Musculoskeletal status and disability of MMPI profile subgroups among patients with low back pain.

Studied Minnesota Multiphasic Personality Inventory (MMPI) profiles of 362 patients with acute and chronic low back pain (LBP) for replicable homogeneous subgroups using 3 cluster-analysis procedures. Two normal and 3 clinically elevated profile subgroups were identified. The 2 normal subgroups were characterized by relatively normal musculoskeletal condition and were least disabled but differed from each other in duration of pain, presence of physical abnormalities, and daily functioning. The most pathologic profile subgroup consisted largely of acute-pain patients whose musculoskeletal condition and daily functioning were similar to those of the normal subgroups. Patients in the 3 abnormal MMPI subgroups were exposed to more LBP physical-risk factors in the workplace. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Empirically derived MMPI profile clusters and characteristics of low back pain patients.

Analysis of the MMPI scores of 401 low-back-pain patients (average age 45 yrs) by a multivariate clustering procedure produced 5 homogeneous subgroups. Three groups with elevated MMPI profiles and 2 unelevated groups showed differences in age, employment, marital status, pretreatment pain intensity, and activity limitations. Follow-up comparisons at 6-mo and 1-yr intervals revealed that the elevated subgroups had a poorer response to treatment. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Short forms of the MMPI with back pain patients.

Compared the Faschingbauer Abbreviated MMPI (FAM) and the Midi-Mult on a sample of 176 back pain outpatients. Correlations with the standard MMPI scales ranged from .67 to .93 on the FAM and from .71 to .89 on the Midi-Mult. The FAM showed higher agreement with MMPI code types than did the Midi-Mult. The 3 versions were compared to independent physician ratings of amount of functional component to patients' pain, and all 3 forms discriminated between "functional" and "organic" patient groups. Results provide tentative evidence that abbreviated MMPIs are useful measures of personality in this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risk of long-term disability among patients with back pain

This follow-up study was designed to identify the differences between the TMJ movements of individuals undergoing orthognathic surgery, with and without positioning of the mandibular proximal segment. A further aim was to assess the location of the terminal hinge axis before and after surgery regarding variations due to mandibular advancement or set back, respectively combined two jaw osteotomy. Mechanical axiographic tracings were documented in 14 patients undergoing orthognatic surgery without positioning of the mandibular proximal segment. The terminal hinge axis position was marked by a tattoo. After surgery two more axiographic tracings were recorded over a follow-up period of 24 months. Changes to the terminal hinge axis position were also documented. Condylar guidance angles showed no differences, whereas Bennett angles decreased by an average of 25%. Subjective or objective TMJ symptoms after surgery could be observed in 64% of the patients, compared to 50% before surgery. Considerable variations in the position of the terminal hinge axis were observed nine months after surgery, especially in the two jaw group. In Class II individuals the terminal hinge axis was found in a cranial position both after 9 and 24 months. Class III individuals with two jaw surgery also gained a long term cranial localisation, whereas Class III patients with mandibular setback only demonstrated a hinge axis position inferior and anterior compared to the preoperative reference. No statistically significant differences were apparent between the axiographic condylar movement parameters in the present group as compared to data published employing condylar positioning.     

MMPI clinical scale correlates.

Discusses and compares the results of 7 independent studies that have attempted empirically to identify the behavioral or symptom correlates of individual MMPI clinical scales for psychiatric patients. Symptom correlates, in general, tend to provide construct validity for the "traditional" interpretation of individual scales. The correlations are uniformly quite low, however, and individual scales evidence relatively few instances of unique discrimination. Major symptom correlates for individual scales also tend to be significantly related to 2-point profile codes that include the individual scales, although there are obvious differences that may be associated with scale profiles. Some possible interactions of scale correlates with race, sex, and clinical setting are noted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Chinese MMPI profiles among neurotic patients.

The Chinese Minnesota Multiphasic Personality Inventory (MMPI) profiles of 1,112 neurotic patients were scored with the Chinese norm, the original MMPI norm, and the MMPI—2 Uniform T scores. In comparison with the Chinese normative sample, the neurotic profiles were elevated on all the clinical scales except Scale 5 (Mf). The neurotic patients also scored higher than schizophrenic patients on Scales 1 (Hs), 2 (D), 3 (Hy), 7 (Pt), 8 (Sc), and 0 (Si). The Chinese normative profiles produced typical neurotic code types of 12/21, 13/31, 23/32, and 27/72. However, the overall T score elevations of the clinical scales were much lower than those found on the American norms. Profiles based on the 3 American norms bore the characteristic peaks on Scales 2 and 8 found among Chinese samples. The authors recommend using both the Chinese and the American norms in the interpretation of the Chinese MMPI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of self-efficacy in rehabilitation outcome among chronic low back pain patients.

