A Replicative Investigation of the Reliability of the MMPI in the Classification of Chronic Headaches

Authors

  • John Nathan Dieter B.S.,

    1. University of Central Florida, Research/Clinical Assistant, Headache Management Center, Winter Park, Florida
    Search for more papers by this author
  • Bernard Swerdlow M.D.

    1. Clinical Assistant Professor, University of Central Florida, Medical Director, Headache Treatment Center, Winter Park Memorial Hospital, Winter Park, Florida
    Search for more papers by this author

Abstract

SYNOPSISThis study attempts to replicate and synthesize previous headache/MMPI research by investigating scale differences amongst diagnoses and between a control group; re-examining the occurrence of the conversion “V” pattern; evaluating the Kudrow-Sutkus (1979) classification system; measuring score changes which occur with prognosis; and observing the effect that “headache items” have on scale score elevations. Several mean scale scores differed from previous studies. A number of these differences were clinically significant. Analysis of variance (ANOVA) (sex [370 males and females] and headache diagnosis) for each scale determined that males had higher L scores; the control group had higher K scores than post trauma, mixed, or vascular patients; each headache diagnosis had higher 1, 2, 3, and 7 scores than the control group (scales 1, 2, and 3 were clinically elevated in only the post trauma and mixed conditions); scale 9 scores varied between conditions; and scale 10 scores were higher for migraine, mixed, cluster, and post trauma patients. Chi-square analysis determined that the conversion “;V” pattern occurred in a significantly greater degree in headache patients. However, the percentage of occurrence ranged from only 12.50 to 31.03 percent. The Kudrow-Sutkus system correctly diagnosed only 40.08 percent of 90 randomly selected subjects. One-way ANOVA determined that no significant change occurred in group scale scores in 20 headache sufferers who received treatment ranging from a multi-disciplinary hospital program to none at all and whose prognosis ranged from excellent to poor. One-way ANOVA determined that the removal of items which inquire about “headache symptoms” produced significant reductions on scales 1 and 3.The inability of this study to replicate previous empirical investigations raises questions of the MMPI's reliability as a diagnostic classifier in chronic headache. Certain elevations on the MMPI may be the result of symptom measurement and not psychopathology.

Ancillary