Complementarity between SDQ-SR and MMPI-A in Assessing Adolescents with Internalizing Disorder : A Preliminary Study / 정신신체의학

OBJECTIVES: The aims of this study were to investigate the psychopathology in adolescents with internalizing disorder using the self-report version of Strengths and Difficulties Questionnaire (SDQ-SR) and the Minnesota Multiphasic Personality Inventory for adolescents (MMPI-A), and to explore the complementarity between these two inventories for diagnostic assessment. METHODS: Ninety-one patients aged 13–17 were divided into two groups by clinical diagnosis, 44 with internalizing disorder and 47 comparison group with other disorders. The data of SDQ-SR and MMPI-A completed by them were analyzed for the ability to predict internalizing disorder. RESULTS: The logistic regression analysis revealed that diagnostic predictability increased by 2.27 times with every 1 point of SDQ-SR emotional symptom score increment. Comparison of ROC curves for internalizing disorders showed that the SE and SP of SDQ-SR emotional symptom with score over 4 was 88.94 and 78.72, respectively. For A-anx of MMPI-A with score over 56, SE and SP was 77.27 and 74.47, respectively. However, combination of these scales could not enhance the predictability of diagnostic classification more than that of SDQ-SR emotional symptom alone. CONCLUSIONS: Emotional symptom scale of SDQ-SR and A-anx, A-aln, A and INTR of MMPI-A should be important subscales for diagnosing the internalizing disorder of adolescents, however, which needs to be examined further with a larger sample size including normal control group.

Indicadores clínicos de personalidad en la adolescencia / Clinical indicators of personality in adolescence

El objetivo de este estudio fue caracterizar la presencia de indicadores clínicos y de contenido de personalidad en una población adolescente, a través del inventario multifásico de personalidad de Minnesota, forma A. La muestra de este estudio está conformada por 69 adolescentes escolarizados, de 14 a 17 años, tanto hombres como mujeres, de estrato socioeconómico medio y alto de la ciudad de Barranquilla. Los datos se analizan con el SPSS versión 19.0 para el análisis de estadísticos descriptivos, los resultados arrojan perfiles válidos y son consistentes con investigaciones previas, según las cuales se puede diferenciar población normal de población con indicadores clínicos de personalidad de importancia; en algunas escalas, sin embargo, los puntajes son más altos que los encontrados en otras investigaciones para grupos similares, dando cuenta de las variaciones introducidas por el contexto y la dinámica sociocultural actual, siendo más elevados para las mujeres. Las características clínicas más significativas son esquizofrenia, hipomanía, masculinidad-feminidad y psicastenia; mientras que los puntajes de las escalas de contenido más significativos son en las de pensamiento extravagante, obsesividad y ansiedad.

The objective of this study was to characterize the presence of clinical and content personality indicators in adolescent students through the Minnesota Multiphasic Personality Inventory Form A. The sample is formed by 69 adolescent secondary school students, aged from 14 to 17, including men and women, middle and high socioeconomic status from Barranquilla. The information was analyzed with SSPSS, 19.0 version for the analysis of descriptive statistics. The results show valid profiles and they are consistent with previous research that according to the population; can be differentiated into normal population and population with clinical indicators of personality. In some scales, although, the scores are higher than the ones found in other similar groups, accounting for the variations introduced by the context and actual sociocultural dynamics, scores are higher particularly in women. The most significant clinical characteristic are schizophrenia, hypomania, masculinity-feminity and psychastenia; while scores in content scales are more significant for Bizarre Mentation, Obsessiveness and Anxiety.

Personalidade e autoavaliação global como estudante: alguns indicadores com um modelo multimonial / Personality and overall self-assessment as student: some indicators through a multimonial model / Personalidad y autoevaluación general como estudiante: algunos indicadores con un modelo multimonial

Neste trabalho analisamos a relação entre a personalidade e o modo como os adolescentes se autoavaliam globalmente como estudantes. Participaram 351 adolescentes dos 14 aos 18 anos, distribuídos por vários níveis de escolaridade. Para avaliar a personalidade, utilizámos o Sumário Estrutural da versão portuguesa do Minnesota Multiphasic Personality Inventory – Adolescent, e um questionário de autoavaliação como estudante, com quatro categorias de resposta possíveis, entre Abaixo da Média e Muito Bom. Num modelo de regressão multinomial identificámos a personalidade como preditor da autoavaliação que os adolescentes fazem de si como estudantes, destacando-se os resultados nas dimensões Imaturidade e Desajustamento Global, o que enfatiza a importância da autorregulação e controlo dos impulsos, bem como da emocionalidade positiva, no modo como os adolescentes se autoavaliam. Os resultados são discutidos considerando o papel da organização da personalidade, não só nos padrões de comportamento observável, como também nas autoavaliações e perceções subjetivas dos indivíduos...

