MMPI-2 and post-traumatic stress disorder predictors: A meta-analysis

Giuseppe Agrusti, Paola Tellaroli, Claudia Scalise, Luca Mandolesi

Accepted December 30, 2019

First published December 30, 2019

https://doi.org/10.26387/bpa.286.3

Abstract

There are numerous studies available in literature that examine the capacity of MMPI-2 to predict the presence of Post-Traumatic Stress Disorder (PTSD) but the results of these studies are not always concordant. This metaanalysis has two objectives: to assess whether MMPI-2 scales exist in predicting PTSD and malingering of the disorder, as well as to define a typical profile for PTSD subjects and Faker subjects, who feign or exaggerate the intensity of their symptoms. The methods used are systematic review, pair-wise and network meta-analysis of the articles, following the PRISMA guidelines and the most important electronic databases. This work is the first of its kind to analyse clinical scales and validity scales able to profile response styles typical of subjects with PTSD and Fakers, useful in predicting subjects’ vulnerability to PTSD. The analyses performed confirm that clinical scales 1 (Hs), 2 (D), 6 (Pa), 7 (Pt), 8 (Sc), specific PTSD scales (PK and PS) and validity scales (L, K, F, FB, FP) are able to discriminate subjects with PTSD from the general population.

References

  • ALBRECHT,N.N.,TALBERT,F.S.,ALBRECHT,J.W.,BOUDEWYNS,P.A., HYER, L.A., TOUZE, J. et al. (1994). A comparison ofMMPI and MMPI-2 in PTSD assessment. Journal of ClinicalPsychology, 50, 578-585.

  • ALWES, Y.R., CLARK, J.A., BERRY, D.T.R. & GRANACHER, R.P.(2008). Screening for feigning in a civil forensic setting. Journalof Clinical and Experimental Neuropsychology, 30, 133-140.

  • AMERICAN PSYCHIATRIC ASSOCIATION (2013). DSM-5.Diagnostic and statistical manual of mental disorders (5th ed.).Arlington, VA: American Psychiatric Publishing (It. ed.: DSM-5.Manuale diagnostico e statistico dei disturbi mentali, quintaedizione. 2014, Milano: Raffaello Cortina).

  • ARBISI, P.A., BEN-PORATH, Y.S. & McNULTY, J. (2006). The abilityof the MMPI-2 to detect feigned PTSD within the context ofcompensation seeking. Psychological Services, 3 (4), 249-261.

  • BAGBY, R.M., BUIS, T. & NICHOLSON, R.N. (1995). Relativeeffectiveness of the standard validity scales in detecting fake-bad and fake-good responding: Replication and extension.Psychological Assessment, 7, 84-92.

  • BAGBY, R.M. & MARSHALL, M.B. (2005). Assessing response biaswith the MCMI modifying indices. In R.J. Craig (Ed.), Newdirections in interpreting the Millon Clinical Multiaxial Inventory.New York: John Wiley.

  • BAGBY, R.M., MARSHALL, M.B. & BACCHIOCHI, J. (2006).The validity and clinical utility of the MMPI-2 malingeringdepression scale. Journal of Personality Assessment, 85, 304-311.

  • BALDRACHI, R., HILSENROTH, M., ARSENAULT, L., SLOAN, P.& WALTER, C. (1999). MMPI-2 assessment of varying levelsof posttraumatic stress disorder in Vietnam combat veterans.Journal of Psychopathology and Behavioral Assessment, 21,109-116.

  • BAREFOOT, J.C., DODGE, K.A., PETERSON, B.L., DAHLSTROM,W.G. & WILLIAMS, R.B. (1989). The Cook-Medley HostilityScale: Item content and ability to predict survival. PsychosomaticMedicine, 51 (1), 46-57.

  • BECK, A.T. & STEER, R.A. (1987). The Revised Beck DepressionInventory. San Antonio, TX: Psychological Corporation.

  • BECK, A.T., STEER, R.A. & GARBIN, M.G. (1988). Psychometricproperties of the Beck Depression Inventory: Twenty-five yearsof evaluation. Clinical Psychology Review, 8, 77-106.

  • BEGIC, D. & JOKIC-BEGIC, N. (2007). Heterogeneity ofposttraumaticstressdisordersymptomsinCroatianwarveterans:retrospective study. Croatian Medical Journal, 48, 133-139.

  • BLAKE, D.D., WEATHERS, F.W., NAGY, L.M., KALOUPEK, D.G.,GUSMAN, F.D., CHARNEY, D.S. & KEANE, T.M. (1995). Thedevelopment of a clinician-administered PTSD scale. Journal ofTraumatic Stress, 8, 75-90.

