MMPI-2 Personality Psychopathology Five (PSY-5) and Prediction of Treatment Outcome for Patients With Chronic Back Pain

Abstract

This study investigated the utility of the MMPI-2-based Personality Psychopathology Five (PSY-5) scales (Harkness, McNulty, & Ben-Porath, 1995) in the outcome prediction of behaviorally oriented chronic-pain treatment. The PSY-5 is a dimensional descriptive system for personality and its disorders. The sample consisted of 120 consecutive chronic-back-pain patients who followed a 4-week multimodal treatment program aimed at achieving a normal pattern of functioning, including return to regular work. The psychometric properties of the PSY-5 scales (Aggressiveness, Psychoticism, Constraint, Negative Emotionality/Neuroticism, and Positive Emotionality/Extraversion) were highly similar to the data reported by Harkness et al. (1995) and also corresponded to the characteristics of chronic-pain patients. The results of the hierarchical regression analyses provided support for the utility of the PSY-5 Positive Emotionality/Extraversion scale for the prediction of emotionally oriented outcome. We conclude that the PSY-5 model of personality psychopathology provides a solid basis for the more systematic study of the complex relation between personality characteristics and multidimensional treatment.

A Systematic Review of Sociodemographic, Physical, and Psychological Predictors of Multidisciplinary Rehabilitation—or, Back School Treatment Outcome in Patients With Chronic Low Back Pain

“…28,48,62-64,66 -69 Ten studies were classified as Phase I, 27,28,32,60 -63,66,67,69 and 7 as Phase II studies. 48,[57][58][59]64,65,68 No studies were classified as Phase III.…”

“…Six articles studied back schools, 27,32,48,60,62,64 3 studied back schools versus multidisciplinary treatment, 28,57,60 and 8 studied multidisciplinary treatment alone. 58,59,61,63,[65][66][67][68][69] Although the basic principles of multidisciplinary treatment and back schools are comparable, there is a large variety in duration, setting (inpatient or outpatient), and implementation between the studied interventions. For example, multidisciplinary treatment at one center may be based on cognitive behavioral concepts but in another, on operant behavioral ones.…”

“…61 The percentage loss to follow-up varied from 0% 66,67 to 27%, 64 in 4 articles the percentage was unclear. 58,61,63,68 Types of Baseline Measures. In total, 79 prognostic factors were studied.…”

“…Five authors studied more than 9 variables, 57-60,65 with a maximum of 19 variables studied by Bendix et al 57 Sociodemographic variables were studied in 8 articles, 57-60,64 -66,68 physical variables in 7, 32,48,57,60 -63 and psychological variables in 10. 27,28,32,58,59,62,65,[67][68][69] Four articles studied "other " predictors, which includes baseline measurements of activity and participation limitation. [57][58][59]69 After classifying predictors into 3 main domains (i.e., sociodemographic, physical, and psychological), it was clear that none of the authors studied predictors from these 3 domains simultaneously.…”

Prognostic factors and underlying mechanisms in chronic low back pain

“…However, 2 articles used an alternative approach by examining the predictive value of individual scales of the MMPI-2, the successor of the MMPI. Scores on the MMPI-2 "Personality Psychopathology Five Scales" were not associated with outcome either 70 . In another article concerning the same study, the author found that high scores on several other scales of the MMPI-2 (i.e., obsessiveness, depression, hypochondriasis, lassitudemalaise, somatic complaints) were associated with worse outcome 71 , although the explained variance was low, and the results slightly failed to reach statistical significance (P < 0.06).…”