Wendell M. Swenson

An MMPI source book : basic item, scale, and pattern data on 50,000 medical patients

An MMPI Source Book. Basic Item, Scale and Pattern Data on 50,000 Medical Patients. By Wendell M. Swenson, John S. Pearson and David Osborne. Minneapolis, University of Minnesota Press and London, Oxford University Press, 1973. 150 p. 7¼“. £4.75.

Chronic pain : which patients may a pain-management program help?

&NA; To ascertain whether chronic‐pain patients who are likely to benefit from a pain‐management program can be identified before treatment, we studied for differences discernible at the beginning of treatment a group who succeeded and did well at 1‐year follow‐up (n = 34) and a group who failed (n = 35). The two groups differed significantly (P < 0.01) in regard to duration of pain, work time lost, number of operations, subjective pain level, and drug dependency. Deviations on the MMPI were greater in failures than in successes; but the differences were not statistically significant. A 7‐item rating scale based on these data differentiated a favorable group (including 71% of the successes) from an unfavorable group (including 86% of the failures) This scale should be helpful in selection of candidates for a pain‐management program, even though it needs further validation.

Substance dependence and chronic pain: Profile of 50 patients treated in an alcohol and drug dependence unit

&NA; Fifty adult patients with chronic pain and substance dependence were admitted to an inpatient unit for treatment of addiction without primary emphasis on treatment of pain. As a group they had received considerable medical attention for their pain, but relatively little for their addictions. When compared with a group of general medical patients, the study population showed MMPI evidence of considerably more psychopathologic characteristics. MMPI data and family histories of substance dependence did not differentiate the study group from a comparable group in a Pain Management Center.

The dissatisfied patient with chronic pain

&NA; Patients with chronic pain may become dissatisfied because of their lack of improvement. Thirteen such patients, encountered in a pain‐management program, registered formal complaints of their dissatisfaction. From their histories they were found to be the most chronic and treatment‐refractory patients encountered, with problems of medication dependency, accident proneness, and dissatisfaction with previous treatment efforts. During hospitalization they opposed psychologic approaches, further manifested their dependency on medication, and some of them had circumscribed delusions. The pain‐management program was difficult to apply to these patients; and further, they resisted other recommendations for treatment and even resisted discharge in some instances. Further psychiatric screening is necessary to avoid the complications presented by this type of patient.

Language changes after neurosurgery for parkinsonism

Approximately one-fourth of a series of 123 patients with parkinsonism and other movement disorders showed language changes after thalamotomy, pallidectomy, and mixed pallidectomy-thalamotomy. Incidence of language change was higher in cases of left thalamotomy, multiple thalamotomies, and mixed procedures. Language impairments were predominantly of higher language functions and were not attributable to generalized intellectual impairment.

Alcoholism in physicians

The Self-Administered Alcoholism Screening Test was completed by physicians attending an annual continuing medical education meeting. Of the responding physicians, 12% were identified as abstainers, 81% were classified as not alcohol-dependent drinkers, 5% were classified as possibly alcoholic, and 2% were classified as probably alcoholic. These results were similar to those obtained in a nonphysician general medical patient population previously given the same questionnaire. The data show that the prevalence of alcoholism among a group of physicians is not substantially different from that in a general medical population.

The Aging MMPI: Development of Contemporary Norms

Twenty-five years of experience with the Mayo Clinic computerized system for the Minnesota Multiphasic Personality Inventory (MMPI) have accrued since Swenson , Rome, and their colleagues proposed this innovation in 1959. Although it is the most respected, widely used, and thoroughly researched objective personality-assessment instrument that has been developed to date, the MMPI is aging. Work on the MMPI began in 1937, and the original normative base was established in the late 1930s and early 1940s . To develop new norms, we selected a random sample of 1,408 subjects, not under care for any physically or mentally handicapping condition and ranging in age from 18 through 99 years, from parts of Iowa, Wisconsin, and Minnesota in a 50-mile radius surrounding Rochester, Minnesota. MMPI responses obtained from this sample were used to develop normalized T-score tables for specific age ranges, and for adults in general, for the 13 basic scales of the MMPI.

Intellectual assessment in a Midwestern alcoholism treatment population.

A study of 867 patients at a midwestern alcoholism treatment center which used Shipley-Hartford Institute of Living Scale scores and WAIS scores indicates that intellectual differences in this population are due to age and socioeconomic differences than to alcoholism. However, these real differences can be used to plan dismissal and rehabilitation policies for individual patients.

BENDER-GESTALT RECALL AS A MEASURE OF MEMORY VERSUS DISTRACTIBILITY

The number of figures recalled from the Bender-Gestalt Test correlated (r = 0.74) with the Wechsler Memory Scale raw scores for 65 patients referred for possible intellectual deficit. There was a significantly higher (P < 0.001) correlation with a factor of memory (r = 0.76) than with a freedom-from-distractibility factor (r = 0.40). These results suggest the Bender-Gestalt recall is a good screening measure of memory.

Using the 1983 norms for the MMPI: Code type frequencies in four clinical samples

MMPI responses obtained from a large random sample of midwestern adults who were 18 through 99 years old and had no physically or mentally handicapping condition yielded a pattern significantly different from the pattern of the original norms. From these data, two new kinds of normative tables have been developed: Norms that reflect, for each sex, the response pattern of the general adult population, and a set of tables, separate for each sex, that allow comparisons to be based on age. In addition, the traditional scoring procedures based on a linear transformation that maintains any underlying skewness of the raw score distribution has been replaced by procedures that yield normalized T scores. The changes that are apparent at the item and scale level are also evident in the frequency with which certain 1- and 2-point codes occur in normal and clinical samples. These changes are apt to make our interpretive statements more meaningful because they are based on contemporary norms.