  • BLOUIN, A.G., PEREZ, E.L. & BLOUIN, J.H. (1988). Computerizedadministration of the Diagnostic Interview Schedule. PsychiatryResearch, 23, 335-344.

  • BOONE, K.B. (2007). A reconsideration of the Slick et al. (1999)criteria for malingered neurocognitive dysfunction. In K.B.Boone (Ed.), Assessment of feigned cognitive impairment: Aneuropsychological perspective. New York: Guilford.

  • BOONE, K.B. (2009). The need for continuous and comprehensivesampling of effort/response bias during neuropsychologicalexaminations. The Clinical Neuropsychologist, 23 (4), 729-741.

  • BUSH, S.S., HEILBRONNER, R.L. & RUFF, R.M. (2014).Psychological assessment of symptom and performancevalidity, response bias, and malingering: Official position of theAssociation for Scientific Advancement in Psychological Injuryand Law. Psychological Injury and Law, 7, 197-205.

  • BUSH, S.S., RUFF, R.M., TROSTER, A., BARTH, J., KOFFLER, S.,PLISKIN, N. et al. (2005). Symptom validity assessment: Practiceissuesandmedicalnecessity.ArchivesofClinicalNeuropsychology,20 (4), 419-426.

  • COOPER, H. & HEDGES, L.V. (1994). The handbook of researchsynthesis. Newbury Park, CA: Russell Sage Foundation.

  • DerSIMONIAN, R. & LAIRD, N. (1986). Meta-analysis in clinicaltrials. Controlled Clinical Trials, 7, 177-188.

  • DI GIORGIO, G., FALCIGLIA, G., VELTRO, F., MALINCONICO,A., MUSTILLO, I., PEDE, V., MUSENGA, E. & BINKIN, N.(2003). Effetti sulla salute del terremoto di San Giuliano, 2002.Bollettino epidemiologico nazionale. Retrieved from: https://www.epicentro.iss.it/ben/2003/settembre2003/2.

  • EGGER, M., SMITH, G.D., SCHNEIDER, M. & MINDER, C. (1997).Bias in meta-analysis detected by a simple, graphical test. BritishMedical Journal, 315, 629-634.

  • ELHAI, J.D., FRUEH, B.C., GOLD, P.B., GOLD, S.N. & HAMNER,M.B. (2000). Clinical presentations of posttraumatic stressdisorder across trauma populations: A comparison of MMPI-2profiles of combat veterans and adult survivors of child sexualabuse. Journal of Nervous and Mental Disease, 188, 708-713.

  • ELHAI, J.D., GOLD, P.B., SELLERS, A.H. & DORFMAN, W.I. (2001).The detection of malingered posttraumatic stress disorder withMMPI-2 fake bad indices. Assessment, 8, 221-236.

  • ELHAI, J.D., NAIFEH, J.A., ZUCKER, I.S., GOLD, S.N., DEITSCH,S.E. & FRUEH, B.C. (2004). Discriminating malingered fromgenuine civilian posttraumatic stress disorder: A validation ofthree MMPI-2 infrequency scales (F, Fp, Fptsd). Assessment, 11,139-144.

  • FAIRBANK, J.A., KEANE, T.M. & MALLOY, P.F. (1983). Somepreliminary data on the psychological characteristics ofVietnam veterans with posttraumatic stress disorders. Journal ofConsulting and Clinical Psychology, 51, 912-919.

  • FORBES, D., CREAMER, M. & McHUGH, T. (1999). MMPI-2 datafor Australian Vietnam Veterans with combat-related PTSD.Journal of Traumatic Stress, 12, 371-378.

  • FRANKLIN, C.L. & THOMPSON, K.E. (2005). Response styleand posttraumatic stress disorder (PTSD): A review. Journal ofTrauma & Dissociation, 6 (3), 105-123.

  • FRUEH, B.C., HAMNER, M.B., CAHILL, S.P., GOLD, P.B. &HAMLIN, K.L. (2000). Apparent symptom overreporting incombat veterans evaluated for PTSD. Clinical Psychology Review,20, 853-888.

  • FRUEH, B.C., SMITH, D.W. & BARKER, S.E. (1996). Compensationseeking status and psychometric assessment of combact veteransseeking treatment for PTSD. Journal of Traumatic Stress, 9 (3),427-439.

