본문 바로가기
KERD
논문KCI 등재

MMPI-2와 Personality Assessment Inventory 타당도 척도를 이용한 외상후 스트레스 장애 환자의 증상과장 평가

Measuring Symptom Exaggeration in Posttraumatic Stress Disorder using the MMPI-2 and the Personality Assessment Inventory Symptom Validity Scales

0

조회

0

다운로드

3

인용

0

참고문헌

키워드

주제분류정신과학

초록

Objective : We investigated whether Posttraumatic stress disorder patients have a higher tendency to exaggerate the extent of their psychological symptoms compared to other psychiatric patients. Methods : Medical records of patients, who had received psychiatric treatment at four university hospitals in Korea between January 2009 and December 2010, were retrospectively reviewed. We compared a group of 37 patients diagnosed with PTSD, and another group of 41 patients diagnosed with neurotic, stress-related and somatoform disorders according to the ICD-10. To compare the extent of malingering in the two groups, we compared the validity scales of MMPI-2 and Personality Assessment Inventory. We determined the number of participants in both groups feigning their responses by using various cutoff scores of the validity indicators. Results : The PTSD group showed significantly higher scores on the F (p=0.001), F (B)(p=0.000), F (P)(p=0.030), F-K (p=0.003) scale of the MMPI-2 compared to the other group of psychiatric patients. The PT-SD group had a significantly higher NIM score (p=0.001) but a lower PIM score (p=0.020) of the PAI compared to the other group of psychiatric patients. Using the cutoff scores, the PTSD group showed a significantly higher number of patients who feigned responses compared to the other group (Fb≥75 (p=0.010), F-K ≥1 (p=0.005), F-K≥10 (p=0.011) from the MMPI-2, and NIM≥80 (p=0.001) from the PAI). Conclusion : These results suggest that PTSD patients have a tendency to exaggerate their symptom. This group of patients overreported the severity of their condition during standardized personality assessment that included the MMPI-2 or PAI compared to patients diagnosed with other psychiatric disorders. Additional research is required to determine the factors influencing symptom exaggeration in PTSD.

Abstract

Objective : We investigated whether Posttraumatic stress disorder patients have a higher tendency to exaggerate the extent of their psychological symptoms compared to other psychiatric patients. Methods : Medical records of patients, who had received psychiatric treatment at four university hospitals in Korea between January 2009 and December 2010, were retrospectively reviewed. We compared a group of 37 patients diagnosed with PTSD, and another group of 41 patients diagnosed with neurotic, stress-related and somatoform disorders according to the ICD-10. To compare the extent of malingering in the two groups, we compared the validity scales of MMPI-2 and Personality Assessment Inventory. We determined the number of participants in both groups feigning their responses by using various cutoff scores of the validity indicators. Results : The PTSD group showed significantly higher scores on the F (p=0.001), F (B)(p=0.000), F (P)(p=0.030), F-K (p=0.003) scale of the MMPI-2 compared to the other group of psychiatric patients. The PT-SD group had a significantly higher NIM score (p=0.001) but a lower PIM score (p=0.020) of the PAI compared to the other group of psychiatric patients. Using the cutoff scores, the PTSD group showed a significantly higher number of patients who feigned responses compared to the other group (Fb≥75 (p=0.010), F-K ≥1 (p=0.005), F-K≥10 (p=0.011) from the MMPI-2, and NIM≥80 (p=0.001) from the PAI). Conclusion : These results suggest that PTSD patients have a tendency to exaggerate their symptom. This group of patients overreported the severity of their condition during standardized personality assessment that included the MMPI-2 or PAI compared to patients diagnosed with other psychiatric disorders. Additional research is required to determine the factors influencing symptom exaggeration in PTSD.

