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Reducing Minnesota Multiphasic Personality Inventory defensiveness: effect of specialized instructions on retest validity in a sample of preoperative bariatric patients

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Abstract

Background

Because of the possibility of being denied or delayed surgery, bariatric patients might have a motivation to minimize any emotional difficulties in the preoperative psychological evaluation. This study examined changes in the psychometric test scores when extremely defensive patients were asked to repeat the testing.

Methods

Changes in the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scale scores were studied in a subsample of patients referred to the author for a preoperative psychological evaluation. After producing defensive MMPI-2 test profiles, these bariatric patients (n = 31) were provided feedback on their defensiveness and asked to be more open and honest on the repeat testing.

Results

The vast majority (94%) of the patients produced valid profiles on the second test. On the second test, significant differences were found on 6 of the 13 MMPI-2 scales, as well as on separate measures of depression, anxiety, and anger.

Conclusion

It appears to be important to include a psychometric measure that includes a validity scale in the evaluation process, because patients might be motivated to present in a defensive or overly virtuous light in fear that a negative evaluation from the psychologist would adversely affect a decision regarding their candidacy for surgery. It is recommended that patients who are defensive in their testing be asked to repeat the test battery.

Section snippets

Patients

This was an archival study of the author’s patient records. The patients in this study were referred for a preoperative psychological evaluation to the independent practice of the author by their surgeon. The patients were referred from multiple surgery clinics. Some surgeons required a psychological evaluation, and others only required such an evaluation if it was requested by the patient’s health insurance company. In all cases, the patients were provided with a choice of psychologists with

Results

Using paired t tests, the data included for analysis were the validity and K-corrected clinical scales of the MMPI-2 and the scores on the BDI-II, the trait portion of the STAI, and the TANG portion of the STAXI. In all but 2 instances (6%) when retested, each patient produced a valid profile on the second testing. This was defined as having an L-scale score of <65 and a K-scale score of <70.

The scaled scores from the first testing were compared with the scores from the second testing. The mean

Discussion

The results of the present investigation suggest that bariatric patients who are initially defensive on a standard psychological test can be less defensive in their second attempt when given feedback and an alternative instructional set. This replicates previous research with airline job applicants [7]. However, in contrast to the findings of the previous research, in which 79% produced valid profiles in the second testing, this proportion increased to 94% in this sample of bariatric patients.

Disclosures

The author has no commercial associations that might be a conflict of interest in relation to this article.

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