The Impact of a Defensive Response Set on the Relationship Between MMPI and Cognitive Tests Among Heart Transplant Candidates

Abstract

Examination of the relationship between self-reported psychological symptoms (e.g., depression and anxiety) and cognitive tests assumes individuals are highly motivated to both openly disclose psychological symptoms and to extend best-effort on cognitive tests. Situations that change this ideal motivational state on either self-report questionnaires or cognitive tests attenuate the validity of this assumption. To illustrate this problem, this study examined the emotional-cognitive correlation in a clinical series of 136 cardiac patients undergoing psychosocial and cognitive evaluation as part of a standard protocol for entry into a cardiac transplant program. The evaluative nature of the psychosocial assessment motivates some candidates to respond in a defensive manner, thereby decreasing the validity of self-report psychological measures. This same situation likely promotes high performance motivation on cognitive tests. It was hypothesized that a defensive response set on the Minnesota Multiphasic Personality Inventory (MMPI), as measured by the F-K (Frequency-Correction) Gough Dissimulation Index, would attenuate the strength of the emotional-cognitive relationship. Cognitive factor scores were generated and correlated with the MMPI state clinical scales (i.e., scales 2, 7, and 8) for both nondefensive and defensive ( F-K ≥ −15) groups. Results show increased emotional distress was reliably associated with decreased cognitive functioning ( rs = −.22 to −.27) among the nondefensive group, but was unrelated in the defensive group. The importance of considering the influence of performance contingencies within research and clinical settings is discussed.

Psychological Disturbance, Incomplete Effort, and Compensation-Seeking Status as Predictors of Neuropsychological Test Performance in Head Injury

“…A number of studies indicate that psychological factors are related to many domains of NP performance, including attention (Putzke et al 1997;Ross, Putnam, Gass, Bailey, & Adams, 2003), memory (Burt, Zembar, & Niederehe, 1995;Putzke et al, 1997;, executive functioning (Gass, Ansley, & Boyette, 1994), and general intelligence (Ackerman & Heggestad, 1997;Wrobel & Wrobel, 1996). Most of these studies have found modest to moderate relationships between psychological disturbance and performance on NP tests and have focused on the assessment of patients with head injury.…”

Detecting Incomplete Effort on the MMPI-2: An Examination of the Fake-Bad Scale in Mild Head Injury

“…Numerous studies have shown these scales to be useful in distinguishing persons feigning various types of psychiatric disorder from true patients and normal controls (Arbisi & Ben-Porath, 1998;Archer, Handel, Greene, Baer, & Elkins, 2001;Bagby et al, 1997;Cramer, 1995;Elhai, Gold, Frueh, & Gold, 2000;Elhai, Gold, Sellers, & Dorfman, 2001;Larrabee, 1998;Lees-Haley, 1991Nicholson et al, 1997;Pensa, Dorfman, Gold, & Schneider, 1996;Strong, Greene, & Schinka, 2000;Tsushima & Tsushima, 2001). The Infrequency minus Correction (FÀK), or Gough's (1950) Dissimulation index, is another measure that has been used in detecting malingering (Cramer, 1995;Elhai et al, 2000;Elhai et al, 2001;Larrabee, 1998;Lees-Haley, 1991;LeesHaley, 1992;Pensa et al, 1996;Smith & Frueh, 1996;Wetzler & Marlowe, 1990) and defensiveness (Putzke, Williams, & Boll, 1998;Putzke et al, 1997).…”

The psychological assessment of candidates for reconstructive hand transplantation

“…This manuscript is an attempt to discuss issues of a standardized psychosocial assessment of candidates for RHT. We describe the 'Innsbruck Psychological Screening Program for Resonctructive Hand Transplantation (iRT-PSP)', drawing on evidence from previous reported clinical experience and our own experience in the psychosocial assessment of candidates for RHT which includes a generalized assessment of measures of cognitive functioning, affective status, psychosocial adjustment, coping, QoL, and life satisfaction [5,[10][11][12][13][14][15][16][17][18][19][20][21][22][23].…”