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1.
Surg Obes Relat Dis ; 20(6): 577-586, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38373868

RESUMO

BACKGROUND: Psychological testing is used in some preoperative psychological evaluations of patients seeking metabolic and bariatric surgery. The Minnesota Multiphasic Personality Inventory-3 (MMPI-3) contains new norms, updated item content, and new scales such as Eating Concerns and Impulsivity, which are relevant to the assessment of patients seeking metabolic and bariatric surgery. OBJECTIVE: The goal of this investigation was to establish convergent and discriminant properties of the MMPI-3 scales with relevant clinical interview and medical record data from electronic medical records. SETTING: Academic medical center in the Midwest. METHODS: A sample of 790 consecutive patients who completed a preoperative psychological evaluation and took the MMPI-3 were included. Data from medical records and the assessment report were coded by a trained research assistant. RESULTS: MMPI-3 scale scores demonstrated good convergent and discriminant validity. For instance, the Emotional/Internalizing Dysfunction scales correlated with depression and anxiety disorder, suicide history, sexual abuse history, psychotropic medication use, and eating behaviors. Behavioral/Externalizing Dysfunction scales correlated with alcohol, nicotine, and substance use and eating behaviors such as loss-of-control overeating. The Eating Concerns scale demonstrated the highest correlational patterns with various eating behaviors such as loss-of-control overeating, binge eating, and stress eating. CONCLUSIONS: MMPI-3 scale scores perform as well as their Minnesota Multiphasic Personality Inventory-2 Restructured Form counterparts. Newer scales, such as Eating Concerns and Impulsivity, perform particularly well in the assessment of various eating behaviors.


Assuntos
Cirurgia Bariátrica , MMPI , Humanos , Feminino , Cirurgia Bariátrica/psicologia , Masculino , Pessoa de Meia-Idade , Adulto , Cuidados Pré-Operatórios/métodos , Obesidade Mórbida/cirurgia , Obesidade Mórbida/psicologia , Reprodutibilidade dos Testes , Adulto Jovem
2.
Surg Obes Relat Dis ; 20(4): 391-398, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38216363

RESUMO

BACKGROUND: Metabolic and bariatric surgery (MBS) leads to beneficial and sustained outcomes. However, many patients evidence weight recurrence and psychosocial functioning may be associated with weight recurrence. The Minnesota Multiphasic Personality Inventory - 3 (MMPI-3) is validated for use in presurgical MBS evaluations and likely has clinical utility in understanding weight recurrence and other aspects of postoperative functioning. OBJECTIVE: The objective of the current investigation is to understand how postoperative psychosocial functioning relates to weight recurrence and other behaviors and constructs 6 years after MBS. SETTING: Cleveland Clinic Bariatric and Metabolic Institute. METHODS: A sample of 163 participants consented to take a battery of self-report measures related to psychological functioning, eating behaviors, adherence, alcohol misuse, and quality of life along with their postoperative weight. MMPI-3 scale scores were prorated from the Minnesota Multiphasic Personality Inventory - 2 - Restructured Form (MMPI-2-RF) or scored from the Minnesota Multiphasic Personality Inventory - 2 - Restructured Form - Expanded (MMPI-2-RF-EX). RESULTS: Weight recurrence was quite variable in this sample. Postoperative MMPI-3 scales related to emotional/internalizing dysfunction were modestly associated with higher weight recurrence. Postoperative MMPI-3 scale scores also demonstrated associations with other postoperative outcomes including measures of eating behaviors, adherence, alcohol misuse, and quality of life. CONCLUSIONS: Postoperative psychosocial functioning as assessed by the MMPI-3 was associated with weight recurrence and a number of other problematic psychological outcomes beyond weight recurrence.


Assuntos
Alcoolismo , Obesidade Mórbida , Humanos , MMPI , Obesidade Mórbida/cirurgia , Obesidade Mórbida/psicologia , Qualidade de Vida , Alcoolismo/diagnóstico , Comportamento Alimentar , Reprodutibilidade dos Testes
3.
Psychol Assess ; 36(4): 262-274, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38236245

