This article presents and compares the results of seven independent studies that have attempted to empirically identify the behavioral or symptom correlates of individual Minnesota Multiphasic Personality Inventory 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 two-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.
PROBLEMThe identification of psychiatric patients who are dangerous to others is an important but often very difficult task. Because actual assaultive behavior among psychiatric patients is a relatively rare occurrence, however, study of this phenomenon and development of predictor measures require large numbers of patients. Recent state-wide automation of demographic and clinical information for all patients within the Missouri Division of Mental Health (DMH) ( 8 , l l~ n ) has provided one basis for such large sample studiec:". 2 , 5 . 6 * g ) . METHODFrom the Missouri DMH clinical data base, 5525 patients were identified whose automated records included demographic, admissions and initial mental status information, in addition to explicit criterion information as to the presence or absence of attempts to harm, or in fact having harmed others, ix., "assaultive behavior". Demographic and admissions information, including such things as sex, race, age, religion, education, marital status, occupation, referral source, previous psychiatric care, type of admission, and hospital involved, was obtained originally on an Admission Face Sheet ( l o ) . Mental status information was recorded originally on a 111-item checklist (11) specifically designed and developed for the DMH automated psychiatric information system. Criterion information, i.e., whether the patient had attempted to harm or in fact harmed others, was recorded originally on an Emergency Room or Admission Checklist ( l o ) , which also was developed for the automated information system. This form includes approximately 100 descriptors that have to do with preadmission behavior rather than behavior observed during the interview, as is the case with the mental status checklist. The principal focus is on symptoms that occur in the month prior t o admission, although for about one-third of the items the interviewer is asked to consider the patient's entire life. Typical items include suicide attempt, arrests, definite drinking problem, extravagance with money, poor personal hygiene, truancy, attempts to harm others, use of barbiturates, and poor job performance.The patient sample consisted of psychiatric inpatients admitted to four Missouri DMH mental health centers. Approximately 60% of the sample was male average age was 43 and the average education was 10 years. Approximately 25% of the sample never had been married, 34% currently were married, 28% were divorced or separated, and 10% were widowed. First admissions accounted for 56% of the sample; 72% were voluntary commitments. Of the sample, l60/0 was diagnostically classified as schizophrenic, 13% as affective disorders, 17% as organic brain syndromes, 3% as mentally deficient, 4% as neurotic, and 5% as personality disorders; 27% of the sample had alcohol or drug abuse diagnoses.The 5525 patients were assigned randomly to a derivation sample (N = 2763) and a validation sample (N = 2762), and a stepwise linear discriminant function (LDF) was used t o derive and cross-validate prediction equations with rega...
The present study has demonstrated that considerations of age and, t o a lesser degree, sex in medical patients with the MMPI 1-3/3-1 profile can improve significantly the association of medical diagnostic classification compared with base rates for organic only of 3995, for functional-psychologic of %yo',, and for mixed of 28%. The relationship of age and medical diagnosis was stronger in males than in females. SUMMARY This study investigated the moderating effects of age and sex on the association of organic, psychologic, and mixed medical diagnoses and the Minnesota Multiphasic Personality Inventory (MMPI) 1-3/3-1 profile. A group of 178 medical patients (86 males and 92 females) was selected as representative of the age distribution of a larger sample of patients with this profile. All profiles matched the Halbower rules. The results were as follows : (1) 39y0 of all patients had only organic diagnoses, whereas 34% had only psychologic diagnoses; ( 2 ) psychologic diagnoses alone were found primarily in the group less than 40 years of age (66%); (3) males and females did not differ significantly with regard t o diagnostic classification, but a trend existed for more psychologic diagnoses among females; (4) median age split yielded significant chi squares for both sexes with regard to organic only vs. some psychologic diagnoses; (5) clinical usefulness was improved with optional age cutoff for each sex. REFERENCES 1. 2.3. 4.GILBERSTADT, H. and JANCIS, M. "Organic" us. "functional" diagnoses from 1-3 MMPI pro-HALBOWER, C. C. A comparison of actuarial versus clinical prediction to classes discriminated SCHWARTZ, M. S. and K I~P P , N. E. The MMPI "conversion V" among 50,000 medical patients: SCHWARTZ, M. S., KRUPP, N. E. and BYRNE, D. Repression-sensitization and medical diagnosis. files. J . din. Psychol., 1967, 83, 480-483. by MMPI. Unpublished doctoral dissertation, University of Minnesota, 1955. a study of incidence, criteria, and profile elevation. J . din. Psychol., 1971, 27, 89-95. PROBLEM Development and use of automated versions of the Minnesota MultiphasicPersonality Inventory (MMPI) have been reported (3, '* 9-18) wherein computerized scoring and interpretive printouts have made possible relatively immediate psychological testing information for patients who are being evaluated. As an initial step toward the development of an automated psychological testing program that can provide prompt information in the psychiatric evaluation of military patients, a
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