MMPI-2 interpretation of patients with cerebrovascular disease: a correction factor

The validity of the conventional Minnesota Multiphasic Personality Inventory (MMPI) interpretation as applied to neurologic patients has been increasingly questioned on the grounds of the test's psychiatric normative base and inclusion of items that may be sensitive to bona fide neurologic symptoms. This study used 110 patients with cerebrovascular disease (CVD) to (i) determine whether the 370-item pool of the MMPI-2 (abbreviated form) contains a unitary neurologic symptom factor, and (ii) devise a systematic approach to correct for patient endorsement of such items. Commonly endorsed items that differentiated the CVD sample from a group of normal adults were factor analyzed. Bona fide neurologic complaints (21 items) emerged as the major discriminative source of variance in the 370 MMPI-2 item pool that tends to inflate estimates of psychopathology (Scales 1, 2, 3, and 8), alter profile codes types, and potentially affect decision-making related to the diagnosis and treatment of CVD patients. Recommendations regarding a greater reliance upon content scales and the use of a corrective scoring key are discussed.