RESUMO

Approximately 30% of patients who undergo spinal surgery for chronic back pain continue to experience significant pain and disability up to 2 months following surgery. Prior studies have identified mental health variables including depression and anxiety as predictors of poorer postsurgical outcomes using screening instruments, but no studies have examined long-term outcomes using the Minnesota Multiphasic Personality Inventory-3 (MMPI-3), a commonly used tool used in presurgical psychological evaluations (PPE). Using group-based trajectory modeling and a sample of 404 spine surgery evaluees, the present study examined the trajectories of changes in disability scores from presurgery through 3, 12, and 24 months postsurgery. We then compared scores on MMPI-3 scales between trajectory groups. We identified three trajectory groups of change in disability over time: a rapid-remitting group (8%), characterized by moderate presurgical disability that rapidly and substantially remitted by 12 and 24 months; a steady-recovering group (68%), characterized by moderate presurgical disability, slower change over time, and mild levels of disability at the 2-year time point; and a persisting disability group (24%), characterized by severe presurgical disability that continued into long-term follow-ups. Participants in the persisting pain group produced higher presurgical scores on somatic/cognitive and internalizing MMPI-3 scales than participants in the rapid-remitting and steady-recovering groups. Our results support the clinical utility of the MMPI-3 in PPEs and highlight the importance of evaluating somatic/cognitive concerns and internalizing dysfunction to identify patients who are likely to have poorer postsurgical outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Ansiedade , MMPI , Humanos , Dor
4.
J Clin Psychol Med Settings ; 31(1): 77-90, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37642803

RESUMO

Pre-surgical psychological assessments are becoming common in the United States and are recommended or required prior to surgical/spinal cord stimulator intervention for chronic back pain. Psychological testing is often recommended for these evaluations and the various versions of the Minnesota Multiphasic Personality Inventory (MMPI) have demonstrated utility for predicting outcomes in this setting. This investigation sought to extend that literature with the newest version of the MMPI, the MMPI-3. The sample comprised of 909 patients (50.5% men, 49.5% women) who consented to participating in an outcome study and took the MMPI-3 along with other self-report measures of pain, functional disability, and emotional functioning prior to surgery as part of their pre-surgical psychological assessment. Self-report measures of pain, functional disability, and emotional functioning were administered again one-year following the intervention. MMPI-3 scale scores accounted for up to 9% of additional variance in the outcomes after controlling for pre-surgical measures. Measures of emotional/internalizing dysfunction, somatic dysfunction, and, to a lesser extent, behavioral/externalizing dysfunction contributed the most to the prediction of poorer outcomes.


Assuntos
MMPI , Estimulação da Medula Espinal , Masculino , Humanos , Feminino , Dor nas Costas , Medula Espinal
5.
Surg Obes Relat Dis ; 20(3): 267-274, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37880030

RESUMO

BACKGROUND: The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) has been widely used in bariatric surgery samples. However, questions remain regarding its utility when predicting changes in body mass index over time following bariatric surgery. OBJECTIVES: Examine whether MMPI-2-RF scales differentially predict 12-month changes in body mass index (BMI) following bariatric surgery when comparing patients with Class III or higher versus Class II or lower obesity. SETTING: Military hospital in the Northwestern United States. METHODS: This retrospective study evaluated data from 193 bariatric surgery patients who completed the MMPI-2-RF as part of presurgical evaluation requirements. Hierarchical linear modeling was used to predict body mass index over a 12-month postsurgical period based on MMPI-2-RF scales. Loss to follow-up rate was 30% during this period. RESULTS: Among patients with Class II or lower obesity, the Symptom Validity, Adjustment Validity, Response Bias, Cynicism, Aggression, Stress/Worry, and Anger Proneness scales showed a significant relationship to BMI after bariatric surgery. Among patients with Class III or higher obesity, the Infrequent Psychopathology Responses, Emotional / Internalizing Dysfunction, Ideas of Persecution, Multiple Specific Fears, and Inefficacy scales showed a significant relationship to body mass index after bariatric surgery. CONCLUSIONS: Certain MMPI-2-RF scales may have better utility in predicting bariatric surgery outcomes based on the patient's obesity severity. The interaction of metabolic and personality factors may play a significant role in weight change following bariatric surgery.