참고문헌 (48)

  1. Eldridge GD, "Contextual issues in the assessment of post traumatic stress disorder", J Trauma Stress, 4, pp.7~23 (1991)
  2. Sparr LF, "Posttraumatic stress disorder as an insanity defense: Medicolegal quicksand", Am J Psychiatry, 143, pp.608~613 (1986)
  3. Guriel J, "Assessing malingered posttraumatic stress disorder: A critical review", Clin Psychol Rev, 23, pp.881~904 (2003)
  4. Sparr L, "Factitious posttraumatic stress disorder", Am J Psychiatry, 140, pp.1016~1019 (1983)
  5. Burkett BG, "Stolen valor: How the Vietnam generation was robbed of its heroes and its history" (1998), Verity Press
  6. Rosen GM, "The Aleutian Enterprise sinking and posttraumatic stress disorder: Misdiagnosis in clinical and forensic settings", Prof Psychol Res Pract, 26, pp.82~87 (1995)
  7. Binder LM, "Persisting symptoms after mild head injury: a review of the postconcussive syndrome", J Clin Exp Neuropsychol, 8, pp.323~346 (1986)
  8. Rosen G., "Posttraumatic stress disorder, pulp fiction and the press", pp.267~269 (1996), Bull Am Acad Psychiatry Law
  9. Franklin CL, "Differentiating overreporting and extreme distress: MMPI-2 use with compensation-seeking veterans with PTSD", J Pers Assess, 79, pp.274~285 (2002)
  10. Pitman RK, "Traumatic stress: the effects of overwhelming experience on mind, body, and society, In Traumatic stress: the effects of overwhelming experience on mind, body, and society", pp.378~397 (1996), The Guilford Press
  11. Rosen G., "DSM’s cautionary guideline to rule out malingering can protect the PTSD data base", J Anxiety Disord, 20, pp.530~535 (2006)
  12. Rosen G, "Pseudo-PTSD", J Anxiety Disord, 21, pp.201~210 (2007)
  13. Hickling EJ, "Detection of Malingered MVA Related Posttraumatic Stress Disorder", J Forensic Psychol Pract, 2, pp.33~53 (2002)
  14. Williams CW, "Clinical scrutiny of litigants’ self-reports", Prof Psychol Res Pract, 30, pp.361~367 (1999)
  15. Hall RCW, "Detection of malingered PTSD: an overview of clinical, psychometric, and physiological assessment: where do we stand?", J Forensic Sci, 52, pp.717~725 (2007)
  16. Frueh BC, "Unresolved issues in the assessment of trauma exposure and posttraumatic reactions, In Issues and Controversies", pp.63~84 (2004), Wiley
  17. Jelicic M, "Symptom validity testing of feigned amnesia for a mock crime", Arch Clin Neuropsychol, 19, pp.525~531 (2004)
  18. Wiley SD, "Deception and detection in psychiatric diagnosis", Psychiatr Clin North Am, 21, pp.869~893 (1998)
  19. Cunnien AJ, "Psychiatric and medical syndromes associated with deception", pp.13~33 (1988), Guilford Press
  20. Fairbank JA, "Psychometric detection of fabricated symptoms of posttraumatic stress disorder", Am J Psychiatry, 142, pp.501~503 (1985)
  21. McCaffrey RJ, "Psychometric detection of fabricated symptoms of combat related post traumatic stress disorder: A systematic replication", J Clin Psychology, 45, pp.76~79 (1989)
  22. Elhai JD, "Cross-validation of the MMPI-2 in detecting malingered posttraumatic stress disorder", J PersAssess, 75, pp.449~463 (2000)
  23. Lees Haley PR, "Efficacy of MMPI-2 validity scales and MCMI II modifier scales for detecting spurious PTSD claims: F, F K, fake bad scale, ego strength, subtle obvious subscales, DIS, and DEB", J Clin Psychol, 48, pp.681~688 (1992)
  24. Rogers R, "Detection of feigned mental disorders", Assess, 10, pp.160~177 (2003)
  25. Calhoun PS, "Feigning combat-related posttraumatic stress disorder on the Personality Assessment Inventory", J Person Assess, 75, pp.338~350 (2000)
