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Using the Millon Behavioral Medicine Diagnostic to Delineate Treatment Outcomes in Rehabilitation

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Abstract

Patients undergoing rehabilitation have been evidenced to improve in different ways depending on their coping styles. Amplifiers, Repressors, and Social Copers are examples of patients who present differently in rehabilitation settings and tend to have differing levels of success in their response to treatment. The current study examined the differential treatment outcomes of three coping style groups undergoing multidisciplinary rehabilitation. A sample of 59 patients suffering from injuries associated with chronic pain were assessed using the Multidimensional Pain Inventory, Beck Depression Inventory, and Beck Anxiety Inventory before, during, and after multidisciplinary pain management treatment. Coping style groups derived from the Millon Behavioral Medicine Diagnostic consisting of Amplifiers, Repressors, and Social Copers were compared with regard to reductions in depression, anxiety, pain, functional impairment, and associated outcomes. Repeated measures ANOVA revealed that Amplifiers, Repressors, and Social Copers had varying levels of success in the treatment program. Hierarchical linear modeling analyses revealed the coping style groups to have significantly different change curves from pre to post-treatment in depression, anxiety, pain severity, functional impairment, affective distress, life control, social support, and soliciting help from others. These findings support prior research emphasizing the value of tailoring treatments in rehabilitation settings toward patients’ coping styles in order to maximize outcomes.

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References

  • Beck, A. T, Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893–897.

    Article  PubMed  Google Scholar 

  • Beck, A. T., Steer R. A., & Garbin M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77–100.

    Article  Google Scholar 

  • Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 53–63.

    Google Scholar 

  • Bryk, A. S., & Raudenbush, S. W. (1987). Application of hierarchical models to assessing change. Psychological Bulletin, 101, 147–158.

    Article  Google Scholar 

  • Bryk, A. S., & Raudenbush, S. W. (1992). Hierarchical linear models. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Butcher, J. N., Dahlstrom, W. G., Graham, J. R., Tellegen, A. M., & Kaemer, B. (1989). MMPI-2: Manual for administration and scoring. Minneapolis, MN: University of Minnesota Press.

    Google Scholar 

  • Butcher, J. N, Graham, J. R., Williams, C. L., & Ben-Porath, Y. S. (1990). Development and use of the MMPI-2 content scales. Minneapolis: University of Minnesota Press.

    Google Scholar 

  • Cipher, D. J., Clifford, P. A., & Schumacker, R. E. (2002). The heterogeneous chronic pain personality: Diverse coping styles among sufferers of chronic pain. Alternative Therapies in Health and Medicine, 8, 93–102.

    Article  Google Scholar 

  • Cipher, D. J., & Clifford, P. A. (2003). Treatment outcome varies with coping style in chronic pain management. The Pain Clinic, 15, 35–44.

    Article  Google Scholar 

  • Cipher, D. J, Fernandez, E., & Clifford, P. A. (2001). Cost effectiveness of multidisciplinary pain management: Comparison of three treatment groups. Journal of Clinical Psychology in Medical Settings, 8, 237–244.

    Article  Google Scholar 

  • Cipher, D. J, Fernandez, E., & Clifford, P. A. (2002). Coping style influences compliance with multidisciplinary pain management. Journal of Health Psychology , 7, 665–673.

    Article  Google Scholar 

  • Cutler, R. B., Fishbain, D. A., Rosomoff, H. L., Abdel-Moty, E., Khalil, T. M., & Rosomoff, R. S. (1994). Does nonsurgical pain center treatment of chronic pain return patients to work? Spine, 19, 643–652.

    Article  PubMed  Google Scholar 

  • Esterling, B. A., Antoni, M. H., Kumar, M., & Schneiderman, N. (1990). Emotional repression, stress disclosure responses, and Epstein-Barr viral capsid antigen titers. Psychosomatic Medicine, 52, 397–410.

    PubMed  Google Scholar 

  • Flor, H., Fydrich, T., & Turk, D. C. (1992). Efficacy of multidisciplinary pain treatment centers: A meta-analytic review. Pain, 49, 221–230.

    Article  PubMed  Google Scholar 

  • Fydrich, T., Dowdall, D., & Chambless, D. L. (1992). Reliability and validity of the Beck Anxiety Inventory. Journal of Anxiety Disorders, 6, 55–61.

    Article  Google Scholar 

  • Furnham, A., Petrides, K. V., Sisterson, G., & Baluch, B. (2003). Repressive coping style and positive self-presentation. British Journal of Health Psychology, 8, 223–49.

    Article  PubMed  Google Scholar 

  • Goldstein, D. A., & Antoni, M. H. (1989). The distribution of repressive coping styles among non-metastatic and metastatic breast cancer patients as compared to non-cancer controls. Psychology and Health, 3, 245–258.

    Google Scholar 

  • Jamison, R. N., Rudy, T. E., Penzien, D. B., & Mosley, T. H. (1994). Cognitive-behavioral classifications of chronic pain: Replication and extension of empirically derived patient profiles. Pain, 57, 277–292.