  • FURUKAWA, T.A., BARBUI, C., CIPRIANI, A., BRAMBILLA, P. &WATANABE, N. (2006). Imputing missing standard deviationsin meta-analyses can provide accurate results. Journal of ClinicalEpidemiology; 59, 7-10.

  • GIROMINI, L., CARFORA LETTIERI, S., ZIZOLFI, S., ZIZOLFI,D., VIGLIONE, D.J., BRUSADELLI, E., PERFETTI, B., DICARLO, D.A. & ZENNARO, A. (2019). Beyond rare-symptomsendorsement: A clinical comparison simulation study using theMinnesota Multiphasic Personality Inventory – 2 (MMPI-2)with the Inventory of Problems-29 (IOP-29). Psychological Injuryand Law.

    doi.org/10.1007/s12207-019-09357-7
  • GLENN,D.M.,BECKHAM,J.C.,SAMPSON,W.S.,FELDMAN,M.E.,HERTZBERG, M.A. & MOORE, S.D. (2002). MMPI-2 profiles ofGulf and Vietnam combat veterans with chronic posttraumaticstress disorder. Journal of Clinical Psychology, 58, 371-381.

  • GREEN, D., ROSENFELD, B., BELFI, B., ROHLEHR, L. & PIERSON,A. (2012). Use of measures of cognitive effort and feignedpsychiatric symptoms with pretrial forensic psychiatric patients.International Journal of Forensic Mental Health, 11, 181-190.

  • GREENBLATT, R.L. & DAVIS, W.E. (1999). Differential diagnosis ofPTSD, schizophrenia, and depression with the MMPI-2. Journalof Clinical Psychology, 55 (2), 217-222.

  • GREENE, R.L. (2000). The MMPI-2: An interpretive manual (2nd ed.).Boston: Allyn & Bacon.

  • HEINZE, M.C. & PURISCH, A.D. (2001). Beneath the mask: Use ofpsychological tests to detect and subtype malingering in criminaldefendants. Journal of Forensic Psychology Practice, 1, 23-52.

  • HIGGINS, J.P.T. & GREEN, S. (Eds.) (2011). Cochrane Handbookfor Systematic Reviews of Interventions Version 5.1.0 [updatedMarch 2011]. Retrieved from: www.handbook.cochrane.org.

  • HIGGINS, J.P.T., THOMAS, J., CHANDLER, J., CUMPSTON, M.,LI, T., PAGE, M.J. & WELCH, V.A. (Eds.) (2019). CochraneHandbook for Systematic Reviews of Interventions version 6.0[updated July 2019]. Retrieved from: www.training.cochrane.org/handbook.

  • HIGGINS, J.P.T. & THOMPSON, S.G. (2002). Quantifyingheterogeneity in a meta-analysis. Stat Med; 21 (11), 1539-1558.

  • HOVENS, J.E., BRAMSEN, I. & van der PLOEG, H.M. (2000).De Zelfinven-tarisatielijst Post traumatische Stressstoornis:ZIL handleiding [Self-report measure for PTSD symptoms: SIPmanual]. Lisse/Leiden, NL: Swets & Zeitlinger.

  • KEANE, T.M., CADDELL, J.M. & TAYLOR, K.L. (1988). Mississippiscale for combat-related posttraumatic stress disorder: Threestudies in reliability and validity. Journal of Consulting andClinical Psychology, 56, 85-90.

  • KEANE, T.M., MALLOY, P.F. & FAIRBANK, J.A. (1984). Empiricaldevelopment of an MMPI subscale for the assessment of combat-related posttraumatic stress disorder. Journal of Consulting andClinical Psychology, 52, 888-891.

  • KEANE, T.M., WOLFE, J. & TAYLOR, K.L. (1987). Posttraumaticstress disorder: Evidence for diagnostic validity and methodsof psychological assessment. Journal of Clinical Psychology, 43,32-43.

  • LANGE, R.T., SULLIVAN, K.A. & SCOTT, C. (2010). Comparison ofMMPI-2 and PAI validity indicators to detect feigned depressionandPTSDsymptomreporting.PsychiatryResearch,176,229-235.

  • LARRABEE, G.J. (2008). Aggregation across multiple indicatorsimproves the detection of malingering: Relationship tolikelihood ratios. The Clinical Neuropsychologist, 22, 666-679.

    doi.org/10.1080/13854040701494987
  • LEES-HALEY, P.R. (1992). Efficacy of the MMPI-2 validity scales andthe MCMI-II modifier scales for detecting spurious PTSD claims:F, F-K, Fake Bad Scale, Ego Strength, Subtle-Obvious subscales,DIS, and DEB. Journal of Clinical Psychology, 48, 681-688.

