This study examined the nature and extent of psychological differences among diagnostic subgroups of temporomandibular disorder (TMD) patients. Three subgroups were identified and labeled as: (1) primary myalgia, (2) primary temporomandibular joint (TMJ) problems, or (3) combination myalgia and TMJ problems. Patients' (n = 112) levels of pain and distress were measured using a VAS pain scale, the McGill Pain Questionnaire, the Beck Depression Inventory, the State-Trait Anxiety Scale and the MMPI. Patients with primary myalgia had the highest scores on the pain and distress measures while patients in the combination group scored between the myalgia and TMJ problem subgroups. When differences in pain levels were controlled, the differences among groups on measures of anxiety and depression were attenuated while the differences on measures of somatic overconcern remained significant. Discriminant function analysis using psychological variables to predict diagnostic grouping produced correct identification of 74% of the structural patients and 46% of the myalgia patients. Implications for different etiological factors among the 3 groups are discussed.

This study examined the direct and mediated contributions of psychosocial variables to posttreatment physical functioning among 142 patients receiving cardiac rehabilitation. Two models were proposed and tested. In the first model, psychosocial factors were correlated and made to predict baseline and 6-week physical functioning. The results showed that after controlling for age, illness severity, baseline physical functioning, and other psychosocial correlates, optimism and social support still significantly predicted better posttreatment physical functioning. In the second model, we explored both the direct and mediational relationships between psychosocial factors and physical health outcomes. Optimism and social support were found to contribute to health outcomes not only directly but also indirectly through the mediation of less engagement in detrimental coping and lower depressive symptoms, whereas hostility and negative coping only predicted outcomes indirectly through mediators. These findings highlighted the importance of addressing psychosocial issues and their interrelationships in cardiac rehabilitation.

Minnesota Multiphase Personality Inventory (MMPI) scores of 401 low back pain patients were analyzed by a multivariate clustering procedure. Three groups with elevated MMPI profiles and two unelevated groups showed differences in age, employment, marital status, pretreatment pain intensity, and activity limitations. Follow-up comparisons revealed that the elevated subgroups had a poorer response to treatment; however, interesting sex differences were noted.

Studies that used the MMPI to predict the response of chronic low back pain patients to standard medical treatment have not produced definitive results. Patients seen in a university hospital orthopedic back pain clinic were given the MMPI before treatment, and 6 to 12 months later 76 patients completed follow‐up forms that indicated their level of intensity during the previous week and their ratings of the success of treatment in relieving their pain as well as in enabling them to return to normal activities. Predictions of poor response were made in terms of either single MMPI scales or code types. Patients with poor outcome on two of the three criteria (level of pain intensity and ability to return to normal activities) had significantly higher scores on the Hs scale. The predicted high risk code types very accurately identified patients with poor response on the same two criteria; however, the code‐type procedure overpredicted poor response in the good outcome group.

No abstract

Introduction: The majority of people with schizophrenia have a diagnosis of tobacco dependence during their lifetime. A major obstacle to reducing the burden of cigarette smoking in this population is that these smokers have lower quit rates when undergoing standard treatment compared to smokers with no mental illness. We sought to determine if combination extended treatment (COMB-EXT) and home visits (HV) would lead to improved outcomes in smokers with schizophrenia. Methods: Thirty-four cigarette smokers with schizophrenia completed either COMB-EXT with HV, COMB-EXT without HV, or treatment as usual (TAU) (random assignment). COMB-EXT consisted of group cognitive-behavioral therapy (CBT), bupropion, nicotine patch, and nicotine lozenge, which were initiated within 2 weeks and continued for 26 weekly visits. HV consisted of biweekly visits to the home with assessment of secondhand smoke (SHS) exposure and brief behavioral therapy with participants and others in the home environment. TAU consisted of group CBT plus serial single or combination medication trials as per standard care. Results: Smokers with schizophrenia who received COMB-EXT (with or without HV) had greater reductions in cigarettes per day than those treated with TAU (both ps < .01). In addition, 7-day point prevalence abstinence rates for the three groups were 45%, 20%, and 8%, respectively, which was significantly higher for COMB-EXT plus HV than TAU (χ 2 (1) = 4.8, p = .03). Groups did not differ significantly in the number of adverse events, and HV were easily scheduled. Conclusion: COMB-EXT improves outcomes for smokers with schizophrenia. HV appeared to provide additional benefit for smoking cessation in this treatment-resistant population. Implications: The clear benefit found here of rapidly initiated, combination, extended treatment over TAU suggests that aggressive and extended treatment should be considered in clinical practice for smokers with schizophrenia. Furthermore, HV to address SHS exposure showed initial promise for assisting smokers with schizophrenia in maintaining abstinence, indicating that this intervention may be worthy of future research.

MMPI scores of black, Mexican-American, and white male offenders were compared in order to investigate whether cultural and/or socioeconomomic factors affect this personality inventory. Comparisons were performed on unmatched and matched (education and occupation) groups that utilized all profiles or valid ones only and examined both trait (individual scales) and type (Goldberg indices) differences. Black-white differences on the MA, K, and HY scales appeared to reflect cultural factors, while differences on MF and alcoholism seemed to be accounted for by socieconomic differences among the groups. Cultural factors seemed to be related to differences between Mexican-Americans and white on the L,K,and overcontrolled hostility scales, while socioeconomic factors appeared to explain differences on the Hs scale. Type differences were not apparent except that Mexican-Americans were classified more often as psychiatric, while whites and blacks scored well into the sociopathic range.

There are contradictory findings about whether there are differences in personality and/or amount of emotional disturbance between patients with functional versus organic low back pain. The MMPI scores of 42 back pain patients diagnosed as "organic" were compared with the scores of 37 patients classified as "functional". The functional patients scored significantly higher than the organics on the Hs, Hy, Pd, Sc, Ma, and Si scales. The organics scored significantly higher than the functionals on the K scale. The results confirm the view that certain symptoms of emotional disturbance are more characteristic of patients who have relatively little evidence of physical findings. However, the degree of overlap between groups was high enough to suggest caution in making predictions and diagnoses about functional versus organic pain on individual patients solely on the basis of personality data.