Millon Behavioral Medicine Diagnostic

What is the MBMD test designed to do?

Medical researchers and healthcare practitioners understand that psychological and personality factors are major contributors to positive health outcomes. The MBMD test can help identify the main psychosocial factors that can contribute to the recovery from, relapse of, or progression of physical disease. By addressing these factors, behavioral health psychologists can help medical professionals better treat their patients. The results may be improved treatment success and rehabilitation/recovery from disease, as well as reduced medical utilization and contained healthcare costs.

What is the norm group for the MBMD test?

The MBMD test was normed on over 700 medical patients with a variety of medical conditions. The norm group included patients with the following conditions: heart problems, cancer, diabetes, gynecological problems, chronic pain, accident/injury, back pain, headaches, neurological problems, gastrointestinal problems, organ transplants, and HIV/AIDS. Approximately 52% of the sample were female, 60% were Caucasian, 48% were married, and 89% had at least a high school diploma.

Recently, bariatric-specific norms were developed for the MBMD test. Using data from 711 prescreened bariatric surgery patients collected across six geographically diverse settings, a bariatric reporting option was developed to represent this unique medical population. Approximately 82% of this sample were female, 65% were Caucasian, 54% were married, and 89% had at least a high school diploma.

Pain patient-specific norms were released for the MBMD in 2010. All 1,200 pain patients, pulled from diverse settings across the U.S., were given the MBMD; included were patients with a variety of ailments and injuries (back, joints, neck, head) and were being evaluated for treatment. This data helped to develop two reports tailored to help assess individuals in two primary pain patient settings, Presurgical and Nonsurgical. Approximately 54% of this sample were female, 69% were Caucasian, 62% were married, and 46% had at least a high school diploma.

Among several differences between norm groups, bariatric and pain patients tend to be more concerned about illness, more prohibited from doing things, and in more pain than the general medical population. Differences such as these indicate that the average bariatric or pain patient is not only physically different from the general medical population but psychologically different as well, justifying the effort to bring a more specific norm groups to MBMD users.

How is the MBMD test different from the MBHI test?

Like the MBHI, the MBMD test provides information about a patient’s coping style. However, it also provides new scales (stress moderators, treatment prognostics, psychiatric indications, and management guides) and negative health habits and response patterns. Our customer research has shown that medical professionals are most interested in obtaining this type of patient information.

How is the MBMD test different from the BHI™ 2 test?

The BHI 2 test is designed to help identify the bio-psycho-social factors that may interfere with a patient’s normal course of recovery from an injury, chronic pain or illness. The BHI 2 test utilizes two sets of norms (rehab/chronic pain patient and community), as well as eight reference groups (chronic pain, headache/head injury, neck injury, back injury, upper extremity injury, lower extremity injury, fake good and fake bad). The MBMD test is a more personality and psychopathology-based test and includes three norm group options. The MBMD also includes some areas not covered by the BHI2, including coping styles, stress moderators and treatment prognostics, as well as negative health habits such as smoking, lack of exercise, and over eating.

How does the MBMD test differ from other medically based psychosocial tests?

Like other personality tests, the MBMD test provides information about a patient’s coping style. However, it also provides new scales (stress moderators, treatment prognostics, and psychiatric indications), and negative health habits that are worthy of a clinician’s attention. The interpretive report takes each patient’s individual style of coping into account in mediating the patient’s psychiatric symptoms, personal assets, external resources, and healthcare utilization. Thus, the interpretive report captures the process of synthesis that a seasoned clinician would use in integrating information from multiple test instruments. All of this can be achieved with high external validity and with minimal patient burden given that each MBMD test administration requires only 20–25 minutes for the patient to complete.

How reliable is the MBMD test?

Internal consistency and test-retest analyses were conducted to estimate the reliability of the MBMD scales. Using the entire sample, the following internal consistency coefficients were obtained: Psychiatric Indications (r^TT=.76 to .89), Coping Styles (r^TT=.54 to .85), Stress Moderators (r^TT=.85 to .89), Treatment Prognostics (r^TTTT=.47 to .80), and Management Guides (r^TT=.77 to .79). The median internal consistency coefficient for all scales is r^TT=.79.

