Increased odds and predictive rates of MMPI-2-RF scale elevations in patients with psychogenic non-epileptic seizures and observed sex differences

Authors

Victor A. Del Bene, NYU Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, NY, New York 10016, United States; Ferkauf Graduate School of Psychology, Clinical Health Psychology Program, Yeshiva University, Bronx, NY 10461, United States.
Miguel Arce Rentería, NYU Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, NY, New York 10016, United States; Fordham University, Psychology Department, Bronx, NY 10485, United States.
Moshe Maiman, NYU Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, NY, New York 10016, United States; Drexel University, Department of Psychology, Philadelphia, PA 19104, United States.
Mitch Slugh, NYU Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, NY, New York 10016, United States; Farleigh Dickinson University, School of Psychology, Teaneck, NJ 07666, United States.
Deana M. Gazzola, NYU Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, NY, New York 10016, United States.
Siddhartha S. Nadkarni, NYU Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, NY, New York 10016, United States.
William B. Barr, NYU Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, NY, New York 10016, United States. Electronic address: William.Barr@nyumc.org.

Document Type

Article

Abstract

OBJECTIVE: The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) is a self-report instrument, previously shown to differentiate patients with epileptic seizures (ES) and psychogenic non-epileptic seizures (PNES). At present, the odds of MMPI-2-RF scale elevations in PNES patients, as well as the diagnostic predictive value of such scale elevations, remain largely unexplored. This can be of clinical utility, particularly when a diagnosis is uncertain. METHOD: After looking at mean group differences, we applied contingency table derived odds ratios to a sample of ES (n=92) and PNES (n=77) patients from a video EEG (vEEG) monitoring unit. We also looked at the positive and negative predictive values (PPV, NPV), as well as the false discovery rate (FDR) and false omission rate (FOR) for scales found to have increased odds of elevation in PNES patients. This was completed for the overall sample, as well as the sample stratified by sex. RESULTS: The odds of elevations related to somatic concerns, negative mood, and suicidal ideation in the PNES sample ranged from 2 to 5 times more likely. Female PNES patients had 3-6 times greater odds of such scale elevations, while male PNES patients had odds of 5-15 times more likely. PPV rates ranged from 53.66% to 84.62%, while NPV rates ranged from 47.52% to 90.91%. FDR across scales ranged from 15.38% to 50%, while the FOR ranged from 9.09% to 52.47%. CONCLUSIONS: Consistent with prior research, PNES patients have greater odds of MMPI-2-RF scale elevations, particularly related to somatic concerns and mood disturbance. Female PNES patients endorsed greater emotional distress, including endorsement of suicide related items. Elevations of these scales could aid in differentiating PNES from ES patients, although caution is warranted due to the possibility of both false positives and the incorrect omissions of PNES cases.

Medical Subject Headings

Adult; Electroencephalography; Epilepsy (diagnosis, physiopathology); Female; Humans; MMPI (standards); Male; Middle Aged; Psychometrics (instrumentation); Reproducibility of Results; Sex Factors; Somatoform Disorders (diagnosis, physiopathology)

Publication Date

7-1-2017

Publication Title

Epilepsy & behavior : E&B

E-ISSN

1525-5069

Volume

72

First Page

43

Last Page

50

PubMed ID

28575766

Digital Object Identifier (DOI)

10.1016/j.yebeh.2017.04.023

Recommended Citation

Del Bene, Victor A.; Arce Rentería, Miguel; Maiman, Moshe; Slugh, Mitch; Gazzola, Deana M.; Nadkarni, Siddhartha S.; and Barr, William B., "Increased odds and predictive rates of MMPI-2-RF scale elevations in patients with psychogenic non-epileptic seizures and observed sex differences" (2017). Neurology. 1693.
https://scholar.barrowneuro.org/neurology/1693