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Validity of the Somatic Complaints Scales of the MMPI-2-RF in an Outpatient Chronic Pain Clinic

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Abstract

Chronic pain has become a significant medical issue. The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) is a broadband psychological test that has been validated for use across various medical settings and can aid in the assessment and treatment planning of chronic pain. In the current investigation, it was hypothesized that the somatic complaints scales of the MMPI-2-RF would demonstrate good convergent validity from a structured psychodiagnostic interview and other measures of pain and somatization, and lack gender bias. Patients (n = 200) who produced valid MMPI-2-RFs in an outpatient chronic pain clinic were included in the study. Patients were also administered the Modified Somatic Perception Questionnaire (MSPQ), Pain Disability Index (PDI), and the Structured Clinical Interview for DSM-IV-TR (SCID). Zero-order and partial correlations (controlling for gender) were calculated between MMPI-2-RF scale scores and other criteria. Stepdown hierarchical regression analyses were used to detect bias. By and large, higher scale scores on the somatic/cognitive scales of the MMPI-2-RF were modestly or substantially correlated with MSPQ scores, PDI scores, and SCID Somatization symptom count, even after controlling for gender. Regression analyses suggested that the MMPI-2-RF scale scores were not biased as a function of gender. These findings support the validity of specific MMPI-2-RF scales to help identify somatization and psychosocial functioning among patients with chronic pain. Identification of somatization early within the course of treatment of chronic pain may help focus treatment targets, including referrals for psychological interventions such as cognitive behavior therapy for chronic pain.

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References

  • Association, A. P. (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Association, A. P. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing. https://doi.org/https://doi.org/10.1176/appi.books.9780890425596.734227

  • Bair, M. J., Robinson, R. L., Katon, W., & Kroenke, K. (2003). Depression and pain comorbidity: A literature review. Archives of Internal Medicine, 163, 2433–2445. https://doi.org/10.1001/archinte.163.20.2433.

    Article  PubMed  Google Scholar 

  • Barsky, A. J., Peekna, H. M., & Borus, J. F. (2001). Somatic symptom reporting in women and men. Journal of General and Internal Medicine, 16, 266–275.

    Article  CAS  Google Scholar 

  • Ben-Porath, Y. S., & Tellegen, A. (2008/2011). The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF): Manual for administration, scoring, and interpretation. University of Minnesota Press. http://www.pearsonassessments.com/HAIWEB/Cultures/en-us/Productdetail.htm?Pid=PAg523&Mode=summary

  • Ben-Porath, Y. S., & Tellegen, A. (2020). The Minnesota Multiphasic Personality Inventory-3: Manual for administration, scoring, and interpretation. Minneapolis: University of Minnesota Press.

    Google Scholar 

  • Ben-Porath, Y. S., & Tellegen, A. (2020). The Minnesota Multiphasic Personality Inventory-3: Technical Manual. Minneapolis: University of Minnesota Press.

    Google Scholar 

  • Block, A. R., & Ben-Porath, Y. S. (2018). MMPI-2-RF User’s Guide for the Spine Surgery and Spinal Cord Stimulator Candidate Interpretive Reports. Minneapolis: University of Minnesota Press.

    Google Scholar 

  • Block, A. R., Ben-Porath, Y. S., & Marek, R. J. (2013). Psychological risk factors for poor outcome of spine surgery and spinal cord stimulator implant: A review of the literature and their assessment with the MMPI-2-RF. Clinical Neuropsychology, 27, 81–107. https://doi.org/10.1080/13854046.2012.721007.

    Article  Google Scholar 

  • Block, A. R., Marek, R. J., & Ben-Porath, Y. S. (2019). Patient activation mediates the association between psychosocial risk factors and spine surgery results. Journal of Clinical Psychology in Medical Settings, 26, 123–130. https://doi.org/10.1007/s10880-018-9571-x.

    Article  PubMed  Google Scholar 

  • Block, A. R., Marek, R. J., Ben-Porath, Y. S., & Kukal, D. (2017). Associations between pre-implant psychosocial factors and spinal cord stimulation outcome: Evaluation using the MMPI-2-RF. Assessment, 24, 60–70. https://doi.org/10.1177/1073191115601518.

