability comprised examination of (a) interrater reliability, the degree to which raters arrive at similar inferences based on the same CBTI profile and (b) interprogram reliability, the level of agreement across different CBTI systems. Profile inferences drawn by four raters were operationalized using q-sort methodology. Results revealed no significant differences overall with regard to interrater and interprogram reliability. Some specific CBTI/profile combinations (e.g., the CBTI by Automated Assessment Associates on a within normal limits profile) and specific profiles (e.g., the 4/9 profile displayed greater interprogram reliability than the 2/4 profile) were interpreted with variable consensus (α range = .21-.95). In practice, users should consider that certain MMPI-2 profiles are interpreted more or less consensually and that some CBTIs show variable reliability depending on the profile.

Scoring correction for MMPI-2 Hs scale with patients experiencing a traumatic brain injury: a test of measurement invariance

It has been suggested that MMPI-2 scoring requires removal of some items when assessing patients after a traumatic brain injury (TBI). Gass (1991. MMPI-2 interpretation and closed head injury: A correction factor. Psychological assessment, 3, 27-31) proposed a correction procedure in line with the hypothesis that MMPI-2 endorsement may be affected by symptoms of TBI. This study assessed the validity of the Gass correction procedure. A sample of patients with a TBI (n = 242), and a random subset of the MMPI-2 normative sample (n = 1,786). The correction procedure implies a failure of measurement invariance across populations. This study examined measurement invariance of one of the MMPI-2 scales (Hs) that includes TBI correction items. A four-factor model of the MMPI-2 Hs items was defined. The factor model was found to meet the criteria for partial measurement invariance. Analysis of the change in sensitivity and specificity values implied by partial measurement invariance failed to indicate significant practical impact of partial invariance. Overall, the results support continued use of all Hs items to assess psychological well-being in patients with TBI.

Assessing Impression Management With the MMPI-2 in Child Custody Litigation

Forensic psychological evaluation of parents in child custody litigation is primarily focused on evaluating parenting capacity and underreporting. The biased responses of underreporting have been classified as Impression Management (IM) or as Self-Deceptive Positivity (S-DP), which are regarded to be conscious or unconscious in nature, respectively. A field study was undertaken to assess impression management on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) in child custody cases, the accuracy of the MMPI-2 scales in classifying IM, and what parents in child custody litigation actually manipulate in terms of IM. A total of 244 parents in child custody litigation and 244 parents under standard instructions were administered the MMPI-2. The results revealed that the L, Mp, Wsd, and Od scales discriminated between both samples of parents; the rate of satisfactory classification (i.e., odds ratio ranged from 5.7 for Wsd to 23.3 for Od) and an incremental validity of Od over Mp and Wsd. As for the effects of IM, the results show IM effects in the Basic Clinical Scales, the Restructured Clinical Scales, the Personality Psychopathology Five Scales, the Content Scales, and the Supplementary Scales. The implications of the results are discussed in relation to the forensic evaluation of parents in child custody litigation.

Psychometric Evaluation of the MMPI-2/MMPI-2-RF Restructured Clinical Scales in an Israeli Sample

The current study cross-culturally evaluated the psychometric properties of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2)/MMPI-2-Restructured Form Restructured Clinical (RC) Scales in psychiatric settings in Israel with a sample of 100 men and 133 women. Participants were administered the MMPI-2 and were rated by their therapists on a 188-item Patient Description Form. Results indicated that in most instances the RC Scales demonstrated equivalent or better internal consistencies and improved intercorrelation patterns relative to their clinical counterparts. Furthermore, external analyses revealed comparable or improved convergent validity (with the exceptions of Antisocial Behavior [RC4] and Ideas of Persecution [RC6] among men), and mostly greater discriminant validity. Overall, the findings indicate that consistent with previous findings, the RC Scales generally exhibit comparable to improved psychometric properties over the Clinical Scales. Implications of the results, limitations, and recommendations for future research are discussed.

Analysis of response patterns on the MMPI-2 in psychiatric prison inmates

In order to assess mental health status, and the classification of both the overreporting and underreporting scales and indexes, 102 psychiatric prison inmates deemed mentally incompetent to stand trial completed the Spanish adaptation of the MMPI-2 under standard instructions (honest responding). The results showed patterns of consistent, non-random, nor extremely acquiescent responses. Moreover, no-outlier responses were detected. In line with the psychiatric diagnosis, all the psychiatric prison inmates were classified by the basic clinical scales as clinical cases of the psychotic dyad i.e., schizophrenia and paranoid ideation. The overreporting scales and indexes (i.e., F, K, Fb, F-K, Fp, Ds and FBS) classified the participants as malingerers, whereas the L, Wsd, and Od underreporting scales as good feigners. These scales assessing impression management i.e., consciously faking good biased responses, did not classify overreporters. Thus, they are robust indicators of honest responding among psychiatric prison inmates. The implications of these results for the practice of forensic psychology are discussed.

