Modified Somatic Perception Questionnaire Scores Research Articles

Validity of the Somatic Complaints Scales of the MMPI-2-RF in an Outpatient Chronic Pain Clinic.

Chronic pain has become a significant medical issue. The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) is a broadband psychological test that has been validated for use across various medical settings and can aid in the assessment and treatment planning of chronic pain. In the current investigation, it was hypothesized that the somatic complaints scales of the MMPI-2-RF would demonstrate good convergent validity from a structured psychodiagnostic interview and other measures of pain and somatization, and lack gender bias. Patients (n = 200) who produced valid MMPI-2-RFs in an outpatient chronic pain clinic were included in the study. Patients were also administered the Modified Somatic Perception Questionnaire (MSPQ), Pain Disability Index (PDI), and the Structured Clinical Interview for DSM-IV-TR (SCID). Zero-order and partial correlations (controlling for gender) were calculated between MMPI-2-RF scale scores and other criteria. Stepdown hierarchical regression analyses were used to detect bias. By and large, higher scale scores on the somatic/cognitive scales of the MMPI-2-RF were modestly or substantially correlated with MSPQ scores, PDI scores, and SCID Somatization symptom count, even after controlling for gender. Regression analyses suggested that the MMPI-2-RF scale scores were not biased as a function of gender. These findings support the validity of specific MMPI-2-RF scales to help identify somatization and psychosocial functioning among patients with chronic pain. Identification of somatization early within the course of treatment of chronic pain may help focus treatment targets, including referrals for psychological interventions such as cognitive behavior therapy for chronic pain.

The Modified Somatic Perception Questionnaire: Operating characteristics in non-pain forensic samples

The objective of the current archival study was to investigate the ability of the Modified Somatic Perception Questionnaire (MSPQ) to discriminate between noncredible and credible neurocognitive dysfunction in a large mixed non-pain forensic sample comprised of personal injury litigants and disability claimants. Participants included 149 adults who underwent comprehensive neuropsychological examination. Criterion groups were formed, i.e., Credible Group (CG), or Noncredible Group (NCG) based upon their performance on stand-alone performance validity tests (PVT) including the Word Memory Test (WMT), and/or Test of Memory Malingering (TOMM), and Victoria Symptom Validity Test (VSVT). After excluding examinees with evidence of somatization participants in the NCG scored significantly higher on the MSPQ compared to participants in the CG. Scores on the MSPQ were not only related to cognitive performance validity but also amplified by the co-existence of somatization. There were no significant effects of gender, age, or race on MSPQ scores. We conclude that the MSPQ demonstrates external validity as a self-report measure of symptom validity that is sensitive to somatic and autonomic complaints in non-pain forensic samples. Future research is needed to develop MSPQ cutscores with external validity pertinent to other non-pain populations.

Examination of the Modified Somatic Perception Questionnaire (MSPQ) in a large sample of credible and noncredible patients referred for neuropsychological testing

Objective: The current study evaluated MSPQ sensitivity to noncredible PVT performance in the context of external incentive, and examined MSPQ false positive rates in noncompensation-seeking neuropsychology patients; and investigated effects of ethnicity/culture, gender, and somatoform diagnosis on MSPQ scores, and relationships with PVT and MMPI-2-RF data. Method: MSPQ scores were compared in credible (n = 110) and noncredible (n = 153) neuropsychology referrals. Results: Noncredible patients scored higher than credible patients. When the credible group was divided into those with somatoform orientation (n = 39) versus those without (n = 71), the credible nonsomatoform group scored lower than the other two groups, who did not differ from each other. MSPQ elevations were found in ethnic minorities, and in individuals who learned English as a second language or concurrently with another language. MSPQ elevations were also associated with chronic systemic diseases, neurologic illness, and substance abuse. Women scored higher than men, but men and women were equally represented among those patients scoring beyond cut-offs. MSPQ scores were minimally related to PVT data but were more strongly correlated with MMPI-2-RF scales, particularly over-report validity scales, RC1, and Somatic/Cognitive scales, with more widespread relationships observed in noncredible patients. Conclusions: A cut-off of 18 resulted in few false positives in credible nonsomatoform patients, and appears appropriate for identifying physical symptom over-report (due to malingering or somatoform orientations), with associated sensitivity of 29%. However, clinicians are cautioned regarding using the MSPQ in patients with systemic, neurologic, and substance abuse conditions, and in ethnic minorities and non-monolingual English-speakers.

