Differentiating Bipolar Disorder from Major Depressive Disorder Using the MMPI-2-RF: A Receiver Operating Characteristics (ROC) Analysis
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We examined the utility of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) to differentiate patients with lifetime bipolar disorder (BD) from patients with lifetime major depressive disorder (MDD), and to differentiate patients with BD who are currently depressed from patients with current MDD. Sixty-one patients with BD (BD-I n = 51, BD-II n = 10) and 381 patients with MDD were administered the MMPI-2; MMPI-2-RF scale scores were derived from these MMPI-2 protocols. Receiver operating characteristics analysis revealed that the MMPI-2-RF Activation (ACT) scale had the largest Area Under the Curve (AUC), which was 0.74. Using a cut-off score of 4 on the ACT scale resulted in 71% of patients being correctly classified as having BD or MDD (sensitivity = 0.67, specificity = 0.71). An examination of currently depressed patients with BD (n = 29) and a randomly selected sample of MDD patients (n = 29) revealed that the ACT scale correctly classified 72% of patients (AUC = 0.75, sensitivity = 0.69, specificity = 0.76). Implications and limitations of these findings were discussed.
- Altshuler, L. L., Post, R. M., Leverich, G. S., Mikalauskas, K., Rosoff, A., & Ackerman, L. (1995). Antidepressant-induced mania and cycle acceleration: a controversy revisited. American Journal of Psychiatry, 152, 1130–1138.
- Angst, J., Gamma, A., Benazzi, F., Ajdacic, V., Eich, D., & Rossler, W. (2003). Toward a re-definition of subthreshold bipolarity: epidemiology and proposed criteria for bipolar-II, minor bipolar disorders and hypomania. Journal of Affective Disorders, 73, 133–146. CrossRef
- Angst, J. A., Adolfsson, R., Benazzi, F., Gamma, A., Hantouche, E., Meyer, T. D., et al. (2005). The HCL-32: towards a self-assessment tool for hypomanic symptoms in outpatients. Journal of Affective Disorders, 88, 217–233. CrossRef
- Baldessarini, R. J., Finklestein, S., & Arana, G. W. (1983). The predictive power of diagnostic tests and the effect of prevalence of illness. Archives of General Psychiatry, 40, 569–573.
- Ben-Porath, Y. S., & Tellegen, A. (2008). Minnesota multiphasic personality inventory – 2 restructured form (MMPI-2-RF). Manual for administration, scoring, and interpretation. Minneapolis: University of Minnesota Press.
- Ben-Porath, Y. S., Butcher, J. N., & Graham, J. R. (2001). Contribution of the MMPI-2 content scales to the differential diagnosis of psychopathology. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 3, 634–640.
- Berk, M., Malhi, G. S., Cahill, C., Carman, A. C., Hadzi-Pavlovic, D., Hawkins, M. T., et al. (2007). The Bipolar Depression Rating Scale (BDRS): its development, validation and utility. Bipolar Disorders, 9, 571–579. CrossRef
- Butcher, J. N., & Rouse, S. V. (1996). Personality: individual differences and clinical assessment. Annual Review of Psychology, 47, 87–111. CrossRef
- Butcher, J. N., Dahlstrom, W. G., Graham, J. R., Tellegen, A., & Kaemmer, B. (1989). Minnesota multiphasic personality inventory (MMPI-2). Manual for administration and scoring. Minneapolis: University of Minnesota Press.
- Camara, W. J., Nathan, J. S., & Puente, A. E. (2000). Psychological test usage: implications in professional psychology. Professional Psychology: Research and Practice, 31, 141–154. CrossRef
- Cohen, J. (1973). Eta-squared and partial eta-squared in communication science. Human Communication Research, 28, 473–490.
- Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale: Erlbaum.
- Cuellar, A. K., Johnson, S. L., & Winters, R. (2005). Distinctions between bipolar and unipolar depression. Clinical Psychology Review, 25, 307–339. CrossRef
- Engström, C., Brändström, S., Sigvardsson, S., Cloninger, R., & Nylander, P. O. (2004). Bipolar disorder I. Temperament and character. Journal of Affective Disorders, 82, 131–134. CrossRef
- First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1995). Structured clinical interview for DSM-IV axis I disorders – patient edition, version 2.0. New York: Biometrics Research Department.
