"The MMPI–2 Restructured Clinical Scales in the assessment of posttraumatic stress disorder and comorbid disorders”: Correction.

Reports an error in "The MMPI-2 Restructured Clinical Scales in the assessment of posttraumatic stress disorder and comorbid disorders" by Erika J. Wolf, Mark W. Miller, Robert J. Orazem, Mariann R. Weierich, Diane T. Castillo, Jaime Milford, Danny G. Kaloupek and Terence M. Keane (Psychological Assessment, 2008[Dec], Vol 20[4], 327-340). The URL for the supplemental material was incomplete. The complete URL is http://dx.doi.org/10.1037/a0012948.supp (The following abstract of the original article appeared in record 2008-17693-002.) This study examined the psychometric properties of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Restructured Clinical Scales (RCSs) in individuals with posttraumatic stress disorder (PTSD) receiving clinical services at Department of Veterans Affairs medical centers. Study 1 included 1,098 men who completed the MMPI-2 and were assessed for a range of psychological disorders via structured clinical interview. Study 2 included 136 women who completed the MMPI-2 and were interviewed with the Clinician Administered Scale for PTSD. The utility of the RCSs was compared with that of the Clinical Scales (CSs) and the Keane PTSD (PK) scale. The RCSs demonstrated good psychometric properties and patterns of associations with other measures of psychopathology that corresponded to current theory regarding the structure of comorbidity. A notable advantage of the RCSs compared with the MMPI-2 CSs was their enhanced construct validity and clinical utility in the assessment of comorbid internalizing and externalizing psychopathology. The PK scale demonstrated incremental validity in the prediction of PTSD beyond that of the RCSs or CSs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Faking specific disorders and temporal response consistency on the MMPI-2.

The ability of persons faking posttraumatic stress disorder (PTSD) or closed-head injury (CHI) to respond consistently across serial testings on the Minnesota Multiphasic Personality Inventory—2 (MMPI-2; J. Butcher, W. Dahlstrom, J. Graham, A. Tellegen, & B. Kaemmer, 1989) was investigated. Results showed that individuals faking PTSD obtained 2-week test–retest reliability scores comparable to individuals completing the MMPI-2 with standard instructions; individuals faking CHI obtained reliability coefficients significantly lower than individuals faking PTSD. A 3?×?2 (Response Style?×?Time) analysis of variance indicated that individuals faking a disorder obtained significantly elevated scores on validity scales sensitive to overreporting; no main effect for time was found. Results suggest that test-takers faking specific disorders can describe symptoms consistently on repeated testing and that type of disorder may affect temporal response consistency. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Psychodynamics of partner, stranger, and generally violent male college students.

Understanding the dynamics of partner violence has been complicated by the fact that "partner violence" may include both partner and generally violent men. The authors hypothesized that partner violence may involve intimacy-related threats to masculinity, violence toward strangers may relate to alcohol abuse, and both partner and stranger violence may relate to object relations pathology. College men were nonviolent or violent toward partners, strangers, or partners and strangers (n?=?10 men in each group). Partner violence was related to higher Schwartz Castration Anxiety Scale scores (B. Schwartz, 1991), from Thematic Apperception Test responses. Stranger violence was related to higher Minnesota Multiphasic Personality Inventory (MMPI-2) and MacAndrew Alcoholism Scale-Revised scores. Neither partner nor stranger violence was related to MMPI-2 anxiety or Westen's Social Cognition and Object Relations Scale (D. Westen, A. Barends, J. Leigh, M. Mendel, & D. Silbert, 1990). The authors discussed implications for understanding the dynamics of partner violence and treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Minnesota Multiphasic Personality Inventory–2 Restructured Form in National Guard soldiers screening positive for posttraumatic stress disorder and mild traumatic brain injury.