  26. Gray MJ, "Evaluation of the Atypical Response scale of the Trauma Symptom Inventory-2 in detecting simulated posttraumatic stress disorder", J Anxiety Disord, 24, pp.447~451 (2010)
  27. Hathaway SR, "The Minnesota multiphasic personality inventory 2nd ed" (1943), University of Minnesota Press
  28. Butcher J, "Minnesota multiphasic personality inventory-2 (MMPI-2): Manual for administration and scoring" (1989), University of Minnesota Press
  29. Morey L., "An interpretive guide to the Personality Assessment Inventory(PAI)" (1996), Psychological Assessment Resources, Inc
  30. Kim YH, "Standardization Study of Personality Assessment Inventory (PAI) : Reliability and Validity", Korean J Clin Psychol, 20, pp.311~329 (2001)
  31. Perconte ST, "Failure to detect fabricated posttraumatic stress disorder with the use of the MMPI in a clinical population", Am J Psychiatry, 147, pp.1057~1060 (1990)
  32. Lange RT, "Comparison of MMPI-2 and PAI validity indicators to detect feigned depression and PTSD symptom reporting", Psychiatry Res, 176, pp.229~235 (2010)
  33. Elhai JD, "Subtypes of clinical presentations in malingerers of posttraumatic stress disorder: An MMPI-2 cluster analysis", Asses, 8, pp.75~84 (2001)
  34. Liljequist L, "An investigation of malingering posttraumatic stress disorder on the Personality Assessment Inventory", J Pers Assess, 71, pp.322~336 (1998)
  35. McGuire BE, "The assessment of malingering in traumatic stress claimants", Psychiatry Psychol & L, 6, pp.163~173 (1999)
  36. Elhai JD, "The detection of malingered posttraumatic stress disorder with MMPI-2 fake bad indices", Assess, 8, pp.221~336 (2001)
  37. Baer RA, "Underreporting of psychopathology on the MMPI-2: A meta-analytic review", Psychol Assess, 14, pp.16~26 (2002)
  38. Wilson JP, "The historical evolution of PTSD diagnostic criteria: from Freud to DSM-IV", J Trauma Stress, 7, pp.681~686 (1994)
  39. Brady KT, "Comorbidity of psychiatric disorders and posttraumatic stress disorder", J Clin Psychiatry, 61, pp.22~32 (2000)
  40. Elhai JD, "Feldman ME. The Infrequency-Posttraumatic Stress Disorder Scale (Fptsd) for the MMPI-2: Development and initial validation with veterans presenting with combat-related PTSD", J Pers Assess, 79, pp.531~549 (2002)
  41. Binder LM, "Money matters: Meta-analytic review of the effects of financial incentives on recovery after closed-head injury", Am J Psychiatry, 153, pp.7~10 (1996)
  42. Rosen GM, "Use of a symptom validity test in the forensic assessment of posttraumatic stress disorder", J Anxiety Disord, 17, pp.361~367 (2003)
  43. Millis SR, "Neuropsychological malingering and the MMPI-2: Old and new indicators", Paper presented at the 30th Annual Symposium on Recent Developments in the Use of the MMPI, MMPI-2, and MMPI-A (1995)
  44. Arbisi PA, "Characteristics of the MMPI-2 F(p) scale as a function of diagnosis in an inpatient sample of veterans", Psychol Assess, 9, pp.102~105 (1997)
  45. Rogers R, "Feigning schizophrenic disorders on the MMPI-2: Detection of coached simulators", J Pers Assess, 60, pp.215~226 (1993)
  46. Butcher J., "The Minnesota Report: Adult Clinical System-Revised4th ed" (2001), Pearson Assessments
  47. Morey LC, "Personality assessment inventory: Professional Manual" (1991), Psychological Assessment Resources
  48. Blanchard DD, "A comparison of the PAI and MMPI-2 as predictors of faking bad in college students", J Pers Assess, 80, pp.197~205 (2003)

관련 논문AI추천

이 간행물의 다른 논문 (6건)