- Ghaemi, S. N., Lenox, M. S., & Baldessarini, R. J. (2001). Effectiveness and safety of long-term antidepressant treatment in bipolar disorder. Journal of Clinical Psychiatry, 62, 565–569. CrossRef
- Goldberg, J. F., & Ernst, C. L. (2002). Features associated with the delayed initiation of mood stabilizers at illness onset in bipolar disorder. Journal of Clinical Psychiatry, 63, 985–991. CrossRef
- Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry, 23, 56–73. CrossRef
- Hirschfeld, R. M. A., Williams, J. B. W., Spitzer, R. L., Calabrese, J. R., Flynn, L., Keck, P. E., Jr., et al. (2000). Development and validation of a screening instrument for bipolar spectrum disorder: the mood disorder questionnaire. American Journal of Psychiatry, 157, 1873–1875. CrossRef
- Hirschfeld, R. M. A., Lewis, L., & Vornik, L. A. (2003). Perceptions and impact of bipolar disorder: how far have we really come? Results of the National Depressive and Manic-Depressive Association 2000 survey of individuals with bipolar disorder. Journal of Clinical Psychiatry, 64, 161–174. CrossRef
- Kessler, R. C., Wittchen, H. U., Abelson, J. M., & Zhou, S. (2000). Methodological issues in assessing psychiatric disorder with self-reports. In A. A. Stone, J. S. Turrkan, C. A. Bachrach, J. B. Jobe, H. S. Kurtzman, & V. S. Cain (Eds.), The science of self-report: Implications for research and practice (pp. 229–255). Mahwah: Erlbaum.
- Mitchell, P. B., Goodwin, G. M., Johnson, G. F., & Hirschfeld, R. M. A. (2008). Diagnostic guidelines for bipolar depression: a probabilistic approach. Bipolar Disorders, 10, 144–152. CrossRef
- Montgomery, S. A., & Åsberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389. CrossRef
- Nichols, D. S. (2006). The trials of separating bath water from baby: a review and critique of the MMPI-2 Restructured Clinical Scales. Journal of Personality Assessment, 87, 121–138. CrossRef
- Parker, G., Hadzi-Pavlovic, D., & Tully, L. (2006). Distinguishing bipolar and unipolar disorders: an isomer model. Journal of Affective Disorders, 96, 67–73. CrossRef
- Parker, G., Fletcher, K., Barrett, M., Synott, H., Breakspear, M., Hyett, M., et al. (2008). Screening for bipolar disorder: the utility and comparative properties of the MSS and MDQ measures. Journal of Affective Disorders, 109, 83–89. CrossRef
- Rom, D. M. (1990). A sequentially rejective test procedure based on a modified Bonferroni inequality. Biometrika, 77, 663–665. CrossRef
- Shear, M. K., Greeno, C., Kang, J., Ludewig, D., Frank, E., Swartz, H. A., et al. (2000). Diagnosis of nonpsychotic patients in community clinics. American Journal of Psychiatry, 157, 581–587. CrossRef
- Solomon, D. A., Leon, A. C., Maser, J. D., Truman, C. J., Coryell, W., Endicott, J., et al. (2006). Distinguishing bipolar major depression from unipolar major depression with the screening assessment of depression-polarity (SAD-P). Journal of Clinical Psychiatry, 67, 434–442. CrossRef
- Streiner, D. L., & Cairney, J. (2007). What’s under the ROC? An introduction to receiver operating characteristics curves. Canadian Journal of Psychiatry, 52, 121–128.
- Swets, J. A. (1988). Measuring the accuracy of diagnostic systems. Science, 240, 1285–1293. CrossRef
- Tellegen, A., Ben-Porath, Y. S., Sellbom, M., Arbisi, P. A., McNulty, J. L., & Graham, J. R. (2006). Further evidence on the validity of the MMPI-2 restructured clinical scales: addressing questions raised by Rogers, Sewell, Harrison, and Jordan, and Nichols. Journal of Personality Assessment, 87, 148–171. CrossRef
- Wehr, T. A., & Goodwin, F. K. (1987). Can antidepressants cause mania and worsen the course of affective illness? American Journal of Psychiatry, 144, 1403–1411.
- Weinstock, L. M., Strong, D., Uebelacker, L. A., & Miller, I. W. (2009). Differential item functioning of DSM-IV depressive symptoms in individuals with a history of mania versus those without: An item response theory analysis. Bipolar Disorders, 11, 289–297. CrossRef
- Youden, W. J. (1950). Index for rating diagnostic tests. Cancer, 3, 32–35. CrossRef
- Zimmerman, M., Galione, J. N., Ruggero, C. J., Chelminski, I., Young, D., Dalrymple, K., et al. (2010). Screening for bipolar disorder and finding borderline personality disorder. Journal of Clinical Psychiatry, 71, 1212–1217. CrossRef
- Differentiating Bipolar Disorder from Major Depressive Disorder Using the MMPI-2-RF: A Receiver Operating Characteristics (ROC) Analysis
Journal of Psychopathology and Behavioral Assessment
Volume 33, Issue 3 , pp 368-374
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- Bipolar disorder
- Major depressive disorder
- Activation scale
- ROC analysis