The Minnesota Multiphasic Personality Inventory–2 Restructured Form (MMPI-2 RF) was administered to 251 National Guard soldiers who had recently returned from deployment to Iraq. Soldiers were also administered questionnaires to identify posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). On the basis of responses to the screening instruments, the National Guard soldiers who produced a valid MMPI-2 RF were classified into four groups: 21 soldiers who screened positive for PTSD only, 33 soldiers who screened positive for mTBI only, 9 soldiers who screened positive for both conditions, and 166 soldiers who did not screen positive for either condition. Results showed that the MMPI-2 RF was able to differentiate across the groups with the MMPI-2 RF specific problem scale Anxiety adding incrementally to MMPI-2 Restructured Clinical scales in predicting PTSD. Both MMPI-2 RC1 (Somatic Complaints) and MMPI-2 RF head pain complaints predicted mTBI screen but did not add incrementally to each other. Of note, all of the MMPI-2 RF validity scales associated with overreporting, including Symptom Validity—Revised (FBS-r), were not significantly elevated in the mTBI group. These findings support the use of the MMPI-2 RF in assessing PTSD in non–treatment-seeking veterans. This further suggests that a positive screen for mTBI alone is not associated with significant emotional disturbance. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The detection of feigned uncoached and coached posttraumatic stress disorder with the MMPI-2 in a sample of workplace accident victims.

In this study research participants completed the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) under standard instructions and then were asked to fake posttraumatic stress disorder (PTSD) when completing the MMPI-2 for a 2nd time in 1 of 4 conditions with different instructions on how to fake PTSD: (a) uncoached, (b) coached about PTSD symptom information, (c) coached about MMPI-2 validity scales, or (d) coached about both symptoms and validity scales. These MMPI-2 protocols were then compared with protocols of claimants with workplace accident-related PTSD. Participants given information about the validity scales were the most successful in avoiding detection as faking. The family of F scales (i.e., F, FB, Fp), particularly Fp, produced consistently high rates of positive and negative predictive power. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The ability of the MMPI-2 to detect feigned PTSD within the context of compensation seeking.

The ability of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) validity scales to detect feigned reports of posttraumatic stress disorder (PTSD) was examined in a group of veterans undergoing a compensation and pension evaluation. Veterans who were seeking compensation for service connected PTSD were randomly assigned to one of two groups: exaggerate PTSD and respond honestly. The MMPI-2 Infrequency (F) family of scales was able to accurately identify the veterans instructed to exaggerate PTSD. The Fake Bad Scale (FBS) did not add incrementally to the prediction of exaggerated PTSD and the Infrequency-Posttraumatic Stress Disorder Scale (Fptsd) added significantly, albeit minimally, to the prediction of exaggerated PTSD. The Infrequency Psychopathology (FP) scale obtained the best overall hit rate in comparison to the other over-reporting indicators on the MMPI-2, both at optimal and at previously recommended cut scores. In sum, the MMPI-2 effectively differentiated compensation seeking veterans instructed to exaggerate PTSD from compensation seeking veterans instructed to respond honestly. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pretreatment predictors of dropout from cognitive behavioral therapy for PTSD in Iraq and Afghanistan war veterans.

Cognitive–behavioral therapies (CBTs) can be effective treatments for posttraumatic stress disorder (PTSD) but their effectiveness is limited by high rates of premature dropout. Few studies have compared pretreatment characteristics of treatment completers and dropouts, and only one has examined these factors in Operations Iraqi Freedom and Enduring Freedom (OIF/OEF) Veterans. This study analyzed archival clinical data from 117 OEF/OIF Veterans evaluated and treated through a Veterans Affairs PTSD clinic. High numbers dropped out of treatment (68%). Treatment dropouts (n = 79) and completers (n = 38) differed significantly on Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scales, PTSD symptom severity, and age. Regression analyses identified one MMPI-2 scale, TRT (negative treatment indicators), and age as unique but modest predictors of dropout. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A racial comparison of combat veterans evaluated for PTSD

This study attempted to replicate the work of Frueh, Smith, and Libet (1996), which showed racial differences on psychological measures of dissociation/thought disturbance and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) F-K index in combat veterans evaluated for posttraumatic stress disorder (PTSD). Veterans completed the Beck Depression Inventory, Mississippi Scale for Combat-Related PTSD, a fixed-response format version of the Dissociative Experiences Scale (DES-FRF), and MMPI-2 prior to treatment at a Veterans Affairs hospital outpatient PTSD clinic. Contrary to expectation, significant racial differences on the DES-FRF, MMPI-2 validity scales, and MMPI-2 Scales 6 and 8 were not found. Consistent with the previous study, no racial differences on measures of anxiety, depression, or PTSD symptomatology were found; nor were there racial differences on clinician ratings of global assessment of functioning or on most categories of psychiatric diagnoses. This suggests that Black and White combat veterans evaluated for PTSD do not differ with regard to reported manifestation or severity of psychopathology.     

