The MMPI-A and 13-year-old inpatients: how young is too young?

This study examined two questions in the use of the MMPI-A with 13-year-old inpatients: (a) are the profiles of 13-year-old inpatients markedly different from those produced by 14-year-old inpatients, and (b) what is the effect of scoring with standard MMPI-A norms versus Archer MMPI-A norms for 13-year-olds. Protocols from 56 13-year-old and 85 14-year-old psychiatric inpatients were analyzed. No significant differences were found for age in mean T scores, and no clear pattern of differences was found in percentage of elevations into the clinical range (T 65) for validity, clinical, content, or supplemental scales. A strong multivariate effect was found with the use of Archer MMPI-A norms resulting in lower T-score values than when standard MMPI-A norms are used. However, univariate differences based on norms were not routinely found with statistically significant differences in only 2 of the 38 scales for males and 7 of the 38 scales for females. The two major exceptions to this finding were that the use of Archer norms versus standard MMPI-A norms resulting in significantly higher mean T scores and a significantly higher percentage of cases falling within the clinical range for Scale 1 and the depression content scale.

Clinical accuracy ratings of MMPI approaches for adolescents: adding ten years and the MMPI-A.

Ehrenworth and Archer (1985) examined the relative merits of adolescent Minnesota Multiphasic Personality Inventory (MMPI) profiles utilizing either adult or adolescent scoring norms (Marks & Briggs, 1972). Eleven years later, the MMPI-A has been introduced into clinical use. It has been suggested that in these early years of the MMPI-A, clinicians plot both MMPI-A norms and Marks and Briggs (1972) norms to derive a clinical interpretation of a given profile, especially when code type interpretation is used (Archer, 1992). This study partially replicates the work of Ehrenworth and Archer (1985) by exploring the relation between code types generated with different norms (MMPI-A [Marks & Briggs, 1972] and adult K-corrected) in a sample of 134 adolescent psychiatric inpatients (77 female, 57 male). Code type narratives were blindly rated by members of the adolescent inpatient treatment staff. Although mean scores for the MMPI-A were significantly lower than those produced by the other two sets of norms, the use of the MMPI-A did not result in a clinical disadvantage. Both sets of adolescent norms (the Marks & Briggs and the MMPI-A) produced higher accuracy ratings than did the use of adult K-corrected norms but did not differ from each other. Gender differences were found on all three sets of norms, with female adolescent psychiatric inpatients scoring higher than male inpatients, particularly on Scales 1, 2, and 3.

Physical abuse in Canadian runaway adolescents.

Recent studies with Canadian runaway youth have questioned the prevalence of abuse experienced by teenaged runaways and the causal contribution of such abuse to runaway experiences (Kufeldt, Duriux, Nimmo, & McDonald, 1992; Kufeldt, & Perry, 1989). This is a descriptive investigation of the physical abuse experienced in a sample of 195 Canadian adolescent runaways: the occurrence, nature and frequency of abuse, the age of onset and duration of abuse, the relationship between the victim and the perpetrator(s), and, who, if anyone, knew of the abuse. This investigation compared and contrasted the physical abuse experienced prior and subsequent to runaway experiences. In this sample, 86% of the population (74% of the males and 90% of the females) reported at least one physically abusive experience. The data reported suggest that this population of adolescents have been the victims of chronic, extreme abuse, experienced at a young age, often perpetrated by the biological parent (most often the mother), and was initiated prior to the first runaway episode. Female runaways were at greater risk than males for all types of abuse experience. Once youths left home, the physical abuse experiences decreased in frequency, but grew in severity, particularly for males.

Clinical predictors of psychopathology in children and adolescents with Tourette Syndrome.

Tourette Syndrome (TS) is a neuropsychiatric disorder of childhood onset characterized by vocal and motor tics and associated psychopathologies. The current study was undertaken to explore the associations between tic symptomatology, related clinical variables and behavioral dysfunction within a cohort of TS subjects. Ninety-two child and adolescent TS subjects were rated through self-measure, and by parents on measures of tic symptomatology, OC characteristics, and dysfunctional behaviors including learning difficulties and attention deficits. Statistical modeling revealed associations among tic clusters, clinical items and behavioral measures, which were unique for the child and adolescent subgroups.

