About the MBMD®

Table of Contents

About the MBMD® 3

1 Brief Description 3

2 About the Authors 3

3 Quick Facts 4

4 Scales 5

5 Norm Groups 6

6 Report Options 6

7 Scoring and Reporting Rules 7

8 Data Export Labels 8

9 FAQs (Frequently Asked Questions) 13

Copyright © 2001, 2006, 2010 NCS Pearson, Inc. All rights reserved.

Pearson is a trademark in the U.S. and/or other countries of Pearson Education, Inc., or its
affiliates(s). MBMD and Millon are registered trademarks of DICANDRIEN, Inc.

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 About the MBMD

1 Brief Description
The Millon® Behavioral Medicine Diagnostic (MBMD) test is a powerful assessment that
offers a contemporary view of the psychosocial assets and liabilities that may support
or interfere with a patient’s course of medical treatment.

The MBMD assessment provides information that may guide physicians, psychologists,
nurses, and other professionals toward a broader understanding of a patient’s bio-
psycho-social health. The test was designed to help increase the probability of positive
healthcare treatment outcomes, which may reduce medical utilization and the overall
cost of care.

New updates include norms for the bariatric and pain populations, increasing the
overall utility of the MBMD test among patients being assessed for weight-loss surgery
and in pain settings.

2 About the Authors

Theodore Millon, PhD, DSc, is a leading psychological theorist, renowned for his APA-
award winning work on an evolutionary theory of personality and psychopathology.
Dr. Millon was the founding editor of the Journal of Personality Disorders and is the
inaugural president of the International Society for the Study of Personality Disorders. He
has been a full professor at Harvard Medical School, the University of Illinois, and the
University of Miami. Principal author of the Millon® Inventories, Dr. Millon has written or
edited more than 30 books, including The Millon Inventories: A Practitioner’s Guide to
Personalized Clinical Assessment (2 nd Edition), Personality-Guided Therapy, The Oxford
Textbook of Psychopathology (2 nd Edition), Contemporary Directions in Psychopathology
(2 nd Edition) and a 3-book series subtitled A Personalized Psychotherapy Approach.
Most recently, he has completed the third edition of Disorders of Personality. He has
contributed more than 250 chapters and articles to numerous books and journals in the
field. In the past decade, he has received psychology’s three highest commendations,
the APA Presidential Citation, the APA’s distinguished Professional Contribution
to Research, and the APF’s Gold Lifetime Achievement Award. With support from
colleagues and Pearson, Dr. Millon established the Institute for Advanced Studies in
Personology and Psychopathology, which he directs as Dean and Scientific Director.

Michael H. Antoni, PhD, a co-author of the MBMD assessment, is a professor of

psychology and psychiatry at the University of Miami, leads the Biobehavioral Oncology
Program at the Sylvester Comprehensive Cancer Center, and is a licensed Clinical
Psychologist in Florida. His research focuses on psychoneuroimmunology applied to
viral infections and certain human cancers. He has led multiple NIH-funded efforts

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 2 About the Authors continued
testing the effects of cognitive behavioral stress management (CBSM) interventions on
psychological adjustment, immune system functioning, and health outcomes in HIV-
infected men and women, women with Human Papilloma Virus-associated cervical
dysplasia, women with breast cancer, men with prostate cancer, and men and women
with chronic fatigue syndrome. He is a Fellow of the Society of Behavioral Medicine, and
is Associate Editor for the International Journal of Behavioral Medicine and Psychology
and Health. He has published over 400 journal articles, abstracts, chapters and books in
the area of health psychology.

3 Quick Facts

Authors: Theodore Millon, PhD, with Michael Antoni, PhD, Carrie

Millon, PhD, Sarah Minor, PhD, and Seth Grossman, PsyD

Publisher: Pearson

Date of Publication: 2001 (Normative Updates in 2006 and 2010)

Appropriate Ages: 18:0–85:11

Norm Groups: Adult medical patients with a wide variety of medical

conditions; patients under evaluation for bariatric surgery

Minimum Reading Level: 6th grade

Administration Time: Approximately 20 minutes

Assessment Length: 165 True-False items

Scales: 4 Response Patterns

5 Psychiatric Indications
11 Coping Styles
6 Stress Moderators
5 Treatment Prognostics
2 Management Guides
6 Negative Health Habits

Report Options: Profile Report - General Medical Report

Profile Report - Bariatric Report
Profile Report - Pain Patient Report

Interpretive Report With Healthcare Provider Summary -

General Medical Report
Interpretive Report With Healthcare Provider Summary -
Bariatric Report
Interpretive Report With Healthcare Provider Summary -
Pain Patient Reports (Presurgical or Nonsurgical)