  • LIBERATI, A., ALTMAN, D.G., TETZLAFF, J., MULROW, C.,GØTZSCHE, PC, IOANNIDIS, J.P.A. et al. (2015). The PRISMAstatement for reporting systematic reviews and meta-analyses ofstudies that evaluate health care interventions: Explanation andelaboration. Evidence; 7 (6), e1000115.

  • LITZ,B.T.,PENK,W.E.,WALSH,S.,HYER,L.,BLAKE,D.D.,MARX,B. et al. (1991). Similarities and differences between MMPI andMMPI-2 applications to the assessment of posttraumatic stressdisorder. Journal of Personality Assessment, 57, 238-253.

  • LYONS, J.A. & WHEELER-COX, T. (1999). MMPI, MMPI-2 andPTSD: Overview of scores, scales, and profiles. Journal ofTraumatic Stress, 12, 175-183.

  • MARSHALL, M.B. & BAGBY, R.M. (2006). The incremental validityand clinical utility of the MMPI-2 Infrequency PosttraumaticStress Disorder Scale. Assessment, 13 (4), 417-429.

  • MODESTI, P.A., REBOLDI, G., CAPPUCCIO, F.P., AGYEMANG, C.,REMUZZI, G., RAPI, S., PERRUOLO, E. & PARATI, G. (2016).Panethnic differences in blood pressure in Europe: A systematicreview and meta-analysis. PLoS One, 11 (1), e0147601.

  • MOODY, D.R. & KISH, G.B. (1989). Clinical meaning of the KeanePTSD Scale. Journal of Clinical Psychology, 45, 542-546.

  • MUNLEY, P.H., BAINS, D.S., BLOEM, W.D. & BUSBY, R.M. (1995).Post-traumatic stress disorder and the MMPI-2. Journal ofTraumatic Stress, 8, 171-178.

  • ORR, S.P., CLAIBORN, J.M., ALTMAN, B., FORGUE, D.F., DEJONG, J.B., PITMAN, R.K. et al. (1990). Psychometric profileof posttraumatic stress disorder, anxious, and healthy Vietnamveterans: Correlations with psychophysiologic responses. Journalof Consulting and Clinical Psychology, 58, 329-335.

  • R CORE TEAM (2019). R: A language and environment for statisticalcomputing. Wien, A: R Foundation for Statistical Computing.

  • RADEMAKER, A.R., KLEBER, R.J., MEIJER, M.E. & VERMETTEN,E. (2009). Investigating the MMPI-2 trauma profile in treatment-seeking peacekeepers. Journal of Personality Assessment, 91 (6),593-600.

  • RESNICK, P.J. (1997). Malingering of posttraumatic disorders. In R.Rogers (Ed.), Clinical Assessment of Malingering and Deception(2nd ed.). New York: Guilford.

  • ROGERS, R. (2008). Detection strategies for malingering anddefensiveness. In R. Rogers (Ed.), Clinical assessment ofmalingering and deception. New York: Guilford.

  • ROGERS, R. & BENDER, D. (2018). Clinical assessment ofmalingering and deception. New York: Guilford.

  • ROGERS, R., SALEKIN, R.T., SEWELL, K.W., GOLDSTEIN, A.M. &LEONARD, K. (1998). A comparison of forensic and nonforensicmalingerers: A prototypical analysis of explanatory models. Lawand Human Behavior, 22, 353-367.

  • ROGERS, R., SEWELL, K.W., MARTIN, M.A. & VITACCO, M.(2003). Detection of feigned mental disorders: A meta-analysisof the MMPI-2 and malingering. Assessment, 10, 160-177.

  • ROGERS, R.R., SEWELL, K.W. & SALEKIN, R.T. (1994). A meta-analysis of malingering on the MMPI-2. Assessment, 1, 227-237.

  • ROYSTON, P. (1995). Remark AS R94: A remark on algorithm AS181: The W-test for normality. Appl Stat, 44 (4), 547-551.

  • RÜCKER, G., KRAHN, U., KÖNIG, J., EFTHIMIOU, O. &SCHWARZER, G. (2019). Netmeta: Network meta-analysis usingfrequentist methods, R package version 1.1-0.

  • SCHEIBE, S., BAGBY, R., MILLER, L. & DORIAN, B. (2001).Assessing posttraumatic stress disorder with the MMPI-2 in asample of workplace accident victims. Psychological Assessment,13, 369-374.

