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For more than 30 years, clinical practice guidelines for the perioperative support of patients who undergo metabolic and bariatric surgery have recommended a formal psychological evaluation before surgery. However, the predictive utility of the evaluation in determining future outcomes has been mixed, leading to controversy regarding whether such evaluations should be required for all potential patients. This empirically based commentary will review the utility and value of the psychological evaluation in addition to the limitations in the extant literature that reduce predictive validity and provide recommendations on how to improve quality of the empirical literature and refinements to increase the utility of preoperative evaluations. Pre-metabolic and bariatric surgery psychological evaluation conducted by an appropriately trained clinician and properly reimbursed by the payor that includes time for psychological testing, integration of data, report writing, medical record review, and feedback to the patient and surgical team, should continue to be the standard of care as it benefits all stakeholders.
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Background The COVID-19 pandemic and subsequent guidelines have had a substantial effect on social norms. This likely affected self-report assessment of psychopathology, namely those that assess obsessive-compulsive tendencies routinely used to screen for obsessive-compulsive disorder (OCD). It was hypothesized that self-report assessment of OCD likely produces inflated, non-discriminating scale scores. Methods Data collection occurred prior to the COVID-19 pandemic with the aim of validating a new psychological test; however, data collection was abruptly halted in March 2020. Data collection was allowed to resume in the latter half of the year. Both groups were racio-ethnically and gender diverse. Results Self-report measures of OCD yielded inflated scores. For instance, the total obsessive-compulsive inventory-revised (OCI-R) average score of all participants went from normative levels prior to COVID-19 (M = 13.69, SD = 10.32) to an average score that was above the clinical cut-off on the OCI-R (M = 32.89; SD = 12.95) during the pandemic (t(135) = 9.66, p < 0.001, Cohen's d = 1.66). Conclusions OCD-related scale scores likely produced false positives in research and practice due to COVID-19 health guidelines put in place to protect against infection that may otherwise be considered contamination fears on OCD measures.
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This study examined statistical bias in the measurement of personality psychopathology in the Latinx population using the Minnesota Multiphasic Personality Inventory-3 (MMPI-3). Data were extracted from two studies that yielded a composite data set of 103 White individuals and 250 Latinx individuals. All participants were administered the MMPI-2-Restructured Form-Extended Battery (MMPI-2-RF-EX) or MMPI-3 and the Personality Inventory for the DSM-5 Short Form (PID-5-SF). First, we conducted correlation analyses between theoretically overlapping scales of the PID-5-SF and the MMPI-3 among White and Latinx individuals. The majority of theoretically associated scales were found to be at least moderately associated in the total sample. In addition, Steiger's z-tests indicated that correlations were similar in magnitude across the White and Latinx ethnic groups. Hierarchical regression subsequently determined the presence of slope and/or intercept bias. Only one analysis (the MMPI-3 Anger Proneness prediction of PID-5-SF Negative Affectivity) indicated statistically significant intercept bias. No evidence of slope bias was found. In other words, these analyses indicated that the vast majority of the relationships between MMPI-3 scales and associated personality psychopathology constructs (as measured by the PID-5-SF) remained consistent across both ethnic groups. Overall, the results supported the appropriate cross-cultural use of the MMPI-3 to assess personality psychopathology.
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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.
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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 JovemRESUMO
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.
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Alcoolismo , Obesidade Mórbida , Humanos , MMPI , Obesidade Mórbida/cirurgia , Obesidade Mórbida/psicologia , Qualidade de Vida , Alcoolismo/diagnóstico , Comportamento Alimentar , Reprodutibilidade dos TestesRESUMO
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).
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Ansiedade , MMPI , Humanos , DorRESUMO
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.