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 4 Scales

Response Patterns
Scale V Validity
Scale X Disclosure
Scale Y Desirability
Scale Z Debasement

Psychiatric Indications
Scale AA Anxiety-Tension
Scale BB Depression
Scale CC Cognitive Dysfunction
Scale DD Emotional Lability
Scale EE Guardedness

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

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

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

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 4 Scales continued

Management Guides
Scale L Adjustment Difficulties
Scale M Psych Referral

Negative Health Habits

Scale N Alcohol
Scale O Drug
Scale P Eating
Scale Q Caffeine
Scale R Inactivity
Scale S Smoking

5 Norm Groups
The normative population of the MBMD test consists of three distinct groups. The first
includes more than 700 patients with a wide variety of medical conditions, including
cancer, diabetes, HIV/AIDS, chronic pain, heart problems, neurological disorders,
gastrointestinal problems, gynecological problems, injuries, and organ transplants.
The second normative sample is composed of 711 patients from around the U.S. who
were undergoing pre-surgical psychological evaluation for bariatric surgery. The third
normative sample is comprised of 1,200 patients from the United States being treated
for issues involving chronic pain.

6 Report Options
Administrators have the option to print profile and interpretive reports based on general
medical, bariatric, or pain-specific populations.

Profile Report
This report provides a profile of the prevalence scores for all the content scales, plus a
rating of the likelihood of a problem indicated by the individual’s Response Patterns and
Negative Health Habits scores. These easy-to-read graphics can help give clinicians a
quick picture of a patient’s strengths and weaknesses. The profile report also includes a
Noteworthy Responses section that alerts the clinician to potential problem areas that
need follow-up.

Interpretive Report With Healthcare Provider Summary

Options:

General Medical Report

Bariatric Report

Pain Patient Reports

Presurgical Pain Patient Report

Nonsurgical Pain Patient Report

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 6 Report Options continued
The interpretive report narrative provides a detailed analysis of the patient’s potential
strengths and weaknesses. Health and clinical psychologists can use this information
to help other medical professionals develop comprehensive and successful treatment
plans for patients.

This report provides an interpretation for each of the five domains (Psychiatric
Indications, Coping Styles, Stress Moderators, Treatment Prognostics, and Management
Guides), plus a Noteworthy Responses section that alerts the clinician to potential
problem areas that need follow-up. The Management Guide serves as a summary,
helping to identify problems that may call for psychological referral and/or medication.

Depending on the norm group selection, the MBMD Interpretive Report includes
specifically tailored considerations for clinicians to help serve as guides in making
prudent and tentative judgments.

In conjunction with the interpretive report, a Healthcare Provider Summary is provided.

This summary was designed for physicians and other healthcare professionals. This one-
page report provides healthcare professionals with a useful and concise summary of
the patient’s potential assets and weaknesses and can be reviewed in a manner similar
to that of medical lab reports.

7 Scoring and Reporting Rules

Administration Scorability Rules
The administration of this assessment cannot be scored if any of the following conditions
are true:

• Identification number is missing or invalid, or first or last name of examinee is missing

or invalid

• Birth date is missing or invalid

• Administration date is missing or invalid

• Gender is missing or invalid

• Age is less than 18 or greater than 85

• Number of omits or invalid test responses is greater than 10

• Birth date is later than the administration date

• All responses must be properly filled first

If an administration is unscorable, you must fill in the appropriate responses or raw scores
before you can score the instrument.

Report Invalidity Rules

Report invalidity rules describe circumstances in which a valid interpretation cannot be
made. Common examples are too many missing responses, an examinee’s age that is
outside the appropriate range, an abnormal score on an assessment’s validity index,
and an uninterpretable profile configuration.

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 7 Scoring and Reporting Rules continued
This report is invalid if the following condition is true:

• The raw V score is greater than 1

Unless you have modified your default system settings, you will always be asked whether
or not you want to print an invalid report. An on-screen message will briefly describe the
invalidity condition and the data you will receive if you print the report. For example,
an invalid report might include a printout of raw and transformed scores, but the scores
would not be plotted and no interpretation would be attempted.