Reliability and Validity of the Farsi Version of the Somatosensory Amplification Scale.

Background:The somatosensory amplification scale (SSAS) is a 10-item self-report instrument designed to assess a tendency to experience normal somatic and visceral sensations as intense, noxious, and disturbing.Objectives:The present study investigated the reliability and validity of the SSAS, developed by Barsky et al. (1988), in the Iranian population.Materials and Methods:The study was carried out on 240 patients with functional gastrointestinal disorders and 30 healthy persons selected by convenience sampling from 2013 to 2014. The patients completed the SSAS, the somatization subscale of the symptom checklist-90-revised (SCL-90-R som), and the modified somatic perception questionnaire (MSPQ), whereas the healthy persons completed just the SSAS.Results:Exploratory factor analysis indicated that the one-factor solution, accounting for 29.42% of the variance, explained that the SSAS items were represented by one global dimension. The SSAS had acceptable internal consistency (α = 0.78) and good test-retest reliability (r = 0.80). The item-to-scale correlations varied from 0.17 to 0.55. Item 2 had the lowest item-total score correlation (r = 0.17), and the α coefficient for the SSAS exceeded when this item was deleted. The convergent validity of the SSAS with somatization was shown with a significant correlation between the SSAS, SCL-90-R som (r = 0.36), and MSPQ scores (r = 0.52). Discriminant validity analysis showed no significant difference in the SSAS between the patient and control groups (P > 0.05) and non-specificity of the SSAS for patients.Conclusions:In sum, the SSAS has acceptable reliability and validity for the Iranian population and the scale measures the same the original scale, namely somatosensory amplification.

A Cluster-Based Method for the Preoperative Identification of Lumbar Degenerative Patients having Higher Risk for Poor Global Outcome

Introduction Surgery for lumbar disc degeneration has been shown to yield poor results in 10 to 45% of the patients. Evidence-based clinical tools for preoperative risk estimation would be very important to identify the “at-risk” patients. Several factors referring on the patients' symptoms, psychosocial issues, and medical history were previously published as significant individual risk factors on outcome, but there is low number of reports on integrative models with advanced statistics. The aim of this study was to identify significant outcome predictors and clinically different subgroups in patients surgically treated because of lumbar degenerative disc disease. Patients and Methods A total of 750 consecutive patients indicated for one- or two-level lumbar decompression/microdiscectomy or fusion surgery (TLIF) were recruited into the study. Patients with previous lumbar surgery or nondisc degeneration-related phenotype were not included into the analysis. Patients completed a questionnaire booklet containing the Oswestry disability index (ODI), visual analogue scales on low back (LBP), and leg pain (LP), Zung depression scale (ZDS), and the Modified Somatic Perception Questionnaire (MSPQ) before the surgery and 2 years after the surgery. Five-point Likert scale on self-reported outcome of the surgery was classified into two categories (“good” and “poor” outcome) and effect of preoperative parameters on that was determined applying uni- and multivariate logistic regression models. Two-step agglomerative cluster analysis was used to determine the best fit cluster structure of the cohort entering the significant outcome predictors into the model. Multivariate analysis of variance (MANOVA) and Fischer test were used to analyze the clinical clusters and their canonical discriminant functions. Chi-square tests were applied to investigate the clinical outcome in the different clusters. Results Four different preoperative parameters; number of spinal levels treated, severity of low back pain, duration of pain, and distress (calculated from ZDS and MSPQ scores) were proved to be significant predictors on surgical outcome in the final multivariate regression model ( p < 0.001). The four parameters identified four different subgroups in patients with good cluster quality. Clinical outcome was significantly different in the four preoperative patient-clusters (poor outcome in 5.1, 12.4, 20.9, and 25.6% of subjects, chi-square = 29.3, df = 3, p < 0.001). Conclusion Preoperative parameters of the patients with lumbar disc degeneration have got significant influence on the midterm surgical outcome. Outcome predictors determine different patient clusters with different risk for poor outcome. Advanced statistical approaches are advised to use in the future for patient stratification and risk estimation.

