3 The original understanding of a conversion reaction was believed to be related to a metaphorical resolution of an intrapsychic conflict (primary gain) that may be reinforced by attention or the removal of undesired responsibilities because of the physical problem (secondary gain). These individuals may react to stress with the development of a physical complaint. 2 Butcher and Williams describe patients with a conversion disorder as exhibiting personalities characterized by denial and flamboyant social interactions. Hathaway and McKinley used 50 patients with a clinical diagnosis of psychoneurosis, most of whom were believed to have a conversion disorder. Scale 3 (hysteria) was intended for the detection and diagnosis of Conversion hysteria. Individuals with an elevated Scale 2 tend to be unhappy, pessimistic, self-deprecating, and sluggish. Rather, this scale may be thought of as a measure of distress and, when it becomes increasing elevated, suggests the possible presence of depression.
Although many individuals with elevations on Scale 2 are depressed, an individual can display an elevated Scale 2, but not meet criteria for a Major Depressive Disorder. The clinical group for Scale 2 (depression) consisted mostly of bipolar (manic-depressive) patients during a depressive episode. Elevated scores on Scale 1 suggest the possibility of numerous somatic complaints, selfishness, immaturity, and narcissism. When the MMPI was constructed, subjects in the “clinical” group consisted of individuals who were excessively concerned with possible ailments that were believed to have limited or no organic basis. 3 McKinley and Hathaway defined Scale 1 (hypochondriasis ) as an abnormal concern over health. The first three clinical scales (hypochondriasis, depression, and hysteria) are the most relevant for medical patients and have been the most widely investigated with pain patients. Common MMPI-2 Scales Associated with Chronic Pain Table 1 summarizes the 3 main validity and 10 main clinical scales of the MMPI-2. 1 It should also be noted that there is a computerized scoring and interpretation system currently available (Pearson Assessments). Literally hundreds of validity studies have established the interpretive meanings of various clinical scale configurations. Scales that exceed a T-score of 65 (1.5 standard deviations above the mean of 50) are considered clinically significant. Raw scores are then transformed into T-scores. A patient’s score on each of these scales is compared to a normative sample, which roughly coincides with the demographic characteristics of the United States. 1Įssentially, the MMPI-2 consists of a set of 3 main validity scales, 10 standard scales, sometimes referred to as clinical scales, and numerous supplemental and subscales. The clinical groups consisted of patients in eight psychiatric diagnostic categories:Ī Masculinity-Femininity Scale and a Social Introversion Scale were added later and were based on non-clinical patients. The “normal” group consisted of, but was not limited to, visitors to, and relatives of, patients at the University of Minnesota Hospital.
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McKinley in 1943 to aid in the diagnosis of psychiatric disorders it was subsequently revised in 1989 to address several issues related to the normative data and outdated language.1 Hathaway and McKinley initially used an empirical keying approach, in which test constructors selected items based on whether the items could differentiate members of a “normal” group-presumably free of psychopathology-from members of a “criterion” group, where individuals had a certain psychiatric diagnosis. 2 The MMPI was developed by Starke Hathaway and J. The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) is one the most widely used personality assessment instruments in the world 1 and arguably the most widely used psychological instruments to study chronic pain.
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