Millon® Behavioral Medicine Diagnostic
Overview: Assessment of psychosocial factors that may support or interfere with a chronically ill patient's course of medical treatment.
Age Range: 18 - 85
Administration: Paper-and-pencil, CD or computer administration
Completion Time: 20–25 minutes (165 true/false items)
Scores/Interpretation: General medical norms based on 700 patients with a wide variety of medical conditions, Bariatric-specific norms based on more than 700 bariatric surgery candidates nationwide, and the Pain Patient norms are based on 1200 patients in the United Stated being treated for issues involving chronic pain.
Scoring Options: Q-global™ web based, Q Local™ Software, Manual Scoring, or Mail-in Scoring
Interpretive (with Healthcare Provider Summary), and Profile Reports
Publication Date: 2001
A World of Information with One Test
The MBMD assessment helps provide a broader understanding of the personal reality that each patient faces. By helping identify psychosocial assets and liabilities that may affect an individual’s response to treatment, the MBMD test enables clinicians to develop tailored treatment recommendations.
Brief yet comprehensive, the MBMD inventory helps gather a range of information that it might otherwise require a battery of instruments to obtain. With three norm groups, one that includes a comprehensive sample of patients with chronic medical conditions, one specific to bariatric surgery candidates, and one specific to patients with chronic pain, this contemporary test can help increase the likelihood of positive treatment outcomes and may thereby reduce the overall costs of care.
How to Use This Test
Psychologists, physicians, nurses and other professionals use the MBMD results to help:
- Identify patients who may have significant psychiatric problems and recommend specific interventions
- Pinpoint personal and social assets that may facilitate adjustment to physical limitations or lifestyle changes
- Determine whether patients need more communication and support in order to comply with prescribed medical regimens
- Structure post-treatment plans and self-care responsibilities in the context of the patient's social network
- NEW! The MBMD's recently added chronic pain norms and Pain Patient Reports can assist with pre-treatment psychosocial evaluations to help professionals select suitable therapies, general and expanded behavioral health evaluations to help determine the most appropriate intervention,and monitoring of treatment interventions and outcomes.
- The MBMD’s bariatric norms can help determine a candidate’s psychological suitability for surgery, assist patients in making significant lifestyle changes, and prepare medical staff to respond to patients’ likely reactions following surgery.
- The MBMD’s general medical normative sample permits the test’s use to be extended into a variety of settings including sleep disorder centers, cancer treatment centers, cardiac rehabilitation programs, neurological rehabilitation units, military and veterans’ hospitals, primary care facilities and family medicine clinics.
- The Interpretive Reports include Healthcare Provider summaries written in language medical professionals can readily understand, helping to facilitate communication between the psychologist and medical staff.
- The test’s 165 items require only 20–25 minutes to complete, helping to reduce patient resistance and fatigue.
- By enabling more effective treatment planning, the MBMD test may help decrease healthcare costs in clinics and hospitals through reduced assessment time, more efficient triage and decreased complications after major procedures.
X - Disclosure
Y - Desirability
Z - Debasement
Negative Health Habits
AA - Anxiety-Tension
BB - Depression
CC - Cognitive Dysfunction
DD - Emotional Lability
EE - Guardedness
1 - Introversion
2A - Inhibited
2B - Dejected
3 - Cooperative
4 - Sociable
5 - Confident
6A - Nonconforming
6B - Forceful
7 - Respectful
8A - Oppositional
8B - Denigrated
A - Illness Apprehension
B - Functional Deficits
C - Pain Sensitivity
D - Social Isolation
E - Future Pessimism
F - Spiritual Absence
G - Interventional Fragility
H - Mediation Abuse
I - Information Discomfort
J - Utilization Excess
K - Problematic Compliance
L - Adjustment Difficulties
M - Psych Referral
- Response Patterns
Help gauge distorted response tendencies in the patient's self-report
- Negative Health Habits
Help gauge recent or current problematic behaviors affecting health, such as Alcohol, Drug, Eating, Caffeine, Inactivity, and Smoking
- Psychiatric Indications
Help identify psychiatric comorbidities that may affect health management such as Anxiety-Tension, Depression, Cognitive Dysfunction, Emotional Lability, and Guardedness
- Coping Styles
Help identify patients' approaches to handling everyday problems, as well as their medical condition and major life stressors
- Stress Moderators
Help identify attitudes and resources that may affect health care such as Illness Apprehension, Social Isolation, Future Pessimism, Pain Sensitivity and Spiritual Absence.
The MBMD test now provides a choice of three normative samples. The general medical norms include a sample of more than 700 patients with a wide variety of medical conditions, including obesity, cancer, diabetes, HIV/AIDS, chronic pain, heart problems, neurological disorders, gastrointestinal complaints, gynecological problems, injuries and organ transplants.
The bariatric norms are based on data collected from 711 prescreened bariatric surgery patients ages 19-68 from across the United States, including 585 females and 126 males with BMIs ranging from 31 to 84.