MMPI-2 Symptom Validity (FBS) Scale: psychometric characteristics and limitations in a Veterans Affairs neuropsychological setting

The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Symptom Validity (Fake Bad Scale [FBS]) Scale is widely used to assist in determining noncredible symptom reporting, despite a paucity of detailed research regarding its itemmetric characteristics. Originally designed for use in civil litigation, the FBS is often used in a variety of clinical settings. The present study explored its fundamental psychometric characteristics in a sample of 303 patients who were consecutively referred for a comprehensive examination in a Veterans Affairs (VA) neuropsychology clinic. FBS internal consistency (reliability) was .77. Its underlying factor structure consisted of three unitary dimensions (Tiredness/Distractibility, Stomach/Head Discomfort, and Claimed Virtue of Self/Others) accounting for 28.5% of the total variance. The FBS's internal structure showed factoral discordance, as Claimed Virtue was negatively related to most of the FBS and to its somatic complaint components. Scores on this 12-item FBS component reflected a denial of socially undesirable attitudes and behaviors (Antisocial Practices Scale) that is commonly expressed by the 1,138 males in the MMPI-2 normative sample. These 12 items significantly reduced FBS reliability, introducing systematic error variance. In this VA neuropsychological referral setting, scores on the FBS have ambiguous meaning because of its structural discordance.

Elevation discrepancies between MMPI-2 clinical and MMPI-2-RF restructured clinical (RC) scales in people with seizure disorders

PURPOSE

People with seizure disorders experience elevated rates of psychopathology, often undiagnosed and untreated. Accurate diagnosis of psychopathology remains an important goal of quality health care for people with seizure disorders. One of the most widely used dimensional measures of psychopathology is the Minnesota Multiphasic Personality Inventory-Second Edition (MMPI-2). Research in heterogeneous mental health samples suggests that the 2008 revision of this measure, the Minnesota Multiphasic Personality Inventory-Second Edition-Restructured Form (MMPI-2-RF), offers better construct fidelity and more cost-effective administration. This study seeks to extend research on MMPI-2-RF scale elevations to a sample of people with seizure disorders.

METHODS

In a consecutive, heterogeneous sample of people with seizure disorders, MMPI-2 and MMPI-2-RF scores were compared in terms of categorical classification agreement (clinically elevated versus not clinically elevated). Scores were also compared in terms of variance attributable to diagnosis-specific items, general demoralization, subtle items, social desirability, and demographic factors.

KEY FINDINGS

Scores on MMPI-2 and MMPI-2-RF provided a statistically significant level of agreement between corresponding clinical diagnostic scales ranging from 68% to 84%. Most classification disagreement was attributable to MMPI-2 clinical scale elevations when MMPI-2-RF scales were not elevated. Regression analysis supported the interpretation that general demoralization, subtle items, social desirability, and demographic factors led to MMPI-2 clinical scale elevations.

SIGNIFICANCE

The results provide evidence that in the context of strong psychopathology classification agreement, the MMPI-2-RF restructured clinical scales provide better construct fidelity compared with the more trait heterogeneous MMPI-2 clinical scales. These results should encourage clinicians to use the MMPI-2 Restructured Form (MMPI-2-RF) for improved psychopathology assessment compared with the MMPI-2 in patients with seizure disorders.

Comparison of Memory Function and MMPI-2 Profile between Post-traumatic Stress Disorder and Adjustment Disorder after a Traffic Accident

OBJECTIVE

Differential diagnosis between post-traumatic stress disorder (PTSD) and adjustment disorder (AD) is rather difficult, but very important to the assignment of appropriate treatment and prognosis. This study investigated methods to differentiate PTSD and AD.

METHODS

Twenty-five people with PTSD and 24 people with AD were recruited. Memory tests, the Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and Beck's Depression Inventory were administered.

RESULTS

There were significant decreases in immediate verbal recall and delayed verbal recognition in the participants with PTSD. The reduced memory functions of participants with PTSD were significantly influenced by depressive symptoms. Hypochondriasis, hysteria, psychopathic deviate, paranoia, schizophrenia, post-traumatic stress disorder scale of MMPI-2 classified significantly PTSD and AD group.

CONCLUSION

Our results suggest that verbal memory assessments and the MMPI-2 could be useful for discriminating between PTSD and AD.