8 Data Export Labels

Demographic Data Description Special Values (if applicable)

ExamineeID Examinee’s identification number  
BDate Examinee’s birth date  
ADate Date of administration  
Gender Examinee’s gender (1=Male; 2=Female)
ClinCH Special Clinical Codes, H  
ClinCCT1 Special Clinical Codes, CT1  
ClinCCT2 Special Clinical Codes, CT2  
ClinCS Special Clinical Codes, S  
ClinCE Special Clinical Codes, E  
Administration Language in which the test was 1=English 2=Spanish
Language administered
Problem1 Major Medical Problems 1st (1=Accident/Injury;
2=Arthritis; 3=Cancer (not
breast); 4=Depression;
5=Diabetes;
6=Gynecological;
7=Headaches; 8=Heart
disease; 9=HIV/AIDS; 10=Pain;
11=Stress/Anxiety; 12=Stroke;
13=Other;  14=Weight/Eating
issues; 15=Bariatric surgery;
16=Breast cancer; 17=COPD/
Breathing disorders;
18=Infertility; 19=Kidney
disorders; 20=Organ
transplant; 21=Plastic
surgery; 22=Sexual difficulties;
23=Sleep/Insomnia;
24=Traumatic brain injury;
25=Urological)
Problem2 Major Medical Problems 2nd (same as for Major Medical
Problems 1st)
MarStat Marital status (1=Married; 2=Living
as Married; 3=Single;
4=Divorced; 5=Separated;
6=Widowed)

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 8 Data Export Labels continued

Demographic Data Description Special Values (if applicable)

Educ Education (1=Did Not Graduate From
High School; 2=High School
Graduate; 3=Technical
Certificate or Diploma;
4=Associate Degree;
5=Bachelors Degree;
6=Masters Degree;
7=Doctorate)
Race Race/Ethnicity (1=White; 2=African-
American; 3=Hispanic;
4=Asian-American;
5=American Indian; 6=Other)
LName Examinee’s last name  
FName Examinee’s first name  
MI Examinee’s middle initial  
Litho Lithocode that appears on the  
assessment scan form
Custom1 Custom field #1  
Custom2 Custom field #2  
Custom3 Custom field #3  
Custom4 Custom field #4  

Score Data Description Special Values (if applicable)

RAW_V Validity Scale Raw Score  
RAW_X Disclosure Scale Raw Score  
RAW_Y Desirability Scale Raw Score  
RAW_Z Debasement Scale Raw Score  
RAW_1 Introversive Scale Raw Score  
RAW_2A Inhibited Scale Raw Score  
RAW_2B Dejected Scale Raw Score  
RAW_3 Cooperative Scale Raw Score  
RAW_4 Sociable Scale Raw Score  
RAW_5 Confident Scale Raw Score  
RAW_6A Nonconforming Scale Raw Score  
RAW_6B Forceful Scale Raw Score  
RAW_7 Respectful Scale Raw Score  
RAW_8A Oppositional Scale Raw Score  
RAW_8B Denigrated Scale Raw Score  
RAW_AA Anxiety-Tension Scale Raw Score  
RAW_BB Depression Scale Raw Score  
RAW_CC Cognitive Dysfunction Scale Raw  
Score
RAW_DD Emotional Lability Scale Raw Score  

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 8 Data Export Labels continued

Score Data Description Special Values (if applicable)

RAW_EE Guardedness Scale Raw Score  
RAW_A Illness Apprehension Scale Raw  
Score
RAW_B Functional Deficits Scale Raw Score  
RAW_C Pain Sensitivity Scale Raw Score  
RAW_D Social Isolation Scale Raw Score  
RAW_E Future Pessimism Scale Raw Score  
RAW_F Spiritual Absence Scale Raw Score  
RAW_G Interventional Fragility Scale Raw  
Score
RAW_H Medication Abuse Scale Raw  
Score
RAW_I Information Discomfort Scale Raw  
Score
RAW_J Utilization Excess Scale Raw Score  
RAW_K Problematic Compliance Scale  
Raw Score
RAW_L Adjustment Difficulties Scale Raw  
Score
RAW_M Psych Referral Scale Raw Score  
RAW_N Alcohol Scale Raw Score  
RAW_O Drug Scale Raw Score  
RAW_P Eating Scale Raw Score  
RAW_Q Caffeine Scale Raw Score  
RAW_R Inactivity Scale Raw Score  
RAW_S Smoking Scale Raw Score  
PS_1 Introversive Scale Prevalence Score  
PS_2A Inhibited Scale Prevalence Score  
PS_2B Dejected Scale Prevalence Score  
PS_3 Cooperative Scale Prevalence  
Score
PS_4 Sociable Scale Prevalence Score  
PS_5 Confident Scale Prevalence Score  
PS_6A Nonconforming Scale Prevalence  
Score
PS_6B Forceful Scale Prevalence Score  
PS_7 Respectful Scale Prevalence Score  
PS_8A Oppositional Scale Prevalence  
Score
PS_8B Denigrated Scale Prevalence  
Score
PS_AA Anxiety-Tension Scale Prevalence  
Score