In this paper, we analyze the relationship between personality and the way adolescents globally assess themselves as students. Participants were 351 adolescents, aged from 14 to 18 years old, and at various levels of schooling. For personality assessment, we used the Structural Summary of the Portuguese version of the Minnesota Multiphasic Personality Inventory – Adolescent, and a questionnaire for students’ self-assessment, with four possible response categories, from Below Average to Very Good. Through a multinomial regression model we identified personality as a predictor of adolescents’ self-assessment as students, being noteworthy Immaturity and Global Maladjustment dimensions, which emphasizes the importance of self-regulation and impulse control characteristics, as well as of positive emotionality, for adolescents' self-assessment as students. Results are discussed considering the role of personality organization, not only for the patterns of observable behavior, but also in self-assessments and subjective perceptions of individuals...

En este artículo se analiza la relación entre la personalidad y la forma como los adolescentes se autoevalúan globalmente como estudiantes. Participaron 351 estudiantes, con edades de 14 a 18 años. Se utilizó el Sumario Estructural de la versión portuguesa del Inventario Multifásico de Personalidad de Minnesota – Adolescentes (MMPI-A) y un cuestionario de autoevaluación como estudiantes. A través de un modelo de regresión multinomial, se ha identificado la personalidad como un preditor significativo de la autoevaluación global de los adolescentes como estudiantes, destacándose las dimensiones Inmadurez e Inadaptación Global, que enfatizó la importancia de la autorregulación y control de los impulsos, así como de emocionalidad positiva, para el modo como los adolescentes se autoevalúan. Los resultados se discuten teniendo en cuenta el papel de la organización de la personalidad, no sólo para los patrones de comportamiento observable, sino también en las autoevaluaciones y percepciones subjetivas de los individuos...

Personalidade e comportamentos problema: um estudo comparativo com adolescentes em contexto escolar / Personality and problem behavior: a comparative study with adolescents in school context

Neste estudo transversal analisámos a relação entre os comportamentos problema ao nível da indisciplina, desrespeito e conflituosidade dos adolescentes, em contexto escolar, e a personalidade e a psicopatologia, operacionalizadas nas dimensões PSY-5 do MMPI-A. Participaram no estudo 351 estudantes do 9º ao 12º ano, com idades compreendidas entre os 14 e os 18 anos, distribuídos em três grupos diferentes, de acordo com o reporte da frequência de comportamentos problema. Os instrumentos foram a versão experimental portuguesa do MMPI-A e um questionário sobre diferentes dimensões do percurso escolar, em que se incluem os comportamentos problema. Através de análise estatística multivariada, verificámos diferenças significativas entre os grupos nas dimensões PSY-5, num padrão em que o grupo de maior frequência de comportamentos problema apresenta resultados superiores no MMPI-A. Os resultados são interpretados numa perspetiva que sublinha a relevância da personalidade na adaptação à vida escolar, bem como a importância da existência de técnicas de avaliação psicológica de forma a detetar, em contexto de normalidade, estudantes em risco de desenvolvimento de trajetórias inadaptativas.

In this cross-sectional study we analyzed the relationship between problem behaviors in school context, such as indiscipline, disrespect or conflictuality, and personality and psychopathology, which were operationalized in the PSY-5 dimensions of the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A). Participants were 351 students from 9th to 12th grades, aged from 14 to 18 years old, and distributed in three different groups, according to their report of problem behavior frequency. Instruments were the Portuguese experimental version of the MMPI-A and a questionnaire on several school dimensions, including problem behaviors. Multivariate statistical analysis of variance indicates significant differences between the groups in PSY-5 dimensions, in a pattern in which the group presenting the highest frequency of problem behaviors has higher results in the MMPI-A. Results are interpreted under a perspective that underlines the importance of personality in the comprehension of adaptation to school, as well as the relevance of psychological assessment techniques that make possible to detect, within normality contexts, students at risk of developing non-adaptive developmental pathways.

