Research using a categorical-polythetic classification system for mental illness has raised concern regarding the validity of categorical classification systems. Recent efforts suggest psychopathology is better understood from a dimensional framework, though there has been varying evidence of a somatization factor. The current investigation seeks to produce and validate a dimensional model of psychopathology, with a particular emphasis on the placement of somatization, across three nonoverlapping medical samples. Using a bariatric surgery seeking sample (n = 1,268), a spine surgery/spinal cord stimulator seeking sample (n = 1,711), and a chronic pain treatment seeking sample (n = 1,388), a dimensional model of psychopathology was replicated across all three samples using a dimensional measure of psychopathology (the Minnesota Multiphasic Personality Inventory-2-Restructured Form [MMPI-2-RF]). Clear evidence of a separate somatization factor was found in addition to broad internalizing, externalizing, and social detachment factors. Constructs assessable with the model yielded good convergent and discriminant validity coefficients with external criteria, and further supported the presence of a higher-order somatization construct.

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Objective We examined the ability of scores on the Minnesota Multiphasic Personality Inventory–2—Restructured Form (MMPI‐2‐RF) scales to predict treatment progress (compliance and activity in therapy) and outcome at termination (success in therapy, readiness for termination, and functioning at termination). Method Our sample included 448 (185 males, 263 females) community mental health center outpatients with an average age of 32.2 years (standard deviation = 10.2). We used MMPI‐2‐RF (self‐report) indicators of personality and psychopathology and a composite outcome variable that represents therapist ratings of clients’ treatment progress and outcomes. Results Scores on several MMPI‐2‐RF scales were correlated and associated with increased risk for poorer psychotherapy progress and outcomes in a mental health outpatient sample. Conclusions Clinicians can utilize the MMPI‐2‐RF to identify clients at risk for therapy process challenges and adverse outcomes, suggesting possible problem areas for intervention.

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