MMPI-2-RF Profiles of Treatment-Seeking Veterans in a VA Pain Clinic and Associations with Markers of Physical Performance

J Clin Psychol Med Settings. 2024 Mar;31(1):58-76. doi: 10.1007/s10880-023-09967-z. Epub 2023 Jul 7.

Abstract

Chronic pain is a debilitating condition for many military Veterans and is associated with posttraumatic stress disorder (PTSD). This study examined the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in 144 Veterans (88.2% male, mean age = 57.95 years) recruited from a VA outpatient pain clinic and associations with self-reported pain severity, pain-related interference in daily activities, prescription opioid use, and objective metrics of physical performance on tasks impacted by pain (walking, stair climbing, grip strength, indexed by a single latent variable). Among the cohort with valid responses on the MMPI-2-RF (n = 117) and probable PTSD, mean Somatic Complaints (RC1) and Ideas of Persecution (RC6) scores were clinically elevated. All MMPI-2-RF scales were more strongly correlated with self-reported pain interference than severity. Regressions revealed associations between self-rated pain interference (but not pain or PTSD severity) and physical performance scores (β = .36, p = .001). MMPI-2-RF overreporting Validity and Higher-Order scales contributed incremental variance in predicting physical performance, including Infrequent Psychopathology Responses (β = .33, p = .002). PTSD severity was associated with prescription opioid use when accounting for the effects of over-reported somatic and cognitive symptoms (odds ratio 1.05, p ≤ .025). Results highlight the role of symptom overreporting and perceptions of functional impairment to observable behaviors among individuals with chronic pain.

Keywords: Chronic pain; MMPI-2-RF; PTSD; Personality; Physical performance.

MeSH terms

  • Analgesics, Opioid / therapeutic use
  • Chronic Pain* / psychology
  • Female
  • Humans
  • MMPI
  • Male
  • Malingering / diagnosis
  • Malingering / psychology
  • Middle Aged
  • Pain Clinics
  • Reproducibility of Results
  • Veterans* / psychology

Substances

  • Analgesics, Opioid