The relationship between structural dimensions of personality and school life in adolescence / A relação entre dimensões estruturais da personalidade e a vida escolar na adolescência

In this cross-sectional study, we analyse the relationship between personality, which was operationalized in the PSY-5 dimensions of the Minnesota Multiphasic Personality Inventory - Adolescent (MMPI-A) and the way students live their lives at school, expressed through indicators of achievement, integration, and overall satisfaction. A total of 351 students, aged 14-18 years, participated in the study. The instruments were the Portuguese version of the MMPI-A and the School Life Questionnaire. Results show a pattern of significant relationships between personality traits and school life, being Disconstraint and Introversion the personality dimensions that stood out mostly in the explanation of school life variables results. Results are analysed considering the importance of personality for the development of more or less adaptive pathways in adolescence.

Neste estudo transversal, analisamos a relação entre a personalidade, operacionalizada nas dimensões PSY-5 do Inventário Multifásico da Personalidade de Minnesota - Adolescente (MMPI-A), e o modo como os adolescentes vivenciam o seu percurso escolar, expresso em indicadores de desempenho, integração e de satisfação global. Participaram no estudo 351 estudantes com idades entre os 14 e os 18 anos. Os instrumentos foram a versão portuguesa do MMPI-A e o Questionário sobre o Percurso Escolar. Os resultados revelam um padrão de relações significativas personalidade-vida escolar, destacando-se as dimensões da personalidade Desinibição e Introversão na explicação da maioria dos resultados das variáveis escolares. Os resultados são analisados considerando a importância da personalidade para a definição de trajetórias de desenvolvimento mais ou menos adaptativas.

Características da personalidade e relacionamento interpessoal na adolescência / Personality traits and interpersonal relationships in adolescence / Rasgos de personalidad y relaciones interpersonales en la adolescencia

Neste estudo, analisamos a relação entre as dificuldades interpessoais na adolescência e dimensões estruturais e clínicas da personalidade, avaliadas pela versão experimental portuguesa do Minnesota Multiphasic Personality Inventory – Adolescent (MMPI-A). Participaram neste estudo 351 estudantes do 9º ao 12º ano, com idades entre os 14 e os 18 anos. Os instrumentos utilizados foram a versão portuguesa do MMPI-A e o Questionário sobre o Percurso Escolar, construído para esta investigação. De acordo com a frequência reportada de dificuldades interpessoais, sobretudo em contexto escolar, constituíram-se dois grupos de estudantes, os quais foram comparados nos resultados do MMPI-A. As análises multivariadas (MANOVAs) revelaram diferenças significativas entre os grupos nas dimensões que sugerem perturbações de personalidade. Os resultados são analisados numa perspectiva que enfatiza a importância da personalidade na vida escolar na adolescência e na distinção de padrões mais ou menos adaptativos de comportamento.

In this cross-sectional study we analyse the relationship between interpersonal difficulties in adolescence and personality clinical and structural dimensions, assessed through the Portuguese version of the Minnesota Multiphasic Personality Inventory – Adolescent (MMPI-A). Participants were 351 ninth to twelfth grade students (ages 14-18), who were distributed by two groups, according to their reported frequency of interpersonal problems, mostly in school context. Instruments were the Portuguese version of the MMPI-A and theSchool Path Questionnaire, which was created for this investigation. Multivariate statistical analysis (MANOVA) reveals significant differences between the groups of frequency of interpersonal difficulties in MMPI-A personality dimensions and in the clinical profile. Results are analyzed on a perspective that emphasizes the importance of personality in school life and in the distinction of more or less adaptive behavior patterns.

En este estudio transversal se analiza la relación entre las dificultades interpersonales en la adolescencia y las dimensiones estructuralesy clínicas de personalidad, evaluadas a través de la versión portuguesa del Inventario Multifásico de Personalidad de Minnesota –Adolescentes (MMPI-A). Los participantes fueron 351 estudiantes de noveno a duodécimo grado (edades 14-18), que fueron distribuidos en dos grupos, de acuerdo a su frecuencia de problemas interpersonales. Los instrumentos fueron la versión portuguesadel MMPI-A y el Cuestionario Sobre la Vida Escolar, el cual fue creado para esta investigación. El análisis estadístico multivariante (MANOVA) ha revelado diferencias significativas entre los grupos de frecuencia de dificultades interpersonales en las dimensiones dela personalidad y en el perfil clínico de MMPI-A. Los resultados se analizan desde una perspectiva que enfatiza la importancia de la personalidad en la vida escolar y en la distinción de los patrones de comportamiento más o menos adaptables.