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MMPI , Estimulação da Medula Espinal , Masculino , Humanos , Feminino , Dor nas Costas , Medula EspinalRESUMO
Maladaptive eating behaviors are typically associated with significant impairment in psychological functioning more broadly. The Minnesota Multiphasic Personality Inventory (MMPI) family of instruments has traditionally been the most frequently used psychological assessment of psychopathology by clinical psychologists. The most recent version, the MMPI-3, features a new Eating Concerns (EAT) scale that screens for the presence of problematic eating behaviors. The goals of the current study were (a) to independently replicate validity correlations reported from the college sample during EAT scale development, (b) to evaluate the utility of EAT scale item-level correlations with other substantive MMPI-3 scales, and (c) to evaluate the ability of the EAT items to predict specific frequency counts of dysfunctional eating behaviors. The current study examined the MMPI-3 assessment of dysfunctional eating behaviors among 188 undergraduate participants. Results indicated that the EAT scale is meaningfully associated with core symptom dimensions of maladaptive eating, including binging, vomiting, restricting, and concerns about weight and shape. In addition, this study identified meaningfully distinct patterns of correlations with personality and psychopathology constructs, and specific behavioral frequencies, across the five individual EAT scale items. These results contribute to the enhanced utility of this important screening scale in clinical settings.
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OBJECTIVE: Our first goal in this study was to identify cultural mistrust critical items (CMCIs) on two versions of the Minnesota Multiphasic Personality Inventory (MMPI)-the MMPI-Second Edition-Restructured Form (MMPI-2-RF) and MMPI-Third Edition (MMPI-3)-that might be endorsed by people of color because of cultural mistrust rather than clinical paranoia. Our second goal was to determine whether CMCIs and items on the MMPI-2-RF/MMPI-3 Ideas of Persecution scale (Restructured Clinical Scale 6 [RC6]) were endorsed at different rates across cultural groups in a nonclinical college sample and a forensic inpatient sample. HYPOTHESES: Our primary hypothesis was that expert raters would reliably identify a subset of MMPI-2-RF and MMPI-3 items as reflective of cultural mistrust. Black college students would endorse the highest level of CMCIs, followed by Latina/o students, and then White students. We hypothesized that the same pattern of findings would occur in forensic inpatients but that the differences would be attenuated because of the high base rate of psychiatric symptomatology and the nature of the forensic assessment setting. METHOD: Three Black female and three Black male psychologists rated the degree to which each item on the MMPI-2-RF and MMPI-3 reflected cultural mistrust. Black (n = 90), Latina/o (n = 83), and White (n = 100) college students were compared on CMCIs and on MMPI-2-RF/MMPI-3 RC6 item endorsement. The same comparisons were made among Black (n = 221), Latina/o (n = 142), and White (n = 483) forensic inpatients who completed the MMPI-2-RF. RESULTS: Black college students endorsed the highest levels of cultural mistrust, followed by Latina/o students, and then White students, resulting in small-to-medium effect sizes (Hedges's gs = 0.14-0.52). Although we observed some item-level differences in forensic patients, the overall pattern of item endorsement did not significantly differ in this group. CONCLUSIONS: There are multiple reasons for the reporting of clinical paranoia and cultural mistrust in forensic assessment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Psiquiatria Legal , MMPI , Feminino , Humanos , Masculino , População Negra , Hispânico ou Latino , Pacientes Internados , Reprodutibilidade dos Testes , População BrancaRESUMO
BACKGROUND: Metabolic and bariatric surgery is effective for sustained weight loss, but binge eating disorder (BED) can be associated with poorer outcomes and lead to weight regain. A common measure used to screen for BED is the Binge Eating Scale (BES). A BES cut-off score of ≥17 previously identified patients who have a high likelihood of meeting criteria for BED. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), lowered the threshold for meeting criteria for BED, and the psychometrics of the BES need to be reevaluated. OBJECTIVE: The objective of the current investigation is to evaluate whether alternative cut-scores on the BES result in better classification of BED based on the DSM-5 revision of the the BED diagnostic criteria. SETTING: Academic medical hospital in the Midwestern United States. METHODS: Patients (n =1133) seeking metabolic and bariatric surgery were randomly split into 2 samples for validation and replication. The validation sample consisted of 561 patients (30.1% men, 35% non-White). The replication sample consisted of 572 patients who were demographically similar to the first random split sample (e.g., 25.3% men, 34.4% non-White). RESULTS: Of these patients, 13.5% met DSM-5 criteria for BED in the validation sample and 13.8% met criteria for BED in the replication sample. Lowering the interpretative cut-off to ≥15 on the BES yielded sensitivity values of >.72, specificity values of >.67, and an accurate classification of BED in >.70 of patients across both samples. These classification values were as good as or better than the standard cut-off score of ≥17 in both samples. CONCLUSIONS: The BES is appropriate to screen for BED in patients who are seeking bariatric surgery. A 2-point decrease in the BES score for clinical interpretation is appropriate-lowering it from 17 to 15 given DSM-5 updates to diagnostic criteria.