Comparison of Four MMPI-2 Validity Scales in Identifying Invalid Neurocognitive Dysfunction in Traumatic Brain Injury Litigants

Four Minnesota Multiphasic Personality Inventory-2 (MMPI-2) validity scales, the F Scale, Symptom Validity Scale (FBS), Henry-Heilbronner Index (HHI), and Response Bias Scale (RBS), were evaluated in 60 personal injury litigants who sustained a traumatic brain injury (TBI). Based on a modified Slick, Sherman, and Iverson ( 1999 ) diagnostic criteria for malingered neurocognitive dysfunction and utilizing test-effort measures embedded in standard neuropsychological testing, a group of 23 patients with probable invalid neurocognitive dysfunction (PI) and a comparable group of 37 patients with noninvalid neurocognitive dysfunction were identified and compared with respect to their MMPI-2 validity scale scores. Logistic regression analyses, receiver-operating characteristic curve and area under the curve analyses, as well as sensitivity, specificity, positive predictive value, and negative predictive value analyses all revealed that RBS performed better than F, FBS, and HHI in classifying PIs. The present results add to a number of recent studies that suggest that RBS is a useful predictor of symptom validity failure and probable neuropsychological malingering among litigating TBI patients. The study also encourages further research employing embedded test-effort measures in classifying invalid neurocognitive dysfunction per the Slick et al. diagnostic criteria.

Maternal personality profile of children affected by migraine

BACKGROUND

Empirical evidence of the important role of the family in primary pediatric headache has grown significantly in the last few years, although the interconnections between the dysfunctional process and the family interaction are still unclear. Even though the role of parenting in childhood migraine is well known, no studies about the personality of parents of migraine children have been conducted. The aim of the present study was to assess, using an objective measure, the personality profile of mothers of children affected by migraine without aura (MoA).

MATERIALS AND METHODS

A total of 269 mothers of MoA children (153 male, 116 female, aged between 6 and 12 years; mean 8.93 ± 3.57 years) were compared with the findings obtained from a sample of mothers of 587 healthy children (316 male, 271 female, mean age 8.74 ± 3.57 years) randomly selected from schools in the Campania, Umbria, Calabria, and Sicily regions. Each mother filled out the Minnesota Multiphasic Personality Inventory - second edition (MMPI-2), widely used to diagnose personality and psychological disorders. The t-test was used to compare age and MMPI-2 clinical basic and content scales between mothers of MoA and typical developing children, and Pearson's correlation test was used to evaluate the relation between MMPI-2 scores of mothers of MoA children and frequency, intensity, and duration of migraine attacks of their children.

RESULTS

Mothers of MoA children showed significantly higher scores in the paranoia and social introversion clinical basic subscales, and in the anxiety, obsessiveness, depression, health concerns, bizarre mentation, cynicism, type A, low self-esteem, work interference, and negative treatment indicator clinical content subscales (P < 0.001 for all variables). Moreover, Pearson's correlation analysis showed a significant relationship between MoA frequency of children and anxiety (r = 0.4903, P = 0.024) and low self-esteem (r = 0.5130, P = 0.017), while the MoA duration of children was related with hypochondriasis (r = 0.6155, P = 0.003), hysteria (r = 0.6235, P = 0.003), paranoia (r = 0.5102, P = 0.018), psychasthenia (r = 0.4806, P = 0.027), schizophrenia (r = 0.4350, P = 0.049), anxiety (r = 0.4332, P = 0.050), and health concerns (r = 0.7039, P < 0.001) MMPI-2 scores of their mothers.

CONCLUSION

This could be considered a preliminary study that indicates the potential value of maternal personality assessment for better comprehension and clinical management of children affected by migraine, though further studies on the other primary headaches are necessary.

Utilizing psychological assessment in rehabilitating patients with occupational musculoskeletal injuries

Patients with occupational musculoskeletal injuries who participate in multidisciplinary rehabilitation programs will likely undergo psychological assessment as a part of the evaluation process. Although the importance of examining non-physical influences on the patient's recovery is widely recognized among clinicians, it is often unclear how findings from psychological assessment are being utilized to facilitate rate of recovery from injury. The purpose of this study was to encourage a re-examination of current psychological assessment practices among multidisciplinary rehabilitation programs and to describe how the Minnesota Multiphasic Personality Inventory (MMPI-2) was utilized with a work-hardening patient sample (n = 86). For the overall patient sample, the MMPI-2 depicted relatively high levels of somatic focus and low levels of psychological distress. To enhance clinical utility, a clustering method identified profile groupings that were distinguishable on the basis of known personality and behavioral correlates. Two profile groupings (Scale 1; Scales 1-3/3-1) were discussed with recommendations for how clinicians may facilitate rate of recovery from injury. The MMPI-2 appears to be particularly useful in identifying treatment conditions that may favorably influence rate of recovery from occupational musculoskeletal injuries.