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 8 Data Export Labels continued

Score Data Description Special Values (if applicable)

PS_BB Depression Scale Prevalence Score  
PS_CC Cognitive Dysfunction Scale  
Prevalence Score
PS_DD Emotional Lability Scale Prevalence  
Score
PS_EE Guardedness Scale Prevalence  
Score
PS_A Illness Apprehension Scale  
Prevalence Score
PS_B Functional Deficits Scale  
Prevalence Score
PS_C Pain Sensitivity Scale Prevalence  
Score
PS_D Social Isolation Scale Prevalence  
Score
PS_E Future Pessimism Scale Prevalence  
Score
PS_F Spiritual Absence Scale Prevalence  
Score
PS_G Interventional Fragility Scale  
Prevalence Score
PS_H Medication Abuse Scale  
Prevalence Score
PS_I Information Discomfort Scale  
Prevalence Score
PS_J Utilization Excess Scale Prevalence  
Score
PS_K Problematic Compliance Scale  
Prevalence Score
PS_L Adjustment Difficulties Scale  
Prevalence Score
PS_M Psych Referral Scale Prevalence  
Score
PTILE_CP_AA Anxiety-Tension Scale Percentile Pain Patient Reports Only
Score
PTILE_CP_BB Depression Scale Percentile Score Pain Patient Reports Only
PTILE_CP_CC Cognitive Dysfunction Scale Pain Patient Reports Only
Percentile Score
PTILE_CP_DD Emotional Lability Scale Percentile Pain Patient Reports Only
Score
PTILE_CP_EE Guardedness Scale Percentile Pain Patient Reports Only
Score
PTILE_CP_1 Introversive Scale Percentile Score Pain Patient Reports Only
PTILE_CP_2A Inhibited Scale Percentile Score Pain Patient Reports Only
PTILE_CP_2B Dejected Scale Percentile Score Pain Patient Reports Only

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 8 Data Export Labels continued

Score Data Description Special Values (if applicable)

PTILE_CP_3 Cooperative Scale Percentile Pain Patient Reports Only
Score
PTILE_CP_4 Sociable Scale Percentile Score Pain Patient Reports Only
PTILE_CP_5 Confident Scale Percentile Score Pain Patient Reports Only
PTILE_CP_6A Nonconforming Scale Percentile Pain Patient Reports Only
Score
PTILE_CP_6B Forceful Scale Percentile Score Pain Patient Reports Only
PTILE_CP_7 Respectful Scale Percentile Score Pain Patient Reports Only
PTILE_CP_8A Oppositional Scale Percentile Pain Patient Reports Only
Score
PTILE_CP_8B Denigrated Scale Percentile Score Pain Patient Reports Only
PTILE_CP_A Illness Apprehension Scale Pain Patient Reports Only
Percentile Score
PTILE_CP_B Functional Deficits Scale Percentile Pain Patient Reports Only
Score
PTILE_CP_C Pain Sensitivity Scale Percentile Pain Patient Reports Only
Score
PTILE_CP_D Social Isolation Scale Percentile Pain Patient Reports Only
Score
PTILE_CP_E Future Pessimism Scale Percentile Pain Patient Reports Only
Score
PTILE_CP_F Spiritual Absence Scale Percentile Pain Patient Reports Only
Score
PTILE_CP_G Interventional Fragility Scale Pain Patient Reports Only
Percentile Score
PTILE_CP_H Medication Abuse Scale Percentile Pain Patient Reports Only
Score
PTILE_CP_I Information Discomfort Scale Pain Patient Reports Only
Percentile Score
PTILE_CP_J Utilization Excess Scale Percentile Pain Patient Reports Only
Score
PTILE_CP_K Problematic Compliance Scale Pain Patient Reports Only
Percentile Score
PTILE_CP_L Adjustment Difficulties Scale Pain Patient Reports Only
Percentile Score
PTILE_CP_M Psych Referral Scale Percentile Pain Patient Reports Only
Score
PTILE_CP_M Psych Referral Scale Percentile Pain Patient Reports Only
Score

Item Response Data Description Special Values (if applicable)

Q1 through Q165 Item responses for questions 1
through 165

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 9 FAQs (Frequently Asked Questions)
What is the MBMD test designed to do?
Medical researchers and healthcare practitioners understand that psychological and
personality factors are major contributors to positive health outcomes. The MBMD test
can help identify the main psychosocial factors that can contribute to the recovery
from, relapse of, or progression of physical disease. Addressing these factors can help
medical professionals better treat their patients. The results may be improved treatment
success and rehabilitation/recovery from disease, as well as reduced medical utilization
and contained healthcare costs.

