Leonard D. Goodstein (1927-2016).

Presents an obituary for Leonard D. Goodstein, who died in Scottsdale, Arizona, on July 20, 2016, at the age of 89. Goodstein was CEO of APA at a crucial time in its history when it faced both crippling financial difficulties and intramural conflict regarding the purpose of the organization. His efforts yielded important financial results and lasting structural changes to the organization. (PsycINFO Database Record

Analysis of Minnesota Multiphasic Personality Inventory-2-Restructured Form response bias indicators as suppressors or moderators in a medical setting.

The use of response bias indicators in psychological measurement has been contentious, with debate as to whether they actually suppress or moderate the ability of substantive psychological indicators to identify the construct of interest. Suppression would indicate that predictor variables contain invalid variance that the bias indicators can suppress, while moderation would indicate differential levels of predictive validity at different levels of bias. Response bias indicators on the Minnesota Multiphasic Personality Inventory (MMPI)-2-Restructured Form (MMPI-2-RF) [infrequent responses (F-r), infrequent somatic responses (Fs), infrequent psychopathology responses (Fp-r), adjustment validity (K-r), uncommon virtues (L-r), symptom validity (FBS-r), and Response Bias Scale (RBS)] were tested to determine whether they suppressed or moderated the ability of the Restructured Clinical Scale 1 (RC1) and Neurologic Complaints (NUC) scale to discriminate between epileptic seizures (ES) and nonepileptic seizures (NES, a conversion disorder that is often misdiagnosed as ES). The MMPI-2-RF was completed by 399 patients with a confirmed diagnosis of ES or NES via Epilepsy Monitoring Unit evaluation. Moderated logistic regression was used to test for moderation, and logistic regression was used to test for suppression. Most of the response bias variables showed a suppressor effect, but moderator effects were not found. These findings extend the use of bias indicators to a psychomedical context.

The relationship of pre-operative health status to sustained outcome in gastric bypass surgery.

The task of sustaining initial weight loss after gastric bypass surgery has been identified as the area of greatest concern in this intervention. The present study investigated the role of good vs. poor pre-operative health as a moderator variable in identifying useful pre-operative predictors of continued weight loss. Follow-up data at a mean of 12.8 months and again at 3.2 years post-operatively were available for 79 patients on 227 interview variables and four psychological assessment instruments. These measures were studied for their success in predicting continued weight loss over the 1­3-year period separately for patients who were in good and in poor general pre-operative health. Previous findings showed that the overall mean simple weight loss to 12.8 months was 45.61 kg, but additional weight loss to 3.2 years was only 0.28 kg. The good and poor pre-operative health groups differed little on these figures. However, the significant predictors of continued weight loss for good-health patients (high anxiety and distress, low self-esteem, poor eating habits, strong expectations of life improvement, and good achievement and coping skills) were quite different from those for poor-health patients (good psychological health and happiness, strong personal support and life satisfaction, good eating habits, and little knowledge about their health). Thus, pre-operative health status served as a powerful moderator in predicting continued weight loss from pre-operative characteristics. These findings offer a means of making more accurate predictions as to which patients are the best candidates for surgery, and also suggest that different psychological and other interventions should be selected according to pre-operative health status.

The effect of underreporting response bias on the assessment of psychopathology.

A recent review offered the conclusion that the utility of considering response bias--in particular, underreporting, or defensiveness--in assessing psychopathology with structured inventories has not been demonstrated in practical criterion-related situations. The present research tested for the presence of suppressor and moderator effects in 3 such mental health classification tasks (disordered participants vs. control participants) using relevant predictors. Regression analyses showed the presence of one or both effects for all 3 tasks. The practical effects of these response biases were then illustrated by examining 4 measures of predictive accuracy at different levels of the response-bias measure: predictor/criterion correlations, hit rates, sensitivity/specificity, and positive/negative predictive power. It was concluded that there is clear utility in taking account of underreporting response bias in practical situations, particularly where extreme response bias is likely to be present. Confirmation of these findings with additional response-bias measures is needed.

Assessment of global psychiatric categories: the PSI/PSI-2 and the MMPI-2-RF.

The 3 Higher Order (HO) scales of the Minnesota Multiphasic Personality Inventory-2 Restructured Form and the 3 core clinical scales of the Psychological Screening Inventory/Psychological Screening Inventory-2 were developed to broadly represent the 3 traditional psychiatric categories of mental disorder: major psychiatric disorder ("psychotic"), general psychological distress ("neurotic"), and significant antisocial characteristics ("character disorder"). The present article reports 2 studies that assessed the validity of test scores from each scale for their intended purpose. Participants included 2 groups of forensic clients (n=138 and 78), college undergraduates (n=100), and previously reported data on larger groups of participants. Validity was supported in 2 ways: high loadings in confirmatory factor models based on the 3 psychiatric categories and medium to large effect sizes in discriminating between relevant disordered groups and normative groups. The tests showed comparable results. Limitations included co-morbidity in some participant groups and the relatively narrow range of psychopathology in undergraduate participants.

