Comparative Study on Personality Assessment Inventory and MMPI-2 Profiles of Groups with High and Low Depression and Suicide Ideation in Psychiatry Patients and Discriminant Variables of Depression and Suicide Ideation

Eun Hye Heo; Seong Hun Jeong; Hee Yang Kang

doi:10.4306/jknpa.2018.57.1.86

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Heo, Jeong, and Kang: Comparative Study on Personality Assessment Inventory and MMPI-2 Profiles of Groups with High and Low Depression and Suicide Ideation in Psychiatry Patients and Discriminant Variables of Depression and Suicide Ideation

Original Article

J Korean Neuropsychiatr Assoc 2018;57(1):86-95.

Published online: 17 January 2018

DOI: https://doi.org/10.4306/jknpa.2018.57.1.86

Comparative Study on Personality Assessment Inventory and MMPI-2 Profiles of Groups with High and Low Depression and Suicide Ideation in Psychiatry Patients and Discriminant Variables of Depression and Suicide Ideation

Eun Hye Heo, BA, Seong Hun Jeong, MD, PhD, Hee Yang Kang, PhD

Department of Neuropsychiatry, Eulji University Hospital, Daejeon, Korea

Hee Yang Kang, PhD Department of Neuropsychiatry, Eulji University Hospital, 95 Dunsanseo-ro, Seo-gu, Daejeon 35233, Korea Tel +82-42-611-3443 Fax +82-42-611-3445 E-mail hy6611@eulji.ac.kr

Revised 5 June 201730 November 2017 Accepted 2 December 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

The purpose of this study was to compare psychological test profiles of psychiatric outpatients with high and low depression/suicide ideation and to identify predictor variables for depression/suicide ideation.

Methods

Component scores of the Personality Assessment Inventory (PAI) and Minnesota Multiphasic Personality Inventory-2 (MMPI-2) were compared using t-tests. Discriminant analysis was conducted for predictor variables of depression/suicide ideation.

Results

Regarding PAI profiles, somatic complaints (SOM), anxiety (ANX), anxiety-related disorder (ARD), depression (DEP), paranoia (PAR), borderline features (BOR), antisocial features (ANT), mania (MAN) drug problems (DRG) scores were significantly elevated in high depression and high suicide ideation groups. Concerning MMPI-2 profiles, the scores of hypochondriasis (Hs), depression (D), hysteria (Hy), psychopathic deviate (Pd), paranoia (Pa), psychasthenia (Pt), schizophrenia (Sc), social introversion (Si) were significantly elevated in these same groups. The PAI and MMPI-2 profile shapes were remarkably similar between high depression and high suicide ideation groups. Therefore, in terms of psychological profile, depression and suicidal ideation seemed to reflect the same construct. However, in discriminant analysis, significant predictors for depression were found to be Pt and D Sc from MMPI-2, while those for suicide ideation were found to be Pa and Sc, suggest subtle differences.

Conclusion

The superficial characteristics of depression and suicide ideation groups reflected by the psychological test profiles seemed similar, but the determining factors may differ. Thus, the psychological interventions for these two groups may have to follow different routes considering these subtle differences.

Keywords: Outpatients, Depression, Suicide, Personality Assessment Inventory, Minnesota Multiphasic Personality Inventory-2, Discriminant analysis

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Fig. 1.

Profile of Personality Assessment Inventory among high and low depression, suicide ideation groups. Validity scales; ICN : Inconsistency, INF : Infrequency, NIM : Negative impression, PIM : Positive impression, Clinical scales; SOM : Somatic complaints, ANX : Anxiety, ARD : Anxiety-related disorder, DEP : Depression, MAN : Mania, PAR : Paranoia, SCZ : Schizophrenia, BOR : Borderline features, ANT : Antisocial features, ALC : Alcohol problems, DRG : Drug problems, Therapeutic consideration scales; AGG : Aggression, SUI : Suicide ideation, STR : Stress, NON : Nonsupport, RXR : Treatment rejection, Interpersonal scales; DOM : Dominance, WRM : Warmth.

Fig. 2.