Assuntos
Cirurgia Bariátrica , Transtornos Mentais , Obesidade Mórbida , Humanos , MMPI , Estudos Retrospectivos , Obesidade Mórbida/psicologia , Transtornos Mentais/diagnóstico , Obesidade , Cirurgia Bariátrica/psicologia , Reprodutibilidade dos Testes
6.
Obes Surg ; 33(6): 1806-1819, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37061626

RESUMO

BACKGROUND: The use of psychological screening instruments prior to bariatric surgery has been well established. However, there is currently no specific literature on psychological screening of candidates for reoperative bariatric surgery. METHODS: This study evaluated archival data for 40 women who were candidates for reoperative bariatric surgery and completed the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF). Profile analysis examined differences between patient groups who did and did not undergo reoperative surgery. MMPI-2-RF profiles for reoperative patients then were compared to previous samples of preoperative and postoperative patients. Hierarchical linear modeling was used to predict BMI following reoperative surgery over a 12-month period based on MMPI-2-RF scales while controlling for age and initial BMI. RESULTS: Profile analysis results showed no significant differences on MMPI-2-RF scale scores between reoperative candidates who did and did not undergo a second surgery. With some minor differences attributed to minimization of symptoms, there were no systematic differences in MMPI-2-RF scale scores for reoperative surgery patients compared to preoperative and postoperative patient groups. BMI outcomes over a 12-month period showed that age and initial BMI were significantly better predictors than MMPI-2-RF scores. CONCLUSIONS: Administration of MMPI-2-RF for reoperative bariatric surgery patients likely is equivalent to its typical use in preoperative screening. Only the MMPI-2-RF Disconstraint scale showed any relationship to BMI outcomes over time following reoperative surgery.


Assuntos
Cirurgia Bariátrica , Obesidade Mórbida , Humanos , Feminino , Obesidade Mórbida/cirurgia , Cirurgia Bariátrica/psicologia , MMPI , Reoperação , Índice de Massa Corporal , Reprodutibilidade dos Testes
7.
J Clin Psychol Med Settings ; 30(3): 673-686, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-36063309

RESUMO

Presurgical psychological assessment of bariatric surgery candidates aims to identify psychosocial risk factors and provide treatment recommendations to facilitate optimal outcomes. Such assessment typically includes psychometric testing and a clinical interview. The Minnesota Multiphasic Personality Inventory (MMPI) has been commonly used as a broadband measure to assess a number of psychosocial domains in bariatric clinics. The newest version of the MMPI, the MMPI-3, was recently released. This study sought to (1) establish whether the MMPI-3 is comparable to the MMPI-2-RF in a sample of patients seeking bariatric surgery, (2) report reliability data for all MMPI-3 scale scores in this sample, and (3) explore associations between commonly used self-report symptom measures and substantive scales of the MMPI-3 to ascertain convergent and discriminant validity patterns. Six hundred and thirty-five presurgical patients completed the MMPI-3 in addition to the Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), and Eating Disorder Examination-Questionnaire (EDE-Q). The majority (79.1%) of the sample was female, 65.5% was white, and 26.6% was Black. Scores on most of the MMPI-3 Emotional/Internalizing Dysfunction scales were meaningfully associated with the PHQ-9, GAD-7, and most EDE-Q subscales (except for Restraint). Meaningful discriminant patterns were observed as well. We conclude that the substantive scales of the MMPI-3 are reliable, comparable to their MMPI-2-RF counterparts, and evidence good convergent validity with extra-test measures assessing depression, anxiety, alcohol use, and eating disorder psychopathology in a preoperative bariatric sample.


Assuntos
Alcoolismo , Cirurgia Bariátrica , Humanos , Feminino , MMPI , Reprodutibilidade dos Testes , Cirurgia Bariátrica/psicologia , Ansiedade
8.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 57(10): 1197-1202, 2022 Oct 07.
Artigo em Chinês | MEDLINE | ID: mdl-36319125

RESUMO

Objective: To explore the basic psychological and personality characteristics of patients with laryngopharyngeal reflux disease (LPRD). Methods: The Minnesota Multiphasic Personality Inventory (MMPI) was used to investigate the psychological personality characteristics of 187 patients with LPRD (Study Group) and 75 healthy subjects (control group) who were treated in the otolaryngology clinic of Wuhan Central Hospital from January 2018 to December 2019. There were 102 males in the study group, aged from 20 to 71 (45.42±10.67) years and 85 females, aged from 18 to 65 (40.97±11.53) years; There were 41 males in the control group, aged from 18 to 67 (41.08±12.03) years and 34 females, aged from 20 to 65 (42.55±12.78) years. SPSS 24.0 software was used for statistical analysis. Results: The T scores of HS hypochondriac scale, D depression scale, Hy hysteria scale, Ma hypomania scale and MAS explicit anxiety scale in LPRD patients were significantly higher than those in healthy controls (t=6.304, 4.293, 5.750, 2.694, 5.178, all P<0.05). Correlation analysis showed that RSI score was positively correlated with T score of HS hypochondriac scale, Hy hysteria scale, Ma hypomania scale and MAS explicit Anxiety Scale (r=0.621, 0.402, 0.393, 0.581, all P<0.05); RFS score was positively correlated with T score of HS hypochondriac scale, Hy hysteria scale and MAS explicit Anxiety Scale (r=0.315, 0.321, 0.375, P<0.05). Conclusions: Compared with healthy people, LPRD patients have special personality psychological characteristics, which are mainly manifested as excessive attention to themselves, exaggerated illness, depression, sensitivity, somatization of psychological problems, irritability and mania. The severity of both subjective symptoms (RSI) and objective signs (RFS) of LPRD patients are related to their psychological personality characteristics.


