Randomized comparison of the Personality Assessment Inventory and the Minnesota Multiphasic Personality Inventory-2 in the epilepsy monitoring unit

The two most common personality measures used in evaluation of patients on epilepsy monitoring units (EMUs) are the Personality Assessment Inventory (PAI) and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Both have been evaluated separately for their ability to distinguish patients with epilepsy from patients with psychogenic events, but they have never been compared directly. The primary aim of this study was to provide comparison data in an EMU population between the PAI, MMPI-2, and the MMPI-2-RF (MMPI-2 Restructured Form). Results show that the PAI Somatic Complaints (SOM) scale and the Conversion subscale (SOM-C), with classification rates of 79%, outperform other indicators from the PAI and indicators from the MMPI-2 and the MMPI-2-RF. Given its other strengths combined with better diagnostic validity performance, the PAI may be the better personality assessment measure for use in distinguishing patients with epilepsy from those with psychogenic seizures in the EMU.

Research highlights► The PAI and MMPI-2 have never been directly compared in the EMU. ► The ability of these tests to differentiate epilepsy from psychogenic nonepileptic seizures was investigated. ► The PAI SOM scale and SOM-C subscale perform best with 79% overall accuracy. ► Likelihood ratios for a range of cut scores are provided. ► It is concluded that the PAI is the better measure for distinguishing epilepsy from psychogenic nonepileptic seizures.