    Article  PubMed  Google Scholar 

  • Block, A. R., Marek, R. J., Ben-Porath, Y. S., & Ohnmeiss, D. D. (2014). Associations between Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) Scores, Workers’ Compensation Status, and Spine Surgery Outcome. Journal of Applied Biobehavioral Research, 19, 248–267.

    Article  Google Scholar 

  • Bragazzi, N. L., Puente, G. D., & Natta, W. M. (2014). Somatic perception, cultural differences and immigration: Results from administration of the Modified Somatic Perception Questionnaire (MSPQ) to a sample of immigrants. Psychology Research and Behavioral Management, 7, 161–166. https://doi.org/10.2147/PRBM.S55393.

    Article  Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Routledge: Psychology Press.

    Google Scholar 

  • Dahlhamer, J., Lucas, J., Zelaya, C., Nahin, R., Mackey, S., DeBar, L., et al. (2018). Prevalence of chronic pain and high-impact chronic pain among adults—United States, 2016. Mmwr-Morbidity and Mortality Weekly Report, 67, 1001–1006. https://doi.org/10.15585/mmwr.mm6736a2.

    Article  PubMed  PubMed Central  Google Scholar 

  • Delisle, V. C., Beck, A. T., Dobson, K. S., Dozois, D. J., & Thombs, B. D. (2012). Revisiting gender differences in somatic symptoms of depression: much ado about nothing? PLoS One, 7.

  • Dersh, J., Polatin, P. B., & Gatchel, R. J. (2002). Chronic pain and psychopathology: Research findings and theoretical considerations. Psychosomatic Medicine, 64, 773–786. https://doi.org/10.1097/01.psy.0000024232.11538.54.

    Article  PubMed  Google Scholar 

  • Deyo, R. A., Walsh, N. E., Schoenfeld, L. S., & Ramamurthy, S. (1989). Studies of the Modified Somatic Perceptions Questionnaire (MSPQ) in patients with back pain. Psychometric and predictive properties. Spine (Phila Pa 1976), 14, 507–510. https://doi.org/10.1097/00007632-198905000-00006.

    Article  CAS  Google Scholar 

  • Dimsdale, J., Creed, F., Disorders, D.-V.W., & o. S. S. . (2009). The proposed diagnosis of somatic symptom disorders in DSM-V to replace somatoform disorders in DSM-IV–a preliminary report. Journal of Psychosomatic Research, 66, 473–476. https://doi.org/10.1016/j.jpsychores.2009.03.005.

    Article  PubMed  Google Scholar 

  • Donaldson, M. B., Learman, K., Wright, A., Brown, C., Howes, C., & Cook, C. E. (2011). Factor structure and concurrent/convergent validity of the modified somatic perception questionnaire and pain beliefs instrument. Journal of Manipulative and Physiological Therapeutics, 34, 30–36. https://doi.org/10.1016/j.jmpt.2010.11.002.

    Article  PubMed  Google Scholar 

  • Dueñas, M., Ojeda, B., Salazar, A., Mico, J. A., & Failde, I. (2016). A review of chronic pain impact on patients, their social environment and the health care system. Journal of Pain Research, 9, 457.

    Article  Google Scholar 

  • Ehde, D. M., Dillworth, T. M., & Turner, J. A. (2014). Cognitive-behavioral therapy for individuals with chronic pain efficacy, innovations, and directions for research. American Psychologist, 69, 153–166. https://doi.org/10.1037/a0035747.

    Article  Google Scholar 

  • Fava, G. A., Freyberger, H. J., Bech, P., Christodoulou, G., Sensky, T., Theorell, T., & Wise, T. N. (1995). Diagnostic-criteria for use in psychosomatic research. Psychotherapy and Psychosomatics, 63, 1–8. https://doi.org/10.1159/000288931.

    Article  PubMed  CAS  Google Scholar 

  • First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. (2002). Structured clinical interview for DSM-IV-TR axis I disorders, research version, patient edition.

  • Jerome, A., & Gross, R. T. (1991). Pain disability index: construct and discriminant validity. Archives of Physical Medicine and Rehabilitation, 72, 920–922. https://doi.org/10.1016/0003-9993(91)90012-8.

