Anthony M. Tarescavage

Reliability, validity, and utility of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in assessments of bariatric surgery candidates.

In the current study, we examined the reliability, validity, and clinical utility of Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2011) scores in a sample of 759 bariatric surgery candidates. We provide descriptives for all scales, internal consistency and standard error of measurement estimates for all substantive scales, external correlates of substantive scales using chart review and self-report criteria, and relative risk ratios to assess the clinical utility of the instrument. Results generally support the reliability, validity, and clinical utility of MMPI-2-RF scale scores in the psychological evaluation of bariatric surgery candidates. Limitations, future directions, and practical application of these results are discussed.

Assessing Psychosocial Functioning of Bariatric Surgery Candidates with the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF)

BackgroundPsychological comorbidity is common in bariatric surgery candidates. Many multidisciplinary teams incorporate psychometric testing to screen for psychological factors that, if left unattended, may negatively impact surgical results. Here, we report descriptive findings and empirical correlates of Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) scales among of bariatric surgery candidates undergoing a pre-surgical psychological evaluation.MethodsThe sample consisted of male (n = 324) and female (n = 658) patients seeking bariatric surgery who were administered the MMPI-2-RF at their psychological evaluation. Psychosocial and medical variables were retrospectively coded from the patients’ medical records. These criteria included history/current mental health diagnoses and treatments, maladaptive eating behaviors/diagnoses, past/current substance use, abuse history, sleep apnea, and denial of surgery.ResultsDescriptive analyses demonstrated similar findings for male and female candidates and replicated previous reports. MMPI-2-RF scales measuring emotional dysfunction were associated with maladaptive eating patterns, a history of Major Depressive Disorder, and previous suicide attempts. Scale scores measuring behavioral dysfunction were associated with current/past substance use and previous physical abuse. MMPI-2-RF scale scores measuring somatic problems were associated with a higher BMI at the time of surgery, sleep apnea diagnosis/adherence, physical/sexual abuse history, active mood disorder, previous mental health diagnoses, and maladaptive eating patterns.ConclusionsThe MMPI-2-RF can aid in identifying a broad range of psychological comorbidity among bariatric surgery candidates. When used in conjunction with a pre-surgical psychological interview, it can aid in the assessment of psychological factors relevant to pre-surgical psychological assessment of bariatric surgery candidates.

Association between the MMPI-2 restructured form (MMPI-2-RF) and malingered neurocognitive dysfunction among non-head injury disability claimants.

The current study examined the over-reporting Validity Scales of the MMPI-2 Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008/2011) in relation to the Slick, Sherman, and Iverson (1999) criteria for the diagnosis of Malingered Neurocognitive Dysfunction in a sample of 916 consecutive non-head injury disability claimants. The classification of Malingered Neurocognitive Dysfunction was based on scores from several cognitive symptom validity tests and response bias indicators built into traditional neuropsychological tests. Higher scores on MMPI-2-RF Validity Scales, particularly the Response Bias Scale (Gervais, Ben-Porath, Wygant, & Green, 2007), were associated with probable and definite Malingered Neurocognitive Dysfunction. The MMPI-2-RFs Validity Scales classification accuracy of Malingered Neurocognitive Dysfunction improved when multiple scales were interpreted. Additionally, higher scores on MMPI-2-RF substantive scales measuring distress, internalizing dysfunction, thought dysfunction, and social avoidance were associated with probable and definite Malingered Neurocognitive Dysfunction. Implications for clinical practice and future directions are noted.

