Department

Psychology, Professional

Date of Paper/Work

2014

Degree Name

Doctor of Psychology (Psy.D.)

Type of Paper/Work

Doctoral Project

Advisors

Christopher S. Vye, Nathaniel W. Nelson

Abstract

The present study represents the first systematic, descriptive analysis of the self-reported concerns and psychological functioning of clients presenting for assessment services through the University of St. Thomas (UST) Interprofessional Center for Counseling and Legal Services (IPC), an outreach mental health clinic developed for individuals who are uninsured or underinsured. Minnesota Multiphasic Personality Inventory – 2 (MMPI-2) and Minnesota Multiphasic Personality Inventory – 2- Restructured Form (MMPI-2-RF) profiles of 94 individuals assessed through the UST IPC revealed three general categories of psychological and emotional presentation, including those endorsing minimal distress, select forms of moderate distress, and severe distress as indicated by endorsement of a broad range of symptoms, with roughly one-third of clients falling in each symptom group. The most common symptom themes included: antisocial traits, and substance use as well as dysphoric, depressive, anxious, and somatic symptoms (>30% clients). Psychotic symptoms, interpersonal difficulties, and feelings of anger were endorsed by a relatively smaller, but distinct number of clients (10-30%). Compared to a group of forensic clients that predominantly consisted of clients referred for a mandatory psychological evaluation as a condition of their probation (n = 40), clients assessed for routine clinical purposes (n = 54) generally endorsed significantly greater distress, differing most significantly (p < 0.05) on endorsement of demoralization, emotional distress, somatic concerns, substance-related concerns and a negative sense of self. These differences were evidenced on the following scales (with accompanying effect sizes): F (0.50), F-r (0.51), Hs (0.58), Hy(0.61), Pt (0.60), RCd (0.60), MLS (0.52), COG (0.59), and SUB (0.52). Profiles were significantly different (p < 0.05) among employed (n = 27) and unemployed (n = 40) examinees, with the latter group presenting with significantly greater emotional distress, internalizing iv symptoms, self-negative beliefs, and isolative tendencies. These differences were observed on the following scales: Fs (0.52), FBS (0.51), EID (0.63), RCd (0.56), RC2 (0.54), RC3 (0.53), GIC (0.59), SUI (0.63), and SFD (0.53). These findings illustrate some of the risk factors that are encountered in a unique community assessment clinic, and highlight the importance of attending to contextual factors when conducting clinical and forensic assessments in a clinic designed to serve the underserved. The range and severity of symptoms observed also underscores the importance of providing accessible, low-cost mental health services to clients who are uninsured or underinsured.

Keywords

Uninsured, underinsured, MMPI-2, MMPI-2-RF, forensic, unemployed

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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