Using a smaller sample (N=41), test-retest reliability estimates were also obtained: Psychiatric Indications (r^TT=.79 to .88), Coping Styles (r^TT=.71 to .90), Stress Moderators (r^TT=.78 to .92), Treatment Prognostics (r^TT=.72 to .88), and Management Guides (r^TT=.78 to .81). The median test-retest coefficient for all scales is r^TT=.83.

Internal consistency and test-retest analyses were also conducted for the bariatric patient sample, resulting in the following reliability estimates: Psychiatric Indicators (r^TT = .70 to .85), Coping Styles (r^TT = .56 to .80), Stress Moderators (r^TT = .77 to .89), Treatment Prognostics (r^TT = .22 to .71), and Management Guides (r^TT = .64 to .69). The median internal consistency coefficient for all scales is r^TT = .70.

What is the validity of the MBMD test?

Several approaches were used to validate the scales included on the MBMD. First, an item-sorting procedure was used that required several medical professionals to identify which scale(s) each item appeared to be logically associated with. Only items that were sorted correctly by the majority of the raters were retained on the test for further analysis.

Second, after the MBMD scales had been refined based on internal consistency considerations, scale scores were correlated with a variety of other measures that assessed similar content domains. For example, the MBMD Depression scale correlated at .87 with the Beck Depression Inventory and .58 with the Brief Symptom Inventory Depression scale.

Third, medical professionals who were familiar with approximately 100 patients rated each patient on a number of attitudes and behaviors that are important to treatment outcomes (e.g., compliance, medication problems, utilization problems). A number of significant relationships were found between the MBMD scales and the medical staff ratings. For example, the Pain Sensitivity scale correlated .62 with a rating of Pain Experiences. The Adjustment Difficulties scale correlated .61 with a rating of Utilization Problems.

When is it appropriate to use the MBMD test?

Because the MBMD test is normed on medical patients, it can be used with patients who are undergoing a variety of medical care, rehabilitation, or surgical treatment regimens. The MBMD can help identify patients with psychiatric problems and recommend interventions. It can also help pinpoint personal and social assets that can help the patient adjust to physical limitations or lifestyle changes.

 It is not appropriate to use the MBMD test with adolescents. The age range for the MBMD test is 18 to 85 years old.

How long does it take to administer the MBMD test?

The MBMD test has 165 True/False items and takes 20–25 minutes to administer.

What are the differences between the MBMD General Medical Interpretive Report, the MBMD Bariatric Interpretive Report, and the MBMD Pain Patient Interpretive Report?

Whereas the MBMD Interpretive Report was normed on a general medical population, the Bariatric Report was normed on a very specific bariatric population and the Pain Patient Interpretive report was normed on a chronic pain population. Using data from 711 prescreened bariatric surgery patients, the MBMD Bariatric Report includes supplementary information that augments the MBMD Interpretive Report in several areas that are salient for patients who are considering, or are candidates for, bariatric surgery. The Pain Patient Report uses data from 1200 patients being treated with chronic pain and augments the MBMD General Medical Interpretive Report in several areas salient for patients being treated either medically or surgically for chronic pain.

Is the MBMD Patient Pain Report based on empirical data?

The statements in the MBMD Pain Patient Reports are based on the research literature, direct empirical studies of the MBMD with pain patients, and plausible hypotheses from clinical experience. The content of the reports was also refined in consultation with pain psychologists who use the MBMD. Of particular importance is the array of validity evidence supporting the value of the MBMD for use with pain patients. MBMD scales showed substantial concurrent validity with a wide variety of other self-report measures that are commonly used with pain patients and that have demonstrated validity with this population, including both general mental health assessments and a number of measures developed specifically for use with pain patients. The predictive value of the test was demonstrated in a study in which MBMD scores obtained at intake to a multidisciplinary pain treatment program correlated strongly with response to treatment.

Why does my interpretive report look so different when I send it to a WordPerfect file?

Users of the MBMD Interpretive Report should anticipate differences in the look of this report when it is sent to a WordPerfect file rather than printed directly from this software. The interpretive report was designed with distinct paragraph headers which are actually graphic boxes inserted between the paragraphs of the report. When the report is sent to a WordPerfect file, the graphics lose their positioning on the page. The interpretive statements are correct in the WordPerfect files; only the formatting of the report is lost.