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Concordance of the MCMI-II, the MMPI, and Axis I discharge diagnosis in psychiatric inpatients.

Discriminant functions of the MMPI and the MCMI-II were compared in a sample of 166 hospitalized psychiatric patients with discharge diagnoses of affective disorder (63), schizophrenia (26), substance abuse (35), and other disorders (42). Of special interest was the comparative diagnostic utility of the two instruments in regards to DSM-III-R Axis I diagnoses. Both tests performed reasonably well in the discriminant function analyses; however, the MCMI-II achieved a somewhat superior overall hit rate with this sample of inpatients (79% to 68%). This difference was tied to greater accuracy of the MCMI-II for identifying the affective disorders group.

Adolescent↗

Maximum likelihood estimates of the ability of the MMPI and MCMI personality disorder scales and the SIDP to identify personality disorders.

The ability of the Minnesota Multiphasic Personality Inventory (MMPI) and Millon Clinical Multiaxial Inventory (MCMI) personality disorder scales and the Structured Interview for DSM-III Personality Disorders (SIDP) to identify personality disorders was estimated statistically using 122 subjects. Each technique was reasonably accurate when various diagnoses were excluded, but they were quite variable in identifying members of specific diagnostic categories. The same general pattern was seen when the disorders were combined into three general diagnostic clusters. The techniques excluded cluster membership fairly well, although there was little agreement across techniques for identifying cluster membership. The MCMI, however, was moderately adept at identifying membership in all three clusters. It was suggested that these instruments should be used cautiously in clinical settings and that additional data on their performance be obtained.

Adult↗

Validity of Harris and Lingoes MMPI subscale descriptors in an outpatient sample.

The validity of the Minnesota Multiphasic Personality Inventory (MMPI) subscales described by Lingoes (1960) along with his predicted correlates was investigated using clinicians' ratings of 85 outpatient therapy clients. Of the 68 predicted correlates, 30 were significant and supported the description of 16 of the subscales, but not necessarily their ability to discriminate nuances of pathology. The most significant correlations were obtained by the D, Pd and Sc subscales, the fewest by the Hy, Pa and Ma subscales. The lack of significant results for 12 subscales is discussed in terms of subscale unreliability, subscale length, or insufficiencies in the criteria or sample tested. The possibility that several of the unsupported subscales may function in the detection of defensiveness was considered.

Adult↗

A strategy for integrating a normal MMPI-2 and dysfunctional Rorschach in a severely compromised patient.

Effective assessment practice is dependent on synthesizing data from multiple sources. Our standard literature and experimental data base does not supply all the information practitioners need to provide assessment services. Practitioners must engage in a variety of novel operations to generate an acceptable assessment product. The role of the practitioner may be conceptualized as an independent contributor to the knowledge base underlying assessment. In this article, I articulate a series of stages serving as a guideline in integrating discrepant data from a Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Rorschach for a disturbed patient. The integrated data provides a more precise understanding of the patient than either data set by itself.

Female↗

Integrating the Rorschach and the MMPI in clinical assessment: conceptual and methodological issues.

The Rorschach and Minnesota Multiphasic Personality Inventory (MMPI) are among the most widely used personality assessment tools. However, there is little guidance in the literature about their combined use. In this article, I discuss conceptual and methodological issue of combining these widely used psychological tests, including the use of the test battery and the necessity of rationales for test utilization. Methodological approaches to integrating the test findings are discussed, including score, construct, test by test, and theory-based integrative approaches. The value of a person-centered interpretive and integrative focus is affirmed.

Humans↗

Screening for maladjustment in college students: an application of receiver operating characteristic curve to MMPI scales.

The ability of two scales derived from the Minnesota Multiphasic Personality Inventory (MMPI) to identify emotional maladjustment in a college setting was examined. The scales were the College Maladjustment scale (Mt) developed by Kleinmuntz (1961) and the Health Opinion Survey based Emotional Disorder scale (Ed). Emotional maladjustment was defined by criteria established in the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, 1987) and assessed through a computerized Diagnostic Interview Schedule. Subjects were 94 female and 62 male students, 51 of whom (33%) met criteria for at least one DSM-III-R disorder. Substance use disorders were most frequent (13.5%), followed by anxiety disorders (11.5%) and depressive disorders (7.1%). Both Mt and Ed had no relationship to substance use disorders but were moderately related to nonsubstance use maladjustment (r approximately .47); receiver operating characteristic (ROC) analysis was employed, and Mt and Ed proved to be a fair-to-good indicator of nonsubstance use maladjustment. Types of decision errors are discussed, and tables provide information concerning predictive accuracy across the entire range of scores.

Adaptation, Psychological↗

The clinical utility of the MMPI-2 in diagnosing unipolar depression among male alcoholics.

The correspondence between Scale 2 elevations on the MMPI-2 and SCID-diagnosed unipolar depression (major depression and dysthymia) and alcohol-induced depression was evaluated among 106 consecutive male admissions to an inpatient alcohol treatment unit. Valid profiles were obtained from 87 subjects, 15% of whom were diagnosed with unipolar depression and another 4.5% with presumed alcohol-induced depression. The sensitivity of Scale 2 (the probability that a depressed subject would obtain an elevated score) ranged from .19 to .42. Positive predictive power (the probability that a subject who obtained an elevated score had a depressive disorder) ranged from .23 to .38. Neither Scale 2 alone nor Scale 2 paired in 2-point code types predicted the presence or absence of comorbid depressive disorders among male alcoholics.

Adult↗

Variants of the MMPI 2-7-8 code type: schizotypal correlates of high point 2, 7, or 8.

