The purpose of this study was to determine the accuracy of Minnesota Multiphasic Personality Inventory 2nd edition (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) validity indicators in the detection of malingering in clinical patients with chronic pain using a hybrid clinical-known groups/simulator design. The sample consisted of patients without financial incentive (n = 23), nonmalingering patients with financial incentive (n = 34), patients definitively determined to be malingering based on published criteria ( n = 32), and college students asked to simulate pain-related disability (n = 26). The MMPI-2 validity scales differentiated malingerers from nonmalingerers with a high degree of accuracy. Hypochondriasis and Hysteria were also effective. For all variables except Scale L, more extreme scores were associated with higher specificity. This study demonstrates that the MMPI-2 is capable of differentiating intentional exaggeration from the effects on symptom report of chronic pain, genuine psychological disturbance, and concurrent stress associated with pursuing a claim in a medico-legal context.
Arbisi, P.A., & Ben-Porath, Y.S. (1995). An MMPI-2 infrequent response scale for use with psychopathological populations: The infrequency-psychopathology scale, "F(p)." Psychological Assessment, 7, 424-431.
2.
Arbisi, P.A., & Butcher, J.N. (2004). Psychometric perspectives on detection of malingering of pain: Use of the Minnesota Multiphasic Personality Inventory-2. Clinical Journal of Pain, 20, 383-391.
3.
Armentrout, D.P., Moore, J.E., Parker, J.C., Hewett, J.E., & Feltz, C. (1982). Pain-patient MMPI subgroups: The psychological dimensions of pain. Journal of Behavioral Medicine, 5, 201-211.
4.
Babikian, T., Boone, K.B., Lu, P., & Arnold, G. (2006). Sensitivity and specificity of various digit span scores in the detection of suspect effort. Clinical Neuropsychologist , 20, 145-159.
5.
Bannwarth, B. (1999). Risk-benefit assessment of opioids in chronic noncancer pain. Drug Safety, 21, 283-296.
6.
Barnes, D., Smith, D., Gatchel, R.J., & Mayer, T.G. (1989). Psychosocioeconomic predictors of treatment success/failure in chronic low-back pain patients. Spine, 14, 427-430.
7.
Barron, F. (1953). An ego-strength scale which predicts response to psychotherapy. Journal of Consulting Psychology, 17, 327-333.
8.
Bianchini, K.J., Greve, K.W., & Glynn, G. (2005). On the diagnosis of malingered pain-related disability: Lessons from cognitive malingering research. Spine Journal , 5, 404-417.
Block, A.R., Gatchel, R.J., Deardorff, W.W., & Guyer, R.D. (2003). The psychology of spine surgery. Washington, DC: American Psychiatric Association.
14.
Block, A.R., Ohnmeiss, D.D., Guyer, R.D., Rashbaum, R.F., & Hochschuler, S.H. (2001). The use of presurgical psychological screening to predict the outcome of spine surgery. Spine Journal, 1, 274-282.
15.
Boden, S.D., Davis, D.O., Dina, T.S., Patronas, N.J., & Wiesel, S.W. (1990). Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects: A prospective investigation. Journal of Bone and Joint Surgery, 72, 403-408.
16.
Boden, S.D., McCowin, P.R., Davis, D.O., Dina, T.S., Mark, A.S., & Wiesel, S. (1990). Abnormal magnetic-resonance scans of the cervical spine in asymptomatic subjects: A prospective investigation. Journal of Bone and Joint Surgery, 72, 1178-1184.
17.
Butcher, J.N., Dahlstrom, W., Graham, J., Tellegen, A., & Kaemmer, B. (1989). MMPI-2: Manual for administration and scoring . Minneapolis: University of Minnesota Press.
18.
Conder, R., Allen, L., & Cox, D. (1992). Manual for the computerized assessment of response bias. Durham, NC: CogniSyst.
19.
Daubert v. Merrell Dow Pharmaceuticals, Inc. 113 S. Ct.; 2796-2798 (1993).
20.
Deardorff, W.W., Chino, A.F., & Scott, D.W. (1993). Characteristics of chronic pain patients: Factor analysis of the MMPI-2. Pain, 54, 153-158.
21.
Delis, D.C., Kramer, J.H., Kaplan, E., & Ober, B.A. (1987). California Verbal Learning Test: Adult version. Manual. San Antonio, TX: Psychological Corporation.
22.
Delis, D.C., Kramer, J.H., Kaplan, E., & Ober, B.A. (2000). California Verbal Learning Test: Adult version. Manual. (2nd ed.) San Antonio, TX: Psychological Corporation.
23.
Etherton, J.L., Bianchini, K.J., Ciota, M.A., Heinly, M.T., & Greve, K.W. (2006). Pain, malingering and the WAIS-III Working Memory Index. Spine Journal, 6, 61-71.
24.
Etherton, J.L., Bianchini, K.J., Greve, K.W., & Heinly, M.T. (2005). Sensitivity and specificity of reliable digit span in malingered pain-related disability. Assessment, 12, 130-136.
25.