Psychosocial influences on upper respiratory infectious illness in children

OBJECTIVE: The aim was to examine variables that might mediate the incidence of Post-Traumatic Stress Disorder (PTSD) in child witnesses to domestic violence. These variables included age, gender, locus of control, self-blame, perception of threat, active versus palliative coping style, maternal emotional health plus aspects of the violence witnessed (intensity, frequency, age of child when first witnessing violence, and time since the last violent episode). METHOD: Following screening for other PTSD inducing experiences, a sample of 20 child witnesses to domestic violence, 15 matched control children, and their mothers were assessed using the following tools: The Straus Conflict Tactics Scale; the Child Post-Traumatic Stress Reaction Index; the Nowicki-Strickland Locus of Control Scale; the General Health Questionnaire, and a Screening Questionnaire designed to elicit qualitative information from both children and mothers including data about any other potential PTSD inducing stressor the subject child may have been exposed to. RESULTS: None of the factors under examination were found to contribute significantly to the severity levels of Post-Traumatic Stress Disorder in relation to witness status. CONCLUSION: The small sample size of the study necessitates that the results be interpreted with caution. Nevertheless the findings indicate that the impact of witnessing domestic violence, in terms of PTSD, is not mediated by factors such as maternal emotional well-being, age and gender of the child, or the child's style of coping with parental conflict. Evidence that variables specifically related to the violence witnessed did not mediate the impact suggests that all domestic violence may have severe and long-term impact on child witnesses.     

The MMPI-2 Restructured Clinical Scales in the assessment of posttraumatic stress disorder and comorbid disorders.

[Correction Notice: An erratum for this article was reported in Vol 21(1) of Psychological Assessment (see record 2009-03401-005). The URL for the supplemental material was incomplete. The complete URL is http://dx.doi.org/10.1037/a0012948.supp] This study examined the psychometric properties of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Restructured Clinical Scales (RCSs) in individuals with posttraumatic stress disorder (PTSD) receiving clinical services at Department of Veterans Affairs medical centers. Study 1 included 1,098 men who completed the MMPI-2 and were assessed for a range of psychological disorders via structured clinical interview. Study 2 included 136 women who completed the MMPI-2 and were interviewed with the Clinician Administered Scale for PTSD. The utility of the RCSs was compared with that of the Clinical Scales (CSs) and the Keane PTSD (PK) scale. The RCSs demonstrated good psychometric properties and patterns of associations with other measures of psychopathology that corresponded to current theory regarding the structure of comorbidity. A notable advantage of the RCSs compared with the MMPI-2 CSs was their enhanced construct validity and clinical utility in the assessment of comorbid internalizing and externalizing psychopathology. The PK scale demonstrated incremental validity in the prediction of PTSD beyond that of the RCSs or CSs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The utility and comparative incremental validity of the MMPI-2 and Trauma symptom Inventory validity scales in the detection of feigned PTSD.

The authors examined the comparative predictive capacity of the Trauma Symptom Inventory (TSI) Atypical Response Scale (ATR) and the standard set of Minnesota Multiphasic Personality Inventory-2 (MMPI-2) fake-bad validity scales (i.e., F, FB, Fp, FBS) to detect feigned posttraumatic stress disorder (PTSD). Remitted trauma victims (n = 60) completed the TSI and MMPI-2 under standard (honest) instructions and then were randomly assigned to 1 of 2 experimental conditions (noncoached/validity scale coached) in which they were administered these instruments again with instruction to fake PTSD. These test protocols were compared with TSI and MMPI-2 results from workplace injury claimants with PTSD (n = 84). The ATR and FBS were able to distinguish only the noncoached participants instructed to fake from the PTSD claimants; in contrast, the F, FB, and Fp scales were able to distinguish both the noncoached and the validity-scale-coached participants from the PTSD claimants. F, FB, and Fp always outperformed the ATR and FBS; neither the ATR nor the FBS was able to add incremental predictive variance to that of F, FB, or Fp. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

MMPI-2 Validity and Award of Service Connection for PTSD During the VA Compensation and Pension Evaluation.