The normative sample for the pain patient reports comprises 1,200 patients in the United States who are being treated for issues involving chronic pain. Norm referenced scores compare the patient to both a general medical norm sample and a chronic pain norm sample.
Both internal consistency and test-retest analyses were used 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 Guide (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 Guide (rtt = .78 to .81). The median test-retest coefficient for all scales is rtt = .83.
Several approaches were used to validate the scales included on the MBMD assessment. First, an item sorting procedure was used that required several medical professionals to place the items into the scales for which they were initially written. 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 to each of the scales. For example, the MBMD Depression scale correlated at .87 with the BDI, and .58 with the BSI Depression scale. The MBMD Spiritual Absence scale correlated at .85 with the Systems of Belief Inventory (a frequently employed measure of spiritual beliefs).
Provides a graphic representation of the prevalence scores for all the content scales, plus a rating for the likelihood of a problem with the Response Patterns and Negative Health Habits.
General Medical Interpretive Report
Provides a detailed narrative analysis of the patient’s reported strengths and weaknesses, a graphic representation of results and a convenient one-page Healthcare Provider Summary. The report also includes syntheses across scale domains, which integrate the results of the separate scales – in much the same way a clinician would integrate the results of several different tests or laboratory reports.
The Healthcare Provider Summary is a one-page report that 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.
Bariatric Interpretive Report
Provides a detailed narrative analysis of the patient’s reported strengths and weaknesses. One-page Bariatric Summary categorizes the patient’s information, normed on more than 700 bariatric surgical patients, and provides probabilistic judgments in areas of presurgical intervention, patient behavior, postsurgical outlook, and postsurgical care. The report also includes a graphic representation of results and a narrative syntheses across scale domains, integrating results of individual scales.
Pain Patient Interpretive Report
Provides a detailed narrative analysis of the patient's reported strengths and weaknesses. The Interpretive Report includes tailored considerations for clinicians working with pain patients to help serve as a guide in making prudent judgments. A three-page section in the report can be customized for either presurgical or nonsurgical populations, normed on 1,200 patients in the United States being treated for issues involving chronic pain.
Scoring and/or Reporting Options
Q-global™ Web-based Administration, Scoring, and Reporting – Enables you to quickly assess and efficiently organize examinee information, generate scores, and produce accurate comprehensive reports all via the Web.
Q Local™ Scoring and Reporting Desktop Software - Enables you to score assessments, report results, and store and export data on your computer.
Mail-in Scoring Service - Specially designed answer sheets are mailed to Pearson for processing within 24–48 hours of receipt; results returned via regular mail.
Fax-in Scoring Service – A Fax-in form is completed and included with your fax-in answer sheets. Pearson processes these within 24 hours of receipt; results returned via fax.
Learn more about Health Psychology
Online Training Program
This complimentary independent study training program provides an overview of the MBMD. A series introduction and three lectures presented by the MBMD co-author, Dr. Seth Grossman provide an introduction to the MBMD and describe the underlying theory, administration and interpretation of the inventory.
Earn up to 3 APA CE credits (Nominal fee applies). Information to obtain CE is included with each module.
Getting Started with the Q-global Training Series
View these brief training modules about Q-global:
- Module 1: Gaining Access to Q-global
- Module 2: Signing in and setting up your account
- Module 3: Managing sub-accounts
- Module 4: How to generate reports
Free CD-based training for the MBMD test now available! Earn up to three CE credits. Get more information.
Using the MBMD with Patients with Chronic Pain
Presenter: Mike Antoni (author), Anne-Marie Kimbell
Pain is one of the most prevalent and one of the costliest health issues in North America, and approaches to treating pain cover a vast spectrum. Some of the most common treatments are simple bed rest, mild medications, acupuncture, physical therapy, injections, powerful opioid drugs, individual and group psychotherapy, and a variety of surgical procedures.
Despite interventions, some patients fail to achieve pain relief. For these – the chronic pain patients – a downward spiral of pain, disability, despair, high healthcare utilization, and overall poor quality of life results in immense costs for both the individual and society. Professionals who work with chronic pain patients recognize that the pain experience involves more than the biological process through which the stimulation of nerves sends information to the brain about possible tissue damage. The patient’s unique constellation of genetics and prior experiences, as well as psychosocial assets and liabilities (e.g., personality factors, concurrent mental health status) form a cognitive and affective lens that affects how nerve stimulation is experienced, which in turn produces a bio-behavioral response.
Date: Sep 12, 2018
Using the Millon Behavioral Medicine Diagnostic (MBMD) in Bariatric Surgery
Presenter: Michael H. Antoni, PhD
Obesity affects about 78 million Americans, and about 24 million have morbid or severe obesity, placing them at major health risk. Bariatric surgery can enable patients to achieve significant weight loss as well as improvement in obesity-related conditions such as diabetes mellitus, hypertension, and sleep apnea. However, the effectiveness of bariatric surgery depends on many patient factors including demographic variables, co-morbid conditions (e.g, affective and psychiatric disorders), health behaviors, cognitive appraisals, coping strategies, and available resources.