Association between symptom duration and intensity, disability, range of motion and modified pain perceptions amongst chronic low back pain patients

Background: Chronic low back pain (CLBP) is a multi-factorial condition which remains a costly health issue. However, our understanding of the association between commonly used outcome measurements (OM) and symptom behaviour is limited for this low back pain subgroup. Previous research has reported moderate to weak correlations between symptom behaviour, range of motion (ROM), and modified pain perceptions in general low back pain populations. However, longer symptom duration and resulting psychological factors in the CLBP population support the hypothesis that different associations exist between self-reported OM and ROM than in the general population. Purpose: To investigate the association between pain intensity on the visual analogue scale (VAS), range of motion, symptom duration (months), the Oswestry disability Index (ODI), the Roland Morris disability questionnaire (RM) and the Modified Somatic Perception Questionnaire (MSPQ) at baseline in a CLBP population. Methods: A cross-sectional study was conducted with CLBP patients (>12weeks with or without leg pain) (n=147) recruited from a hospital CLBP clinic. Participants completed the VAS, ODI, RM and MSPQ, and a physiotherapist measured ROM of the lumbar spine using a standard tape measure protocol. Data was analysed using SPSS statistical analysis software (version 20) (SPSS inc., Chicago, IL). Independent sample analysis was conducted to assess for significant differences (p<0.05) between genders, and Pearson product-moment correlation coefficients were calculated to identify potential correlations between all baseline OM. Results: Across all the OM, only lumbar extension ROM differed significantly between genders (u=1897, p=0.024). Correlation analysis showed that the disability OM of ODI and RM were not correlated. Weak correlations were reported between the RM and MSPQ scores (r(145) = 0.39, p<0.001), the VAS and ODI (r(145) = 0.39, p <0.001), and lumbar rotation to the right and symptom duration (r(145) = 0.18, p=0.031). Conclusion: The assumption that increased self-reported pain intensity may be associated with limited spinal movement and elevated modified somatic pain perceptions in CLBP patients was not supported by this study. Neither did this study indicate strong associations between psychological factors and self-reported disability. Except for right rotation, symptom duration was also not associated with any ROM, pain, disability, or modified somatic pain perception measures. Pain intensity was weakly correlated with disability on the ODI, and the MSPQ was weakly correlated with the RM score, which supports similar findings in previous research. The results suggest that pain levels do not dictate patient disability status, and that strong associations between psychological factors and self-reported disability are not substantiated. Implications: Absence of strong association between the OM highlights that clinicians should view multiple OM in the context of the patient presentation, rather than in isolation. The ODI may be a more reliable indicator of pain related functional status than the RM. Whereas the RM may be more appropriate when used in conjunction with the MSPQ.

Accuracy of the Modified Somatic Perception Questionnaire and Pain Disability Index in the Detection of Malingered Pain-Related Disability in Chronic Pain

The Modified Somatic Perception Questionnaire (MSPQ) and the Pain Disability Index (PDI) are both popular clinical screening instruments in general orthopedic, rheumatologic, and neurosurgical clinics and are useful for identifying pain patients whose physical symptom presentations and disability may be non-organic. Previous studies found both to accurately detect malingered pain presentations; however, the generalizability of these results is not clear. This study used a criterion groups validation design (retrospective cohort of patients with chronic pain, n = 328) with a simulator group (college students, n = 98) to determine the accuracy of the MSPQ and PDI in detecting Malingered Pain Related Disability. Patients were grouped based on independent psychometric evidence of MPRD. Results showed that MSPQ and PDI scores were not associated with objective medical pathology. However, they accurately differentiated Not-MPRD from MPRD cases. Diagnostic statistics associated with a range of scores are presented for application to individual cases. Data from this study can inform the clinical management of chronic pain patients by screening for psychological overlay and malingering, thus alerting clinicians to the possible presence of psychosocial obstacles to effective treatment and triggering further psychological assessment and/or treatment.

