Can you say more about MMPI-II and depression vs. organic damage? My MMPI scores showed significant depression.

There are certain scales that will indicate depression but also indicate organic brain injury with or without depression. If scales 1, 2, 3, 7, or 8 are elevated, they can indicate depression or organic brain injury. NP's tend to not consider this since the research was not well published nor followed.

The MMPI-II should be used more as a tool to understand the patient's perception of their problems rather than a diagnostic tool.

The primary author of the research was Lloyd Cripe Ph.D. who worked with two other researchers, Maxwell and Hill. Cripe developed a system for evaluating the 63 individual MMPI questions that elevate with mTBI and called it the Cripe Neurological Symptoms (C.N.S.) index. The various research studies were done between 1994 and 1997 at the University of Washington.

A suggested alternative with better indications is the Personality Assessment Inventory-Revised (PAI-R) by Morey (1991) even though it has a similar but lesser tendency to endorse depression in mTBI patients.

The optimum is to use the CNS to fully evaluate the individual answers for a more valid diagnosis.

Here is a reference to the study http://www.ncbi.nlm.nih.gov/pubmed/7797650

Although, in the end, does it really matter what the source of the impairment is? In the end, my brain doesn't work right, whether because of the concussion or the depression or both together. What advantages are there to doing some of these alternate tests?

I went through a day of testing and looking to get results this week. I am curious what others on here experienced. I know there were several puzzle type part to the test and some memorization and some even questions dealing with historical figures? not sure what it all means yest but until the end of the test there was a questionaire that asked more psycological information so if this is the standard neuro psyc testing then how can that illicit depression over everything else

Yep, that sounds very similar to what I had. The cognitive testing showed that my cognitive functions (vocab and problem-solving and all that) still work -- albeit slowly. So the more significant results came from the MMPI-II (the psychological part). That showed elevated depression, but apparently that scale can also be high if there's chronic pain and some other stuff. That, at least, is what I have gleaned so far.

Have you seen the actual scales from the MMPI? Just a general comment about elevated depression is meaningless. Did the report mention anything more specific?

The difference is BIG. If the diagnosis is MCI (Mild Cognitive Impairment) caused by depression, then the treatment will be to ignore the head trauma and dump you off to a doctor to prescribe anti-depressants.

The CNS system is just a way to interpret the MMPI scales. It is not a test at all.

Getting labeled MCI due to depression can become the kiss of death to an injury claim or any follow up treatment. Your MCI can be interpreted as psycho-somatic. That diagnosis will be trouble.

Did the report mention any validity scales? These are used to score whether you are malingering or faking your symptoms. I scored 48 and 49 out of 50 with 50 meaning absolutely no malingering. My NPA had two malingering tests. A normal score for a patient who is malingering/faking is in the 30's or lower. I aced the no malingering tests but the NP still tried to say I was faking it and was depressed.

He did not like my high IQ scales in the WAIS tests. He determined that I could not possibly have bottom 5 % and 12% scores in the memory tests but still have a high IQ. My WAIS processing speed was at the bottom 10% level, too. Research suggests that divergent scores between IQ and memory functions are indicative of organic brain injury.

NPA's can be good or even great or they can be totally counter-productive.

I am not sure what the test I had was called but it was several hours of putting puzzle like pictures in from on me and then reading me small stories and asking later what I could recall. There was then a flash card like segment that you have to figure out a pattern but how can all of this determine depression or mental deficits??? I would thing it would primarily show areas of cognitive slowness or normal function. So my take away from the above comments is that if you score poorly - it means you are either severly depressed or malingering. if you do ok then nothing is wrong with you so how does this help you at all??

My three seperate sessions of neuropsychological testing came out as at or above average on every measure. Like yer man on the 'You look great!' youtube video says it was like when you feel terrible and don't want to go to school, but when your mum takes your temperature it comes out fine.

Luckily the psychologist seems to understand that my problem is more to do with the fatigue and symptoms being easily brought on by mental effort rather than me not being able to think per se. I would hope that they are all able to make this distinction; if I was told that I was fine and should just pull myself together it would have been very disheartening.

Hello again,

This is an update on my efforts to get neuropsych testing. After making a lot of phone calls, I was told by the UCSF acquired brain injury unit to send an email to a neuropsychologist who works at the county hospital where I get treatment. The email was sent, and the neuropsychologist replied the same day, suggesting that my public health doctor contact them about my case. She said my doctor could send her an email and she would help him with the referral.

I left a message for my doctor yesterday, providing the information and asking for a return call. Hopefully he will call back soon and maybe I can get the right testing.

Will keep you all posted.

That's great news!

My neurologist, doctor, the psychiatrist and some other medical professionals I saw all thought I needed to have neuropsychological testing done, but my insurance carrier denied the referrals and then denied the subsequent appeals.