Assuntos
Refluxo Laringofaríngeo , Masculino , Feminino , Humanos , Refluxo Laringofaríngeo/diagnóstico , Mania , Hipofaringe , MMPI , Personalidade
9.
World Neurosurg ; 164: e908-e914, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35618234

RESUMO

OBJECTIVE: The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and the Patient-Reported Outcomes Measurement Information System-29 (PROMIS-29) are used to assess patient psychology, pain, and quality of life. As psychological factors, such as depression and anxiety, are associated with poor perioperative outcomes, we aim to translate MMPI-2-RF values to PROMIS-29 scores and establish cutoff values for PROMIS-29 anxiety and depression domains that might warrant attention preoperatively. METHODS: Seventy adult patients scheduled for an elective spinal surgery between July 2018 and February 2020 who completed both the MMPI-2-RF and PROMIS-29 preoperatively at a single institution were reviewed. RESULTS: Patients with MMPI-2-RF scores of 65 or greater (the cutoff for psychopathology) in the emotional/internalizing dysfunction scale (4.29%) had an average PROMIS-29 depression score of 14.33, which is significantly higher than the control group's (<65 score) 8.49 score (P = 0.04). Similarly, those demonstrating psychopathology on the demoralization (4.29%) and helplessness/hopelessness (4.29%) scales had average PROMIS-29 depression scores significantly higher than the control group's averages (15.33 vs. 8.45, P = 0.02 and 14.33 vs. 8.49, P = 0.04, respectively). Patients with an MMPI-2-RF score of 65 or greater on the emotional/internalizing dysfunction (4.29%), stress/worry (10.00%), and anxiety (7.14%) scales had average PROMIS-29 anxiety domain scores of 15, 15, and 15, respectively, which were significantly greater than that of the control group's scores (8.94, P = 0.04; 8.75, P = 0.004; and 8.55, P < 0.001, respectively). CONCLUSIONS: PROMIS-29 scores of 15 or greater on the depression and anxiety domains may have psychopathologies that warrant addressing, given their increased likelihood of having poor outcomes.


Assuntos
Depressão , MMPI , Adulto , Ansiedade/diagnóstico , Depressão/diagnóstico , Humanos , Sistemas de Informação , Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida , Reprodutibilidade dos Testes
10.
Psychol Assess ; 34(4): 379-389, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34855439

RESUMO

The Minnesota Multiphasic Personality Inventory (MMPI) family of instruments has been commonly used for the evaluation of patients seeking surgical intervention for back pain. A new version of the MMPI, the Minnesota Multiphasic Personality Inventory-3 (MMPI-3), has been released with updated normative data, expanded and revised item content, and updated scales. The purpose of this investigation is to report reliability and validity findings for MMPI-3 scale scores of patients seeking spine surgery. Using a sample of 761 spine surgery candidates (390 men and 371 women), descriptive data, reliability and standard error of measurement, and zero-order correlations using external criteria (self-report and information gathered from a medical record review/clinical interview) were calculated. By and large, men and women produced MMPI-3 scale scores that were similar with a few exceptions. Many reliability estimates and standard errors of measurement were replicable compared to those reported for the MMPI-3 normative sample for scales that yielded adequate range. The scale scores of the MMPI-3 also yielded evidence of good convergent and discriminant validity when correlated with external criteria. Indeed, MMPI-3 scale scores accounted for 2%-15% of incremental variance in data obtained via the clinical interview and medical chart, once other self-report measures were accounted for. Overall, many of the MMPI-3 scale scores used in spine surgery evaluations appear to be reliable and valid. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Assuntos
MMPI , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Autorrelato
11.
Dermatology ; 238(2): 276-282, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34325430