Fluoxetine-induced memory impairment in an adolescent.

This paper describes a 14-year-old male patient who complained of memory problems during treatment with fluoxetine for major depression. The patient showed impairments on all five scales of the Wechsler Memory Scale-Revised during fluoxetine treatment. Three of the scales, Verbal Memory, Visual Memory, and General Memory, showed statistically significant improvements after fluoxetine was discontinued. This case represents the first time memory deficits related to fluoxetine were quantitated with a standardized memory test. It points to cognitive side effects that need to be understood.

Patterns of obsessive compulsive symptoms in Tourette subjects are independent of severity.

Studies have examined the expression of obsessive compulsive (OC) symptoms in obsessive compulsive disorder (OCD), OCD with co-occurring Tourette's Syndrome (TS) or chronic motor tic disorder (CMT) and TS alone. In adult samples, there appears to be a relatively consistent OC symptom thematic content that characterizes OCD alone and OCD in conjunction with tics or TS. Previous studies have controlled for the severity of OC symptoms in OCD and TS groups. In the current study, it was our objective to determine whether patterns of OC symptoms in TS are independent of OC symptom severity. The current exploratory study examined OC symptom expression in a nonclinically based TS sample with a broad range of OC symptoms and severity and a selected clinical OCD sample without TS/tics. Univariate and multivariate statistical analysis explored patterns of OC symptom expression between the two groups. Similar to previous reports examining OC symptoms in OCD and OCD with TS/tics, subjects with OCD alone were characterized by contamination obsessions and cleaning compulsions. In contrast, TS subjects had more somatic, sexual and symmetry obsessions and more checking, counting and touching/blinking compulsions, independent of OC symptom and tic severity. A discriminant function using obsessive items alone correctly grouped 91.4% of cases. The current study replicates patterns of OC symptom expression unique to OCD alone. Patterns of OC symptoms, in particular obsessive symptoms, can robustly predict membership in OCD or TS groups, even with a substantial variation in OC symptom severity as measured by the Y-BOCS score.

Histories of sexual abuse in adolescent male runaways.

In this study, data on sexual victimization in the histories of 89 Canadian male runaways as well as information on physical victimization, family structure, family financial stability, delinquent and criminal activities, and reasons for running away from home were evaluated. The population of male runaways evidenced dramatically higher rates of sexual and physical abuse than did randomly sampled populations. Sexually abused and nonsexually abused male runaways shared characteristics noted in the literature as common to runaways: problem families, high rates of delinquency, depression, tension, low self-image, and history of physical abuse. Sexually abused male runaways differed from nonsexually abused runaways in their reactions to their runaway event, with sexually abused male runaways responding in highly avoidant patterns coupled with extreme withdrawal from all types of interpersonal relationships. These differences are explained as consistent with known sequelae of sexual abuse, and the implications for treatment by runaway shelters and for further research are suggested.

Runaway youths and sexual victimization: gender differences in an adolescent runaway population.

Running away from home has often been viewed as one of the sequelae to sexual abuse. Our study of 144 adolescent runaways finds that 38% of male runaways (n = 89) and 73% of female runaways (n = 55) report having been sexually abused. The impact of abuse is examined by studying, within each gender group, its relationship to the subject's perceptions of sexual activity, relationships with peers and adults, involvement with delinquent/criminal activities, and physical and emotional complaints. The results of assessing the differences between abused and nonabused adolescents show that both the victimized males and females are more likely to report anxiety and suicidal feelings than are their nonabused counterparts. Male victims of sexual abuse are more likely to report physical symptomatology and fear of adult men. Female victims of sexual abuse are more likely to be confused about sex and to engage in delinquent/criminal activities. Discussion focuses on gender differences and runaway behaviors in relation to sexual victimization with the suggestion that differences in the degree of abuse and the sex of the abuser may explain study findings.