Jason R. Bacchiochi

The predictive capacity of the MMPI-2 and PAI validity scales and indexes to detect coached and uncoached feigning.

The objective of this study was to examine the relative effectiveness of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the Personality Assessment Inventory (PAI) validity scales and indexes to detect malingering. Research participants were either informed (coached) or not informed (uncoached) about the presence and operating characteristics of the validity scales and instructed to fake bad on both the MMPI-2 and PAI. The validity scale and index scores produced by these research participants were then compared to those scores from a bona fide sample of psychiatric patients (n = 75). Coaching had no effect on the ability of the research participants to feign more successfully than those participants who received no coaching. For the MMPI-2, the Psychopathology F scale, or F(p), proved to be the best at distinguishing psychiatric patients from research participants instructed to malinger, although the other F scales (i.e., F and Fb) were also effective. For the PAI, the Rogers Discriminant Function index (RDF) was clearly superior to the other PAI fake-bad validity indicators; neither the Negative Impression Management scale nor Malingering Index were effective at detecting malingered profiles in this study. Overall, RDF proved to be marginally superior to F and F(p) in distinguishing MMPI-2 and PAI protocols produced by research participants asked to malinger and psychiatric patients. Both the RDF and the F and F(p) scales, however, were able to increase the predictive capability of one another.

The Stability of the Response Styles Questionnaire Rumination Scale in a Sample of Patients With Major Depression

Response style theory (RST; S. Nolen-Hoeksema, 1991a) posits that ruminative response style (RRS) to depression prolongs and intensifies depressed mood, maintains a current depressive episode, and increases the likelihood of a new (or recurrent) depressive episode. The goal of this investigation was to examine the relative (i.e., retest reliability) and absolute (i.e., mean level change) stability of self- and symptom-focused RRS measured by the Response Style Questionnaire (RSQ; S. Nolen-Hoeksema, 1991b) with 110 patients being treated for major depression. In all patients, both kinds of RRS showed relative stability. In remitted patients, neither kind of RRS showed absolute stability. In currently depressed patients, only self-focused RRS showed absolute stability. On the basis of these results it is proposed that symptom-focused RRS may intensify depressed mood and current depressive episode, as well as predispose to recurrence, whereas self-focused RRS may prolong a current depression and increase the likelihood of a new depressive episode.

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.

Distinguishing Bipolar Depression, Major Depression, and Schizophrenia With the MMPI-2 Clinical and Content Scales

Clinical and content scales from the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) were used to examine the capacity of these scales to assist in the differential diagnosis of a sample of 212 psychiatric patients-137 with major depression; 43 with schizophrenia; and 32 with bipolar disorder, depressed state. Consistent with the previous literature, the clinical scales Depression (D), and Schizophrenia (Sc), and the content scales Depression (DEP), and Low Self-Esteem (LSE) best distinguished major depression from schizophrenia; the content scale DEP proved to be the most powerful predictor in distinguishing bipolar depression from schizophrenia. No clinical or content scale proved to be effective in distinguishing patients with bipolar depression from patients with major depression. In general, the content scales outperformed the clinical scales.

Validation of Connectedness and Neediness as Dimensions of the Dependency Construct

This study (1) tested the 2-factor structure of the DEQ dependency scale (Neediness and Connectedness subscales) using confirmatory factor analyses (CFA) in a student sample, adult community sample, and a clinical sample of patients with major depression; (2) assessed the discriminant validity of these 2 subscales by comparing their differences in clinical and nonclinical samples, and by examining their relation to depression severity; (3) examined differences between men and women on these factors; and (4) explored the pattern of correlations of these factors to the domains and facets of the 5-Factor Model of Personality (FFM). Neither the CFA nor the pattern of differences between the 3 samples and between the men and women provided strong support for the 2-factor model of dependency; nor was the expected association to severity of depression found. Only weak support of a 2-factor model emerged from the correlations of these constructs with the FFM.

The validity and clinical utility of the MMPI-2 Malingering Depression scale.

In this study, we examined the validity and clinical utility of the MMPI–2 (Butcher, Graham, Tellegen, Dahlstrom, & Kaemmer, 2001) Malingering Depression scale (Md) in relation to the MMPI–2 F scales (F, FB, FP) to detect feigned depression. Overall, the FB scale and the F/FP scale combination were the best single predictors, although the Md scale did discriminate successfully cases of feigned depression from patients with bona fide depression. The Md scale added predictive capacity over the F scales, and the FB scale and the F/FP scale combination added predictive capacity over the Md scale; however, the actual increase in the number of cases predicted was minimal in each instance. In sum, although the Md scale is able to detect accurately feigned depression on the MMPI–2 (predictive validity), it does not confer a distinct advantage (incremental validity) over the existing standard validity scales—F, FB, and FP.

A descriptive study of a specialized worker's psychological trauma program

BACKGROUND Psychological trauma in the workplace is gaining recognition as an important cause of workplace disability but little is known about the workers who are affected. The Psychological Trauma Program (PTP) in Toronto (Canada) is a specialized provincial workers compensation board assessment program for workers with psychological sequelae of workplace trauma. AIMS To characterize workers presenting to the PTP in terms of demographic, occupational, traumatic exposure and diagnostic variables. METHODS A retrospective secondary analysis of all workers referred to the PTP for assessment within 1 year of traumatic event between 1999 and 2006. RESULTS Five hundred and thiry-one referred workers were included in the study. Most workers were working-age male (76%), married (65%) and labourers (43%). Nearly half were born outside Canada. Post-traumatic stress disorder was the primary diagnosis in 44%. Fifty-eight percent had one or more secondary diagnoses. For just over half of the workers, the traumatic event resulted in a permanent physical impairment. CONCLUSIONS Specialist referral may be indicated for workers experiencing prolonged recovery following workplace trauma. Male workers and those with co-morbidities or permanent injuries may be more likely to require referral. Individualized treatment approaches are likely important; however, more research is needed to guide future interventions.