Preoperative Narcotic Use and Its Relation to Depression and Anxiety in Patients Undergoing Spine Surgery

Prospective review of registry data at a single institution from October 2010 to June 2012. To assess whether the amount of preoperative narcotic use is associated with preoperative depression and anxiety in patients undergoing spine surgery for a structural lesion. Previous work suggests that narcotic use and psychiatric comorbidities are significantly related. Among other psychological considerations, depression and anxiety may be associated with the amount of preoperative narcotic use in patients undergoing spine surgery. Five hundred eighty-three patients undergoing lumbar (60%), thoracolumbar (11%), or cervical spine (29%) were included. Self-reported preoperative narcotic consumption was obtained at the initial preoperative visit and converted to daily morphine equivalent amounts. Preoperative Zung Depression Scale (ZDS) and Modified Somatic Perception Questionnaire (MSPQ) scores were also obtained at the initial preoperative visit and recorded as measures of depression and anxiety, respectively. Resistant and robust bootstrapped multivariable linear regression analysis was performed to determine the association between ZDS and MSPQ scores and preoperative narcotics, controlling for clinically important covariates. Mann-Whitney U tests examined preoperative narcotic use in patients who were categorized as depressed (ZDS ≥ 33) or anxious (MSPQ ≥ 12). Multivariable analysis controlling for age, sex, smoking status, preoperative employment status, and prior spinal surgery demonstrated that preoperative ZDS (P = 0.006), prior spine surgery (P = 0.007), and preoperative pain (0.014) were independent risk factors for preoperative narcotic use. Preoperative MSPQ (P = 0.083) was nearly a statistically significant risk factor. Patients who were categorized as depressed or anxious on the basis of ZDS and MSPQ scores also showed higher preoperative narcotic use than those who were not (P < 0.0001). Depression and anxiety as assessed by ZDS and MSPQ scores were significantly associated with increased preoperative narcotic use, underscoring the importance of thorough psychological and substance use evaluation in patients being evaluated for spine surgery.

1861 – Affective temperaments and somatization in a 55 healthy subjects sample

Introduction Some authors have found an association between affective temperaments and mood fluctuations, and a common comorbidity between somatization disorders and mood disorders. In addition, It’s known a significant association between abnormal affective temperaments and somatoform disorders. Objectives The present study investigated associations between affective temperaments and somatization in a 55 healthy subjects sample. Aim The aim of the study was to describe associations between affective temperament and somatization scores in a sample of healthy subjects. Method In this observational study we adopted the following rating scales: Mini International Neuropsychiatric Interview (MINI), 17-item Self Rating Depression Scale (SDS), Hypomania check list 32(HCL-32), Self Rating Anxiety Scale (SAS), DCPR diagnostic criteria for psychosomatic research, Brief TEMPS-A, Modified Somatic Perception Questionnaire (MSPQ), Somatosensory Amplification Scale- SSAS. Results Logistic regression analysis showed that cyclothymic temperament scores at Brief TEMPS-A are associated with MSPQ scores for somatic perception (somatosensory amplification) and SASS scores (hypochondriacal aspects). Moreover, depressive temperaments scores at Brief TEMPS-A are significantly associated to MSPQ tools. Conclusion Our data suggest an association between an affective temperamental dysregulation and somatization aspects in a 55 healthy subjects sample.

Correlation of preoperative depression and somatic perception scales with postoperative disability and quality of life after lumbar discectomy

Object Lumbar discectomy is the most common surgical procedure performed in the US for patients experiencing back and leg pain from herniated lumbar discs. However, not all patients will benefit from lumbar discectomy. Patients with certain psychological predispositions may be especially vulnerable to poor clinical outcomes. The goal of this study was therefore to determine the role that preoperative depression and somatic anxiety have on long-term back and leg pain, disability, and quality of life (QOL) for patients undergoing single-level lumbar discectomy. Methods In 67 adults undergoing discectomy for a single-level herniated lumbar disc, the authors determined quantitative measurements of leg and back pain (visual analog scale [VAS]), quality of life (36-Item Short Form Health Survey [SF-36]), and disease-specific disability (Oswestry Disability Index) preoperatively and at 6 weeks, 3, 6, and 12 months after surgery. The degree of preoperative depression and somatization was assessed using the Zung Self-Rating Depression Scale and a modified somatic perception questionnaire (MSPQ). Multivariate regression analyses were performed to assess associations between Zung Scale and MSPQ scores with achievement of a minimum clinical important difference (MCID) in each outcome measure by 12 months postoperatively. Results All patients completed 12 months of follow-up. Overall, a significant improvement in VAS leg pain, VAS back pain, Oswestry Disability Index, and SF-36 Physical Component Summary scores was observed by 6 weeks after surgery. Improvements in all outcomes were maintained throughout the 12-month follow-up period. Increasing preoperative depression (measured using the Zung Scale) was associated with a decreased likelihood of achieving an MCID in disability (p = 0.006) and QOL (p = 0.04) but was not associated with VAS leg pain (p = 0.96) or back pain (p = 0.85) by 12 months. Increasing preoperative somatic anxiety (measured using the MSPQ) was associated with decreased likelihood of achieving an MCID in disability (p = 0.002) and QOL (p = 0.03) but was not associated with leg pain (p = 0.64) or back pain (p = 0.77) by 12 months. Conclusions The Zung Scale and MSPQ are valuable tools for stratifying risk in patients who may not experience clinically relevant improvement in disability and QOL after discectomy. Efforts to address these confounding and underlying contributors of depression and heightened somatic anxiety may improve overall outcomes after lumbar discectomy.

