Neurotic tendencies among chronic pain patients: an MMPI item analysis

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Abstract
Chronic pain patients have elevated scores on the hypochondriasis (Hs), depression (D) and hysteria (Hy) scales of the MMPI (Minnesota Multiphasic Personality Inventory]. 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 analysis of these scales and the K scale (a measure of defensiveness) were performed 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 2 control groups, one a general medical patient sample, the other consisting of 1st-yr college students. Items showing group endorsement differences of .gtoreq. 10% 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 Hy. While the D scale results revealed a considerable amount of depressive symptomatology (such as sleep disturbance, poor self-esteem, apathy, 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. Their responses did not conform to the classic hysterical pattern.

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