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Risk of misinterpretation of MMPI Schizophrenia scale elevations in chronic pain patients
James E Moore1, Miles E McFall, Daniel R Kivlahan
1Virginia Mason Medical Center, 1100 Ninth Avenue, Seattle, WA 98101 U.S.A. VA Medical Center, 1660 South Columbian Way, Seattle, WA 98108 U.S.A. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195 U.S.A.
Abstract:
Seventy-three chronic pain patients with elevated MMPI Schizophrenia (Sc) scale scores (T score greater than 70) were compared with 55 psychotic and 87 non-psychotic psychiatric patients with elevated Sc scores to examine group differences in item content patterns on the Harris and Lingoes subscales. Chronic pain patients evidenced lower scores on all Harris and Lingoes Sc subscales, except for the Bizarre Sensory Experiences subscale on which they scored significantly higher than the psychiatric groups. Results demonstrate that Sc is elevated in many chronic pain patients because they endorse somatic symptoms and items suggestive of depression and inertia, whereas psychotics endorse more items reflecting bizarre and disordered thinking, social alienation and defective inhibition, and non-psychiatric patients endorse more depression, despair, thought disorganization and social alienation. These data suggest that high Sc scores of many chronic pain patients reflect symptoms and sequelae of their physical problems, and do not necessarily reflect severe psychopathology.