    Article  PubMed  CAS  Google Scholar 

  • Kotov, R., Krueger, R. F., Watson, D., Achenbach, T. M., Althoff, R. R., Bagby, R. M., … Zimmerman, M. (2017). The hierarchical taxonomy of psychopathology (HiTOP): A dimensional alternative to traditional nosologies. Journal of Abnormal Psychology, 126, 454–477. https://doi.org/https://doi.org/10.1037/abn0000258.

  • Kotov, R., Ruggero, C. J., Krueger, R. F., Watson, D., Yuan, Q., & Zimmerman, M. (2011). New dimensions in the quantitative classification of mental illness. Archives of General Psychiatry, 68, 1003–1011. https://doi.org/10.1001/archgenpsychiatry.2011.107.

    Article  PubMed  Google Scholar 

  • Ladwig, K. H., Marten-Mittag, B., Erazo, N., & Gundel, H. (2001). Identifying somatization disorder in a population-based health examination survey: Psychosocial burden and gender differences. Psychosomatics, 42, 511–518. https://doi.org/10.1176/appi.psy.42.6.511.

    Article  PubMed  CAS  Google Scholar 

  • Ladwig, K. H., Marten-Mittag, B., Formanek, B., & Dammann, G. (2000). Gender differences of symptom reporting and medical health care utilization in the German population. European Journal of Epidemiology, 16, 511–518. https://doi.org/10.1023/a:1007629920752.

    Article  PubMed  CAS  Google Scholar 

  • Lautenschlager, G. J., & Mendoza, J. L. (1986). A step-down hierarchical multiple-regression analysis for examining hypotheses about test bias in prediction. Applied Psychological Measurement, 10, 133–139. https://doi.org/10.1177/014662168601000202.

    Article  Google Scholar 

  • Main, C. J. (1983). The Modified Somatic Perception Questionnaire (MSPQ). Journal of Psychosomatic Research, 27, 503–514. https://doi.org/10.1016/0022-3999(83)90040-5.

    Article  PubMed  CAS  Google Scholar 

  • Marek, R. J., Anderson, J. L., Tarescavage, A. M., Martin-Fernandez, K., Haugh, S., Block, A. R., et al. (2020). Elucidating somatization in a dimensional model of psychopathology across medical settings. Journal of Abnormal Psychology, 129, 162–176. https://doi.org/10.1037/abn0000475.

    Article  PubMed  Google Scholar 

  • Marek, R. J., & Ben-Porath, Y. S. (2017). Using the Minnesota Multiphasic Personality Inventory–2–Restructured Form (MMPI-2-RF) in Behavioral Medicine Settings. In M. E. Maruish (Ed.), Handbook of Psychological Assessment in Primary Care Settings (2nd ed., pp. 631–662). London: Routledge.

    Google Scholar 

  • Marek, R. J., Ben-Porath, Y. S., Epker, J. T., Kreymer, J. K., & Block, A. R. (2020). Reliability and Validity of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in spine surgery and spinal cord stimulator samples. Journal of Personality Assessment, 102, 22–35. https://doi.org/10.1080/00223891.2018.1488719.

    Article  PubMed  Google Scholar 

  • Marek, R. J., Ben-Porath, Y. S., Sellbom, M., McNulty, J. L., & Heinberg, L. J. (2015). Validity of Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) scores as a function of gender, ethnicity, and age of bariatric surgery candidates. Surgery for Obesity and Related Diseases, 11, 627–634. https://doi.org/10.1016/j.soard.2014.10.005.

    Article  PubMed  Google Scholar 

  • Marek, R. J., Block, A. R., & Ben-Porath, Y. S. (2015). The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF): Incremental validity in predicting early postoperative outcomes in spine surgery candidates. Psychological Assessment, 27, 114–124. https://doi.org/10.1037/pas0000035.

    Article  PubMed  Google Scholar 

  • Marek, R. J., Block, A. R., & Ben-Porath, Y. S. (2019). Validation of a psychological screening algorithm for predicting spine surgery outcomes. Assessment, 26, 915–928. https://doi.org/10.1177/1073191117719512.

    Article  PubMed  Google Scholar 

  • McBeth, J., Prescott, G., Scotland, G., Lovell, K., Keeley, P., Hannaford, P., et al. (2012). Cognitive behavior therapy, exercise, or both for treating chronic widespread pain. Archives of International Medicine, 172, 48–57.