Examined the role of self-efficacy beliefs in the rehabilitation of 45 low back pain patients participating in a 3-wk rehabilitation program. Increments in self-efficacy beliefs during the rehabilitation program were not associated with improved patient functioning at discharge from the program. However, in support of the theorized role of self-efficacy in behavior change, these increments in self-efficacy significantly predicted better patient functioning and less reported pain at the 6-mo follow-up assessment. Implications of these findings for the rehabilitation of low back pain patients are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Low back pain problems among steelworkers

The associations between low-back pain and occupational work loads, life-style factors, and sociodemographic factors were examined in 469 steel plant workers (436 males, 33 females), mean age (sd): 40 (12) years. Fifty-one per cent had experienced low-back pain during the preceding year. The strongest associations were found between recent low-back pain and domestic recreational activities (> or = h/wk vs 0-2 h/wk), and between recent low-back pain and work pace (too fast vs. adequate), odds ratios (95% confidence limits) being respectively 3.0 (1.5-5.8), and 2.3 (1.2-4.2). We considered a subject to have a particularly severe history of low-back pain if he or she due to low-back trouble (i) had ever been admitted to a hospital, (ii) had ever had to change work or, (iii) had had more than one week's sick-leave accumulated during the preceding year. There was a strong association between a severe low-back pain history and life-time occupational exposure to heavy and frequent lifting on the job. Forty-seven per cent of severe low-back pain events could be ascribed to heavy and frequent lifting, provided the associations were causal. We conclude that domestic recreational activities may be an important potential confounder in studies on occupational risk factors for low-back pain, and that, based on the results of this and of other studies, a case for prevention still seems to exist regarding lifting of heavy burdens in the work environment.     

MMPI profile characteristics of psychiatric patients in an urban Canadian setting.

Studied the Minnesota Multiphasic Personality Inventory (MMPI) profiles of 363 inpatient and outpatient urban Canadian psychiatric patients (mean age = 31.5 yrs). The profiles as a group did not differ markedly from 2 recent American samples in their single most elevated clinical scales, in the most commonly occurring 2-point code types, or in classifiability according to the profile typology of P. A. Marks and W. Seeman (1963). With no rule violations, the Marks and Seeman typology classified only 20% of the sample; allowing 1 rule violation per profile increased the classification rate to only 41%. Further research into the applicability of American MMPI clinical lore to English-speaking Canadian populations is encouraged. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral correlates of single-scale MMPI code types.

Attempted to determine whether reliable demographic and behavioral correlates could be found for singe-scale Minnesota Multiphasic Personality Inventory (MMPI) code types. Ss were 661 patients in a psychiatric hospital. Utilizing a split-sample technique to allow for replication, high-point, low-point, high-score, and low-score code types were studied. Each code type was compared with other Ss on 73 demographic and behavioral variables. Separate analyses were done for male and female code types. Only correlates reliable across both samples are reported. A sufficiently large number of reliable correlates were identified, suggesting that single-scale code types can be considered a meaningful approach to MMPI interpretation. The importance of using replication procedures was confirmed. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethnic comparability of the MMPI in pain patients

The MMPI basic validity and clinical scales' patterns of 295 White-, African- and Latino-American pain patients were compared. Mean group differences across ethnic groups on scales L, F, K, Mf, and Si were revealed in multivariate analysis of covariance for females, while differences across ethnic groups on scales F, K, Mf, Sc, Ma, and Si were revealed for males. In the univariate follow-up analyses of covariance, significant main effects were obtained for ethnicity along with education and (occasionally for males) duration of pain. Various high-point, two-point, and other profile patterns were examined and notable gender/ethnic group differences were found. The pattern of intercorrelations of the MMPI scales mean T scores with various demographic and clinical characteristics suggested some notable divergence across subgroups on certain correlates of the pain experience.     

MMPI correlates of social and physical anhedonia.

The construct validity of scales measuring social and physical anhedonia (L. J. Chapman et al, 1976) was investigated by performing simple and canonical correlation analyses of clinical, content, and pure scales from the MMPI. Ss were 243 consecutively admitted male veterans (mean age 31.87 yrs) in an inpatient drug dependence treatment program. Results support predictions that anhedonia, defined as a deficiency in the ability to experience pleasure, would be associated with social maladjustment and confused thinking and, further, that anhedonia scales would measure personality characteristics other than depression. Social anhedonia and physical anhedonia were associated with the clinical scales Validity and Social Introversion, the content scales Social Maladjustment and Psychoticism, and Pure Scale 7, which measures characteristics associated with the 278 MMPI profile type and Diagnostic and Statistical Manual of Mental Disorders (2nd edition) equivalents of "schizophrenia, latent type." Degree of association was stronger for scales measuring social anhedonia, contrary to the test authors' speculations that the measure of physical anhedonia would be the more promising of the 2 scales. The construct validity of personality assessment suggested that further study is warranted, particularly to determine other aspects of everyday living that may be implicated in measures of social and physical anhedonia. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Functional correlates in the rehabilitation of occupational low back pain

The aim of this preliminary report was to identify physiological parameters related to functional improvement in industrial workers with occupational low back pain (LBP) undergoing an intensive rehabilitation program. Four able-bodied and four LBP industrial workers were evaluated before and after a 4-week rehabilitation program. Dynamic and static strength tests, namely sustained isometric contractions, were performed in conjunction with surface electromyographic (EMG) measurements. Significant pre-rehabilitation differences were found between the two groups. Measured forces changed significantly in LBP subjects immediately after rehabilitation. No significative changes were found in the control subjects after the rehabilitation program. After rehabilitation, the slope of decay of the median frequency of the EMG power spectrum at L4 level, during a 60-sec isometric submaximal (60% MVC) contraction, decreased significantly (p < 0.02) indicating a lower fatigue level.     