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Cirurgia Bariátrica , Transtorno da Compulsão Alimentar , Obesidade Mórbida , Masculino , Humanos , Feminino , Transtorno da Compulsão Alimentar/complicações , Obesidade Mórbida/cirurgia , Manual Diagnóstico e Estatístico de Transtornos MentaisRESUMO
BACKGROUND: Assessment of eating disorder psychopathology during preoperative psychological evaluations could be facilitated with psychometrically valid measures. One of the most commonly used measures, the Eating Disorder Examination Questionnaire (EDE-Q), is lengthy and has been found to have psychometric limitations. Research has identified a shorter version that has received reliable support across diverse samples but requires further validation for use with patients being evaluated for bariatric surgery. OBJECTIVES: To cross-validate the factor structure of the EDE-Q: Brief Form (EDE-Q-BF, standalone, nonnested version) with patients being evaluated for bariatric surgery across English- and Spanish-language versions and establish measurement invariance for gender and language. SETTING: Northeastern hospital in the United States. METHODS: Participants (n = 618) undergoing evaluations prior to bariatric surgery who identified as Hispanic/Latino/a/x and consented to participate in this research study (which did not influence eligibility for bariatric surgery) completed self-reports. Of the 618 participants, 92 were male and 526 were female, 318 preferred English and were administered English versions of the measures, and 300 preferred Spanish and were administered Spanish versions of the measures. RESULTS: The 3-factor structure ("Restraint," "Weight/Shape Concerns," and "Body Dissatisfaction") of the EDE-Q-BF fit the data well (χ2 [11] = 18.47; P = .071; root mean square error of approximation [RMSEA] = .033; comparative fit index [CFI] > .99; standardized root mean squared residual [SRMR] = .02). Scaler invariance was met for both gender and language. Correlations with external criteria further supported its validity. CONCLUSION: The EDE-Q-BF can easily be administered as part of a preoperative psychological assessment battery to screen for eating disorder psychopathology and is valid for Hispanic/Latino/a/x men and women who speak either English or Spanish.
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Cirurgia Bariátrica , Transtornos da Alimentação e da Ingestão de Alimentos , Feminino , Humanos , Masculino , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Hispânico ou Latino , Idioma , Psicometria , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
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.
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Alcoolismo , Cirurgia Bariátrica , Humanos , Feminino , MMPI , Reprodutibilidade dos Testes , Cirurgia Bariátrica/psicologia , AnsiedadeRESUMO
Quiet ego is a relatively novel, increasingly studied, multi-dimensional concept characterized by a compassionate, interdependent worldview and an adaptive balance between self-interest and concern for others. Quiet ego has been associated with a range of characteristics that can promote relationship quality, responding effectively in the face of challenges, and greater well-being. However, it is currently unknown to what extent quiet ego translates across cultures and settings. The present research leverages cultural and organizational theories to evaluate the conceptual and structural validity of quiet ego for Latinx/Hispanic individuals in the U.S. and to examine relationships among quiet ego, work supervisor relationship quality, and goals in the workplace. Employed college student participants (n = 831; nLatinx/Hispanic = 305) completed an online survey, and collected data were subjected to confirmatory factor analysis and path analysis. Findings confirmed the overall structural model of quiet ego with four primary dimensions (perspective taking, inclusive identity, detached awareness, and growth-mindedness) and indicated that this structure did not differ between Latinx/Hispanic and non-Latinx/Hispanic subsamples. Further, results cohered with the proposed model suggesting that quiet ego might facilitate relationship quality with a workplace supervisor, which, in turn could foster balanced, intrinsically motivating perceptions that one's work goals benefit both oneself and others (mutual gain motivation). The study suggests that quiet ego may be a construct with meaning and utility in Latinx/Hispanic populations and in employment settings. However, further research is needed, and specific suggestions for future study are discussed.