Consumo de alcohol y drogas en adolescentes evaluado a través del MMPI-A / Alcohol and drugs use in adolescents assessed through the MMPI-A

Currently, the consumption of alcohol and drugs is a major public health problem worldwide due to its high social and economic impact. In Chile, the highest prevalence and greatest drug consumption rates occur in young people aged 19 to 25 years. Adolescence is the most vulnerable development stage for starting drug use. The latest study from CONACE (Chilean National Council for Drugs Control) in school population indicates that 15.1% of students report having used marijuana in the past year, while 33% admitted current use of tobacco and 36% of alcohol. Drug use among adolescents is exacerbated upon verification of its relationship with other risk behaviors as law transgressions, sexual promiscuity, teenage pregnancy and family difficulties. This situation has led various theorists to develop psychological assessment tools to specifically detect and evaluate drug use in adolescence. Among the instruments for psychological assessment, self-report measures have been the most widely used method to evaluate the use of alcohol and other drugs and their associated problems. One of the greatest strengths of self-report measures is that they can detect problems related to drugs in people who for various reasons would like to hide their status of substance abusers. The Minnesota Multiphasic Personality Inventory for Adolescents (MMPI-A) is one of the best self-report instruments for clinical assessment in adolescent population. The MMPI-A consists of 478 items with True and False response format and it has three scales that specifically detect substance abuse problems; they are: MacAndrew's Alcoholism Scale Revised (MAC-R, in Spanish MAC-A), Alcohol/Drug Problem Acknowledgement Scale (ACK, in Spanish RPAD) and Alcohol/Drug Problem Proneness Scale (PRO, in Spanish TPAD). In Chile, there is a MMPI-A version which has empirical studies that support its use with general population Chilean adolescents. These studies also highlight the usefulness that MAC, ACK and PRO scales could have to provide detailed information on specific features that would impact on the use of alcohol and drugs. The aim of this study was to examine the ability of the MMPI-A Chilean version to detect substance abuse problems in specific settings. Its objectives were: 1. to determine the applicability of MAC-R, ACK and PRO scales in different samples of Chilean adolescents, 2. to evaluate the ability of these scales to discriminate problematic substance use in adolescents with and without other clinical problems, and 3. to propose discriminative cut-off scores for the indicated scales. In order to accomplish these goals, we used a quantitative methods approach with a descriptive correlational design for three independent groups. The sample comprised 74 adolescents (44 males and 30 females) with clinical problems that had substance use, diagnosed according to the CONACE criteria for unproblematic consumption categories (occasional and habitual consumption) and DSM-IV criteria for problematic use (abuse and dependence). This group was named "clinical adolescents with consumption" (CCC). Using this group as reference, we selected two additional contrasting groups: a group of adolescents with clinical problems but without substance use called "clinical adolescents without consumption" (CSC; n=71), and a group of school adolescents from general population without substance consumption problems nor other psychopathological problems that would warrant clinical attention called "school-youngsters from general population" (EPG; n=74). The total sample (n=219) had an average age of 16.3 years (SD=1.3) and was collected in urban centers located in south-central Chile. Two instruments were used: The Minnesota Multiphasic Personality Inventory for Adolescents (MMPI-A), which provides the three scales for the assessment of substance abuse: the MAC-R scale is a revision of the MAC scale, originally developed by MacAndrew to distinguish alcoholic from non-alcoholic psychiatric outpatients; the other two scales were developed for the assessment of alcohol and other drugs problems among adolescents. Specifically, the ACK scale was a rationally constructed scale of 13 items with obvious content relating to alcohol or other drug use; while the PRO scale was a 36-item scale constructed empirically by selecting items with no-obvious content related to substance uses that discriminated between adolescents who were in treatment for substance abuse and normal adolescents, or adolescents in clinical treatment. In addition, the clinical MMPI-A scales were used as a supplementary measure. The second instrument was a semi-structured clinical interview based on two clinical guides called protocols A and B. Protocol A allows for doing a clinical interview with adolescents starting from two open-ended questions that inquire reasons for consultation and information on family structure and dynamics. It also checks symptoms in six areas including school, behavioral, emotional, physical, sexual and interpersonal symptoms. Behavioral symptoms include the checking out for consumption of alcohol and drugs. Those adolescents who respond positively to the consumption of alcohol and drugs must answer Protocol B. This is a clinical guide of ad hoc construction, based on the criteria used by the CONACE for the diagnosis of non-problematic use of substances and the DSM-IV criteria for diagnosis of drug abuse and dependence.