From an initial pool of 699 Minnesota Multiphasic Personality Inventory-2s (MMPI-2s) obtained as part of the Department of Veterans Affairs (VA) Compensation and Pension (C & P) examinations for posttraumatic stress disorder (PTSD), the authors selected individuals with raw scores above 7 on the Frequency Psychpathology (F[p]) scale. The high F(p) group was matched to individuals with scores of 2 or less on the F(p) scale, and MMPI-2 interpretations, rates of disability awards for PTSD, and subsequent health care utilization were compared. The majority of psychological reports in the high F(p) group failed to indicate that the claimant's MMPI-2 appeared invalid. Moreover, there was no significant difference in rates of disability awards for PTSD or health care utilization across groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive–behavioral therapy for PTSD and depression symptoms reduces risk for future intimate partner violence among interpersonal trauma survivors.

Objective: Women who develop symptoms of posttraumatic stress disorder (PTSD) and depression subsequent to interpersonal trauma are at heightened risk for future intimate partner violence (IPV) victimization. Cognitive–behavioral therapy (CBT) is effective in reducing PTSD and depression symptoms, yet limited research has investigated the effectiveness of CBT in reducing risk for future IPV among interpersonal trauma survivors. Method: This study examined the effect of CBT for PTSD and depressive symptoms on the risk of future IPV victimization in a sample of women survivors of interpersonal violence. The current sample included 150 women diagnosed with PTSD secondary to an array of interpersonal traumatic events; they were participating in a randomized clinical trial of different forms of cognitive processing therapy for the treatment of PTSD. Participants were assessed at 9 time points as part of the larger trial: pretreatment, 6 times during treatment, posttreatment, and 6-month follow-up. Results: As hypothesized, reductions in PTSD and in depressive symptoms during treatment were associated with a decreased likelihood of IPV victimization at a 6-month follow-up even after controlling for recent IPV (i.e., IPV from a current partner within the year prior to beginning the study) and prior interpersonal traumas. Conclusions: These findings highlight the importance of identifying and treating PTSD and depressive symptoms among interpersonal trauma survivors as a method for reducing risk for future IPV. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Examining comorbidity and posttraumatic stress disorder in a Vietnam veteran population using the MMPI-2

Examined the discriminant validity of the MMPI-2 in assessing comorbidity in a posttraumatic stress disorder (PTSD) Vietnam veteran population. The Structured Clinical Interview for the DSM-III-R (SCID) was used to diagnose veterans and to classify them into four groups: PTSD Only, PTSD with mood disorders, PTSD with other anxiety disorders, and PTSD with mood and anxiety disorders. All groups had clinical elevations on scales F, 1, 2, 3, 4, 6, 7, 8, 0, PK, and PS, with peak elevations on scales 8, 7, and 2. The PTSD Only group's MMPI-2 scores were not significantly lower than other groups' scores. The PTSD+Mood/Anxiety group was significantly more elevated on scales 2 and 7 than the PTSD Only and PTSD+Anxiety group but did not otherwise show significantly higher scale elevations than others groups. No significant differences existed between groups on scales F, L, K, PK, and PS. Implications of these results for PTSD and the current diagnostic system are explored.     

All PTSD symptoms are highly associated with general distress: Ramifications for the dysphoria symptom cluster.

