A further look at validity of the MMPI with low back patients

Abstract

Tested the accuracy of the MMPI for two separate predictions: organic vs. functional back disorder, and appropriate vs. inappropriate disability (N = 123). Consistent with other reports, the Low Back and.Dorsal scales did not improve upon chance prediction. However, disability was predicted with a high degree of accurac by Hypochondria& and Hystena, which suggested that precedence shoJd be given to these two scales. Because organically based pain and severe psychological symptomatology were not mutually exclusive, the error rate was high when the MMPI was used to predict organicit . Clinicians therefore are urged to avoid predicting whether a physical basia &r ain exists and to focus primarily on the psychological aspects of the disabgty.

Clinical characteristics of fibrositis. II. A “Blinded,” controlled study using standard psychological tests

“…Constant uncertainty about the nature or even existence of a disease, or being told by physicians that "there's nothing wrong" or "it's all in your head" could be expected to worsen this problem. There may be a higher incidence of psychopathology in patients with low back pain who fail to respond to conventional therapy than in those who do respond (40)(41)(42)(43).…”

Role of psychosocial risk factors in work-related low-back pain.

“…Two factors , psychological state and aspects of work satisfaction, have been the main focus of research. Low-back pain has been consistently associated with neurotic signs such as depression, anxiety, and heightened somatic awareness in low -back pain sufferers drawn from patient populations (1)(2)(3)(4)(5). While several studies have suggested similar associations between psychological factors and low-back pain in nonpatient populations, the findings have not been consistent (6)(7)(8)(9)(10) .…”

MMPI predictors of outpatient medical utilization rates following psychotherapy.

“…Several past attempts to use the MMPI in the prediction of the response of medical patients to treatment have found that scales Hs and Hy are predictive of treatment failures. These two scales predicted treatment failures among patients in a behaviorally oriented rehabilitation program for chronic pain (Maruta et al, 1979), low back pain patients in a university hospital orthopedic clinic (McCreary et al, 1980), and patients in a low-back-pain clinic (Rosen et al, 1980). In this study, high scores on scales Hs and Hy, along with scale D, were predictive of medical patients who did not experience a reduction in physician visits after receiving psychotherapy.…”