The identification of neurologically relevant items in the MMPI-2

The assessment of personality and (mal) adjustment after brain damage is regarded as an important aspect of rehabilitation. However, the administration of widely used self-report questionnaires, such as the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), is restricted because of the danger of overscoring psychopathology and personality disorders. This is due to the inclusion of items reflecting manifestations of neurological dysfunction. Earlier investigations revealed variable neurologically relevant items (NRIs), within and between discrete cerebral aetiologies for the MMPI as well as the first part of the MMPI-2. In this study, 10 neuropsychologists, 10 neurologists, 10 psychiatrists, and 10 physiatrists identified NRIs in the complete MMPI-2. An item was considered to be an NRI based on professional expertise as well as type of brain damage. Based on a substantial inter-rater agreement index, four sets of clinical relevant NRIs were selected: one for brain damage in general and three partially overlapping sets for stroke, traumatic brain damage, and whiplash. Thus, the findings of this study unveil items which may indicate bona fide symptoms or manifestations related to neurological damage or dysfunction, rather than just reflecting psychopathology or personality disorders. It is advocated to develop an interpretative approach to correct for the impact of these NRIs on MMPI-2 scores.