Neurotic tendencies among chronic pain patients: an MMPI item analysis

Previous research has shown chronic pain patients to have elevated scores on the Hypochondriasis (Hs), Depression (D), and Hysteria (Hy) scales of the MMPI. While high scores on these scales are generally considered to reflect neurotic symptomatology and emotional disturbance, their interpretation is more ambiguous within this patient population. Item-level and subscale analyses of these scales and the K scale (a measure of defensiveness) were performed in order to clarify the meaning of these elevated scores. In these analyses a pain group's endorsement of each item was compared with the responses of two control groups, one a general medical patient sample, the other consisting of first year college students. Items showing group endorsement differences of 10% or greater were interpreted as providing significant information about the pain sample. Analysis of the Hs items indicated that a significant portion of the pain group exhibited the vague and diffuse somatic complaining characteristic of hypochondriasis. While the D scale results revealed a considerable amount of depressive symptomatology (such as sleep disturbance, poor self-esteem, apathy, and feelings of unhappiness, anxiety, and dissatisfaction), they did not support the notion that pain patients have the personality characteristics associated with severe depression. Analyses of the Hy and K scales indicated that the pain patients were no more defensive than were either of the control groups, and that their responses did not conform to the classic hysterical pattern.