Clinical limitations of the low back scale

Tsushihlaz, William T.; Towne, W. Scott

doi:10.1002/1097-4679(197904)35:2<306::aid-jclp2270350216>3.0.co;2-x

Cited by 15 publications

(6 citation statements)

References 5 publications

(5 reference statements)

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“…Finally, a strong association with psychosomatic factors was observed, and corroborated by the trend in the odds ratios according to the magnitude of the disorders . Although there is some evidence of an association between low-back pain and psychological factors such as anxiety, depression, or hysteria, no consistent results emerge from the literature (30)(31)(32). Most studies on psychological factors and low-back pain have been carried out retrospecti vely, in which case it is not possible to conclude whether the psychological troubles are the cause or the consequence of low-back pain .…”

supporting

confidence: 79%

Low-back pain in commercial travelers.

Pietri¹,

Leclerc²,

Boitel³

et al. 1992

Scand J Work Environ Health

111

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Low-back pain in commercial tra velers. Scand J Work Environ Health 1992;18:52-8. The role of occupation al environment in the occurrence of low-back pain was analyzed for 1719 commercial tra velers (1376 men and 343 women). At the beginning of the study (To)the group was interviewed to determine current lifestyle and occupat ional factors associated with low-back pain during the previous 12 months. Twelve month s later (at T 1 ) , a subsample of 1118 persons (893 men, 225 women) was reinterviewed to study the association between the incidence of low-back pain during the year of follow-up and the risk factors at To. At To low-back pain was significantly related with time spent driving a car at work, comfort of the car seat, carrying loads during work, standing for long periods at work, smoking, and psychosomatic factor s. At T 1 driving 10 h/week or more, seat comfort, and psychosomatic factors were associated with first occurrence of low-back pain .

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supporting

confidence: 79%

Low-back pain in commercial travelers.

Pietri¹,

Leclerc²,

Boitel³

et al. 1992

Scand J Work Environ Health

111

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“…Towne and Tsushima (1978) reported that the use of the Lb Scale correctly classified 75% of functional patients, but that once the false-positive rate was included, the rate dropped to 40%. Similar results were obtained by these researchers a year later (Tsushima & Towne, 1979).…”

Section: Mmpisupporting

confidence: 89%

Psychometric testing: The early years and the MMPI.

Robinson¹

2000

Personality Characteristics of Patients With Pain.

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Table 2.1 -MMPI Scales Validity Scales Clinical Scales L Scale F Scale K Scale Scale 1 (Hypochondriasis) Scale 2 (Depression) Scale 3 (Hysteria) Scale 4 (Psychopathic Deviate) Scale 5 (Masculinity-Femininity) Scale 6 (Paranoia) Scale 7 (Psychasthenia) Scale 8 (Schizophrenia) Scale 9 (Hypomania) Scale 0 (Social Introversion)could omit an item, including carelessness, confusion, and indecisiveness. Occasionally, items are omitted because individuals are uncomfortable admitting information about themselves. Regardless of the reason, the omission of too many items will invalidate the test (Graham, 1993).The L Scale was designed to spot individuals who naively present themselves in an overly favorable light (Meehl & Hathaway, 1946, as cited in Graham, 1993. Patients who have a high L score might have difficulty admitting to even minor flaws. For instance, they would have to report that they read every editorial in the newspaper or that they like everyone they meet. Depending on the degree of the elevation, and on other extratest variables, an elevated L Scale suggests a host of situationally based or long-standing characteristics, including denial, defensiveness, or a lack of insight (Graham, 1993).The F Scale was designed to recognize unusual, deviant, and atypical ways of approaching the MMPI test items (Meehl & Hathaway, 1946, as cited in Graham, 1993. The scale consists of items that fewer than 10% of the adult normal group scored in a specific direction. For example, fewer than 10% of the normal group responded "true" to the statement, "Evil spirits possess me at times." Graham (1993) described three important functions of the F Scale: (a) recognizing abnormal test-taking sets, (b) gauging the severity of psychopathology, and (c) suggesting other clinically relevant information about an individual. An excessively elevated F Scale suggests the possibility of an invalid test, possibly because of a patient's confusion or an attempt to "fake bad." In addition, an elevated score can suggest that a person is seeking the attention of health care providers (Graham, 1993). Generally, the F Scale suggests a person's level of distress or the severity of the psychopathology, with extreme elevations raising the distinct possibility of psychosis.The K Scale was developed to detect individuals who attempt to portray themselves in either an overly favorable or an overly unfavorable manner, but to detect them in a more sophisticated way than that offered by the L Scale (Meehl & Hathaway, 1946, as cited in Graham, 1993. Elevated scores can suggest defensiveness or the ability to cope with stressors. Conversely, lower scores can suggest a perceived inability to manage difficult circumstances or stressors (Graham, 1993). As with all the validity scales, an excessive elevation suggests the possibility of an invalid test.Although the MMPI might not have been able to identify and diagnose individ-

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“…A detailed psychological assessment should be carried out before all re-operations. There is no evidence that the MMPI low back scale will differentiate between those patients who will have a poor, fair or good outcome after spinal fusion [30], or from decompression [7], nor does it identify non-organic from organic low back pain [25], but an abnormal profile directs the surgeon's attention to factors other than the spine which may be responsible for low back pain. It does not necessarily mean that a second operation will fail, but the operation can only be justified if both patient and surgeon are aware of the risks (Fig.…”

Section: Discussionmentioning

confidence: 99%

Failed lumbar spinal surgery

Dhar

Porter

1992

International Orthopaedics

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Failures and poor results of 160 patients after lumbar spinal surgery between 1980 and 1984 were analysed retrospectively. A self-rated questionnaire carried out 12 months after operation revealed 20 poor results; these occurred most commonly after multiple operations, decompression and fusion as compared to disc excision. The commonest cause was failure to recognise abnormal pain behaviour before operation. A more careful preoperative assessment should reduce the incidence of failure.

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Clinical limitations of the low back scale

Cited by 15 publications

References 5 publications

Low-back pain in commercial travelers.

Low-back pain in commercial travelers.

Psychometric testing: The early years and the MMPI.

Failed lumbar spinal surgery

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