This study used longitudinal data collected from two trauma-exposed samples, survivors of community violence (N = 294) and wildfire evacuees (N = 234), to examine a key claim underlying a proposed reformulation of the symptom structure of posttraumatic stress disorder (PTSD). This theory, which we term the PTSD–dysphoria model, posits that 8 of 17 symptoms of PTSD reflect dysphoria or general psychological distress and might be deemphasized to improve the utility of the PTSD construct (Simms, Watson, & Doebbeling, 2002). For each sample, we analyzed PTSD symptoms and measures of general distress administered at 2 time points. A consistent pattern of findings was observed across assessments for each sample: All 17 PTSD symptoms were highly associated with measures of general distress. Moreover, we found no evidence that dysphoria symptoms were more highly correlated than PTSD-specific symptoms with general distress. Results call into question both the conceptual basis and the clinical utility of differentiating between symptoms that appear to be relatively specific to PTSD and those that seem more broadly characteristic of general psychological distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recommendations for working with domestic violence survivors, with special attention to memory issues and posttraumatic processes.

This article proposes principles for working effectively with survivors of domestic violence. Recommendations are based on a review of the available literature and organized within the following sections: therapist competence, therapeutic framework and relationship, assessment and diagnosis, the structure of the treatment process and relationship, interventions for dealing with posttraumatic reactions, and group interventions. The relevance of the delayed memory debate for domestic violence survivors is also discussed. The complexity of battering dynamics and the need for sensitive, competent treatment of victims are emphasized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Posttraumatic stress in children and adolescents exposed to family violence: I. Overview and issues.

Exposure to child physical abuse and parents' domestic violence can subject youth to pervasive traumatic stress and can lead to posttraumatic stress disorder (PTSD). This article presents evolving conceptualizations in the burgeoning field of trauma related to family violence exposure and describes how the often repeating and ongoing nature of family violence exposure can complicate a PTSD diagnosis. In addition, recent literature indicates that children exposed to family violence may experience problems in multiple domains of functioning and may meet criteria for multiple disorders in addition to PTSD. Considerations salient to the recognition of traumatic stress in this population and that inform assessment and treatment planning are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

MMPI-2 profiles of adult women with child sexual abuse histories: Cluster-analytic findings.

This study used a cluster analysis to examine the clinical profiles of female survivors of child sexual abuse. Eighty-five participants who presented for group therapy to deal specifically with issues related to sexual abuse completed the revised version of the Minnesota Multiphasic Personality Inventory (MMPI-2; J. N. Butcher, W. G. Dahlstrom, J. R. Graham, A. Tellegen, & B. Kaemmer, 1989) as part of an extensive assessment procedure. The cluster-analytic procedure used in this study allowed 5 subgroups within the population to emerge, supporting the idea that women who report having been sexually abused as children are not a homogeneous group. Additional analyses indicated differences on the basis of cluster membership on the MMPI-2 content scales, as well as other measures of psychological distress. The treatment implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A function in apoptosis other than transactivation inherent in the NH2-terminal domain of p53

This study used a cluster analysis to examine the clinical profiles of female survivors of child sexual abuse. Eighty-five participants who presented for group therapy to deal specifically with issues related to sexual abuse completed the revised version of the Minnesota Multiphasic Personality Inventory (MMPI-2; J. N. Butcher, W. G. Dahlstrom, J. R. Graham, A. Tellegen, & B. Kaemmer, 1989) as part of an extensive assessment procedure. The cluster-analytic procedure used in this study allowed 5 subgroups within the population to emerge, supporting the idea that women who report having been sexually abused as children are not a homogeneous group. Additional analyses indicated differences on the basis of cluster membership on the MMPI-2 content scales, as well other measures of psychological distress. The treatment implications of these findings are discussed.     

The structure of distress following trauma: Posttraumatic stress disorder, major depressive disorder, and generalized anxiety disorder.

The current report used confirmatory factor analysis to examine the latent structures of both key features and associated symptoms of three disorders that commonly develop following a traumatic event: posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD). Participants were 228 motor-vehicle accident survivors who sought treatment for emotional difficulties. PTSD, MDD, and GAD were assessed with a combination of self-report and interview-based measures. The results of construct level analyses suggested that PTSD, MDD, and GAD are distinguishable but highly correlated disorders following a traumatic event. Symptom level analyses supported a model where the Reexperiencing, Avoidance, and Hypervigilance factors were subsumed under the PTSD construct. However, in this model the Dysphoria factor was a higher order construct correlated with the PTSD, MDD, and GAD factors, suggesting that the Dysphoria cluster may not be unique to PTSD. Diagnostic and theoretical implications of these results are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)