The Millon Behavioral Medicine Diagnostic (MBMD) helps assess psychosocial factors that may support or interfere with a patient’s course of medical treatment. This webinar will describe how the MBMD was developed and how its’ specialized Bariatric Report can be used as part of a comprehensive evaluation to identify patient assets and liabilities to tailor a treatment plan that will optimize post-operative outcomes.
Date: May 22, 2018
Overview of the Millon Behavioral Medicine Diagnostic (MBMD)
Presenter: Michael H. Antoni, PhD
The Millon Behavioral Medicine Diagnostic (MBMD) helps assess psychosocial factors that may support or interfere with a chronically ill patient’s course of medical treatment. It offers population-specific reports for general medical patients, pain patients, and bariatric patients. Composed of only 165 true/false items and featuring 38 clinically relevant scales, the MBMD helps increase the likelihood of positive treatment outcomes and thereby helps reduce overall cost of patient care.
This webinar will provide an introduction to the MBMD and describe the underlying theory, administration and interpretation of the inventory. It will also illustrate how the MBMD can be used as part of a comprehensive evaluation to identify patients who may have significant psychiatric problems, and construct treatment plans tailored to their individual needs.
Date: Jul 25, 2017
MBMD Pain Patient Reports Webinar
Presenter: Gloria Maccow, PhD and Deborah Kukal, PhD
The MBMD (Millon Behavioral Medicine Diagnostic) inventory is designed to provide the critical psychological information doctors need to treat the whole patient. This webinar covers the following topics:
- Psychological assessment with the MBMD.
- Introduction of new norm group for pain population.
- Description of customized Pain Patient Interpretive Reports.
Date: Oct 20, 2011
Frequently asked questions follow. Click on a question to see the response.
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. By addressing these factors, behavioral health psychologists 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.
What is the norm group 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.
Recently, bariatric-specific norms were developed for the MBMD test. Using data from 711 prescreened bariatric surgery patients collected across 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; included were patients with a variety of ailments and injuries (back, joints, neck, head) and were being evaluated for treatment. 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.
Among several differences between norm groups, bariatric and pain patients tend to be more concerned about illness, more prohibited from doing 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 a more specific norm groups to MBMD users.
How is the MBMD test different from the MBHI test?
Like the MBHI, 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. 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 bio-psycho-social factors that may interfere with a patient’s normal course of recovery from an injury, chronic pain or illness. The BHI 2 test utilizes two sets of norms (rehab/chronic pain patient and community), as well as eight reference groups (chronic pain, headache/head injury, neck injury, back injury, upper extremity injury, lower extremity injury, fake good and fake bad). The MBMD test is a more personality and psychopathology-based test and includes three norm group options. The MBMD also includes some areas not covered by the BHI2, including coping styles, stress moderators and treatment prognostics, as well as negative health habits such as smoking, lack of exercise, and over eating.
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 that are worthy of a clinician’s attention. 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 only 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 (rTTTT=.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.
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.
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, rehabilitation, or surgical treatment regimens. The MBMD 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 85 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 differences between the MBMD General Medical Interpretive Report, the MBMD Bariatric Interpretive Report, and the MBMD Pain Patient Interpretive Report?
Whereas the MBMD Interpretive Report was normed on a general medical population, the Bariatric Report was normed on a very specific bariatric population and the Pain Patient Interpretive report was normed on a chronic pain population. Using data from 711 prescreened bariatric surgery patients, the MBMD Bariatric Report includes supplementary information that augments the MBMD Interpretive Report in several areas that are salient for patients who are considering, or are candidates for, bariatric surgery. The Pain Patient Report uses data from 1200 patients being treated with chronic pain and augments the MBMD General Medical Interpretive Report in several areas salient for patients being treated either medically or surgically for chronic pain.
Is the MBMD Patient Pain Report based on empirical data?
The statements in the MBMD Pain Patient Reports are based on the research literature, direct empirical studies of the MBMD with pain patients, and plausible hypotheses from clinical experience. The content of the reports was also refined in consultation with pain psychologists who use the MBMD. Of particular importance is the array of validity evidence supporting the value of the MBMD for use with pain patients. MBMD scales showed substantial concurrent validity with a wide variety of other self-report measures that are commonly used with pain patients and that have demonstrated validity with this population, including both general mental health assessments and a number of measures developed specifically for use with pain patients. The predictive value of the test was demonstrated in a study in which MBMD scores obtained at intake to a multidisciplinary pain treatment program correlated strongly with response to treatment.
Why does my interpretive report look so different when I send it to a WordPerfect file?
Users of the MBMD Interpretive Report should anticipate differences in the look of this report when it is sent to a WordPerfect file rather than printed directly from this software. The interpretive report was designed with distinct paragraph headers which are actually graphic boxes inserted between the paragraphs of the report. When the report is sent to a WordPerfect file, the graphics lose their positioning on the page. The interpretive statements are correct in the WordPerfect files; only the formatting of the report is lost.