Development of an MMPI-2 Scale to Aid in Assessing Opioid Use Disorder

by Jude M Chamberlain

Institution: Kent State University
Department: College of Arts and Sciences / Department of Psychology
Degree: PhD
Year: 2014
Keywords: Psychology; Mental Health; Personality; Personality Psychology; Psychological Tests; MMPI-2; Opioid Use Disorder; Opioid Abuse; Opioid Dependence; Opiate; Prescription Drugs; Scale Development; MMPI-2-RF; Addiction; Personality Assessment
Record ID: 2042063
Full text PDF: http://rave.ohiolink.edu/etdc/view?acc_num=kent1398255420


Prescriptions for opioid painkillers increased from 40 million in 1991 to 257 million in 2009 and a significant increase in abuse of these medications has paralleled their greater availability (National Institute on Drug Abuse [NIDA], 2013). Although the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Graham, Ben-Porath, Tellegen, & Dahlstrom, 2001) is the most widely used clinical personality assessment instrument for addictions counselors working with adults (Juhnke, 2002), it contains no scale to specifically assist in assessing opioid use disorder. This study utilized MMPI-2 protocols produced by participants at a Midwestern court psychiatric clinic (n=1,545) to develop scales to aid in assessing opioid use disorder. The sample was split in half randomly, one half serving as a derivation sample (n=799) and the other as a cross-validation sample (n=742). Item selection for the 66-item rationally derived opioid scale was guided by characteristics of opioid abusers identified by literature review. Item selection for the 20-item empirically derived opioid scale resulted from chi-square analyses identifying MMPI-2 items that differentiated opioid abusers from those who abused other drugs or no drugs. Principal component analysis with oblique rotation was used to examine the factor structure of the empirically derived scale. Independent samples t-tests determined that only mean raw scores on the empirically derived opioid scale significantly differentiated among the two groups within the cross-validation sample. Hierarchical logistic regression analyses determined that the empirically derived opioid scale added incrementally to the existing MMPI-2 substance abuse scales in their ability to identify opioid abusers. Comparison of classification accuracies indicated that, compared with the MAC-R, AAS, and APS, the empirically derived opioid scale yielded the greatest overall classification hit rate (86%) and demonstrated particular utility in ruling out individuals who do not meet criteria for opioid use disorder.