Profile of Minnesota Multiphasic Personality Inventory-2 among high and low depression, suicide ideation groups. Validity scales; VRIN : Variable response inconsistency, TRIN : True response inconsistency, F : Infrequency, F(B) : Back infrequency, F(P) : Infrequency psychopathology, L : Lie, K : Correction, S : Superlative self-presentation, Clinical scales; Hs : Hypochondriasis, D : Depression, Hy : Hysteria, Pd : Psychopathic deviate, Mf : Masculinity-femininity, Pa : Paranoia, Pt : Psychasthenia, Sc : Schizophrenia, Ma : Hypomania, Si : Social introversion.

Table 1.

Demographic characteristics and clinical diagnosis of patients

Variables	Total (%)
Gender
Male	147 (64.5)
Female	81 (35.5)
Age
18-19	49 (21.5)
20-29	81 (35.5)
30-39	35 (15.4)
40-49	30 (13.2)
50-59	22 (9.6)
60-69	8 (3.5)
Higher than 70	3 (1.3)
Education (years)
0-6	10 (4.4)
7-9	21 (9.2)
10-12	103 (45.2)
13-16	81 (35.5)
Higher than 17	13 (5.7)
Diagnosis
Alcohol-related disorder	12 (5.3)
Anxiety disorder	35 (15.3)
Bipolar disorder	10 (4.4)
Depressive disorder	45 (19.7)
Adjustment disorder	50 (21.9)
Schizophrenia spectrum disorder	33 (14.5)
Post-concussional disorder	13 (5.7)
Personality disorder	13 (5.7)
Somatic symptom disorder	5 (2.2)
Neurocognitive disorder	12 (5.3)
PAI (SUI scale)
Lower than 70T	154 (67.5)
Higher than 70T	74 (32.5)
PAI (DEP scale)
Lower than 70T	105 (46.1)
Higher than 70T	123 (53.9)

PAI : Personality Assessment Inventory, SUI : Suicide ideation, DEP : Depression

Table 2.

T-test result of PAI between low and high depression groups

Scales	High depression group (n=123)	Low depression group (n=105	5) t p
Scales	M±SD	M±SD	t (p)
Validity scales
ICN	52.36±11.63	51.30±12.06	-0.67
INF	51.43±11.23	52.98±11.04	0.37
NIM	75.75±15.97	54.82±11.07	-11.643∗∗∗
PIM	34.11±15.46	46.59±13.45	6.52∗∗∗
Clinical scales
SOM	75.42±16.77	56.80±11.74	-9.55∗∗∗
ANX	71.00±12.15	54.09±11.44	-10.77∗∗∗
ARD	69.94±11.97	54.22±11.24	-10.17∗∗∗
DEP	83.05±9.41	56.25±9.27	-21.58∗∗∗
MAN	55.49±13.46	49.66±13.15	-3.29∗∗
PAR	71.21±17.66	54.61±13.01	-8.15∗∗∗
SCZ	70.18±16.11	51.50±10.55	-10.49∗∗∗
BOR	66.72±13.80	51.20±10.99	-9.45∗∗∗
ANT	59.60±15.78	49.76±11.57	-5.42∗∗∗
ALC	55.24±17.64	52.34±17.64	-1.37
DRG	64.48±18.97	57.40±15.44	-3.11∗
Therapeutic consideration scales
AGG	58.67±14.90	51.50±11.44	-4.11∗∗∗
SUI	74.67±15.58	51.16±11.31	-13.16∗∗∗
STR	68.84±10.82	54.57±11.11	-9.80∗∗∗
NON	68.41±14.39	56.17±12.35	-6.83∗∗∗
RXR	34.12±12.65	45.94±11.31	7.38∗∗∗
Interpersonal scales
DOM	41.56±11.45	48.30±11.07	4.49∗∗∗
WRM	39.35±14.60	47.15±11.56	4.42∗∗∗

^∗ : p＜0.05,

^∗∗ : p＜0.01,

^∗∗∗ : p＜0.001. PAI : Personality Assessment Inventory, M : Mean, SD : Standard deviation, Validity scales; ICN : Inconsistency, INF : Infrequency, NIM : Negative impression, PIM : Positive impression, Clinical scales; SOM : Somatic complaints, ANX : Anxiety, ARD : Anxiety-related disorder, DEP : Depression, MAN : Mania, PAR : Paranoia, SCZ : Schizophrenia, BOR : Borderline features, ANT : Antisocial features, ALC : Alcohol problems, DRG : Drug problems, Therapeutic consideration scales; AGG : Aggression, SUI : Suicide ideation, STR : Stress, NON : Nonsupport, RXR : Treatment rejection, Interpersonal scales; DOM : Dominance, WRM : Warmth

Table 3.

