E-ISSN : 2733-4538
The purpose of this study was to examine the similarities and distinctiveness among Postraumatic stress disorder (PTSD), Major depressive disorder (MDD), and co-occuring PTSD and Depressive disorder (DD) with MMPI-2-RF. Data of 187 patients (59 with PTSD, 69 with MDD, 59 with PTSD+DD) were collected from the Department of Psychiatry of three university hospitals. Using Minnesota Multiple Personality Inventory-2-Restructured Form (MMPI-2-RF), clinical characteristics were compared to determine which scale has utility in differentiating among the groups. Significant differences in all of the Higher-Order (H-O) Scales, almost of the Restructured Clinical Scales and the Specific Problems Scales were observed among three groups. Multinominal logistic regression analyses showed that Emotion/Internalizing Dysfunction (EID) and Thought Dysfunction (THD) in H-O Scales were useful in differentiating between PTSD and MDD. Emotion/ Internalizing Dysfunction (EID) in H-O Scale, Malaise(MLS) in Somatic/Cognitive Scales and Negative Emotionality/Neuroticism-Revised (NEGE-r) in PSY-5 Scales were significant predictors in distinguishing comorbid group from PTSD. The results suggest that there are distinct clinical characteristics among the three groups, although PTSD, MDD, and comorbid group share many symptoms.
American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorder (4th ed.). Washington, DC:American Psychiatric Press.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorder (5th ed.). Washington, DC:American Psychiatric Press.
Armour, G., & Shevlin, M. (2010). Testing the dimensionality of PTSD and the specificity of the dysphoria factor. Journal of Loss and Trauma, 15, 11-27.
Ben-Porath, Y. S., & Tellegen, A. (2008). Minnesota Multiphasic Personality Inventory-2 restructured form. Minneapolis, MN:University of Minnesota Press.
Bernardy, N. C., & Friedman, M. J. (2015). Psychophamarcological strategies in the management of posttraumatic stress disorder (PTSD): What have we learned? Current Psychiatry Reports, 17(20), 1-20.
Blanchard, E. N., Buckley, T. C., Hickling, E. J., & Taylor, A. E. (1998). Posttraumatic stress disorder and comorbid major depression:Is the correlation an illusion? Journal of Anxiety Disorder, 12, 21-37.
Breslau, N., Davis, G. C., Andreski, P., & Peterson, E. (1991). Traumatic events and posttraumatic stress disorder in an urban population of young adults. Archives of General Psychiatry, 48, 216-222.
Butcher, J. N., Graham, J. R., Ben-porath, Y. S., Tellegen, A., Dahlstrom, W. G., & Kaemmer, B. (2001). MMPI-2(Minnesota Multiphasic Personality Inventory-2): Manual for administration, scoring, and interpretation, revised edition. Minneapolis, MN: University of Minnesota Press.
Dekel, S., Solomon, Z., Horesh, D., & Ein-Dor, T. (2014). Posttraumatic stress disorder and depressive symptoms: Joined or independent sequelae of trauma? Journal of Psychiatry Research, 54, 64-69.
Elhai, J. D., Carvalho, L. F., Miguel, F. K., Palmieri, P. A., Primi, R., & Frueh, B. C. (2011). Testing whether posttraumatic stress disorder and major depressive disorder are similar or unique constructs. Journal of Anxiety Disorder, 25, 404-410.
Elhai, J. D., Contractor, A. A., Tamburrino, M., Fine, T. H. Cohen, G., Shirley, E., ... Galea, S. (2015). Structural relations between DSM-5 PTSD and major depression symptoms in military soldiers. Journal of Affective Disorder, 175, 373-378.
Elhai, J. D., Grubaugh, A. L., Kashdan, T. B., & Frueh, B. C. (2008). Empirical examination of a proposed refinement to DSM-IV posttraumatic disorder symptom criteria using the National Comorbidity Survey Replication data. Journal of Clinical Psychiatry, 69, 597-602.
Flory, J. D., & Yehuda, R. (2015). Comorbidity between post-traumatic stress disorder and major depressive disorder: Alternative explanations and treatment considerations. Clinical Research, 17, 141-150.
Forbes, D., Elhai, J. D., Miller, M. W., & Creamer, M. (2010). Internalizing and externalizing class in posttraumatic stress disorder:A latent class analysis. Journal of Traumatic Stress, 23, 340-349.
Gamez, W., Watson, D., & Doebbeling, B. N. (2007). Abnormal personality and the mood and anxiety disorder: Implications for structural models of anxiety and depression. Journal of Anxiety Disorder, 21, 526-539.
Grant, D. M., Beck, J. G., Marques, L., Palyo, S. A., & Clap, J. D. (2008). The structure of distress following trauma: Posttraumatic stress disorder, major depressive disorder, and generalized anxiety disorder. Journal of Abnormal Psychology, 117, 662-672.
Green, B. L. Krupnick, J. L., Chung, J., Siddique, J., Krause, E. E., Revicki, D., ... Miranda J. (2006). Impact of PTSD comorbidity on one-year outcomes in a depression trial. Journal of Clinical Psychology, 62, 815-835.