The MMPI and chronic pain.

112 chronic pain patients (mean age 48.4 yrs) completed the MMPI upon entering either an anesthesiologic or a psychiatric treatment program. Pretreatment MMPI performance was found to be successful in predicting patient outcome an average of 20 mo following treatment, with the K (Test-Taking Attitude), Hypochondriasis, Hysteria, and Masculinity and Femininity scales accounting for most of the variance. The strength of this relationship varied as a function of the measure of outcome and type of treatment received. Substantial MMPI differences were found when Ss with only one part of their body in pain were compared with those with multiple pain complaints. Significant MMPI differences were also found in comparisons based on Ss' sex, type of pain (e.g., head vs back), and type of treatment for which was referred (i.e., psychiatric vs anesthesiologic). Clinical implications of the observed MMPI differences are discussed. Results are seen as demonstrating the value of the MMPI as a clinical and research instrument within this population. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

MMPI profile constellations in incest families.

Used the Minnesota Multiphasic Personality Inventory (MMPI) to study the personality characteristics of 4 groups of Ss from incest families: 33 natural father perpetrators (aged 21–64 yrs), 29 stepfather perpetrators (aged 21–64 yrs), 44 nonparticipating mothers (aged 25–69 yrs), and 22 daughter victims (aged 15–20 yrs). Further analyses compared each of the 4 experimental groups to control groups from nonincestuous families that were matched for sex, age, race, education, and socioeconomic status (SES). The daughter victims' mean profile was more elevated and differed significantly from the profiles of the other 3 groups on the Validity, Psychasthenia, and Schizophrenia scales. Although the natural fathers and stepfathers differed significantly, the mean profiles of each group were not pathological (T?     

Psychosocial correlates of chest pain among African-American women

While 10-30% of individuals with chest pain who undergo cardiac arteriography are found to have no demonstrable pathology, women are far more likely than men to have normal coronary arteries in the presence of angina. Black women, in particular, frequently seek medical attention for persistent episodes of chest pain. This cross-sectional study was designed to examine the potential role of psychological and social factors in relation to chest pain among black women. Among our population-based sample of 188 women, 48% reported experiencing chest pain. Seventeen of these cases met the Rose criteria for classification as cardiac pain while 74 of them reported pain not consistent with cardiac origin. A statistically significant difference was observed in the stress scores among the women; the highest stress scores occurred among those with Rose angina and the lowest scores were obtained from those women reporting no chest pain experiences (p < 0.001). There was no association detected between the presence and type of chest pain and psychosocial measures of depression and coping abilities. These results confirm the high rates of chest pain experienced among black women, and provide insight into the role of psychological factors that should be considered in the identification of treatment options.     

Low back pain among cooks in nursery schools

BACKGROUND: Kwashiorkor is an edimatous form of severe malnutrition and is the predominant form of childhood malnutrition in Malawi. Potassium depletion is common and contributes to the high mortality. The aim of this study was to determine if high potassium supplementation improves the outcome of kwashiorkor treatment. METHODS: We performed a randomised, double-blind, placebo-controlled, clinical trial of high potassium supplementation in 99 children with kwashiorkor. Controls (n = 51) received a standard potassium intake of 4.7 mmol/kg/day. The intervention group (n = 48) received 7.7 mmol/kg/day. All cases (intervention and control groups) were treated in the hospital-based Nutrition Rehabilitation Center and received a standard treatment regime of mild feeds, mineral and vitamin supplements, and antibiotics. RESULTS: There was no significant difference in length of hospitalization, or time for resolution of oedema between groups. The case-fatality rate was reduced by 33% in the high potassium intervention group (13/48) compared to controls (21/51). There was a significant reduction in late deaths (13 in controls vs 3 in intervention group; odds ratio 5.3, 95% confidence interval 1.2-31.0) but no difference in early deaths (0-5 days). The intervention group also had significantly fewer presumed septic episodes (3 vs 18, odds ratio 8.9, confidence interval 2.2-50.9), respiratory symptoms, and new skin ulcerations than controls. CONCLUSIONS: The high potassium supplementation reduced mortality and significant morbidity in kwashiorkor. This may be due to improved myocardial and immune function from earlier repletion of intracellular potassium. We recommend that the standard potassium supplement for the initial phase of treatment of kwashiorkor be increased from 4 to 8 mmol/kg/day.