Transcript Does Clinical Training Facilitate Feigning Schizophrenia

Does Clinical Training Facilitate
Feigning Schizophrenia on the
MMPI-2?
Bagby, R.M., Rogers, R., Nicholson, R., Buis,T, Seeman, M.V., Rector N.
(1997). Does clinical training facilitate schizophrenia on the
MMPI-2. Psychological Assessment, 9(2), 106-112.
Presented by
Valerie Gutierrez, Vynette Moore &
April Osback
Research Question
• Study assessed the effect of knowledge of
psychopathology and psychological testing
on the ability to feign schizophrenia on the
Minnesota Multiphasic Personality
Inventory-2
Bagby, R.M., Rogers, R., Nicholson,
R., Buis, T., Seeman, M.V., Rector,
N. (1997). Does clinical training
facilitate schizophrenia on the
MMPI-2. Psychological Assessment,
9(2), 106-112.
Previous Research
• Differences among the groups of malingering participants were not
significant and were similar to those found for persons asked to
malinger in previous studies (Graham, Watts & Timbrook, 1991;
Wetter, Baer, Berry, Robison & Sumpter, 1993)
• Asked patients with specific mental disorders to feign a more severe
episode (Rogers, Sewell, & Ustad, 1995)
– Advantage: makes use of persons with direct experience with a particular
disorder
• Asked persons without diagnosed mental disorders, but who have
different levels of knowledge about psychopathology, to feign specific
mental disorders (Rogers, Ornduff, & Sewell, 1993)
Bagby, R.M., Rogers, R., Nicholson,
R., Buis, T., Seeman, M.V., Rector,
N. (1997). Does clinical training
facilitate schizophrenia on the
MMPI-2. Psychological Assessment,
9(2), 106-112.
Hypothesis
• Two clinically trained groups would be
more successful at feigning schizophrenia
that the undergrad students
• Of the two clinically trained groups, the
clinical psychology grad students would be
more successful at feigning schizophrenia
than psychiatric residents and fellows
Bagby, R.M., Rogers, R., Nicholson,
R., Buis, T., Seeman, M.V., Rector,
N. (1997). Does clinical training
facilitate schizophrenia on the
MMPI-2. Psychological Assessment,
9(2), 106-112.
Sample Critique & Technique
• 4 Samples:
–
–
–
–
Clinical Psychology Grad Students
Psychiatric Residents and Fellows
Undergraduate Psychology Students
Patients with Schizophrenia
• Convenience Sampling
Bagby, R.M., Rogers, R., Nicholson,
R., Buis, T., Seeman, M.V., Rector,
N. (1997). Does clinical training
facilitate schizophrenia on the
MMPI-2. Psychological Assessment,
9(2), 106-112.
Variables
• 1 DV
– MMPI-2 scores
• 3 IV’s
– Clinically Trained
• Clinical Psychology Grad Students
• Psychiatric Residents and Fellows
– No Clinical Training
• Undergrad Psychology Students
– Control
• Patients with Schizophrenia
Bagby, R.M., Rogers, R., Nicholson,
R., Buis, T., Seeman, M.V., Rector,
N. (1997). Does clinical training
facilitate schizophrenia on the
MMPI-2. Psychological Assessment,
9(2), 106-112.
Control Variables
• Exclusion Criteria: for patient sample and
malingering groups was a True Response
Inconsistency Scale (TRIN)
• Standard instruction for all participants
Bagby, R.M., Rogers, R., Nicholson,
R., Buis, T., Seeman, M.V., Rector,
N. (1997). Does clinical training
facilitate schizophrenia on the
MMPI-2. Psychological Assessment,
9(2), 106-112.
Data Analysis
• Multivariate ANOVA
– - to assess overall group differences for the clinical scales and
validity indicators
• Univariate F tests
• Scheffé procedure
- to assess the differences between pairs of groups
• Hierarchical regression analyses
– to identify those validity indicators beyond the traditional F scale
that were able to distinguish between the sample of patients with
schizophrenia and each of the 3 malingering groups
Bagby, R.M., Rogers, R., Nicholson,
R., Buis, T., Seeman, M.V., Rector,
N. (1997). Does clinical training
facilitate schizophrenia on the
MMPI-2. Psychological Assessment,
9(2), 106-112.
