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Adolescent DPD 1 Running Head: ADOLESCENT DPD Adolescent depressive personality disorder measured by the MACI and MMPI-A Jason L. Deselms, M.A. Wichita State University* Darwin Dorr, Ph.D.* C. Don Morgan, Ph.D. University of Kansas School of Medicine- Wichita Matthew M. Woolley, M.A.* Send correspondence to: Jason Deselms, M.A. Department of Psychology Wichita State University 1845 Fairmount Wichita, Kansas 67260-0034 Website: http://psychology.wichita.edu/dprc E-Mail: [email protected] Poster session presented at the American Psychological Association Convention August 22, 2002; Chicago, IL Draft Copy Adolescent DPD 2 Abstract The construct of DPD has a long history in the empirical and theoretical literature. While there is a plethora of research studies examining DPD in adult populations, relatively little is known regarding the characteristics of DPD in an adolescent sample. This study examined the relationship of the MACI’s Doleful and Depressive Affect Scales to relevant scales measuring depressed mood on the MMPI-A. As the Doleful scale is intended to measure a pessimistic personality style, as opposed to negative affect, it was expected that these correlations would be fairly low. Conversely, as the Depressive Affect scale is intended to measure submerged mood it was expected that correlations between this scale and mood scales on the MMPI-A would be high. The Doleful scale, in fact, was highly correlated with several measures of depressed affect on the MMPI-A. Adolescent depressive personality disorder measured by the MACI and MMPI-A Depressive personality disorder (DPD) has a long history in the empirical and theoretical literature. Although it has been examined for over 75 years by researchers and clinicians (Huprich, 1998; Ryder & Bagby 1999; Ryder, Bagby, & Dion, 2001), there is still a great deal of controversy surrounding the clinical utility of DPD as a distinct personality disorder. With the publication of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) the construct of DPD was introduced to the Axis II dimensions. However, given that the concept of DPD remains controversial it was included in the DSM-IV Appendix of disorders needing further study. According to Kaplan and Sadock (1997), DPD differs from the depressive disorders in that the latter are mood disorders whereas DPD is a pervasive personality pattern. The belief is that in DPD the individual manifests a cognitive worldview that is depressive, gloomy, and pessimistic, which in turn foments depressive affect and other symptoms of mood disorder. A recent investigation found considerable overlap between DPD and dysthymia (Ryder, Bagby, & Dion, 2001), a disorder which appears very similar in nature to DPD. The authors noted that while there is an estimated 50% overlap between these two disorders, the defining feature that Draft Copy Adolescent DPD 3 differentiates DPD from dysthymia is a lack of depressed mood in DPD individuals. The Millon Adolescent Clinical Inventory (MACI, Millon, 1993) was developed to assess Axis I and II disorders in adolescents using Millon’s theoretical model of personality and psychopatholgy. The MACI Doleful (2B) scale is designed to assess the DPD construct, while the Depressive Affect (FF) scale on the MACI is intended to measure submerged mood. While a plethora of studies have examined the DPD construct in adult populations (i.e. Bagby & Ryder, 1999; Hirschfeld & Holder, 1994; Klein & Miller, 1993; Klein & Shih, 1998; Lyoo, Gunderson, & Phillips, 1998; Ryder, Bagby, & Dion, 2001), a recent literature review identified no current studies which have examined this construct utilizing an adolescent sample. This paper examines the relationship of the MACI’s Doleful and Depressive Affect scales to relevant scales measuring depressed mood on the Minnesota Multiphasic Personality InventoryAdolescent (MMPI-A, Butcher, Williams, Graham, Archer, Tellegen, Ben-Porath, & Kaemmer, 1992). As the Doleful scale is intended to measure a pessimistic personality style, as opposed to negative affect, it was expected that these correlations would be fairly low. Conversely, as the Depressive Affect scale is intended to measure submerged mood it was expected that correlations between this scale and mood scales on the MMPI-A would be high. Method Participants A total of 247 adolescents hospitalized in a mid-western psychiatric inpatient facility, 101 (41%) male and 149 (59%) female, were utilized in this study. The average age of the adolescents ranged from 11 to 18 years, with a mean age of 15 years (SD = 1.42). Eighty-six percent of the adolescent inpatients utilized in the study were Caucasian, 8% were African American, and 5% were Hispanic. The average length of hospitalization ranged from 1 to 30 days, with a mean stay of 6.6 days. Procedure The MACI and MMPI-A were administered to adolescent inpatients as a standardized assessment battery, as part of a psychological consultation service. Tests were administered by a trained psychomatrist, and participants were provided with a standardized set of instructions prior to beginning