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Millon™ Behavioral Medicine Diagnostic (MBMD) - Frequently Asked Questions

What is the MBMD test designed to do?

When is it appropriate to use the MBMD test?

How long does it take to administer the MBMD test?

What is the norm group for the MBMD test?

How is the MBMD test different from the MBHI test?

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

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

How reliable is the MBMD test?

What is the validity of the MBMD test?

What is the difference between the MBMD Interpretive Report and the MBMD Bariatric Report?

Is the MBMD Bariatric Report based on empirical data?

Can I receive an Interpretive Report (not a Bariatric Report) for an examinee in a Bariatric setting?

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


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.

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 or 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 89 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.

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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.

Among several differences between norm groups, bariatric 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 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 group 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.

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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 psychopathology-based test and has a broader medical norm group consisting of a wide variety of medical conditions. 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 20–25 minutes for the patient to complete.

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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 (rTT=.76 to .89), Coping Styles (rTT=.54 to .85), Stress Moderators (rTT=.85 to .89), Treatment Prognostics (rTTTT=.47 to .80), and Management Guides (rTT=.77 to .79). The median internal consistency coefficient for all scales is rTT=.79.

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

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

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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 Utilisation Problems.

What is the difference between the MBMD Interpretive Report and the MBMD Bariatric Report?

Whereas the MBMD Interpretive Report was normed on a general medical population, the Bariatric Report was normed on a very specific bariatric 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.

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Is the MBMD Bariatric Report based on empirical data?

Based on the bariatric-specific scores and profiles, the Bariatric Report is intended to assist clinicians in making prudent and tentative management decisions for pre-surgical bariatric patients. Although the probabilistic statements made in the Bariatric Report are not empirically-derived and should not be considered definitive, they reflect judgments based on clinical experience, the bariatric research literature, and theory-deduced inferences. Non-psychosocial factors, such as BMI, energy metabolism, diabetic consequences, and hypertension, should also be kept in mind as outcome modifiers.

Studies to gather probabilistic predictive outcome indices are currently underway. Upon completion, these data will be drawn upon to further refine plausible hypotheses for this specific medical population.

Can I receive an Interpretive Report (not a Bariatric Report) for an examinee in a Bariatric setting?

Yes. When a bariatric patient is being evaluated, the clinician can choose to receive either the MBMD Interpretive Report or Bariatric Report. If the MBMD Interpretive Report option is chosen for the bariatric patient, the original general medical norms will be used. Similarly, if the Bariatric Report option is chosen, the bariatric norms will be used.

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.

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Key Information

Description

Assess psychosocial factors that may support or interfere with a chronically ill patient's course of medical treatment

Author(s)

Dr Theodore Millon

Michael Antoni

Carrie Millon

Sarah Minor

Seth Grossman

Publication Year

2001

Age Range

18 years and older

Administration

Individual - 20 to 25 mintues

Qualification Code

CL2


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