Results
• Significant Multivariate effects were found
for:
– 10 CLINICAL SCALES
• F(27, 342.34) = 7.67, P < .001.
– VALIDITY INDICATORS
• F(21, 342.25) = 9.04, P < .001.
Bagby, R.M., Rogers, R., Nicholson,
R., Buis, T., Seeman, M.V., Rector,
N. (1997). Does clinical training
facilitate schizophrenia on the
MMPI-2. Psychological Assessment,
9(2), 106-112.
Design Type
• Quasi-Experimental
– IV not manipulated, but there were 3 groups
• Between Subjects
– Comparison between 3 groups
• Factorial
– 3 IV’s
Bagby, R.M., Rogers, R., Nicholson,
R., Buis, T., Seeman, M.V., Rector,
N. (1997). Does clinical training
facilitate schizophrenia on the
MMPI-2. Psychological Assessment,
9(2), 106-112.
Authors’ Interpretations
• Undergrad psychology students and clinically trained
persons with advances training in psychopathology and
psychological testing tend to over endorse symptoms
associated with schizophrenia when directed to feign that
disorder
• Individuals with limited clinical training and knowledge of
psychopathology tend to over endorse symptoms that may
not be specific to that disorder
Bagby, R.M., Rogers, R., Nicholson,
R., Buis, T., Seeman, M.V., Rector,
N. (1997). Does clinical training
facilitate schizophrenia on the
MMPI-2. Psychological Assessment,
9(2), 106-112.
Limitations
•
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•
•
•
Participants recruited from only one university and one registry
No random sampling
Small sample size
Male/female ratio uneven
Large range of experience with the MMPI-2 in the sample of grad
students, which has the potential to compromise the integrity of the
internal validity of the study
• Use actual patients suffering from Schizophrenia as opposed to outpatients who are in the residual phase of their illness
Bagby, R.M., Rogers, R., Nicholson,
R., Buis, T., Seeman, M.V., Rector,
N. (1997). Does clinical training
facilitate schizophrenia on the
MMPI-2. Psychological Assessment,
9(2), 106-112.
Critical Review
• Interesting points made by authors
– All groups over emphasized the symptoms of
schizophrenia
– Even mental health professionals have
difficulty in feigning psychopathology
successfully on the MMPI-2
Bagby, R.M., Rogers, R., Nicholson,
R., Buis, T., Seeman, M.V., Rector,
N. (1997). Does clinical training
facilitate schizophrenia on the
MMPI-2. Psychological Assessment,
9(2), 106-112.
Critical Review
• Questionable Arguments made by Authors
– Claims that individuals knowledgeable about psychopathology
tend to over endorse symptoms thought to be features of a specific
disorder, but at the same time says that they are able to refrain from
endorsing symptoms
– The authors claims that their findings are significant based on a p <
.001 scale
• If this was done on another scale (e.g. p < .05) their findings
might not have been significant
Bagby, R.M., Rogers, R., Nicholson,
R., Buis, T., Seeman, M.V., Rector,
N. (1997). Does clinical training
facilitate schizophrenia on the
MMPI-2. Psychological Assessment,
9(2), 106-112.
Conclusion
• Clinically trained participants produced generally
lower scores on the clinical scales and validity
indicators than did the undergrad students
• The scores for the clinical scales were higher for
all groups asked to feign schizophrenia when
compared with the schizophrenic sample
Bagby, R.M., Rogers, R., Nicholson,
R., Buis, T., Seeman, M.V., Rector,
N. (1997). Does clinical training
facilitate schizophrenia on the
MMPI-2. Psychological Assessment,
9(2), 106-112.
Discussion
• What might have been a better way to obtain a
sample being that the sample is not representative
of the greater population?
• Although it was stated that some participants had
limited familiarity with the MMPI-2, do you think
this bias had any effect on the results?
Bagby, R.M., Rogers, R., Nicholson,
R., Buis, T., Seeman, M.V., Rector,
N. (1997). Does clinical training
facilitate schizophrenia on the
MMPI-2. Psychological Assessment,
9(2), 106-112.
The End