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This investigation explored the effect of posttraumatic stress disorder (PTSD) simulation on Minnesota Multiphasic Personality Inventory-2 (MMPI-2) responses, to detect malingered from genuine PTSD. Sixty-four adult PTSD outpatients at a child sexual abuse (CSA) survivor treatment program were compared with 85 adult college students instructed and trained to malinger PTSD. MMPI-2 overreporting indices examined were F, F-Fb, F-K, F(p), Ds2, O-S, OT, and FBS. A stepwise discriminant analysis identified F(p), F-K, and O-S as the best malingering predictors. A predictive discriminant analysis yielded good hit rates for the model, with impressive cross-validation results. Cutoff scores were assessed for the model's predictors. Clinical implications for detecting malingered PTSD using the MMPI-2 are discussed.

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The controversy regarding delayed recall of childhood sexual abuse (CSA) has deflected> attention from the question of whether memory recovery and other trauma-focused treatment approaches are effective for abuse survivors. More than a decade of clinical experience has convinced many experts that as a primary treatment strategy, this approach often leads to decompensation among CSA survivors. However, few treatment alternatives have been clearly articulated. One such alternative, contextual therapy, is grounded in evidence that many CSA survivors grow up in an interpersonal context that fails to transmit the capacities needed for effective daily functioning. Contextual therapy retains trauma-focused interventions as one component of a broader framework aimed at helping survivors develop adaptive capacities that, rather than having been disrupted by trauma, may never have been attained in the first place. From this perspective, abuse trauma is seen as compounding these deficits, rather than as a sole cause of them.

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This investigation examined differences in symptom patterns of two different trauma samples using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). MMPI-2s of 122 male combat veterans seeking outpatient treatment for combat-related PTSD were compared with those of 64 PTSD-diagnosed adults seeking outpatient treatment for the effects of child sexual abuse (CSA). We examined variables related to degree of health concerns, depression, somatization, anger and hostility, masculine-feminine traits, paranoid ideation, anxiety, difficulties thinking and concentrating, elevated mood, and social introversion, as well as test-taking attitude. MANOVAs revealed between-group differences on several variables. However, when analyses controlled for the effect of age, nearly all differences disappeared; the only remaining difference was in a scale measuring anger. Thus, it appears CSA survivors and combat veterans are much more similar than different in their clinical presentation on the MMPI-2. Conceptual issues in the assessment of PTSD are discussed.

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The relationship between coercion strategies used by perpetrators of childhood sexual abuse (CSA) and elevations of CSA survivors on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) was investigated. Participants were 151 women survivors of CSA in outpatient treatment at a university-based community mental health center. Scores on the MMPI-2 clinical scales and the Keane posttraumatic stress disorder (PTSD) scale were examined. Main effects were found for promised or received rewards on several clinical scales and the PTSD scale of the MMPI-2, independent of the presence of force. Specifically, the presence of such rewards was associated with significantly higher levels of symptomatology on Paranoia (Pa), Psychasthenia (Pt), Schizophrenia (Sc), and PTSD (Pk). There were no main or interaction effects noted for the presence of actual or threatened force on any of the scales.

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We attempted to cross-validate findings from a previous study (Elhai, Gold, Sellers, & Dorfman, in press) using a clinical sample of combat-related war veterans to distinguish genuine from malingered posttraumatic stress disorder (PTSD) on the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). The MMPI-2 scores of 124 male combat war veterans at the PTSD outpatient treatment program of a Veterans Affairs Medical Center were compared with those of 84 adult college students instructed and trained to malinger PTSD. MMPI-2 overreporting variables examined were F, F-Fb, F-K, F(p), Ds2, O-S, OT, and FBS. A stepwise discriminant analysis identified F. F-Fb, F-K, Ds2, O-S, and OT as the best malingering predictors. A predictive discriminant analysis yielded good hit rates for the model with impressive cross-validation results. We assessed cutting scores for the predictors of the model. We discuss clinical implications for using the MMPI-2 to distinguish malingered PTSD from combat-related PTSD.