RESUMO

BACKGROUND: Plaque psoriasis has been associated with anxiety, depression, suicidal ideation and various personality traits. However, studies on hypochondriasis, i.e. the belief of serious illness despite having no or only mild symptoms, are currently scarce. OBJECTIVE: The aim of this study was to assess hypochondriasis and personality traits in psoriasis patients using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). METHODS: We conducted an observational study on patients with plaque psoriasis who underwent MMPI-2 testing. Demographic and clinical data, including comorbidities, alcohol consumption, and smoking, were collected. RESULTS: A total of 136 consecutive psoriatic patients were included. The mean age (±SD) was 53.7 (±13.5), mean PASI (Psoriasis Area Severity Index) was 12.4 (±9.9), and mean disease duration was 23.3 (±15.7) years. Pathologically elevated scores in the Hypochondriasis scale were observed in 27.9% of patients. Furthermore, in a few other MMPI-2 scales (Anxiety, Fears and Negative Treatment Indicators) ≥25% of patients obtained pathologically elevated scores. Conversely, the scales that had the highest proportion of low scorers were Ego Strength and Dominance. At regression analysis, higher psoriasis severity and female gender were associated with higher scores in the Hypochondriasis scale (p = 0.03 and 0.001). Finally, 72.8% reported any alcohol consumption and 8.1% heavy alcohol consumption. CONCLUSION: About one third of patients with psoriasis have high scores in the MMPI-2 hypochondriasis evaluation scale. Poor individual coping resources also appeared to be distinctive psychological features in a significant proportion of psoriatic patients.


Assuntos
Hipocondríase , Psoríase , Ansiedade/epidemiologia , Feminino , Humanos , Hipocondríase/complicações , Hipocondríase/diagnóstico , Hipocondríase/psicologia , MMPI , Personalidade , Psoríase/complicações
12.
Psychol Assess ; 33(12): 1169-1180, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34110865

RESUMO

The present study evaluated the criterion validity and practical utility of Minnesota Multiphasic Personality Inventory-3 (MMPI-3) scores in preemployment evaluations of police candidates (n = 377) and candidates for other public safety occupations (n = 276) in the Midwestern United States. Preemployment psychological reports were used to rate problems in the ten California Commission on Peace Officer Standards and Training screening dimensions (POST-10 dimensions). MMPI-3 T score means and standard deviations indicated that substantive scale scores were generally lower and less variable relative to the normative sample. MMPI-3 scores were meaningfully associated with problems in the POST-10 dimensions with similar patterns as past research but with generally larger effect sizes (likely due, in part, to criterion contamination). Relative risk ratio (RRR) findings supported the practical utility of interpretive guidelines described in the MMPI-3 Police Candidate Interpretive Report interpretive manual. Results are discussed in terms of the wider MMPI-2-RF literature in police officer preemployment evaluations. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
MMPI , Polícia , Humanos , Programas de Rastreamento , Razão de Chances , Psicometria , Reprodutibilidade dos Testes
13.
Eat Weight Disord ; 26(8): 2545-2553, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33548052

RESUMO

PURPOSE: A considerable number of post-bariatric surgery patients report problematic eating behaviors (PEBs) and/or eating disorders (EDs). Examining psychosocial variables associated with ED symptoms may identify targets for postoperative interventions to reduce these behaviors and improve surgical outcomes. METHODS: A total of 161 participants completed the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and the Eating Disorder Examination-Questionnaire (EDE-Q). Participants were classified into ED risk or no ED risk groups and subjective binge eating (SBE) or no SBE groups. Independent-sample t tests were computed to examine mean differences in total weight loss (%TWL) and MMPI-2-RF scale scores between the ED groups. Relative Risk Ratios (RRRs) were computed to determine which MMPI-2-RF scales were associated with increased risk of ED group membership. RESULTS: The ED risk group lost significantly less weight (19.36% TWL) than the no ED risk group (25.18% TWL). The SBE group lost significantly less weight (17.98% TWL) than the no SBE group (25.57% TWL). Participants in the ED groups scored significantly higher on internalizing and externalizing MMPI-2-RF scales than the no ED groups. These scales were associated with increased risk (1.55-2.55 times the risk) of being classified into the ED groups. CONCLUSIONS: Patients who experienced postoperative ED symptoms lost significantly less weight than patients without ED symptoms. Postoperative ED symptoms are related to, and may be impacted by, higher levels of internalizing and externalizing dysfunction after surgery. Postoperative assessment of and interventions targeting psychosocial dysfunction could decrease ED symptoms. LEVEL OF EVIDENCE: III: Evidence obtained from well-designed cohort or case-control analytic studies.