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INTRODUCTION: As of December 1, 2020, when the Advisory Committee on Immunization Practices published their COVID-19 vaccine distribution and prioritization recommendations, health care workers (HCWs) and the elderly were deemed to be at greatest risk of contracting the coronavirus. Limited extant research suggests that most HCWs are willing to receive the COVID-19 vaccine, and findings from studies examining vaccine uptake in non-HCW samples also have reported high vaccination willingness. The health belief model (HBM) and the theory of planned behavior (TPB) suggest that beliefs about severity and susceptibility of disease, perceived benefits of and obstacles to vaccination, and normative beliefs of others affect vaccine uptake. Further, perceptions of safety, side effects, and demographic factors can uniquely impact COVID-19 vaccine uptake. METHOD: Using a cross-sectional design, we recruited 526 participants via social media, through snowball emailing methods, and from university settings. RESULTS: The present findings demonstrate that 37% of participants intend to get the vaccine, and 35% reported that they might get the vaccine. No relationships among demographic factors, willingness to receive the vaccine, and level of intent were observed. However, those who reported that they would not receive the COVID-19 vaccine demonstrated fewer positive attitudes, less agreement, fewer normative views, and less anticipatory regret regarding the COVID-19 vaccine. Also, perceptions of susceptibility, severity, and barriers were associated with participants' willingness to get the COVID-19 vaccine. DISCUSSION: Our results suggest that factors related to the HBM and TPB might uniquely impact COVID-19 vaccine acceptability and could guide the crafting of interventions meant to encourage vaccine uptake. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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COVID-19 , Vacinas , Idoso , COVID-19/prevenção & controle , Vacinas contra COVID-19/uso terapêutico , Estudos Transversais , Humanos , SARS-CoV-2RESUMO
Limitations of a polythetic-categorical classification system has sparked ongoing quantitative efforts to establish a valid and reliable method for diagnosing mental illness. Dimensional methods of classification, such as the Hierarchical Taxonomy of Psychopathology (HiTOP), have been found to ameliorate the limitations of a categorical approach - despite the provisional placement of a Somatoform spectrum. The current investigation sought to elucidate the placement of the Somatoform spectrum within the HiTOP model, and to further corroborate discriminant and convergent validity of the Somatoform spectrum. Using a sample of patients seeking chronic low-back pain treatment (n = 200), superior model fit suggested Somatoform fits better as a separate spectrum from Internalizing and placing Somatoform as a subfactor of Internalizing did not improve model fit. Discriminant and convergent validity with an external criteria demonstrated distinctiveness of the Somatoform spectrum from the Internalizing spectrum in the HiTOP model.
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Transtornos Mentais , Psicopatologia , Humanos , Estudos Longitudinais , Transtornos Mentais/diagnósticoRESUMO
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).
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MMPI , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , AutorrelatoRESUMO
Eating disorders are prevalent among college student populations. Although previous iterations of the instrument did not include specific measurement of eating pathology, the Minnesota multiphasic personality inventory-3 (MMPI-3) now includes a specific scale (i.e., Eating Concerns [EAT]) to assess problematic eating behaviors. The current study examined the MMPI-3 assessment of eating pathology among 249 undergraduate women. A pattern emerged where symptoms of internalizing psychopathology on the MMPI-3 were generally associated with symptoms of eating disorder. However, the newly included EAT scale demonstrated the strongest associations with most areas of eating dysfunction. Further, hierarchical regression analyses suggested that the EAT scale added substantial incremental predictive utility (up to 23%) over other MMPI-3 scales combined in assessing eating pathology. Classification accuracy statistics yielded high sensitivity and specificity coefficients when predicting eating disorder risk at an EAT scale score cutoff of 75 T or higher. These findings support the use of the MMPI-3 in assessing eating pathology in college women, although its performance with men and with women not of college age remains to be studied.