En la actualidad, el consumo de alcohol y drogas es uno de los mayores problemas de salud pública en el mundo, debido a su alto costo social y económico. En Chile, las prevalencias más altas y la mayor intensidad en el consumo de drogas se registran en los jóvenes de 19 a 25 años, siendo la adolescencia la etapa más vulnerable para el inicio del consumo de drogas. El último estudio del CONACE (Comisión Nacional de Control de Estupefacientes) en población escolar señala que 15.1% de los estudiantes chilenos declaran haber consumido marihuana en el último año, mientras que 33% reconoce un consumo actual de tabaco y 36% de alcohol. El consumo de drogas en adolescentes se agrava al comprobarse su relación con otras conductas de riesgo, lo que plantea la necesidad de desarrollar instrumentos de evaluación psicológica que consideren el consumo de drogas en la adolescencia de modo específico. Entre los instrumentos de evaluación psicológica, las medidas de autorreporte han sido el método más utilizado para evaluar el uso de alcohol y drogas, pues permiten detectar este problema en personas que por diferentes motivos desearían esconder su condición de abusadores de sustancias. Uno de los instrumentos de autorreporte es el Inventario Multifásico de la Personalidad de Minnesota para Adolescentes (MMPI-A) el cual posee tres escalas que evalúan el consumo de alcohol y drogas: Alcoholismo de MacAndrew Revisada (MAC-A; en inglés, MAC-R), Reconocimiento de Problemas con el Alcohol y/o Drogas (RPAD; en inglés, ACK) y Tendencia a Problemas con el Alcohol y/o Drogas (TPAD; en inglés, PRO). Aunque en Chile existe una versión en español de la prueba y estudios empíricos que respaldan su uso con adolescentes chilenos, no se había estudiado su funcionamiento con adolescentes consumidores de drogas, lo cual motivó el desarrollo de la presente investigación. Los objetivos del estudio fueron: 1. conocer el comportamiento de las escalas MAC-A, RPAD y TPAD en diferentes muestras de adolescentes chilenos, 2. evaluar la capacidad de estas escalas para discriminar el consumo problemático de sustancias en adolescentes con y sin otros problemas clínicos y 3. proponer puntajes de corte discriminativos para las escalas señaladas. La muestra está compuesta por 74 adolescentes (44 hombres y 30 mujeres) con problemas clínicos que presentaban consumo de sustancias, diagnosticado según los criterios del CONACE para las categorías de consumo no problemático (ocasional y habitual) y del DSM-IV para el consumo problemático (abuso y dependencia). Este grupo fue denominado adolescentes Clínicos Con Consumo (CCC). A partir de él se seleccionó a dos grupos de contrastación: un grupo de adolescentes consultantes por problemas clínicos pero sin consumo de sustancias, los cuales fueron denominados adolescentes Clínicos Sin Consumo (CSC) y un grupo de adolescentes escolarizados de población general sin problemas de consumo ni otros problemas psicopatológicos que ameritaran una consulta clínica, denominados adolescentes Escolares de Población General (EPG). Los principales resultados de este estudio muestran que el MMPI-A es capaz de discriminar a los adolescentes clínicos consumidores de drogas de los adolescentes clínicos sin consumo y de los escolares de población general. Las puntuaciones de las escalas clínicas en general son superiores en los dos grupos de procedencia clínica que en el grupo normal. Las escalas suplementarias, MAC-A, RPAD y TPAD, poseen una capacidad de discriminación muy alta; la mayor capacidad de discriminación de las tres escalas se logra al diferenciar entre los adolescentes del grupo CCC y los del grupo EPG en los dos sexos, siendo TPAD la que mejor discrimina. Además, cabe destacar la utilidad de MAC-A y RPAD para distinguir entre adolescentes con consumo problemático y no problemático. Estos resultados demuestran la utilidad del MMPI-A para evaluar a adolescentes chilenos con sospecha de consumo de drogas e incentivan el estudio, adaptación y utilización de este instrumento en Latinoamérica.