Wutzler Uwe, Venner Margit, Villmann Thomas, Decker Oliver, Ott Undine, Steiner Thomas, Gumz Antje
Clinic of Psychotherapy and Psychosomatic Medicine, Asklepios Fachklinikum Stadtroda, Germany.
Psychosoc Med. 2009 Oct 13;6:Doc04. doi: 10.3205/psm000060.
Living organ donation involves interference with a healthy organism. Therefore, most transplantation centres ascertain the voluntariness of the donation as well as its motivation by means of a psychosomatic evaluation. The circumstance that the evaluation is compulsory and not a primary concern of the donor-recipient pair may occasion respondents to present only what they consider innocuous and socially adequate. Thus, the information value of the results can be considerably affected.
In the context of a psychosomatic evaluation prior to living kidney transplantation, 71 donor-recipient pairs were screened at the transplantation centre of Friedrich Schiller University, Jena. Using the validity scales of the Minnesota Multiphasic Personality Inventory (MMPI) ("infrequency" (F), "lie" (L) and "correction-scales" (K)) and the Dissimulation Index according to Gough ("F-K"), we tried to find traits of dissimulation and denial.
About 50% of the participants showed an infrequency raw score of zero. This means that at least half of the sample is apprehensive which may cause a cautious and controlled attitude towards the examination. The K-value (T>/=59) and the Dissimulation Index (F-K</=-15) indicated dissimulation in 29% and 26% of the overall sample. Moreover, it affects the score of 11 respondents (8%) so profoundly that any significance regarding the personality traits is lost.
In the setup of the examination situation as well as in the interpretation of test-psychological findings, the occurrence and possible influence of dissimulation should be considered. The validity scale of the MMPI can help to obtain an objective clinical impression of dissimulation in problem cases.
活体器官捐赠涉及对健康机体的干预。因此,大多数移植中心通过身心评估来确定捐赠的自愿性及其动机。评估具有强制性且并非供受者双方的首要关注点这一情况,可能会使受访者只呈现他们认为无害且符合社会规范的内容。这样一来,结果的信息价值可能会受到很大影响。
在耶拿弗里德里希·席勒大学移植中心进行活体肾移植前的身心评估过程中,对71对供受者进行了筛查。我们使用明尼苏达多相人格调查表(MMPI)的效度量表(“频率”(F)、“说谎”(L)和“校正量表”(K))以及根据高夫编制的掩饰指数(“F - K”),试图找出掩饰和否认的特征。
约50%的参与者频率原始得分是零。这意味着至少一半的样本存在担忧情绪,这可能导致他们对检查持谨慎和克制的态度。K值(T≥59)和掩饰指数(F - K≤ - 15)表明,在整个样本中分别有29%和26%的人存在掩饰行为。此外,它对11名受访者(8%)的得分影响极大,以至于关于人格特质的任何意义都丧失了。
在检查情境的设置以及对测试心理结果的解释中,应考虑掩饰行为的发生及其可能产生的影响。MMPI的效度量表有助于在疑难案例中获得关于掩饰行为的客观临床印象。