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MMPI , Transtornos Mentais , Feminino , Humanos , Masculino , Transtornos Mentais/diagnóstico , Psicopatologia , EstudantesRESUMO
Many patients who seek treatment for chronic back pain are also at a higher risk of having comorbid anxiety- and depression-related disorders. Measures of mood and anxiety are routinely used in medical settings to screen for depression- and anxiety-related symptoms. However, factor analyses of other measures of mood and anxiety in medical settings often detect a somatization factor which, in turn, limits their discriminant validity for use across medical settings. The Inventory of Depression and Anxiety Symptoms-II (IDAS-II) is a comprehensive self-report inventory that assesses varying aspects of mood and anxiety. The purpose of this investigation is to examine the three-factor structure and validity of the IDAS-II in a chronic pain treatment-seeking sample. A total of 169 patients completed the IDAS-II and the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) upon admission. Confirmatory factor analyses were computed using the scales of the IDAS-II and zero-order correlations between the IDAS-II factors from the best-fitting model and scale scores of the MMPI-2-RF. Overall, a three-factor structure of the IDAS-II was not supported; instead, a one-factor solution fit best. Using the MMPI-2-RF as external criteria, the one-factor of the IDAS-II correlated highest with the Somatic Complaints scale and the Demoralization scale. Overall, item content on the IDAS-II shares overlap with many symptoms that patients with chronic pain likely would endorse. Discussion about implications of using mood/anxiety measures and models in medical settings that are in line with the Hierarchical Taxonomy of Psychopathology (HiTOP) are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Transtornos de Ansiedade , Depressão , Ansiedade/diagnóstico , Transtornos de Ansiedade/diagnóstico , Dor nas Costas/diagnóstico , Depressão/diagnóstico , Humanos , MMPI , Reprodutibilidade dos TestesRESUMO
BACKGROUND: The Attitudes Toward Persons with Obesity (ATOP) scale is widely used to assess stigmatization toward persons with obesity. The measure has previously been suggested to assess three facets-self-esteem, personality, and social difficulties-however, psychometric support for this has been inconsistent and warrants further study if the measure intends to be scored this way. OBJECTIVES: Explore and confirm the factor structure of the ATOP in people assessed prior to bariatric surgery and reassessed 1 year postoperatively SETTING: Midwestern hospital in the USA. MATERIALS AND METHODS: Three-hundred sixteen people who were seeking bariatric surgery were assessed preoperatively, and 161 of those people were reassessed 1 year after surgery with a battery of measures including the ATOP. Exploratory factor analysis (EFA) was performed on ATOP data from a random split-half of people before surgery, and confirmatory factor analysis (CFA) was performed on the second randomly selected half. With the postoperative sample, a CFA was performed, testing the best-fitting model from the preoperative CFA findings. RESULTS: The EFA suggested a two-factor structure interpreted as self-esteem and personality/social difficulties. This structure was supported by CFA performed on the second randomly selected half of people at preoperative assessment and by CFA performed on people 1 year following surgery. Tests of measurement invariance suggested that the two-factor structure was similar at both time points. CONCLUSIONS: Only two factors for the ATOP were empirically supported in the current sample (self-esteem and personality/social difficulties), which is slightly different from the three factors that were originally proposed when the measure was developed. This factor structure is supported both prior to bariatric surgery and 1 year after bariatric surgery.
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Cirurgia Bariátrica , Obesidade Mórbida , Atitude , Análise Fatorial , Humanos , Obesidade/cirurgia , Obesidade Mórbida/cirurgia , Psicometria , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
Psychopathology has been associated with patient reports of poor outcome and an algorithm has been useful in predicting short-term outcomes. The objective of this study is to investigate whether a pre-surgical psychological algorithm could predict 1-year spine surgery outcome reports, including pain, functional disability, and emotional functioning. A total of 1,099 patients consented to participate. All patients underwent spine surgery (e.g., spinal fusion, discectomy, etc.). Pre-operatively, patients completed self-report measures prior to surgery. An algorithm predicting patient prognosis based on data from the pre-surgical psychological evaluation was filled out by the provider for each patient prior to surgery. Post-operatively, patients completed self-report measures at 3- and 12-months after surgery. Longitudinal latent class growth analysis (LCGA) was used to derive patient outcome groups. These outcome groups were then compared to pre-surgical predictions made. LCGA analyses derived three groups of patients from the reported outcome data (entropy = .84): excellent outcomes, good outcomes, and poor outcomes. The excellent and good groups demonstrated improvements over time, but the poor outcome groups, on some measures, reported worsening of pain, functional disability, and emotional functioning over time. The pre-surgical algorithm yielded good concordance with the statistically derived outcome groups (Kendall's W = .81). Using a pre-surgical psychological evaluation algorithm for predicting long-term spine surgery outcomes can identify patients who are unlikely to report good outcomes, and point to areas for psychological intervention that can either improve surgery results or to be utilized as alternatives to elective spine surgery. (PsycInfo Database Record (c) 2021 APA, all rights reserved).