Etherton, J.L., Bianchini, K.J., Heinly, M.T., & Greve, K.W. (2006). Pain, malingering, and performance on the WAIS-III Processing Speed Index. Journal of Clinical and Experimental Neuropsychology, 28, 1218-1237.
26.
Fishbain, D.A., Cutler, R., Rosomoff, H.L., & Rosomoff, R.S. (1999). Chronic pain disability exaggeration/malingering and sub-maximal effort research. Clinical Journal of Pain, 15, 244-274.
27.
Fishbain, D.A., Turner, D., Rosomoff, H.L., & Rosomoff, R.S. (2001). Millon behavioral health inventory scores of patients with chronic pain associated with myofascial pain syndrome. Pain Medicine, 2, 328-335.
28.
Friedman, A.F., Gleser, G.C., Smeltzer, D.J., Wakefield, J.A., & Schwartz, M.S. (1983). MMPI overlap item scales for differentiating psychotics, neurotics, and nonpsychiatric groups. Journal of Consulting and Clinical Psychology, 51, 629-631.
29.
Friedman, A.F., Lewak, R., Nichols, D.S., & Webb, J.T. (2001). Psychological assessment with the MMPI-2. Mahwah, NJ: Lawrence Erlbaum.
30.
Gatchel, R.J. (2004). Psychosocial Factors That Can Influence the Self-Assessment of Function. Journal of Occupational Rehabilitation, 14, 197-206.
31.
Gatchel, R.J., Polatin, P.B., & Kinney, R.K. (1995). Predicting outcome of chronic back pain using clinical predictors of psychopathology: A prospective analysis. Health Psychology, 14, 415-420.
32.
Gervais, R.O., Green, P., Allen, L.M., & Iverson, G.L. (2001). Effects of coaching on symptom validity testing in chronic pain patients presenting for disability assessment. Journal of Forensic Neuropsychology, 2, 1-19.
33.
Gough, H.G. (1950). The F minus K dissimulation index for the Minnesota Multiphasic Personality Inventory. Journal of Consulting Psychology , 14, 408-413.
34.
Gough, H.G. (1954). Some common misconceptions about neuroticism. Journal of Consulting Psychology, 18, 287-292.
35.
Gough, H.G. (1957). Manual for the California Psychological Inventory . Palo Alto, CA: Consulting Psychologist Press.
36.
Graham, J. (1990). The MMPI-2: Assessing personality and psychopathology . New York: Oxford University Press .
37.
Green, P., Allen, L.M., & Astner, K. (1996). The Word Memory Test: A user's guide to the oral and computer-administered forms, US version 1.1. Durham, NC: CogniSyst.
38.
Greene, R. (2000). The MMPI/MMPI-2: An interpretative manual (2nd ed.). Needham Heights, MA: Allyn & Bacon.
39.
Greiffenstein, M.F., Baker, W.J., & Gola, T. (1994). Validation of malingered amnesia measures with a large clinical sample. Psychological Assessment, 6, 218-224.
40.
Greiffenstein, M.F., Fox, D.D., & Lees-Haley, P.R. (2007). The MMPI-2 Fake Bad Scale in detection of noncredible brain injury claims. In K. B. Boone (Ed.), Detection of noncredible cognitive performance (pp. 210-235). New York: Guilford.
41.
Greve, K.W., & Bianchini, K.J. (2004). Setting empirical cutoffs on psychometric indicators of negative response bias: A methodological commentary with recommendations. Archives of Clinical Neuropsychology , 19, 533-541.
42.
Greve, K.W., Bianchini, K.J., & Ameduri, C.J. (2003). Use of a forced-choice test of tactile discrimination in the evaluation of functional sensory loss: A report of 3 cases. Archives of Physical Medicine Rehabilitation, 84, 1233-1236.
43.
Greve, K.W., Bianchini, K.J., Black, F.W., Heinly, M.T., Love, J.M., Swift, D.A., et al. (2006). The prevalence of cognitive malingering in persons reporting exposure to occupational and environmental substances . Neurotoxicology, 27, 940-950.
44.
Greve, K.W., Bianchini, K.J., Doane, B.M., Love, J.M., & Stickle, T.R. (2005). Psychological evaluation of the emotional effects of a community toxic release. Journal of Occupational and Environmental Medicine, 47, 51-59.
45.
Greve, K.W., Bianchini, K.J., Love, J.M., Brennan, A., & Heinly, M.T. (2006). Sensitivity and specificity of MMPI-2 validity scales and indicators to malingered neurocognitive dysfunction in traumatic brain injury. Clinical Neuropsychologist, 20, 491-512.
46.
Harris, I., Mulford, J., Solomon, M., van Gelder, J.M., & Young, J. (2005). Association between compensation status and outcome after surgery: A meta-analysis. Journal of the American Medical Association, 293, 1644-1652.
Iverson, G.L., & McCracken, L.M. (1997). "Postconcussive" symptoms in persons with chronic pain. Brain Injury, 11, 783-790.
49.
Keller, L.S., & Butcher, J.N. (1991). Assessment of chronic pain patients with the MMPI-2 . Minneapolis: University of Minnesota Press.
