A configural approach to understanding MMPI-A PSY-5 scales: Commonly occurring profiles and correlates.

摘要

This study sought to identify the most commonly occurring combinations of MMPI-A PSY-5 scale configurations in an adolescent inpatient psychiatric sample. From these trait configurations, clinical descriptions were formulated for each group based upon the correlational relationship of PSY-5 traits with various types of criterion measures that included the Beck Depression Inventory, Beck Hopelessness Scale, Symptom-Checklist-90-Revised, Youth Self Report, Rorschach, Chart Review, and Hopkins Psychiatric Rating Scale.The sample consisted of 681 adolescents between the ages of 13 and 17 who were receiving inpatient psychiatric treatment at the time of assessment. Patients presented with a variety of Axis I DSM-IV diagnoses including disruptive behavior disorders, mood disorders, psychotic disorders, and psychiatric/substance abuse disorders (dual diagnosis). A rule-based empirical approach using asymmetrical cutoffs was employed to identify the most commonly occurring PSY-5 configurations. Each scale was coded as 0, 1, or 2 to signify clinically significant low scores (35 &ge T), normal scores (40 T > 65), or clinical elevation (T > 65) through a series of Pearson chi square analyses. A series of chi square analyses and independent samples t-tests were then performed to assess differences in presentation across criterion measures between those adolescents who presented with maladaptive personality features on PSY-5 scales and those in the sample who did not.Based upon rule-based criteria, 432 participant (63% of a psychiatric sample) presented with pathological personality traits on PSY-5 scales. Twelve commonly occurring scale configurations were identified based upon frequency of occurrence being at least 1.5 percent of the validation sample in order to ensure sufficient statistical power. Trait configurations were then grouped into categories of Negative Emotionality/Neuroticism (Low NEG, High NEG, and High NEG-High INT), Introversion (Low INT, High INT, and High NEG-High INT) Aggressiveness (Low AGG, High AGG, and High AGG-High NEG) and Psychoticism-Disconstraint (Low PSY-Low DIS, High PSY-High INT-High DIS, and High PSY-High AGG-High DIS). Though this last category is composed of two distinct traits, Psychoticism and Disconstraint did not occur independently with significant frequency in this sample. Conjointly, they occurred at a significant rate at both the low and high end of the dimensions.Descriptive profiles for each category were then created from additional assessment data and comparing each group to within-sample "normals", or those 249 individuals (37%) with no emergent clinically significant scores on PSY-5 scales. While there was some overlap with regard to symptom expression, each group was also identified as having unique characteristics that can be used to understand how interaction of pathological personality traits impacts symptom expression. Future research should focus on identifying the commonly occurring pathological personality trait structure in nonclinical and non-hospitalized adolescents in order to improve generalizability of findings.