Harkness, A. R., & McNulty, J. L. (1994). The personality psychopathology five(PSY-5): Issue from the pages of a diagnostic manual instead of a dictionary. In S. Strack & M. Lorr (Eds.). Differentiating normal and abnormal personality. New York:Springer.
Jang, H. A., Park, E. H., Jon, D. Hong, N., Kim, K. H., & Choi, J. Y. (2015). Clinical characteristics of elderly depression using MMPI-2-RF. The Korean Journal of Health Psychology, 20, 643-664.
Jeong, S., Lee, E. H., Kim, J. H., Han, K., & Moon, K. (2013). Diagnostic utility of MMPI-2-RF scales: Differentiating bipolar disorder from major depressive disorder. Korean Journal of Clinical Psychology, 32, 371-388.
Kemp, A. H., Felmingham, K. Das P., ... Williams, L. M. (2007). Influence of comorbid depression on fear in posttraumatic stress disorder: An fMRI study. Psychiatry Research, 155, 265-269.
King, D. W., Leskin, G. A., King, L. A., & Weathers, F. W. (1998). Confimatory factor analysis of the clinical-administered PTSD scale: Evidence for the dimensionality of posttraumatic stress disorder. Psychological Assessment, 10, 90-96.
Kruger, R. F., & Markon, K. E. (2006). Understanding psychopathology:Melding behavior genetics, personality, and quantitative psychology to develop an empirically based model. Current Directions in Psychological Science, 15, 113-117.
Miller, M. W., Kaloupek, D. G., Dillon, A. L., & Keane, T. M. (2004). Externalizing and internalizing subtypes of combat-related PTSD: A replication and extension using the PSY-5 scales. Journal of Abnormal Psychology, 113, 636-645.
Miller, M. W., Wolf, E. J., Harrington, K. M., Brown, T. A., Kaloupek, D. G., & Keane, T. M. (2010). An evaluation of competing models for structure of PTSD symptoms using external measures of comorbidity. Journal of Traumatic Stress, 23, 631-638.
Miller, M. W., Wolf, E. J., Reardon, A. M., Greene, A., Ofrat, S., & Mclnerney, S. (2012). Personality and the latent structure of PTSD comorbidity. Journal of Anxiety Disorder, 26, 599-607.
Moon, K., Yook, K., Han, K., & Kim, J. H. (2015). Diagnostic utility of MMPI-2-RF scales: Distinguishing bipolar disorder, major depressive disorder, and schizophrenia. Korean Journal of Clinical Psychology, 34, 101-123.
Nijdam, M. J., Gersons, B. P., & Olff, M. (2013). The role of major depression in neurocognitive functioning in patients with posttraumatic stress disorder. European Journal of Psychotraumatology, 4, 1-7.
O’Donnell, M. L., Creamer, M., & Pattison, P. (2004). Posttraumatic stress disorder and depression following trauma: Understanding comorbidity. American Journal of Psychiatry, 161, 1390-1396.
Oquendo, M., Brent, D. A., Birmaher, B., Greenhill, L., Kolko, D. Stanley, B., ... Mann, J. J. (2005). Posttraumatic stress disorder comobid with major depression: Factors mediating the association with suicidal behavior. American Journal of Psychiatry, 162, 560-566.
Post, L. M., Zoellner, L. A., Youngstrom, E., & Feeny, N. G. (2011). Understanding the relationship between co-ocurring PTSD and MDD: Symptom severity and affect. Journal of Anxiety Disorder, 25, 1122-1130.
Sellbom, M., Bagby, R. M., Kusher, S., Quilty, L. C., & Ayearst, L. E. (2012). Diagnostic construct validity of MMPI-2 Restructured Form (MMPI-2-RF) scale score. Assessment, 19, 176-186.
Sellborn, M., Ben-Porach, Y. S., & Bagby, R. M. (2008). On the hierarchical structure of mood and anxiety disorders: Confirmatory evidence and elaboration of a model of temperament markers. Journal of Abnormal Psychology, 117, 579-590.
Simms, L. J., Watson, D., & Doebbeling, B. N. (2002). Confirmatory factor analyses of posttraumatic stress symptoms in deployed and nondeployed veterans of the Gulf War. Journal of Abnormal Psychology, 111, 637-647.
van Minnen, A., Zoellner, L. A., Harned, M. S., & Mills, K. (2015)Change in comorbid conditions after prolonged exposure for PTSD: A literature review. Current Psychiatry Reports, 17(17), 1-16.
Wolf, E., Miller, M. W., Orazem, R. J., Weierich, M. R., Castillo, D. T., Milford, J., ... Keane, T. M. (2008). The MMPI-2 restructured clinical scales in the assessment of posttraumatic stress disorder and comorbid disorders. Psychological Assessment, 20, 327-340.
Yehuda, R., Flory, J. D., Birere, L. M., Henn- Haase, C., Lehrmer, A., Desarnaud, F., ... Meaney, M. J. (2015). Lower methylation of glucocorticoide receptor gene promoter 1F in peripheral blood of veterans with posttraumatic stress disorder. Biological Psychiatry, 22, 356-364.
Yehuda, R., Teicher, M. H., Trestman, R. L., Levengoog, R. A., & Siever, L. J. (1996). Cortisol regulation in posttraumatic stress disorder and major depression: A chronobiological analysis. Biological Psychiatry, 40, 79-88.