50.
Larrabee, G. (1998). Somatic malingering on the MMPI and MMPI-2 in litigating subjects. Clinical Neuropsychologist, 12, 179-188.
51.
Larrabee, G. (2003). Detection of symptom exaggeration with the MMPI-2 in litigants with malingered neurocognitive dysfunction. Clinical Neuropsychologist, 17, 54-68.
52.
Lechner, D.E., Bradbury, S.F., & Bradley, L.A. (1998). Detecting sincerity of effort: A summary of methods and approaches. Physical Therapy, 78, 867-888.
53.
Lees-Haley, P.R., English, L.T., & Glenn, W.J. (1991). A Fake Bad Scale on the MMPI-2 for personal injury claimants. Psychological Reports, 68, 203-210.
54.
Lees-Haley, P.R., Iverson, G.L., Lange, R.T., Fox, D.D., & Allen, L.M. (2003). Malingering in forensic neuropsychology: Daubert and the MMPI-2. Journal of Forensic Neuropsychology, 3, 167-203.
55.
Linton, S.J. (2002). Early identification and intervention in the prevention of musculoskeletal pain. American Journal of Industrial Medicine , 41, 433-442.
56.
Linton, S.J., & Boersma, K. (2003). Early identification of patients at risk of developing a persistent back problem: The predictive validity of the Orebro Musculoskeletal Pain Questionnaire. Clinical Journal of Pain, 19, 80-86.
57.
Lubin, B., Larsen, R.M., & Matarazzo, J.D. (1984). Patterns of psychological test usage in the United States. American Psychologist, 39, 451-454.
58.
Marks, P.A., & Seeman, W. (1963). The actuarial description of abnormal personality . Baltimore: Williams & Wilkins .
59.
Mathias, C.W., Greve, K.W., Bianchini, K.J., Houston, R.J., & Crouch, J.A. (2002). Detecting malingered neurocognitive dysfunction using the reliable digit span in traumatic brain injury. Assessment, 9, 301-308.
60.
Meyers, J.E., Millis, S.R., & Volkert, K. (2002). A validity index for the MMPI-2. Archives of Clinical Neuropsychology, 17, 157-169.
61.
Mittenberg, W., Patton, C., Canyock, E.M., & Condit, D.C. (2002). Base rates of malingering and symptom exaggeration . Journal of Clinical and Experimental Neuropsychology, 24, 1094-1102.
62.
Nelson, N.W., Sweet, J.J., & Demakis, G.J. (2006). Meta-analysis of the MMPI-2 Fake Bad Scale: Utility in forensic practice. Clinical Neuropsychologist, 20, 39-58.
63.
Portenoy, R.K. (1996). Adjuvant analgesic agents. Hematology/ Oncology Clinics of North America, 10, 103-119.
64.
Reynolds, C.R. (1998). Detection of malingering during head injury litigation . New York: Plenum.
65.
Robinson, M.E., & Dannecker, E.A. (2004). Critical issues in the use of muscle testing for the determination of sincerity of effort. Clinical Journal of Pain, 20, 392-398.
66.
Robinson, M.E., Swimmer, G.I., & Rallof, D. (1989). The P-A-I-N MMPI classification system: A critical review. Pain, 37, 211-214.
67.
Rogers, R. (1997). Clinical assessment of malingering and deception (2nd ed.) New York: Guilford.
68.
Rogers, R., Sewell, K.W., Martin, M.A., & Vitacco, M.J. (2003). Detection of feigned mental disorders: A meta-analysis of the MMPI-2 and malingering. Assessment, 10, 160-177.
69.
Rosen, J.C., Grubman, J.A., Bevins, T., & Frymoyer, J.W. (1987). Musculoskeletal status and disability of MMPI profile subgroups among patients with low back pain . Health Psychology, 6, 581-598.
70.
Schofferman, J., Anderson, D., Hines, R., Smith, G., & White, A. (1992). Childhood psychological trauma correlates with unsuccessful lumbar spine surgery. Spine, 17, S138-S144.
71.
Slesinger, D., Archer, R.P., & Duane, W. (2002). MMPI-2 characteristics in a chronic pain population . Assessment, 9, 406-414.
72.
Slick, D.J., Sherman, E.M., & Iverson, G.L. (1999). Diagnostic criteria for malingered neurocognitive dysfunction: Proposed standards for clinical practice and research. Clinical Neuropsychologist, 13, 545-561.
73.
Tombaugh, T. (1996). Test of Memory Malingering manual. New York: MultiHealth Systems.
74.
Vendrig, A.A., Derksen, J.L., & de Mey, H.R. (1999). Utility of selected MMPI-2 scales in the outcome prediction for patients with chronic back pain. Psychological Assessment, 11, 381-385.
75.
Voorhies, R.M., Jiang, X., & Thomas, N. (2007). Predicting outcome in the surgical treatment of lumbar radiculopathy using the pain drawing score, McGill short form pain questionnaire, and risk factors including psychosocial issues and axial joint pain. Spine Journal, 7, 516-524.