Development and validation of brief content scales for the Psychological Screening Inventory-2.

This article describes the development of 21 brief content (BC) scales to supplement the existing scales of the Psychological Screening Inventory-2 (PSI-2), and three validity studies to support their use for both the PSI-2 and the original PSI. The BC scales comprise groups of four or more items that are statistically homogeneous in content and are replicated across three data sets: PSI and PSI-2 normative data and a PSI-based group of forensic respondents. Concurrent validity was shown in correlations with the following: (a) the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) basic clinical scales, Content scales, PSY-5 scales, and Restructured Clinical (RC) scales; (b) family/friend observer ratings; and (c) therapist ratings in an outpatient substance abuse treatment program. Consistent with the purpose of the PSI/PSI-2, the BC scales are intended to provide additional screening information and not a comprehensive representation of psychopathology.

Validation of diagnostic measures based on latent class analysis: a step forward in response bias research.

The use of criterion group validation is hindered by the difficulty of classifying individuals on latent constructs. Latent class analysis (LCA) is a method that can be used for determining the validity of scales meant to assess latent constructs without such a priori classifications. The authors used this method to examine the ability of the L scale of the MMPI-2 (J. N. Butcher et al., 2001), the Impression Management scale of the Balanced Inventory of Desirable Responding (D. L. Paulhus, 1991), and the Endorsement of Excessive Virtue scale of the Psychological Screening Inventory (R. I. Lanyon, 1970) to identify favorable response bias (misrepresentation) in a situation where no criterion for individual classifications existed. Results suggest that LCA can be used as a method for assessing the validity of scales that measure unobservable conditions.

Are exaggerated health complaints continuous or categorical? A taxometric analysis of the Health Problem Overstatement Scale.

A taxometric analysis of 3 factor scales extracted from the Health Problem Overstatement (HPO) scale of the Psychological Screening Inventory (PSI; R. I. Lanyon, 1970, 1978) was performed on the data from 1,240 forensic and psychiatric patients. Mean above minus below a cut, maximum covariance, and latent-mode factor analyses produced results indicative of dimensional latent structure for the exaggerated health complaints construct. The outcome of this and several other recent taxometric investigations indicates that across 3 different domains of feigning (i.e., psychiatric symptoms, memory problems, and health complaints), the overall feigning construct is ordered continuously along 1 or more dimensions rather than partitioned into discrete categories of malingerers and nonmalingerers. These findings call for more research on the extent to which the different domains of feigning share 1 or more dimensions in common.

Prediction of long-term outcome after gastric bypass surgery.

BACKGROUND: To investigate the predictability and sustainability of weight loss in gastric bypass (GBP) surgery after the first year, we conducted a 3-year follow-up of patients who had already been comprehensively studied preoperatively and after 1 year. METHODS: Preoperative data had been obtained for 131 morbidly obese patients on a 273-item interview and five psychological assessment instruments, and some of these data had been obtained again after a mean of 12.8 months. For this study, weight data were obtained on 79 patients at a mean of 3.2 years postoperatively. RESULTS: Over the 1-3 year interval, mean simple weight loss and simple BMI decrease were essentially zero, compared with 45.61 kg and 16.52 respectively over the 0-1 year interval. Further, the 0-1 year and 1-3 year losses were uncorrelated. Optimal predictor variables for 1-3 year loss included three preoperative measures (expectation of increased self-confidence, amount of informational support, and total coping skills) plus functional eating behaviors after 1 year. Together they showed a multiple correlation of .55 with weight loss and .55 with BMI change. These predictors differed from the predictors of change over 0-1 year, and they continued to be significant after controlling for several preoperative characteristics. CONCLUSIONS: The factors influencing long-term continuing weight loss after GBP are different from those influencing initial loss, and involve positive characteristics such as skills, information, and expectations. The results suggest the importance of actively teaching such skills during the first postoperative year.

Predictors of outcome after gastric bypass surgery.

BACKGROUND: Weight loss outcome predictions after gastric bypass (GBP) surgery based on individual findings have shown relatively little consistency. The present study took a more comprehensive approach, utilizing extensive pre-surgery interview and psychological test data both individually and in composite predictors. METHODS: Pre-surgery data were obtained for 131 morbidly obese patients on a 273-item interview and 5 psychological assessment instruments, and weight loss measures (simple weight change and BMI change) were obtained at a mean of 12.8 months following surgery. RESULTS: Individual predictor variables based on existing research findings showed expected but mostly nonsignificant correlations with weight loss. Optimal composite predictor variables were constructed for 4 general areas of pre-surgery assessment as represented in the literature: physica/medical health, psychological health, interpersonal support, and eating disorder. Each composite variable significantly predicted weight loss, and together they showed multiple correlations of .50 with simple weight change and .54 with simple BMI change. CONCLUSIONS: Sustained weight loss after GBP was related to a rather wide range of pre-surgery variables, each of which made a small contribution, but composite variables grounded in the general literature provided more effective prediction. It is cautioned that continued success after > or =2 years could be dependent on yet other variables, with a possible contribution from some post-surgery factors.