Assuntos
Cirurgia Bariátrica , Transtornos da Alimentação e da Ingestão de Alimentos , Obesidade Mórbida , Humanos , MMPI , Redução de Peso
14.
Surg Obes Relat Dis ; 17(5): 1008-1016, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33640259

RESUMO

BACKGROUND: Research identifying preoperative psychosocial predictors of bariatric surgery outcomes has yielded inconsistent results with minimal examination of longer-term outcomes. Utilizing a broadband measure of personality and psychopathology during the preoperative evaluation helps to identify preoperative risk factors for suboptimal bariatric surgery outcomes. OBJECTIVE: Examine predictors of outcome and the incremental contribution of presurgical psychological testing to various long-term bariatric surgery outcomes. SETTING: Academic medical center. METHOD: A total of 168 postoperative patients (average of 6 postoperative years) consented to participate in the outcome study. Participants were weighed by the trained research/clinical staff and completed a battery of self-report questionnaires, including measures assessing eating attitudes and behaviors and weight-related quality-of-life (QoL). Patients had completed the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) as part of the institution's routine preoperative psychosocial evaluation. Weight loss was calculated as percent total weight loss (%TWL) and percent weight regain (%WR) was calculated as a percentage of maximum weight loss. Other preoperative data were obtained from a review of each patient's electronic medical record (EMR). From the initial sample, 145 patients were retained for analyses in the present study. RESULTS: Preoperative problematic eating variables predicted long-term postoperative problematic eating behaviors and body image concerns. Scores on preoperative MMPI-2-RF scales measuring Demoralization, Dysfunctional Negative Emotions, Antisocial Behaviors, and Hypomanic Activation were consistent incremental predictors of 6-year outcomes, accounting for an additional 3%-24% of the variability in postoperative eating behaviors and QoL. CONCLUSIONS: The preoperative psychological evaluation can be used to identify predictors of long-term bariatric surgery outcomes. Identification of these risk factors provides important targets for pre- and postoperative clinical interventions to maximize surgical outcomes.


Assuntos
Cirurgia Bariátrica , Obesidade Mórbida , Humanos , MMPI , Obesidade Mórbida/cirurgia , Qualidade de Vida , Redução de Peso
15.
Obes Surg ; 31(5): 2335-2338, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33196980

RESUMO

Eating pathology is common pre-operatively and continues to be prevalent following bariatric surgery. A new version of the Minnesota Multiphasic Personality Inventory (MMPI), the MMPI-3, contains a new scale called Eating Concerns (EAT) that aims to assess problematic eating behaviors. The current investigation seeks to establish preliminary convergent validity of the MMPI-3 EAT scale in a postoperative bariatric surgery sample. Thirty-eight consecutive participants took the MMPI-3 and the Eating Disorder Examination-Questionnaire (EDE-Q). Higher MMPI-3 EAT scale scores were meaningfully associated with %Weight Regain (r = .37) and scale scores on the EDE-Q [Eating Concerns (r = .67), Weight Concerns (r = .39), Shape Concerns (r = .54), and the EDE total score (r = .59)]. Initial examination of the EAT Specific Problem Scale of the MMPI-3 yields good clinical utility in assessing eating pathology in a postoperative bariatric surgery sample.


Assuntos
Cirurgia Bariátrica , Obesidade Mórbida , Comportamento Alimentar , Humanos , MMPI , Obesidade Mórbida/cirurgia , Período Pós-Operatório
16.
Surg Endosc ; 35(8): 4725-4737, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-32880013

