MMPI profiles of brain-damages and schizophrenic patients

A review of four MMPI indices which differentiate between organicity and schizophrenia

Reviewed studies investigating the internal and external validity of four MMPI indices differentiating between schizophrenia and CNS disorders were contrasted and critiqued. Two types of test construction methods were identified as development procedures for the indices discussed, which were the item and profile analysis approaches. Although the indices developed by the profile analysis method proved more accurate in separating patients into the two diagnostic categories, hit rates were consistently affected by the degree of overlapping symptomatology between diagnostic sample groups. Variable hit rates reported for each of the indices ultimately lead one to question the MMPI's clinical utility for distinguishing patients presenting mixed organic and schizophrenic symptoms. Results from several studies converged on the conclusion that these MMPI indices measured a general degree of disturbance factor rather than schizophrenia or organicity.

A comparison of the effectiveness of MMPI indices in the discrimination of brain-damaged and schizophrenic patients

Assessed the effectiveness of 22 published MMPI procedures to differentiate organic brain syndrome (OBS) from schizophrenic (Sc) patients. Generally, each procedure previously has been suggested to have some effectiveness in making this differentiation. When assessed across studies, however, the S groups have differed on so many relevant variables (age, sex, clinical setting, etc.) that direct comparisons of their relative effectiveness cannot be made. In the current study the accuracy rates are presented for each of the 22 discrimination procedures with a sample matched on age, education, and IQ and also with an unmatched sample, all selected from the patient population at a neuropsychiatric setting. With the matched sample the Hs-Pt Index (Watson, Plemel , & Jacobs, 1978) and the Sc-O Scale, Unweighted Long form (Watson, 1971) reached statistical significance (p less than .10). With the unmatched sample both of the above procedures plus the OBS Signs procedure ( Markowitz , 1973) and P-O Scale (Watson & Plemel , 1978) reached statistical significance (p less than .10). Overall accuracy rates of those procedures found to be statistically significant ranged from 61.5 to 70.0%. These accuracy rates compare favorably to those obtained with more complex and time-consuming neuropsychiatric batteries.

MMPI-derived indicators of organic brain dysfunction

For more than a decade researchers have been attempting to develop a reliable and valid way in which the MMPI can be used as an indicator of organic brain dysfunctioning. This investigation reviews the major approaches and tries all of them on a sample of 32 organic and 34 schizophrenic hospital patients. Results show that the MMPI methods used assigned patients correctly in 45 to 76% of cases. The Sc scale of the MMPI was generally superior to other scales. Most methods predicted better for women than for men. In all, the idea of making the organic-schizophrenic distinction on the basis of the MMPI appears to have been a "nice try" that ultimately did not yield the desired results.

Differentiating brain damage from schizophrenia: a further test of Russell's MMPI key

Previous attempts to differentiate brain-damaged from schizophrenic patients largely have been inconsistent when employing various methods derived from the MMPI. Russell developed an MMPI key for this purpose that is based on an explicit rationale of differential MMPI test performance for these populations. The present study used this MMPI key in an attempt to distinguish 20 brain-damaged, 21 schizophrenic and 24 clinically depressed Ss. The results demonstrated that the key has some clinical utility in making the distinction between brain damage and schizophrenia; however, it performed poorly in correctly classifying the depressed Ss.

The diagnostic use of the MMPI in organic brain dysfunction

Investigated two problem areas: (a) difficulty in the diagnoses of some types of organic brain dysfunctions; and (b) lack of accuracy in the differentiation of patients with organic disorders from patients with nonorganic disorders. Hospitalized male Ss (N = 152) were selected by diagnoses to form one nonorganic and three organic groups. For each group, data from Ss' MMPI protocols were analyzed via Cattel's Coefficient of Profile Similarity and discriminant analysis. Both MMPI factor scales (Barker, Fowler, & Peterson, 1971) and the usual clinical scales were used and compared in all analyses. Statistically significant differences among groups were found on both scales, with a greater separation of the groups provided by the factor scales. Results suggest that the MMPI, through the use of regression formulas derived from discriminant analysis of multiple groups, may be of diagnostic utility in organic brain dysfunction.

The diagnosis of brain-damage by the MMPI: a comprehensive evaluation

A number of research studies have proposed various methods for using the MMPI to identify brain dysfunction. This previous research has taken one of three major approaches. The present study compared the major approaches in a population consisting of 30 schizophrenic, 30 brain-damaged and 30 hospitalized normal patients. The results indicated that the most effective diagnosis device was the use of the Sc scale alone or in conjunction with the remaining clinical scales and the F scale. None of the organic scales or keys were able to match the performance of the Sc scale alone. The poor results obtained bring into question the use of these scales in any other setting without an extensive research validation. An alternate method that might be used to employ the MMPI in the diagnosis of brain dysfunction was suggested.

Study of structural analysis: comparing differential diagnoses based on psychiatric evaluation, the MMPI, and structural analysis of the Hand Test and Rorschach

Experimental investigation of Structural Analysis compared diagnoses of 30 psychiatric inpatients derived independently from psychiatric evaluations, MMPI analyses, and Structural Analysis interpretation of Hand Test and Rorschach data. Results yielded positive preliminary implications for the use of Structural Analysis in psychodiagnostics.

An MMPI sign to separate organic from functional psychiatric patients

Evaluated the utilities of all 90 possible unweighted additive/subtractive two-scale MMPI combinations as indices to separate brain-damaged from functional patient groups in a Veterans Administration psychiatric hospital. One index, Hs-PT, showed more promise than any of the other 89. Hs-PT mean scores were significantly higher among organics than among alcoholics, neurotics, affective psychoses, character disorders, process schizophrenics or reactive schizophrenics. Interpretative information on the Hs-PT index was presented.

Validation of a brain-damage vs. schizophrenia MMPI key

Since neuropsychologic tests largely have failed to separate schizophrenic from brain-damaged patients, an MMPI key was constructed to make such a separation. When cross-validated, this key provided a 76% correct separation and achi2 significant beyond the .001 level for 50 schizophrenic and 50 brain-damaged profiles. Neuropsychologic tests should be used to separate normals from brain-damaged patients and the MMPI to separate schizophrenic from brain-damaged patients.

Unilateral brain lesions and MMPI performance: a preliminary study

Samples of 15 Ss with right- and 20 Ss with left-hemisphere brain lesions secondary to war-related penetrating missile wounds were matched for age, education, and recency of injury and evaluated with the MMPI. Right-hemisphere lesioned Ss produced a composite profile with all scales within normal limits. In contrast, the composite profile of left-hemisphere lesioned Ss showed significant elevations on the Sc, D, and Hs clinical scales, suggesting increased psychopathological responses in such Ss. Although the general configurations of the composite MMPI profiles in the two samples were similar, significant differences in the elevation of both validity and clinical scales were obtained. The results tend to support previous findings of a depressive-catastrophic reaction in patients with lesions in the dominant hemisphere, while not supporting the euphoric-indifference response in nondominant-hemisphere lesioned Ss.