Utility of the Psychological Screening Inventory: a review.

The Psychological Screening Inventory (PSI; R. I. Lanyon, 1970, 1973, 1978, 1993, 2006) was developed as a cost-effective screening device in identifying persons for whom a more complete psychological evaluation should be conducted. The author reviews data bearing on the utility of the PSI in this regard and in more general applications. The Alienation scale showed strong effect sizes in distinguishing psychiatric inpatients from controls, the Social Nonconformity scale in distinguishing incarcerated groups from control, and the Discomfort scale in identifying persons with general psychological distress. These findings were supported by correlational data with comparable scales, and by a variety of smaller comparison studies. Meaningful discriminations were also shown for adolescents and for college-age young adults. Findings in studies of substance abusers and medical problems were also reviewed. Response Distortion scales showed effectiveness similar to that of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; J. N. Butcher, W. G. Dahlstrom, J. R. Graham, A. Tellegen, & B. Kaemmer, 1989) validity scales. Validity was also shown for several of the seven available foreign language translations. It was concluded that the PSI is effective for the tasks for which it was designed.

Construct validity of the misrepresentation scales of the psychological screening inventory.

This study provides construct validity evidence and reliabilities (consistency and stability) for 5 misrepresentation (response distortion) scales of the Psychological Screening Inventory (PSI; Lanyon, 1970, 1973, 1978) in assessing 3 constructs: exaggeration of psychopathology, exaggeration of personal virtue, and exaggeration of health problems. Using data from forensic cases, the existence and independence of these 3 constructs were confirmed in data from the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) and the Balanced Inventory of Desirable Responding (Paulhus, 1986, 1991). The PSI scales were then shown to load highly on these constructs. The PSI scales also showed the expected patterns when their mean scores were examined for 15 sets of responses from participant groups with varied motivations to misrepresent. We present receiver operating characteristic data to show the success of the scales in distinguishing between simulators and appropriate comparison groups. Using the same data, we also present classification accuracy in terms of positive predictive power and negative predictive power based on a sensitivity level of 90% and misrepresentation base rates of .20 and .10.

The Assessment of Adult Health Care Orientations: Development and Preliminary Validation of the Multidimensional Health Profile-Health Functioning Index (MHP-H) in a National Sample.

This paper describes the development and preliminary validation of the Multidimensional Health Profile-Health Functioning Index (MHP-H), a 69-item self-report instrument designed to assess a variety of behaviors, perceptions, attitudes, and beliefs presumed to influence health status and the pursuit of lay and professional health care. The MHP-H briefly measures adult health history, health habits, health care utilization, health beliefs and attitudes, and response to illness (help-seeking behaviors). A national sample of adults (N = 673) was assessed, comprising 3 age groupings (18-32, 33-50, and 51-89) crossed with gender and then further subdivided into several subsamples for purposes of reliability and validity assessment. In addition, a group of spouse "key informants" was also recruited. Preliminary validation of single-item indicators as well as confirmatory factor analyses of multi-item scales was achieved. The present findings support the psychometric and practical utility of the MHP-H and warrant its use by health psychologists in a variety of research and applied settings.

Assessing the misrepresentation of health problems.

Although respondent misrepresentation in many areas of psychological testing has been widely studied, little is available for evaluating misrepresentation during health-related psychological assessments. In this article, I report the empirical development and validation of such scales for 2 screening inventories: the Psychological Screening Inventory (the HPO scale; Lanyon, 1970, 1978) and the Multidimensional Health Profile (the HPE scale; Ruehlman, Lanyon, & Karoly, 1998a, 1998b, 1999). In each case, judges were asked to simulate the misrepresentation of health problems. Items were selected whose frequencies differed from normal responding; these items were screened for marked content irrelevance and further refined using data from additional respondents. Validation data showed that for both scales the group means for persons with genuine health problems were up to 1 SD above the normative mean, and the means for suspected and actual simulators were about 2 SDs higher than the health-problem groups.

Characteristics of compensable disability patients who choose to litigate.

This study tested the hypothesis that personal characteristics, when profiled by performance on MMPI-2 scales related to attention-seeking behavior through somatization, would differ between compensable personal injury claimants who choose to go to litigation and those who choose not to litigate. The authors examined the MMPI-2 profiles and other file data, including type and severity of injury, on 96 patients who litigated and 46 who chose not to litigate. The profiles of the two groups differed significantly overall. The difference was accounted for by the litigating patients' significantly higher scores on the hypochondriasis (Hs), depression (D), and hysteria (Hy) scales. The Hs and Hy differences held up separately in claimants with physical injuries and in claimants whose injuries were psychological only. The differences also persisted after severity of injury was held constant. The profiles of the two groups did not differ in either defensiveness or exaggeration (i.e., on the validity scales L, F, and K). At least some of the differences in reported impairments between patients in general and personal injury claimants appear to be related to whether the patients choose to litigate, and the choice to litigate could be a function of personality-related, rather than situational, factors. A more definitive test of this hypothesis would require the availability of preinjury personality data.