RESUMO

BACKGROUND: Minnesota Multiphasic Personality Inventory-2 (MMPI-2) is used for psychological screening of bariatric surgery (BS) candidates. To date, no studies have analyzed the relationship between MMPI-2 and early returns to hospital. The aim of this study was to determine whether high T scores on the MMPI-2 clinical scales were associated with early return to hospital after primary bariatric surgery. METHODS: Patients who completed an MMPI-2 evaluation, undergoing primary BS from 2014 to 2016 were evaluated. T score for the tested scales were collected and stratified into a high T score (T > 65) vs not (T < 65). The optimal 'cut-point' (specific number of high T scores predicting likelihood for 30-day ED-visit/hospital readmission) was calculated using Youden's Index (J) = Max(c) [sensitivity (c) + specificity (c) - 1], where c = number of scales with a T score > 65. Patients were stratified based on the optimal cut-point which was determined to be ≥ 4 high T scores. Univariate and multivariate logistic regression analyses were used to identify differences between groups and predictors for early ED-visits and hospital readmissions. RESULTS: 375 patients had psychological evaluations available for review. Patients were divided into those with ≥ 4 high T scores (Scr(≥4); n = 86) versus not (Scr (<4); n = 289). Multivariate analysis showed Scr(≥ 4) (aOR 2.99, CI 1.20-7.47; p = 0.019), bipolar disorder (aOR 4.82, CI 1.25-18.83; p = 0.022), and urgent hospital complications (aOR 6.81, CI 2.02-22.91; p = 0.002), were significant independent predictors of 30-day readmissions. Early ED-visits were significantly predicted by public insurance (aOR 3.30, CI 1.22-8.91; p = 0.019), but the effect of the Scr(≥4) profile (aOR 2.42, CI 0.97-6.09; p = 0.06), while influential, did not reach significance. CONCLUSION: Differences in personality traits may be associated increased 30-day readmissions following primary bariatric surgery. Our study represents a novel application of the MMPI-2.


Assuntos
Cirurgia Bariátrica , Obesidade Mórbida , Humanos , MMPI , Obesidade Mórbida/cirurgia , Readmissão do Paciente , Personalidade
17.
Scand J Psychol ; 62(2): 203-210, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33217011

RESUMO

Personality and psychopathology features may play an important role as predisposing factors for fibromyalgia (FM). However, psychological heterogeneity of FM patients has been suggested. Based on two personality psychopathology clusters, we intend to explore psychological heterogeneity in FM patients, specifically, to identify if personality features had other psychological and psychopathological correlates. Secondarily, we also want to identify if personality features have association with health-related correlates. The participants were female FM patients (n = 56) between 30 and 60 years old. The instruments were: Minnesota Multiphasic Personality Inventory (MMPI-2) content and supplementary scales, Fibromyalgia Impact Questionnaire (FIQ), and Numerical Rating Scale (NRS-11). Multivariate analyses of variance (MANOVAs) identified that Cluster 2 (n = 24), characterized by a combination of negative affectivity and social inhibition, presented a more disturbed profile, with several features of symptomatic behavior, general maladjustment, and important clinical problem areas. The associations of personality variables with FM impact and self-reported pain are null, with the exception of Disconstraint scale. In conclusion, FM patients may be very different at the psychological level, concerning personality and psychopathological features that may compromise their treatment. Personality and health-related dimensions do not seem to be associated.


Assuntos
Fibromialgia/complicações , Fibromialgia/psicologia , MMPI , Transtornos Mentais/complicações , Transtornos Mentais/psicologia , Personalidade , Adulto , Análise por Conglomerados , Feminino , Humanos , Transtornos Mentais/diagnóstico , Pessoa de Meia-Idade , Inquéritos e Questionários
18.
Obes Surg ; 31(2): 712-724, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33040294

RESUMO

INTRODUCTION: Mental health professionals routinely assess psychosocial risk factors prior to bariatric surgery to help identify factors that may impede surgical outcomes. Data regarding longer-term psychosocial functioning postoperatively are needed. PURPOSE: Assess the psychosocial functioning of patients who obtained bariatric surgery approximately 6 years ago. METHODS: A total of 161 patients consented to participate in the outcome study. Participants were compensated for their time and participation. Participants were weighed by the research/clinical staff and asked to complete a battery of self-report measures, including the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF). Other measures targeted adherence, eating behaviors/body image, alcohol use, and quality of life. RESULTS: Postoperative MMPI-2-RF scores indicate psychosocial functioning is largely similar to previously published pre-surgical functioning data. Six-year weight loss outcomes were lower than previous studies reported for a similar postoperative time period (mean %total weight loss = 22.98%; standard deviation = 11.71), though quality of life scores were relatively high. Postoperative MMPI-2-RF scale scores were associated with poorer psychosocial functioning, reduced adherence, greater eating behaviors/body image concerns, greater alcohol use severity, lower quality of life, and less overall weight loss. CONCLUSIONS: Psychological dysfunction 6 years after surgery is associated with various adverse outcomes. Ongoing, postoperative treatment may result in better long-term functioning for patients.