The relationship of pain and health-related quality of life in Korean patients with Parkinson’s disease

Parkinson's disease (PD) is a chronic progressive neurodegenerative disorder. Increasing attention has been focused on the pain and health-related quality of life (HrQOL) in patients with PD. Objective - To evaluate the relationship between pain and the HrQOL in patients with PD. Eighty-two patients with PD were included and classified into two groups according to the presence of pain. The Hoehn and Yahr scale, the Unified Parkinson's Disease Rating Scale (UPDRS), the Modified Somatic Perception Questionnaire (MSPQ), the Zung Depression Inventory--Self-rating Depression Scale (SDS), the Visual Analogue Scale and the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) were administered. The factors influencing the pain, HrQOL and parkinsonian manifestations were evaluated. The PD with pain group had higher UPDRS part III scores, lower SF-36 scores, higher SDS scores and higher MSPQ scores than the PD without pain group. The presence of pain, high Hoehn and Yahr stage, advanced age and somatic perception were the factors that had a negative effect on the physical component of the HrQOL. Depression and somatic perception were the most important predictive factors for the mental component of the HrQOL. Depression and poor parkinsonian motor abilities were the leading factors contributing to pain. Pain and depression were major detrimental factors affecting the physical and mental aspects of the HrQOL respectively. Therefore, the treatment of pain and depression can be important to improve the HrQOL.

The Relationship Between the Modified Somatic Perception Questionnaire and Dynamic Platform Posturography

To analyze if patients whose vestibular symptoms are associated with nonorganic sway patterns show more evidence of somatization and/or malingering than patients whose vestibular symptoms are associated with normal or physiologically abnormal sway patterns observed in people with documented vestibular pathologic findings. One hundred fifteen patients with complaints of vestibular dysfunction and hearing impairment. Computerized dynamic posturography (CDP) and completion of the Modified Somatic Perception Questionnaire (MSPQ)--a validated test for the detection of malingering. Computerized dynamic posturography results classified into 4 categories (normal, physiologic abnormal, borderline-aphysiologic, and aphysiologic) were correlated with the results of the MSPQ. A significant CDP group effect on the MSPQ, with the aphysiologic patients scoring significantly higher than the other groups. Moreover, a significantly higher proportion of aphysiologic patients scored more than the MSPQ cutoffs for malingering. Results indicate that patients who have aphysiologic CDP sway patterns are more likely to have higher MSPQ scores. Both aphysiologic CDP results and high MSPQ scores have been associated with intentional exaggeration. These results indicate that patients with both aphysiologic CDP findings and high MSPQ scores are more likely to be intentionally exaggerating their balance-related complaints and deficits.

Somatic awareness and coronary artery disease in women with chest pain

To determine if there was a relationship between level of somatic awareness and coronary artery disease (CAD) in women with chest pain. Descriptive, correlational study. Urban, university-affiliated, tertiary care hospital. Fifty-five women without a previous history of heart disease admitted to the hospital for evaluation of chest pain. Modified Somatic Perception Questionnaire (MSPQ); Patterson and Horowitz clinical criteria for classification of chest pain; Supplemented Rose Questionnaire for angina; age; and CAD risk factors. A small but significant inverse correlation was found between level of somatic awareness as measured by MSPQ scores and degree of CAD (r = 0.2932, p < 0.05). MSPQ scores significantly differed between women with CAD (lower scores) and women without CAD (higher scores) (p < 0.05). MSPQ score was the most important factor in a logistic regression model that modestly but significantly predicted presence or absence of CAD. Somatic awareness may be an important factor to consider in evaluating the awareness and response of women to symptoms of myocardial ischemia and to chest pain of both cardiac and noncardiac etiologies.