When is it appropriate to use the MBMD test?

Because the MBMD test is normed on medical patients, it can be used with patients
who are undergoing a variety of medical care or treatment regimens. The MBMD test
can help identify patients with psychiatric problems and recommend interventions. It
can also help pinpoint personal and social assets that can help the patient adjust to
physical limitations or lifestyle changes.

It is not appropriate to use the MBMD test with adolescents. The age range for the
MBMD test is 18 to 89 years old.

How long does it take to administer the MBMD test?

The MBMD test has 165 True/False items and takes 20–25 minutes to administer.

What are the norm groups for the MBMD test?

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.

In 2006, bariatric-specific norms were released for the MBMD test. Using data from
711 prescreened bariatric surgery patients collected from 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.

Pain patient-specific norms were released for the MBMD in 2010. All 1,200 pain patients,
pulled from diverse settings across the U.S., were given the MBMD. This data helped
to develop two reports tailored to help assess individuals in two primary pain patient
settings, Presurgical and Nonsurgical. Approximately 54% of this sample were female,
69% were Caucasian, 62% were married, and 46% had at least a high school diploma.

There are several differences between the norm groups.  Bariatric and pain patients
tend to be more concerned about illness, less able to do things, and in more pain than
the general medical population. Differences such as these indicate that the average
bariatric or pain patient is not only physically different from the general medical
population but psychologically different as well, justifying the effort to bring more
specific norm groups to MBMD users.

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 9 FAQs (Frequently Asked Questions) continued
How is the MBMD test different from the MBHI test?
Like the MBHI assessment, the MBMD test provides information about a patient’s
coping style. However, it also provides new scales (stress moderators, treatment
prognostics, psychiatric indications, and management guides) and negative health
habits and response patterns. The MBMD test also includes a larger range of patient
populations and clinical settings. The MBMD interpretive report includes a one-page
Healthcare Provider Summary, which outlines assessment findings and treatment
recommendations. Our customer research has shown that medical professionals are
most interested in obtaining this type of patient information.

How is the MBMD test different from the BHI 2 test?

The BHI 2 test is designed to help identify the psychological and psychosocial factors
that may interfere with a patient’s normal course of recovery from an injury. The BHI 2
test was normed on physical rehabilitation and chronic pain patients. The MBMD test is
a more psychopathology-based test and has a broader medical norm group, so it can
be applied to a wider range of patients.

How does the MBMD test differ from other medically based psychosocial tests?
Like other personality tests, the MBMD test provides information about a patient’s
coping style. However, it also provides new scales (stress moderators, treatment
prognostics, and psychiatric indications), and negative health habits. The interpretive
report takes each patient’s individual style of coping into account in mediating the
patient’s psychiatric symptoms, personal assets, external resources, and healthcare
utilization. Thus, the interpretive report captures the process of synthesis that a seasoned
clinician would use in integrating information from multiple test instruments. All of this
can be achieved with high external validity and with minimal patient burden given that
each MBMD test administration requires 20-25 minutes for the patient to complete.

How reliable is the MBMD test?

Internal consistency and test-retest analyses were conducted 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 Guides (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 Guides (rTT=.78
to .81). The median test-retest coefficient for all scales is rTT=.83.

Internal consistency and test-retest analyses were also conducted for the bariatric
patient sample, resulting in the following reliability estimates: Psychiatric Indicators
(rTT = .70 to .85), Coping Styles (rTT = .56 to .80), Stress Moderators (rTT = .77 to .89),
Treatment Prognostics (rTT = .22 to .71), and Management Guides (rTT = .64 to .69).
The median internal consistency coefficient for all scales is rTT = .70.

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 9 FAQs (Frequently Asked Questions) continued
What is the validity of the MBMD test?
Several approaches were used to validate the scales included on the MBMD. First,
an item-sorting procedure was used that required several medical professionals to
identify which scale(s) each item appeared to be logically associated with. 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. For example, the MBMD Depression scale correlated
at .87 with the Beck Depression Inventory and .58 with the Brief Symptom Inventory
Depression scale.

Third, medical professionals who were familiar with approximately 100 patients rated
each patient on a number of attitudes and behaviors that are important to treatment
outcomes (e.g., compliance, medication problems, utilization problems). A number
of significant relationships were found between the MBMD scales and the medical
staff ratings. For example, the Pain Sensitivity scale correlated .62 with a rating of
Pain Experiences. The Adjustment Difficulties scale correlated .61 with a rating of
Utilization Problems.

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