Millon Behavioral Medicine Diagnostic

The Millon Behavioral Medicine Diagnostic MBMD, provides an assessment of psychosocial factors that may support or interfere with a chronically ill patient's course of medical treatment. Psychologists, physicians, nurses and other professionals use the MBMD results to help:


 * Identify patients who may have significant psychiatric problems and recommend specific interventions
 * Pinpoint personal and social assets that may facilitate adjustment to physical limitations or lifestyle changes
 * Determine whether patients need more communication and support in order to comply with prescribed medical regimens
 * Structure post-treatment plans and self-care responsibilities in the context of the patient's social network

Key Features

 * The MBMD’s recently added bariatric norms can help determine a candidate’s psychological suitability for surgery, assist patients in making significant lifestyle changes, and prepare medical stuff to respond to patients’ likely reactions following surgery.


 * The MBMD’s broad normative sample permits the test’s use to be extended into sleep disorder centers, cancer treatment centers, cardiac rehabilitation programs, bariatric surgery departments, pain treatment centers, neurological rehabilitation units, military and veterans’ hospitals, primary care facilities and family medicine clinics.


 * The Interpretive Report includes a one-page, tear-off Healthcare Provider Summary written in language medical professionals can readily understand, helping to facilitate communication between the psychologist and medical staff.


 * The test’s 165 items require only 20–25 minutes to complete, helping to reduce patient resistance and fatigue.


 * By enabling more effective treatment planning, the MBMD test may help decrease healthcare costs in clinics and hospitals through reduced assessment time, more efficient triage and decreased complications after major procedures.

Response Patterns
X - Disclosure Y - Desirability Z - Debasement

Negative Health Habits
Alcohol Drugs Eating Caffeine Inactivity Smoking

Psychiatric Indicators
AA - Anxiety-Tension BB - Depression CC - Cognitive Dysfunction DD - Emotional Liability EE - Guardedness

Coping Styles
1 - Introversion 2A - Inhibited 2B - Dejected 3 - Cooperative 4 - Sociable 5 - Confident 6A - Nonconforming 6B - Forceful 7 - Respectful 8A - Oppositional 8B - Denigrated

Stress Moderators
A - Illness Apprehension B - Functional Deficits C - Pain Sensitivity D - Social Isolation E - Future Pessimism F - Spiritual Absence

Treatment Prognostics
G - Interventional Fragility H - Mediation Abuse I - Information Discomfort J - Utilization Excess K - Problematic Compliance

Management Guide
L - Adjustment Difficulties M - Psych Referral

Test Components

 * Response Patterns. Help gauge distorted response tendencies in the patient's self-report
 * Negative Health Habits. Help gauge recent or current problematic behaviors affecting health, such as Alcohol, Drug, Eating, Caffeine, Inactivity, and Smoking
 * Psychiatric Indications. Help identify psychiatric comorbidities that may affect health management such as Anxiety-Tension, Depression, Cognitive Dysfunction,

Emotional Liability, and Guardedness.
 * Coping Styles. Help identify patients' approaches to handling everyday problems, as well as their medical condition and major life stressors
 * Stress Moderators. Help identify attitudes and resources that may affect health care such as Illness Apprehension, Social Isolation, Future Pessimism, Pain Sensitivity and Spiritual Absence.

Norms
The MBMD test now provides a choice of two normative samples. The general medical norms include a sample of more than 700 patients with a wide variety of medical conditions, including obesity, cancer, diabetes, HIV/AIDS, chronic pain, heart problems, neurological disorders, gastrointestinal complaints, gynecological problems, injuries and organ transplants. The bariatric norms are based on data collected from 711 prescreened bariatric surgery patients ages 19-68 from across the United States, including 585 females and 126 males with BMIs ranging from 31 to 84.

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.

Reliability
Both internal consistency and test-retest analyses were used 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 (rtt = .47 to .80); and Management Guide (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 Guide (rtt = .78 to .81). The median test-retest coefficient for all scales is rtt = .83.

Validity
Several approaches were used to validate the scales included on the MBMD assessment. First, an item sorting procedure was used that required several medical professionals to place the items into the scales for which they were initially written. 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 to each of the scales. For example, the MBMD Depression scale correlated at .87 with the BDI, and .58 with the BSI Depression scale. The MBMD Spiritual Absence scale correlated at .85 with the Systems of Belief Inventory (a frequently employed measure of spiritual beliefs).