New Paper: MMPI-2-RF correlates in the VA

I’m excited to have another paper in press, this time at the Journal of Personality Assessment. This paper utilizes the same national sample I’ve previously published on to examine service era differences, provide comparison groups for specific treatment clinics, and examine trends in validity scale performance. In my new paper, we provide correlations between the MMPI-2-RF and a variety of commonly utilized self-report measures of symptom severity within the VA (e.g., those for anxiety, depression, and PTSD). This, in conjunction with these other VA papers, offers an interpretive framework for clinicians to use as they interpret assessment profiles for Veterans receiving care.

You can download the pre-print of the accepted paper HERE.

Here are a few of the key take aways that stand out to me:

  1. Of those given the PCL in the sample (a PTSD screener for DSM-5), the average score is a 50 (the cut score recommended for screening for PTSD is a 33).
  2. Across the board, DSM-4 screeners for PTSD have stronger/more reliable relationships to content associated with a PTSD diagnosis on the MMPI-2-RF than the DSM-5 PTSD screener. The reasoning for this is unclear.
  3. The BDI-2 (a measure of depression that makes up part of a major suicide screener) is not related meaningfully to any of the types of indicators you would expect (e.g., hopelessness, suicidality, depression, anhedonia) on the MMPI-2-RF. That’s really surprising and alarming given how it gets used in the VA.
  4. Adding to the last point, elevations are fairly high across a lot of measures (both screeners and those on the MMPI-2-RF). This is consistent with the high rate of disorders in the VA and suggest that those who get assessed are likely to experience a variety of mental health problems.

Here are those relationships for the internalizing and scales of the MMPI-2-RF

int

Nice Job Brittney!

This year the lab had two papers accepted with Brittney on them. The most recent was accepted into the Journal of Clinical and Experimental Neuropsychology and covered her AACN presentation from this summer on use of the MMPI-2-RF to detect invalid responding in a sample of active duty army. Download the paper HERE.

Recap of the presentation on her most recent publication:

AACN

And here is the article from earlier this year on the PAI response profiles using a sample collected on a VA outpatient PTSD Clinic

Ingram, Sharpnack, Mosier, & Golden (in press) Evaluating symptom endorsement typographies of trauma-exposed veterans on the Personality Assessment Inventory (PAI): A latent profile analysis

 

Note. This post has been updated to include a link to the paper on the MMPI-2-RF validity scales with the military sample (update 1/4/2020).

Another labtastic Halloween

Another great door decorating year for the lab. We had a lab meeting yesterday and all the undergrads brought their greatest ideas – we settled on the evil laboratory door and it turned out great. There were working on this til 6:30 last night and I love it.

Admittedly, the whole department has some awesome doors and I’m digging the bracket challenge we’re doing.

EIK5ZvtXsAIjgX1EIKmGJAWwAAMOnC

Now the next question, how long can you leave Halloween decorations up for?

Question after that, when is too early to start planning for next year?

 

Help seeking in men

The article Brian Cole and I wrote is online now at Psychology of Men and Masculinities. It’s a super cool article that starts to break down the influence of self-stigma and gender role norms to see how they predict different types of help seeking – friends, professionals, self-help, and (of course) avoidance.

Check it out! We’re already planning for our follow-up study!

Accepting students

I am excited to be continuing the growth of my lab and will be accepting a student to start next year in the Counseling psychology PhD program. We have a ton of projects going on and its a great time to jump in. If you are interested in help seeking behaviors, we have a ton of cool projects in the middle of data collection. Those interested in military populations, we’ve got those as well. If you are interested in assessment, we have even more!

If you are interested in the lab, I’d LOVE to hear from you! Send me an email with info about your experiences, interests, and questions you have about how you would fit. I’m happy to give you more details about my mentoring style, the lab, TTU, and the Counseling program.

 

As you consider becoming a Red Raider, here is some actual footage of our lab environment

source.gif

Undergrad lab member in the spotlight

I wanted to take a minute to brag about one of the lab members. Liz was an awesome addition to the lab this semester and I’m glad she joined us. Clearly she stands out to the TTU department as well!

New paper: Male help-seeking – depression and stigma

I’m thrilled to have the new paper with Dr. Brian Cole accepted to Psychology of Men and Masculinities. We took at a look at help seeking behaviors in men with depressive symptoms to get a better idea of what coping and help seeking looks like, and then at how stigma and gender identity conflict predicts those behaviors.

Model 1 - Cole Dissertation SEM

Above is a slightly simplified figure from the paper, but the take away is clear for me. Help seeking varies, and so do their relationships to classic barriers to mental healthcare like self-stigma. If we want to improve our understanding of therapy engagement, we can’t act like everyone copes the same or that everything will influence those different methods the same way.

My comments on the PTSD guidelines

Division 29 (Psychotherapy) did some great work putting together a special issue critiquing the APA guidelines on the treatment of PTSD. If you haven’t already, check it out here. I read through the articles yesterday and had a ton of reactions. There was some really great work in there. I tweeted a bunch of them out (link below) but I have one big takeaway:

If we continue to do research on therapy efficacy, we can’t ignore the largest basis of literature supporting the role of working alliance as a central mechanism of change.  RCTs that know of a causal mechanism that do not control for those effects are not performing good science. Working alliance CAN and MUST be measured for us to make any claims about ‘what treatment is best’.

Alex Williams (the author of a fantastic recent article on the state of RCT/evidence-based care) commented that the reason that they haven’t done so was because doing so ‘didn’t answer the question they wanted to ask’, but blindfolds and intentional avoidance don’t make for good science.

New Paper: MMPI-2-RF and Service Era differences

A new paper was just accepted in the Journal of Clinical Psychology in Medical Settings which examines how era of military service influences scores on the MMPI-2-RF for veterans. We used a national sample of assessments conducted in PTSD Clinical Team (PCT) settings around the country and, after controlling for gender because of different rates in service, contrasted the means and clinical elevation rates for with Vietnam and Gulf War service histories. In contrast to the MMPI-2 which demonstrated that these service experiences resulted in distinctive symptom presentations, the MMPI-2-RF provides a more generalizable and consistent interpretive basis with largely negligible differences.

Click here to access a pre-print version of the paper.

Upcoming APA Presentation by Brittney Golden

Following up on her presentation at AACN on sensitivity of the MMPI-2-RF over-reporting scales in a military concussion clinic (a project that just got a revise and resubmit as well!), Brittney is presenting on potential test bias and the resulting differential performance observed across the over-reporting scales based on previous meta-analytically identified moderators.

APAposter_MMPIbias_Final

This isn’t quite the final version just yet, but I couldn’t wait to share! Long story short- the same moderators we see impacting performance (score and rate of invalidity) in meta-analysis show up when we look for them in individual samples. White, college educated, men with no mental health diagnoses endorse less pathology and invalidate scores less frequently within samples drawn from the same referral source.

She is doing an awesome job on this project. Check it out.