Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

The MMPI with Injured Workers

In the ideal world, where the surgeon has time not only to determine whether surgery is indicated and/or whether it has been successful, were he/she also to have to time to secure extensively psychological data, all could be accomplished by one provider and in one visit.

But this ideal is unfeasible. Often when obtaining an orthopedic history, a patient becomes resistant to discuss family, personal or social problems. The frequent remark is _this has nothing to do with my back (knee, arm, ankle, etc),_ and the patient becomes suspicious, guarded, and resentful.

The patient expects such questions from a psychologist. Thus, two individuals asking the same questions will receive quite different verbal and emotional responses.

But you also asked if the MMPI and similar standardized tests were necessary_mandatory. I strongly feel the answer is _yes._ While it would be theoretically possible to gather all the data by asking the precise questions, the MMPI is more cost effective, not prone to any intonation in the doctor_s voice when asking the same questions.

More importantly, and for a variety of reasons, patients are often more candid and forthcoming when the questions are presented in written form. They do not process what the doctor is thinking or whether their answers are leading to other questions. In effect, it is more thorough, more efficient and certainly more accurate.

A psychological diagnosis which is based solely upon verbal questioning and lacks appropriate psychodiagnostic tests is, at best, questionable.

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