  • SCHLENGER, W.E. & KULKA, R.A. (1987). Performance of theKeane-Fairbank MMPI scale and other self-report measures inidentifying posttraumatic stress disorder. Paper presented at theAmerican Psychological Association meetings, New York.

  • SCHWARZER, G. (2007). Meta. An R package for meta-analysis. RNews, 7 (3), 40-45.

  • SMITH, G.P. & BURGER, G.K. (1997). Detection of malingering:Validation of the Structured Inventory of MalingeredSymptomatology (SIMS). Journal of American AcademicPsychiatry and the Law, 25, 183-189.

  • SPIELBERGER, C.D. (1983). Manual of the State-Trait AnxietyInventory. Palo Alto, CA: Consulting Psychologists Press.

  • SPITZER, R.L., WILLIAMS, J.B.W. & GIBBON, M. (1987). Structuredclinical interview for DSM-III-R (SCID). New York: New YorkState Psychiatric Institute.

  • STERNE, J.A.C., SUTTON, A.J., IOANNIDIS, J.P.A, TERRIN,N., JONES, D.R., LAU, J. et al. (2011). Recommendations forexamining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ, 343, d4002.

  • TALBERT,F.S.,ALBRECHT,N.N.,ALBRECHT,J.W.,BOUDEWYNS,P.A., HYER, L.A., TOUZE, J.H. et al. (1994). MMPI profiles inPTSD as a function of comorbidity. Journal of Clinical Psychology,50, 529-537.

  • TOLIN, D.F., MALTBY, N., WEATHERS, F.W., LITZ, B.T., KNIGHT,J. & KEANE, T.M. (2004). The use of the MMPI-2 Infrequency-Psychopathology Scale in the assessment of posttraumaticstress disorder in male veterans. Journal of Psychopathology andBehavioral Assessment, 26 (1), 23-29.

  • vanIMPELEN,A.,MERCKELBACH,H.,JELICIC,M.&MERTEN,T.(2014).TheStructuredInventoryofMalingeredSymptomatology(SIMS): A systematic review and meta-analysis. The ClinicalNeuropsychologist, 28, 1336-1365.

  • VIGLIONE, D.J., GIROMINI, L. & LANDIS, P. (2017). Thedevelopment of the Inventory of Problems-29: A brief self-administered measure for discriminating bona fide from feignedpsychiatric and cognitive complaints. Journal of PersonalityAssessment, 99 (5), 534-544.

  • WEATHERS, F.W., LITZ, B.T., HERMAN, D.S., HUSKA, J.A. &KEANE, T.M. (1993). The PTSD checklist: Reliability, validity, &diagnostic utility. Paper presented at the Annual Meeting of theInternational Society for Traumatic Stress Studies, San Antonio,

  • TX.WELLS, G.A., SHEA, B., O’CONNELL, D., PETERSON, J., WELCH,V., LOSOS, M. & TUGWELL, P. (2012). The Newcastle-OttawaScale (NOS) for assessing the quality of nonrandomised studies inmeta-analyses. Retrieved from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp.

  • WETTER, W.M., BAER, R.A., BERRY, D.T.R., ROBINSON, I.H.& SUMPTER, J. (1993). MMPI-2 profiles of motivated fakersgiven specific symptom information: A comparison to matchedpatients. Psychological Assessment, 5, 317-323.

  • WEYERMANN, A.G., NORRIS, F.H. & HYER, L.A. (1996).Examining comorbidity and posttraumatic stress disorder ina Vietnam veteran population using the MMPI-2. Journal ofTraumatic Stress, 9, 353-360.

  • WIDOWS, M.R. & SMITH, G.P. (2004). SIMS: Structured Inventoryof Malingered Symptomatology professional manual. Odessa, FL:Psychological Assessment Resources.

  • WILSON, J. & WALKER, A. (1990). Toward an MMPI trauma profile.Journal of Traumatic Stress, 3, 151-168.

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Agrusti Giuseppe. Tellaroli Paola. Scalise Claudia. Mandolesi Luca. MMPI-2 and post-traumatic stress disorder predictors: A meta-analysis. BPA Applied Psychology Bulletin. 2019;286(1):31-54. doi:10.26387/bpa.286.1.

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Agrusti Giuseppe. Tellaroli Paola. Scalise Claudia. Mandolesi Luca. MMPI-2 and post-traumatic stress disorder predictors: A meta-analysis. BPA Applied Psychology Bulletin. 2019;286(1):31-54. doi:10.26387/bpa.286.1.