T-test result of PAI between low and high suicide ideation groups

Scales	High suicide ideation group (n=97)	Low suicide ideation group (n=131)	t (p)
Scales	M±SD	M±SD	t (p)
Validity scales
ICN	53.84±12.39	50.93±11.45	-1.70
INF	52.50±10.54	51.29±11.40	-0.77
NIM	81.24±15.23	58.84±13.17	-10.86∗∗∗
PIM	30.59±16.07	44.31±13.66	6.70∗∗∗
Clinical scales
SOM	77.93±17.55	61.52±14.54	-7.98∗∗∗
ANX	73.54±12.10	58.25±12.89	-8.55∗∗∗
ARD	72.54±11.74	57.94±12.51	-8.40∗∗∗
DEP	84.70±11.63	63.98±13.79	-11.16∗∗∗
MAN	60.41±13.87	49.15±11.89	-6.33∗∗∗
PAR	75.26±17.97	57.95±14.62	-7.22∗∗∗
SCZ	73.66±15.28	55.77±14.00	-8.77∗∗∗
BOR	70.95±13.07	54.10±12.20	-9.54∗∗∗
ANT	64.04±16.47	50.76±11.75	-6.22∗∗∗
ALC	58.89±18.95	51.51±13.76	-2.99∗∗
DRG	68.05±18.60	57.94±16.41	-4.17∗∗∗
Therapeutic consideration scales
AGG	62.76±14.92	51.82±11.82	-5.52∗∗∗
SUI	85.15±10.38	53.61±10.43	-21.41∗∗∗
STR	70.42±10.93	58.35±12.17	-7.24∗∗∗
NON	69.57±15.96	59.51±13.03	-4.72∗∗∗
RXR	33.88±11.88	42.30±13.26	4.64∗∗∗
Interpersonal scales
DOM	43.85±11.88	45.05±11.70	0.72
WRM	39.76±17.04	44.47±11.73	2.15∗∗

^∗ : p＜0.05,

^∗∗ : p＜0.01,

Table 4.

T-test result of MMPI-2 between low and high depression groups

Scales	High depression group (n=123)	Low depression group (n=105)	t (p)
Scales	M±SD	M±SD	t (p)
Validity scales
VRIN	44.19±9.48	48.85±9.49	3.70∗∗∗
TRIN	56.00±5.24	57.57±6.12	2.09∗
F	64.10±13.41	49.76±8.55	-9.76∗∗∗
F(B)	66.02±11.59	50.99±9.64	-10.47∗∗∗
F(P)	53.66±11.48	46.72±7.91	-5.36∗∗∗
L	44.08±7.90	48.27±10.55	3.34∗∗
K	41.77±7.14	48.69±9.21	6.25∗∗∗
S	40.69±9.08	48.18±10.58	5.68∗∗∗
Clinical scales
Hs	61.74±11.25	51.38±8.89	-7.76∗∗∗
D	71.22±11.93	55.65±11.49	-9.99∗∗∗
Hy	62.83±10.16	52.33±10.13	-7.79∗∗∗
Pd	63.76±11.60	52.69±9.13	-8.07∗∗∗
Mf	52.47±9.76	49.74±9.67	-2.11∗
Pa	68.64±15.91	53.18±9.88	-8.94∗∗∗
Pt	71.78±12.86	53.97±11.17	-11.07∗∗∗
Sc	69.41±13.05	52.30±9.88	-11.26∗∗∗
Ma	51.54±9.96	49.22±11.48	-1.64
Si	67.96±12.74	54.38±10.95	-8.55∗∗∗