the test. Those cases which were determined to be invalid due to inconsistent item Draft Copy Adolescent DPD 4 endorsement, under-reporting (i.e. disclosure raw score < 201) or over-reporting (i.e. disclosure raw score > 589) of psychopathology were excluded from analysis (N = 3). Results Table 1 displays the intercorrelation between the selected MACI and MMPI-A scales. An examination of the table indicates that the MACI scale 2B (Doleful), in fact, was highly correlated with several measures of depressed affect on the MMPI-A. These results were as follows: D (2)=.58, Dep=.76, Aln=.58, D1=.66, D4=.68, and D5=.68. There were also several high correlations with other MMPI-A scales assessing negative affect including Pt (7)=.70, A=.73, Anx=.70, Lse=.62. Further, the correlations of the Depressive Affect Scale (FF) with these same scales were very similar. These results were as follows: D (2)= .61, Dep= .79, Aln=.62, D1= .72, D4=.72, D5=.70, Pt (7)= .76, A= .77, Anx= .70, and Lse= .68. Discussion The hypothesis, that the MACI’s Doleful and Depressive Affect scales would correlate with conceptually similar scales on the MMPI-A, was not supported. Very little research has been done, thus far, on DPD and the MACI Doleful scale so it is too early to decide if it is a clinical construct sufficiently different from depression itself. However, the results of the present exploratory study do not lend strong support for a separate construct of DPD. Draft Copy Adolescent DPD 5 References American Psychiatric Association (1994). Diagnostic and statistical manual of mental disordersRevised (4th ed.). (DSM-IV). Washington, DC: American Psychiatric Association. Bagby, R.M., & Ryder, A.G. (1999). The diagnostic discriminability of dysthymia and depressive personality disorder. Depression & Anxiety, 10, 41-49. Butcher, J.N., Williams, C.L., Graham, J.R., Archer, R.P., Tellegen, A., Ben-Porath, Y.S., & Kaemmer, B. (1992). MMPI-A (Minnesota Mulitiphasic Personality InventoryAdolescent): Manual for administration, scoring, and interpretation. Minneapolis: University of Minnesota Press. Hirschfeld, R.M.A., & Holzer, C.E. (1994). Depressive personality disorder: Clinical implications. Journal of Clinical Psychiatry, 55, 10-17. Huprich, S.K. (1998). Depressive personality disorder: Theoretical issues, clinical findings, and future questions. Clinical Psychology Review, 18, 477-500. Kaplan, H.I, & Sadock, B.J. (1997). Kaplan & Sadock’s Synopsis of psychiatry: Behavioral sciences/clinical psychiatry. Baltimore, MD: Lippincott Williams & Wilkins. Klein, D.N., & Miller, G.A. (1993). Depressive personality in a nonclinical sample. American Journalof Psychiatry, 150, 1718-1724. Klein, D.N., & Shih, J.H. (1998). Depressive personality: Associations with DSM-III-R mood and personality disorders and negative and positive affectivity, 30-month stability, and prediction of course of Axis I depressive disorders. Journal of Abnormal Psychology, 197, 319-327. Lyoo, K., Gunderson, J.G., & Phillips, K.A. (1998). Personality dimensions associated with depressive personality disorder. Journal of Personality Disorders, 12, 46-55. Millon, T. (1993). The Millon Adolescent Clinical Inventory Manual. Minneapolis, MN: National Computer Systems. Ryder, A.G., Bagby, R.M. (1999). Diagnostic viability of depressive personality disorder. Journal of Personality Disorders, 13, 99-117. Ryder, A.G., Bagby, R. M., Dion, K.L. (2001). Chronic, low grade depression in a nonclinical sample: Depressive personality or dysthymia? Journal of Personality Disorders, 15(1), 84-93. Draft Copy Adolescent DPD 6 Table 1 Correlations for the Doleful & Oppositional MACI Scales with the MMPI-A Scale 2B (Doleful) Scale FF (Depressive Affect) K D(2) Pd(4) Pa(6) Pt(7) Sc(8) Si(0) Imm A Anx Obs Dep Aln Lse Fam Trt D1 D4 D5 Hy3 Pd4 Pd5 Pa1 Pa2 Sc1 Sc2 Sc3 Sc4 Si3 K D(2) Pd(4) Pa(6) Pt(7) Sc(8) Si(0) Imm A Anx Obs Dep Aln Lse Fam Trt D1 D4 D5 Hy3 Pd4 Pd5 Pa1 Pa2 Sc1 Sc2 Sc3 Sc4 Si3 -.560 .614 .511 .554 .759 .673 .611 .557 .767 .698 .618 .792 .622 .681 .400 .635 .723 .718 .738 .670 .643 .705 .522 .644 .638 .622 .594 .679 .654 -.552 .582 .593 .544 .701 .634 .500 .535 .728 .701 .612 .765 .580 .623 .495 .603 .661 .679 .683 .631 .619 .731 .499 .627 .610 .589 .603 .659 .599 Legend for MMPI-A Scales D(2) = Depression Pd(4) = Psychopathic Deviate Pa(6) = Paranioa Pt(7) = Psychasthenia Sc(8) = Schizophrenia Ma(9) = Hypomania Ack = Alcohol/Drug Acknowledge Pro = Alcohol/Drug Proneness Imm = Immaturity A = Welsh’s Anxiety Anx = Anxiety Obs = Obsessiveness Dep = Depression Aln = Alienation Ang = Anger Con = Conduct Problems Lse = Low Self-Esteem Fam = Family Problems Sch = School Problems Trt = Negative Treatment Indicators D1 = Subjective Depression D4 = Mental Dullness D5 = Brooding Hy3 = Lassitude Malaise Pd1 = Familial Discord Pd4 = Social Alienation Pd5 = Self-Alienation Pa1 = Persecutory Ideas Pa2 = Poignancy Sc1 = Social Alienation Sc2 = Emotional Alienation Sc3 = Lack of Ego Mastery- Cognitive Sc4 = Lack of Ego Mastery- Cognative Si3 = Alienation Self and Others Note: N=233. Correlations empirically selected based on Pearson Correlation > .50. Draft Copy