Somatoform's placement and validity in the hierarchical taxonomy of psychopathology (HiTOP).

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.

Factor structure and validity of the Inventory of Depression and Anxiety Symptoms-II (IDAS-II) in a chronic back pain treatment-seeking sample.

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).

Validity of the Somatic Complaints Scales of the MMPI-2-RF in an Outpatient Chronic Pain Clinic.

Chronic pain has become a significant medical issue. The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) is a broadband psychological test that has been validated for use across various medical settings and can aid in the assessment and treatment planning of chronic pain. In the current investigation, it was hypothesized that the somatic complaints scales of the MMPI-2-RF would demonstrate good convergent validity from a structured psychodiagnostic interview and other measures of pain and somatization, and lack gender bias. Patients (n = 200) who produced valid MMPI-2-RFs in an outpatient chronic pain clinic were included in the study. Patients were also administered the Modified Somatic Perception Questionnaire (MSPQ), Pain Disability Index (PDI), and the Structured Clinical Interview for DSM-IV-TR (SCID). Zero-order and partial correlations (controlling for gender) were calculated between MMPI-2-RF scale scores and other criteria. Stepdown hierarchical regression analyses were used to detect bias. By and large, higher scale scores on the somatic/cognitive scales of the MMPI-2-RF were modestly or substantially correlated with MSPQ scores, PDI scores, and SCID Somatization symptom count, even after controlling for gender. Regression analyses suggested that the MMPI-2-RF scale scores were not biased as a function of gender. These findings support the validity of specific MMPI-2-RF scales to help identify somatization and psychosocial functioning among patients with chronic pain. Identification of somatization early within the course of treatment of chronic pain may help focus treatment targets, including referrals for psychological interventions such as cognitive behavior therapy for chronic pain.

Waddell non-organic signs: new evidence suggests somatic amplification among outpatient chronic pain patients.

BACKGROUND CONTEXT: Waddell et al. identified a set of eight non-organic signs in 1980. There has been controversy about their meaning, particularly with respect to their use as validity indicators. PURPOSE: The current study examined the Waddell signs in relation to measures of somatic amplification or over-reporting in a sample of outpatient chronic pain patients. We examined the degree to which these signs were associated with measures of over-reporting. STUDY DESIGN/SETTING: This study examined scores on the Waddell signs in relation to over-reporting indicators in an outpatient chronic pain sample. PATIENT SAMPLE: We examined 230 chronic pain patients treated at a multidisciplinary pain clinic. The majority of these patients presented with primary back or spinal injuries. OUTCOME MEASURES: The outcome measures used in the study were Waddell signs, Modified Somatic Perception Questionnaire, Pain Disability Index, and the Minnesota Multiphasic Personality Inventory-2 Restructured Form. METHODS: We examined Waddell signs using multivariate analysis of variance (MANOVA) and analysis of variance (ANOVA), receiver operating characteristic analysis, classification accuracy, and relative risk ratios. RESULTS: Multivariate analysis of variance and ANOVA showed a significant association between Waddell signs and somatic amplification. Classification analyses showed increased odds of somatic amplification at a Waddell score of 2 or 3. CONCLUSIONS: Our results found significant evidence of an association between Waddell signs and somatic over-reporting. Elevated scores on the Waddell signs (particularly scores higher than 2 and 3) were associated with increased odds of exhibiting somatic over-reporting.

Can brief measures effectively screen for pain and somatic malingering? Examination of the Modified Somatic Perception Questionnaire and Pain Disability Index.

BACKGROUND CONTEXT: Recent rise in fraudulent disability claims in the United States has resulted in psychologists being increasingly called upon to use psychological tests to determine whether disability claims based on psychological or somatic/pain complaints are legitimate. PURPOSE: To examine two brief measures, Modified Somatic Perception Questionnaire (MSPQ) and the Pain Disability Index (PDI), and their ability to screen for malingering in relation to the Bianchini et al. criteria for malingered pain-related disability published in The Spine Journal (2005). STUDY DESIGN: Examined brief self-report measures between litigating and nonlitigating pain samples. PATIENT SAMPLE: We compared 144 disability litigants, predominantly presenting a history of musculoskeletal injuries with psychiatric overlay, with 167 nonlitigating pain patients who were predominantly in treatment for chronic back pain issues and other musculoskeletal conditions. OUTCOME MEASURES: Modified Somatic Perception Questionnaire, Pain Disability Index, Minnesota Multiphasic Personality Inventory-2 Restructured Form, Test of Memory Malingering, Letter Memory Test, Victoria Symptom Validity Test, Structured Interview of Reported Symptoms-second edition, Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders somatoform disorders module. METHODS: We examined a sample of 144 individuals undergoing compensation-seeking evaluations in relation to 167 nonlitigating pain patients. RESULTS: Group differences on both the MSPQ and PDI were calculated, as well as sensitivities, specificities, and positive and negative predictive powers for both measures at selected cutoffs. CONCLUSIONS: The results suggest that both the MSPQ and PDI are useful to screen for pain malingering in forensic evaluations, especially the MSPQ, which performed the best in differentiating between the groups.

Ovarian cancer care: a case study in determined living.

BACKGROUND: The balance between quality of life and aggressive treatment fuels strong debate in cancer care. Recently, more attention is focused on blending advanced care, palliative care and hospice treatments in a patient-specific, tailored manner. This case study explores quality of life, the role of psychosocial factors in treatment selection, and the role of medical bias in end-of-life decision-making. CASE REPORT: The patient was a 55-year-old woman with advanced recurrent epithelial ovarian cancer. The disease course was essentially unremitting with only 5 months of non-progression after initial treatment. Multiple courses of chemotherapy were provided, in addition to a wide range of advanced and aggressive therapies to treat the cancer, as well as prolong life. Hospice care was an active part of treatment over 2 separate time periods, with a 1-year hiatus between admissions into hospice care. CONCLUSION: This case study provides an example of blending aggressive treatment, palliative care and hospice care to allow a patient to achieve specific life milestones, while attempting to preserve quality of life.