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OBJECTIVE: The purpose of this study was to explore gender differences in symptomatology among sexual abuse survivors utilizing a standardized measure of specific symptom patterns, the Symptom Checklist 90-Revised (SCL-90-R). METHOD: Gender differences in symptomatology of adults sexually victimized as children were examined. Participants were 162 women and 25 men entering an outpatient treatment program for adult survivors of childhood sexual abuse (CSA) in a university-based community mental health center. Symptomatology was measured using the Symptom Checklist 90-Revised (SCL-90-R). RESULTS: Although no differences appeared when examining the raw data, the results changed dramatically once the data were converted into T-scores and epidemiological SCL-90-R gender differences were taken into account. The findings indicate that men exhibited significantly more interpersonal sensitivity, depression, anxiety, and phobic anxiety than women in relation to their respective normative samples. CONCLUSIONS: The use of nonclinical T-scores in this study allows for the interpretation that men survivors of childhood sexual abuse (CSA) have higher levels of symptomatology than women survivors when compared to their respective normative samples.

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OBJECTIVE: The goal of this investigation was to examine similarities and differences in childhood sexual abuse (CSA) characteristics between men and women survivors in outpatient psychotherapy utilizing a substantial sample size of men, while examining an extensive range of abuse characteristics. METHOD: Abuse characteristics of 48 men from an outpatient treatment program for adult survivors of CSA in a university-based community mental health center were compared with those of 257 women from the same program. Data on abuse history were collected at admission or as soon thereafter as possible using a structured clinical interview with established reliability. RESULTS: Women were significantly more likely to have been sexually abused by a family member. Men were significantly more likely to report having oral sex performed upon them. Otherwise, no significant gender differences not attributable to anatomical differences (e.g., vaginal vs. anal intercourse) were found. CONCLUSIONS: The findings suggest that very few differences exist in the nature and extent of CSA reported by men and women. Thus CSA perpetrated on boys appears largely comparable in nature and extent to that committed against girls.

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Sexual addiction has received increasing attention in the past decade. We review existing literature on (a) competing conceptualizations of this syndrome as constituting an addictive, obsessive-compulsive, or impulse control disorder; (b) symptomatology and progression; (c) etiological models; and (d) treatment approaches. Based on this review, we conclude by identifying questions requiring resolution via empirical investigation.

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Characteristics of the abuse experience by 135 women entering an outpatient treatment program for survivors of childhood sexual abuse were assessed utilizing a structured clinical interview. Areas assessed included: nature, frequency and duration of the abuse; participant's age at onset of abuse; perpetrator characteristics; childhood physical abuse experiences; and circumstances leading to abuse cessation. Participants who had been molested by more than one perpetrator were administered questions about the abuse committed by each perpetrator separately. Abuse by the first individual to molest a participant was found to be more likely to be incestuous, of higher frequency, and more extensive and invasive than that by later perpetrators. Survivors seeking therapy indicated experiencing considerably more severe abuse, at a younger age, for longer duration, and at the hands of more perpetrators than previously reported in the literature on nonclinical samples of survivors.

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The present study was designed to assess the relation between Loevinger's hierarchy of ego development stages, measured by the Washington University Sentence Completion Test, and adjustment patterns as measured by the Minnesota Multiphasic Personality Inventory. A total of 150 high school students between the ages of 14 and 15, 75 boys and 75 girls, served as subjects. It was hypothesized that certain adjustment patterns were more prevalent at certain points of the ego development hierarchy than at others, specifically: (a) hypochondriasis and psychopathic deviance at the ego stages below conformity; (b) hysteria at the conformist ego level; and (c) obsessive-compulsiveness and paranoia at the ego stages above conformity. All of these hypotheses, except that regarding psychopathic deviance, were supported by the data. One unpredicted relationship, a tendency for depression to be most characteristic of the conformist ego group, was found.