    Article  PubMed  Google Scholar 

  • Jamner, L. D., & Schwartz, G. E. (1986). Self-deception predicts self-report and endurance of pain. Psychosomatic Medicine, 48, 211–223.

    PubMed  Google Scholar 

  • Jamner, L. D., Schwartz, G. E., & Leigh, H. (1988). The relationship between repressive and defensive coping styles and monocyte, eosinophile, and serum glucose levels: Support for the opiod peptide hypothesis of repression. Psychosomatic Medicine, 50, 567–575.

    PubMed  Google Scholar 

  • Kerns, R. D., Turk, D. C., & Rudy, T. E. (1985). The West Haven-Yale Multidimensional Pain Inventory (WHYMPI). Pain, 23, 345–356.

    Article  PubMed  Google Scholar 

  • Kleinke, C. L. (1992). How chronic pain patients cope with pain: Relation to treatment outcome in a multidiscipinary pain clinic. Cognitive Therapy and Research, 16, 669–685.

    Article  Google Scholar 

  • Long, J. D. (2000). Multilevel modeling for repeated measures. Advanced Methodology and Statistics Seminar, AABT Annual Convention.

  • Lorr, M. (1983). Cluster analysis for social scientists. San Francisco: Jossey-Bass.

    Google Scholar 

  • Millon, T, Antoni, M. H, Millon, C., Meagher, S., & Grossman, S. (2001). Test Manual for the millon behavioral medicine diagnostic. Minneapolis, MN: National Computer Services.

    Google Scholar 

  • Millon, T., Green, C. J., Meagher, R. B. (1979). The MBHI: A new inventory for the psychodiagnostician in medical settings. Professional Psychology, 10, 529–539.

    Article  Google Scholar 

  • Raudenbush, S., Bryk, T., & Congdon, R. (2000). HLM 5 Hierarchical Linear and Nonlinear Modeling. Scientific Software International.

  • Schwartz, G. E. (1989). Disregulation theory and disease: Toward a general model for psychosomatic medicine. In S. Cheren (Ed.), Psychosomatic medicine: Theory, physiology, and practice (Vols. 1 & 2, pp. 91–117). International Universities Press Stress and Health series, Monographs 1 & 2.

  • Stevens, J. (1996). Applied multivariate statistics for the social sciences. Mahway, New Jersey: Lawrence Erlbaum.

    Google Scholar 

  • Tabachnick, B. G., & Fidell, L. S. (1996). Using multivariate statistics, (3rd ed.). NewYork: Harper Collins.

    Google Scholar 

  • Turk, D. C. (1996). Efficacy of multidisciplinary pain centers in the treatment of chronic pain. In J. N. Campbell, & M. J. Cohen (Eds.), Pain treatment centers at the crossroads: A practical conceptual reappraisal. Seattle: IASP Press.

  • Turk, D. C., & Rudy, T. E. (1988). Toward an empirically derived taxonomy of chronic pain patients: Integration of psychological assessment data. Journal of Consulting and Clinical Psychology, 56, 233–238.

    Article  PubMed  Google Scholar 

  • Ward, J. (1963). Hierarchical grouping to optimize an objective function. American Statistical Association, 58, 236–244.

    Article  Google Scholar 

  • Watten, R. G, Vassend, O., Myhrer, T., & Syversen, J. L. (1997). Personality factors and somatic symptoms. European Journal of Personality, 11, 57–68.

    Article  Google Scholar 

  • Wickramasekera, I. (1993). Assessment and treatment of somatization disorders: The high risk model of threat perception. Handbook of clinical hypnosis (pp. 587–621). Washington, D.C.: American Psychological Association.

  • Wilcoxson, M. A., Zook, A., Zarski, J. J. (1988). Predicting behavioral outcomes with two psychological assessment methods in an outpatient pain management program. Psychology and Health, 2, 319–333.

    Google Scholar 

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Authors and Affiliations

  1. Department of Psychiatry, UNT Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA

    Daisha J. Cipher, Anita K. Kurian & Kimberly G. Fulda

  2. HighPoint Rehabilitation Institute, Arlington, USA

    Richard Snider & Johann Van Beest

Authors
  1. Daisha J. Cipher
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  2. Anita K. Kurian
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  3. Kimberly G. Fulda
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  4. Richard Snider
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  5. Johann Van Beest
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Correspondence to Daisha J. Cipher.

Additional information

A program (provided in either SAS or SPSS syntax) that will compute MBMD coping style group membership will be provided upon request. Request by e-mail to: dcipher@hsc.unt.edu or by fax to: +1-817-7352270.

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Cipher, D.J., Kurian, A.K., Fulda, K.G. et al. Using the Millon Behavioral Medicine Diagnostic to Delineate Treatment Outcomes in Rehabilitation. J Clin Psychol Med Settings 14, 102–112 (2007). https://doi.org/10.1007/s10880-007-9066-7

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  • DOI: https://doi.org/10.1007/s10880-007-9066-7

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