Using presurgical psychological testing to predict 1-year appointment adherence and weight loss in bariatric surgery patients: predictive validity and methodological considerations

BACKGROUND Previous studies suggest that presurgical psychopathology accounts for some of the variance in suboptimal weight loss outcomes among Roux-en-Y gastric bypass (RYGB) patients, but research has been equivocal. OBJECTIVES The present study seeks to extend the past literature by examining associations between presurgical scale scores on the broadband Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and suboptimal weight loss and poor adherence to follow-up 1 year postoperatively after accounting for several methodologic considerations. SETTING Cleveland Clinic Bariatric and Metabolic Institute, Cleveland, Ohio, USA. METHODS The sample consisted of 498 RYGB patients, who produced a valid presurgical MMPI-2-RF protocol at program intake. The sample was primarily female (72.9%), Caucasian (64.9%), and middle-aged (mean = 46.4 years old; standard deviation [SD] = 11.6). The mean presurgical body mass index (BMI) was 47.4 kg/m(2) (SD = 8.2) and mean percent weight loss (%WL) at 1 year postoperatively was 31.18 %WL (SD = 8.44). RESULTS As expected, scales from the Behavioral/Externalizing Dysfunction (BXD) domain of the MMPI-2-RF were associated with worse weight loss outcomes and poor adherence to follow-up, particularly after accounting for range restriction due to underreporting. Individuals producing elevated scores on these scales were at greater risk for achieving suboptimal weight loss (<50% excess weight loss) and not following up with their appointment compared with those who scored below cut-offs. CONCLUSIONS Patients who are more likely to engage in undercontrolled behavior (e.g., poor impulse control), as indicated by presurgical MMPI-2-RF findings, are at greater risk for suboptimal weight loss and poor adherence to follow-up following RYGB. Objective psychological assessments should also be conducted postoperatively to ensure that intervention is administered in a timely manner. Future research in the area of presurgical psychological screening should consider the impact of underreporting and other discussed methodologic issues in predictive analyses.

Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) predictors of police officer problem behavior.

The purpose of this study was to investigate the predictive validity of the Minnesota Multiphasic Personality Inventory–2–Restructured Form (MMPI-2-RF) in a sample of law enforcement officers. MMPI-2-RF scores were collected from preemployment psychological evaluations of 136 male police officers, and supervisor ratings of performance and problem behavior were subsequently obtained during the initial probationary period. The sample produced meaningfully lower and less variant substantive scale scores than the general population and the MMPI-2-RF Police Candidate comparison group, which significantly affected effect sizes for the zero-order correlations. After applying a correction for range restriction, MMPI-2-RF substantive scales demonstrated moderate to strong associations with criteria, particularly in the Emotional Dysfunction and Interpersonal Functioning domains. Relative risk ratio analyses showed that cutoffs of 45T and 50T maintained reasonable selection ratios because of the exceptionally low scores in this sample and were associated with significantly increased risk for problematic behavior. These results provide support for the predictive validity of the MMPI-2-RF substantive scales in this setting. Implications of these findings and limitations of these results are discussed.

Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) Scores Generated From the MMPI-2 and MMPI-2-RF Test Booklets: Internal Structure Comparability in a Sample of Criminal Defendants

We investigated the internal structure comparability of Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) scores derived from the MMPI-2 and MMPI-2-RF booklets in a sample of 320 criminal defendants (229 males and 54 females). After exclusion of invalid protocols, the final sample consisted of 96 defendants who were administered the MMPI-2-RF booklet and 83 who completed the MMPI-2. No statistically significant differences in MMPI-2-RF invalidity rates were observed between the two forms. Individuals in the final sample who completed the MMPI-2-RF did not statistically differ on demographics or referral question from those who were administered the MMPI-2 booklet. Independent t tests showed no statistically significant differences between MMPI-2-RF scores generated with the MMPI-2 and MMPI-2-RF booklets on the test’s substantive scales. Statistically significant small differences were observed on the revised Variable Response Inconsistency (VRIN-r) and True Response Inconsistency (TRIN-r) scales. Cronbach’s alpha and standard errors of measurement were approximately equal between the booklets for all MMPI-2-RF scales. Finally, MMPI-2-RF intercorrelations produced from the two forms yielded mostly small and a few medium differences, indicating that discriminant validity and test structure are maintained. Overall, our findings reflect the internal structure comparability of MMPI-2-RF scale scores generated from MMPI-2 and MMPI-2-RF booklets. Implications of these results and limitations of these findings are discussed.