    Article  Google Scholar 

  • McCord, D. M., & Drerup, L. C. (2011). Relative practical utility of the Minnesota Multiphasic Personality Inventory-2 Restructured Clinical Scales versus the Clinical Scales in a chronic pain patient sample. Journal of Clinical and Experimental Neuropsychology, 33, 140–146. https://doi.org/10.1080/13803395.2010.495056.

    Article  PubMed  Google Scholar 

  • Pollard, C. A. (1984). Preliminary validity study of the pain disability index. Perceptual and Motor Skills, 59, 974. https://doi.org/10.2466/pms.1984.59.3.974.

    Article  PubMed  CAS  Google Scholar 

  • Sellbom, M. (2017). Mapping the MMPI-2-RF specific problems scales onto extant psychopathology structures. Journal of Personality Assessment, 99, 341–350. https://doi.org/10.1080/00223891.2016.1206909.

    Article  PubMed  Google Scholar 

  • Sellbom, M. (2019). The MMPI-2-Restructured Form (MMPI-2-RF): Assessment of Personality and Psychopathology in the Twenty-First Century. Annual Review of Clinical Psychology, 15, 149–177. https://doi.org/10.1146/annurev-clinpsy-050718-095701.

    Article  PubMed  Google Scholar 

  • Tait, R. C., Chibnall, J. T., & Krause, S. (1990). The Pain Disability Index: psychometric properties. Pain, 40, 171–182. https://doi.org/10.1016/0304-3959(90)90068-o.

    Article  PubMed  Google Scholar 

  • Tarescavage, A. M. (2015). Predicting treatment outcomes among low back pain patients using the Minnespota Multiphasic Personality Inventory-2-Restructured Form Kent State University].

  • Tarescavage, A. M., Scheman, J., & Ben-Porath, Y. S. (2015). Reliability and validity of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in evaluations of chronic low back pain patients. Psychological Assessment, 27, 433–446. https://doi.org/10.1037/pas0000056.

    Article  PubMed  Google Scholar 

  • Tarescavage, A. M., Scheman, J., & Ben-Porath, Y. S. (2018). Prospective Comparison of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and MMPI-2-Restructured Form (MMPI-2-RF) in Predicting Treatment Outcomes Among Patients with Chronic Low Back Pain. Journal of Clinical Psychology in Medical Settings, 25, 66–79. https://doi.org/10.1007/s10880-017-9535-6.

    Article  PubMed  Google Scholar 

  • Tellegen, A., & Ben-Porath, Y. S. (2008/2011). The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF): Technical Manual. University of Minnesota Press. http://www.pearsonassessments.com/HAIWEB/Cultures/en-us/Productdetail.htm?Pid=PAg523&Mode=summary

  • Von Korff, M., Crane, P., Lane, M., Miglioretti, D. L., Simon, G., Saunders, K., et al. (2005). Chronic spinal pain and physical-mental comorbidity in the United States: Results from the national comorbidity survey replication. Pain, 113, 331–339. https://doi.org/10.1016/j.pain.2004.11.010.

    Article  Google Scholar 

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Authors and Affiliations

  1. University of Houston-Clear Lake, Houston, TX, USA

    Lauren D. Mickens & Duyen M. Nghiem

  2. Eastern Kentucky University, Richmond, KY, USA

    Dustin B. Wygant

  3. VA Tennessee Valley Healthcare System, Nashville, TN, USA

    Robert L. Umlauf

  4. Sam Houston State University College of Osteopathic Medicine, 925 City Central Avenue, Conroe, TX, 77304, USA

    Ryan J. Marek

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  1. Lauren D. Mickens
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  2. Duyen M. Nghiem
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Correspondence to Ryan J. Marek.

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Conflict of interest

Ryan J. Marek receives grant funding from the University of Minnesota Press unrelated to this project. Dustin B. Wygant is a paid consultant to the University of Minnesota Press, publisher of the MMPI-2-RF and Pearson Assessments. Lauren D. Mickens, Duyen M. Nghiem, and Robert L. Umlauf report no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study at the time the data were collected.

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Mickens, L.D., Nghiem, D.M., Wygant, D.B. et al. Validity of the Somatic Complaints Scales of the MMPI-2-RF in an Outpatient Chronic Pain Clinic. J Clin Psychol Med Settings 28, 789–797 (2021). https://doi.org/10.1007/s10880-021-09766-4

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