Assuntos
Cirurgia Bariátrica , Obesidade Mórbida , Humanos , MMPI , Obesidade Mórbida/cirurgia , Funcionamento Psicossocial , Qualidade de Vida
19.
Int J Immunopathol Pharmacol ; 34: 2058738420934629, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32567420

RESUMO

Nickel (Ni) oral hyposensitization treatment (NiOHT) is an effective management approach for Ni allergy. No health-related quality of life (HRQoL) data exist for the pre- and post-treatment with NiOHT in systemic nickel allergy syndrome (SNAS). The aims of this study were (a) to explore HRQoL in SNAS patients, (b) to assess changes of HRQoL after 1 year of NiOHT; (c) to evaluate psychological status of patients. SNAS patients completed the Short-Form 36-Item Health Survey and Psychological General Well-Being Index before and 1 week after the end of NiOHT. Moreover, psychological state was assessed with the Minnesota Multiphasic Personality Inventory (MMPI-2). A total of 52 patients self-reported pre- and post-treatment questionnaires. HRQoL was poor at baseline. After 1 year of NiOHT, all outcome measure scores improved by about 20% with respect to baseline data (P < 0.01 for all indices, except depressed mood). Finally, 33 patients performed the MMPI-2. High rates for hypochondriasis and depression were noted. Furthermore, most of the patients had high scores for anxiety, depression, and health concerns. This is the first study showing that NiOHT improves HRQoL of SNAS patients, which can be considered a "personalized medicine" approach.


Assuntos
Dessensibilização Imunológica/métodos , Hipersensibilidade/terapia , Níquel , Adulto , Idoso , Ansiedade/etiologia , Ansiedade/psicologia , Estudos de Coortes , Depressão/etiologia , Depressão/psicologia , Feminino , Humanos , Hipersensibilidade/psicologia , Hipocondríase/etiologia , Hipocondríase/psicologia , MMPI , Masculino , Pessoa de Meia-Idade , Testes do Emplastro , Medicina de Precisão , Qualidade de Vida , Inquéritos e Questionários , Síndrome , Resultado do Tratamento , Adulto Jovem
20.
Dig Dis Sci ; 65(8): 2302-2310, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32157497

RESUMO

BACKGROUND: The personality traits of endoscopists have been suggested to affect the adenoma detection rate (ADR). We thus evaluated the relationship between endoscopists' personality traits and the ADR during colonoscopy using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). METHODS: In total, 1230 patients (asymptomatic and aged 50-80 years) who underwent screening or surveillance (≥ 5 years) colonoscopy were recruited from 13 university hospitals by 20 endoscopists between September 2015 and December 2017. We retrospectively measured the ADR, polyp detection rate (PDR), and number of adenomas per colonoscopy (APC). All 20 endoscopists completed all 567 true/false MMPI-2 items. RESULTS: The overall mean colonoscopy withdrawal time, PDR, ADR, and APC were 7.3 ± 2.8 min, 55%, 45.3%, and 0.97 ± 1.58, respectively. No significant difference was observed in the MMPI-2 clinical scales (e.g., hypochondriasis and psychasthenia), content scales (e.g., obsessiveness and type A character), or supplementary scales (e.g., dominance and social responsibility) between the high ADR group (ADR ≥45%, n = 10) and the low ADR group (ADR < 45%, n = 10). In multivariate logistic regression analysis, the ADR was associated significantly with patient age and sex. The ADR was related significantly to endoscopists' colonoscopy experience and the per-minute increase in the colonoscopy withdrawal time (OR 1.21, 95% CI 1.06-1.38, p = 0.005). In a logistic regression analysis adjusted for patient factors, the ADR was associated significantly with ego strength (OR 1.04, 95% CI 1.00-1.09, p = 0.044), as measured by the MMPI-2. CONCLUSIONS: With the exception of ego strength, the endoscopists' personality traits were not associated with adenoma or polyp detection.


Assuntos
Adenoma/diagnóstico , Neoplasias do Colo/diagnóstico , Pólipos do Colo/diagnóstico , Colonoscopia/estatística & dados numéricos , Gastroenterologistas/psicologia , Idoso , Colonoscopia/psicologia , Feminino , Humanos , MMPI , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
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