Use of the MMPI-2-RF Suicidal/Death Ideation and Substance Abuse Scales in Screening Bariatric Surgery Candidates

Bariatric surgery patients are at increased risk for suicide and lifetime substance abuse problems, and these risks are surgical contraindications. The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) has scales to screen for these risks factors, among others. We seek to evaluate the classification accuracy of the MMPI-2-RF Suicidal/Death Ideation (SUI) and Substance Abuse (SUB) scales to optimize their use in bariatric surgery settings. Data were collected from 1,311 (72.1% female; 65.5% Caucasian) bariatric surgery candidates from the Cleveland Clinic as well as 295 (94.1% female; 85.9% Caucasian) bariatric surgery candidates from a private practice in St. Paul, Minnesota. Classification accuracies were calculated at original and revised SUI and SUB interpretative cutoffs in the Cleveland Clinic sample and replicated in the St. Paul sample. Significant and meaningful classification accuracy gains were demonstrated by excluding a death ideation item from the SUI scale and lowering the interpretive cutoff on the SUB scale. Practical implications and study limitations are discussed.

Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) predictors of police officer problem behavior and collateral self-report test scores.

The current study examined the predictive validity of Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008/2011) scores in police officer screenings. We utilized a sample of 712 police officer candidates (82.6% male) from 2 Midwestern police departments. The sample included 426 hired officers, most of whom had supervisor ratings of problem behaviors and human resource records of civilian complaints. With the full sample, we calculated zero-order correlations between MMPI-2-RF scale scores and scale scores from the California Psychological Inventory (Gough, 1956) and Inwald Personality Inventory (Inwald, 2006) by gender. In the hired sample, we correlated MMPI-2-RF scale scores with the outcome data for males only, owing to the relatively small number of hired women. Several scales demonstrated meaningful correlations with the criteria, particularly in the thought dysfunction and behavioral/externalizing dysfunction domains. After applying a correction for range restriction, the correlation coefficient magnitudes were generally in the moderate to large range. The practical implications of these findings were explored by means of risk ratio analyses, which indicated that officers who produced elevations at cutscores lower than the traditionally used 65 T-score level were as much as 10 times more likely than those scoring below the cutoff to exhibit problem behaviors. Overall, the results supported the validity of the MMPI-2-RF in this setting. Implications and limitations of this study are discussed.

Reliability and validity of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in evaluations of chronic low back pain patients.

The purpose of the current study was to investigate the reliability and concurrent validity of Minnesota Multiphasic Personality Inventory (MMPI)-2-Restructured Form (2-RF) (Ben-Porath & Tellegen, 2008/2011) scores in a sample of 811 chronic low back pain patients (346 males, 529 females) beginning treatment in a short-term interdisciplinary pain rehabilitation program. We calculated internal consistency coefficients, mean-item correlations, and SEM for all substantive scales, as well as zero-order correlations with collateral medical record information and self-report testing. Results indicated reliability and validity for most of the MMPI-2-RF substantive scales. Implications of these findings and limitations of this study are discussed.

Use of Prehire Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) Police Candidate Scores to Predict Supervisor Ratings of Posthire Performance.

We examined associations between prehire Minnesota Multiphasic Personality Inventory-2–Restructured Form (MMPI-2-RF) scores and posthire performance ratings for a sample of 131 male police officers. Substantive scale scores in this sample were meaningfully lower than those obtained by the test’s normative sample and substantially range restricted, but scores were consistent with those produced by members of the police candidate comparison group (Corey & Ben-Porath). After applying a statistical correction for range restriction, we found several associations between MMPI-2-RF substantive scale scores and supervisor ratings of job-related performance. Findings for scales from the emotional dysfunction and interpersonal functioning domains of the test were particularly strong. For example, scales assessing low positive emotions and social avoidance were associated with several criteria that may be affected by lack of engagement with one’s environment and other people, including problems with routine task performance, decision making, assertiveness, conscientiousness, and social competence. Implications of these findings for assessment science and practice are discussed.