^∗ : p＜0.05,

^∗∗ : p＜0.01,

^∗∗∗ : p＜0.001. MMPI-2 : Minnesota Multiphasic Personality Inventory-2, M : Mean, SD : Standard deviation, Validity scales; VRIN : Variable response inconsistency, TRIN : True response inconsistency, F : Infrequency, F(B) : Back infrequency, F(P) : Infrequency psychopathology, L : Lie, K : Correction, S : Superlative self-presentation, Clinical scales; Hs : Hypochondriasis, D : Depression, Hy : Hysteria, Pd : Psychopathic deviate, Mf : Masculinity-femininity, Pa : Paranoia, Pt : Psychasthenia, Sc : Schizophrenia, Ma : Hypomania, Si : Social introversion

Table 5.

T-test result of MMPI-2 between low and high suicide ideation groups

Scales	High suicide ideation group (n=97)	Low suicide ideation group (n=131)	t (p)
Scales	M±SD	M±SD	t (p)
Validity scales
VRIN	43.85±9.94	47.53±9.45	2.66∗∗
TRIN	55.97±5.16	57.08±5.93	1.38
F	67.78±13.69	52.55±10.20	-8.51∗∗∗
F(B)	69.88±11.28	53.96±10.50	-10.44∗∗∗
F(P)	55.69±11.13	47.97±9.33	-5.15∗∗∗
L	43.19±8.35	47.36±9.64	3.36∗∗
K	39.73±6.71	47.47±8.66	7.40∗∗∗
S	38.66±8.60	46.61±10.36	5.89∗∗∗
Clinical scales
Hs	62.61±12.39	52.26±9.92	-5.07∗∗∗
D	69.01±13.83	61.66±13.57	-3.81∗∗∗
Hy	61.91±10.71	56.12±11.27	-3.69∗∗∗
Pd	64.01±11.48	56.09±11.22	-4.95∗∗∗
Mf	52.78±10.81	50.46±9.20	-1.68
Pa	72.36±16.78	56.31±11.76	-7.40∗∗∗
Pt	72.24±14.12	59.42±13.61	-6.58∗∗∗
Sc	71.01±13.88	56.97±12.42	-7.69∗∗∗
Ma	54.43±10.91	48.53±10.11	-4.09∗∗∗
Si	67.35±13.27	58.99±13.13	-4.48∗∗∗

^∗ : p＜0.05,

^∗∗ : p＜0.01,

Table 6.

Discriminant analysis of MMPI-2 among high and low depression groups

Stage	Independent variable	Wilk's λ (p)	η²	F (p)
1	Pt	0.649 (＜0.001)	0.351	122.43 (＜0.001)
2	D	0.609 (＜0.001)	0.391	72.35 (＜0.001)
3	Sc	0.556 (＜0.001)	0.444	59.71 (＜0.001)

MMPI-2 : Minnesota Multiphasic Personality Inventory-2, Pt : Psychasthenia, D : Depression, Sc : Schizophrenia

Table 7.

Classification result of high and low depression groups using Pt, D, Sc as predictable variables

Actual groups	n	Predicted groups
Actual groups	n	Low depression group (%)	High depression group (%)
Low depression group	105	85 (81.0)	20 (19.0)
High depression group	123	26 (21.1)	97 (78.9)

Percentage of discriminating groups exactly=79.2%. Pt : Psychasthenia, D : Depression, Sc : Schizophrenia

Table 8.

Discriminant analysis of MMPI-2 among high and low suicide ideation groups

Stage	Independent variable	Wilk's λ (p)	η²	F (p)
1	Pa	0.764 (＜0.001)	0.236	69.79 (＜0.001)
2	Sc	0.746 (＜0.001)	0.254	38.39 (＜0.001)

MMPI-2 : Minnesota Multiphasic Personality Inventory-2, Pa : Paranoia, Sc : Schizophrenia

Table 9.

Classification result of high and low depression groups using Pa, Sc as predictable variables

Actual groups	n	Predicted groups
Actual groups	n	Low suicide ideation group (%)	High suicide ideation group (%)
High suicide ideation group	154	123 (79.9)	31 (20.1)
Low suicide ideation group	74	23 (31.1)	51 (68.9)

Percentage of discriminating groups exactly=76.3%. Pa : Paranoia, Sc : Schizophrenia

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