The assessment of denial and physical complaints: the validity of the Hy scale and associated MMPI signs.

Little and Fisher (1958) have demonstrated that the MMPI Hysteria (Hy) scale consists primarily of items that address the denial of psychological problems (the DN scale) and items that involve the admission of physical problems (the AD scale). The traditional interpretation of an elevated Hy score implies that both DN and AD subscales are elevated significantly. Using samples of psychiatric (N = 1,246), medical (N = 330), and chronic pain patients (N = 126), the effectiveness of the HY scale and of various combinations of MMPI scales as predictors of the simultaneous occurrence of these two characteristics was evaluated. The results suggest that when the 13 standard MMPI scales were used, simultaneous elevations on scales K, HS, and HY proved to be the best indicator of the denial of psychological factors associated with a physiological disorder. It was found unwarranted to suggest the presence of hysteroid features on the basis of an elevated HY score unless scales K and HS also were elevated. The value of the HY scale as a measure of psychological denial associated with physical complaints must be considered questionable.