Our study sought to evaluate whether examination of the high-point scale among subjects with a 2-7-8 parent configuration on the MMPI could assist in the identification of individuals with schizotypal features. Additionally, this study compared male 2-7-8 subjects to female 2-7-8 subjects to determine whether gender mediates endorsement of items associated with these features. Subjects (N = 106) who produced a 2-7-8 parent profile were subdivided according to high point (2, 7, or 8), and the three subgroups were subsequently compared on other self-report measures associated with schizotypal attributes. Subgroup comparisons revealed that the High 8 and High 2 groups produced a pattern of responding consistent with schizotypal characteristics. In contrast, the at-risk status of the High 7 group appears doubtful. Comparisons based on gender generally revealed no differences among female and male 2-7-8 subjects.

Adolescent↗

Perceptions of MMPI item subtlety: influences of age and ethnicity.

This study examined the influences of age and ethnicity on perceived item subtlety in Minnesota Multiphasic Personality Inventory (MMPI) Scales F and 9. One hundred twenty-one male adolescents (67 White, 54 Black) rated the items composing these scales in terms of their relationship to a psychological problem. The mean item ratings and subsequent subtle-obvious classifications were then compared to established ratings obtained from adults (Christian, Burkhart, & Gynther, 1978; Wiener, 1948). Results indicated significant differences in both item ratings and classifications between adolescents and adults on Scales F and 9. Significant differences between Black and White adolescents were found on Scale F but not on Scale 9, even when differences in verbal-comprehension abilities between groups were considered. These results suggest that it may be inappropriate to use current subtle-obvious keys with adolescents and minorities.

Adolescent↗

Validation of the MMPI-2 Low Self-Esteem Content Scale.

We explored the concurrent validity of the MMPI-2 Low Self-Esteem (LSE) Content scale by asking 216 undergraduate students to complete the Minnesota Multiphasic Personality Inventory-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1991), Harter Adult Self-Perception Profile (Harter, 1986a) and Rosenberg Self-Esteem Scale (Rosenberg, 1965). Results suggest the LSE renders a good assessment of global self-esteem as well as being a measure of three distinct components of self-esteem. These specific subscales, identified by factor analysis, were labeled Ineptitude, Negative Self-Value, and Negative Comparison with Others. The LSE and its subscales produced good internal consistency (alpha and Gutman Split Half) coefficients.

Adolescent↗

A hostility scale for the California Psychological Inventory: MMPI, observer Q-sort, and big-five correlates.

Using two samples, we developed and validated a hostility scale that can be scored from the California Psychological Inventory (CPI) and serves as an alternate for the Cook-Medley Hostility Scale (Ho; Cook & Medley, 1954). The CPI Hostility (H) scale consists of 33 items that are either duplicates or close equivalents of specific Ho items, and the two scales correlate at least .90 in samples differing in sex. The H and Ho scales show a similar pattern of correlations with conceptually relevant MMPI scales and with observer-rated personality attributes tapping Barefoot, Peterson, et al.'s (1991) five hostility categories of Hostile Affect, Cynicism, Aggressive Responding, Social Avoidance, and Hostile Attributions. These findings provide evidence for the equivalence of the two hostility scales, as well as external validation for those personality characteristics that are purported to underlie the construct of hostility as tapped by both the original Ho scale and the new CPI H scale.

Adolescent↗

A new perspective on gender orientation measurement with the MMPI-2: development of the Masculine-Feminine Pathology Scale.

A new scale of gender orientation for the MMPI-2 (Minnesota Multiphasic Personality Inventory-II; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) called the Masculine-Feminine Pathology Scale, or Mfp, was developed as an alternative to the available Mf, GM, and GF scales. It differs from previous scales in its emphasis on symptomatic correlates of gender. Items were included in the new scale if they (a) discriminated between male and female psychiatric patients and (b) were likely to be indicators of psychopathology. Statistical analyses suggested an acceptably reliable but factorially complex scale. When used to predict clinician ratings of global psychopathology, the scale demonstrated incremental validity over both the existing gender-related scales and the traditional clinical scales. Scores at the "feminine" end of the Mfp scale seem to reflect distress characterized by high levels of anxiety. Scores at the "masculine" end of the Mfp scale suggest a more composed interpersonal presentation, which may reflect an amoral attitude. It is suggested that the new scale may prove superior to the existing gender role scales as a supplement to other clinical scales. Avenues for future research with the Mfp scale are discussed.

Adult↗

A comparison of two interpretive approaches for the MMPI--A Structural Summary.

We undertook this study to provide empirically derived interpretative recommendations for the MMPI-A Structural Summary through an evaluation of factor elevation patterns. We examined the frequency of single-factor, two-factor, and multifactor elevations in a clinical sample of 363 adolescents receiving inpatient, outpatient, or residential treatment. Two methods of determining factor elevation (a simple majority of scales and subscales within a specific factor with T-score elevations at critical level, versus the mean T score generated by all the scales and subscales for each factor) yielded comparable findings concerning the frequency of factor elevation, permitting reliance on the former, easier-to-use method to define elevation. The most salient two-factor co-elevations were the 3-7 (Disinhibition-Familial Alienation), 2-8 (Immaturity-Psychoticism), 1-5 (General Maladjustment-Health Concerns), and 2-7 (Immaturity-Familial Alienation) patterns. This study also examined whether factor pattern elevations varied as a function of age, gender, or diagnosis. Data analyses revealed no differences between younger (ages 13-14) and older (ages 15-18) adolescents on factor elevation as defined by the first criterion. However, significant differences were found between boys and girls on Factors 3 (Disinhibition) and 5 (Health Concerns). Results also indicated that a larger proportion of depressed adolescents obtained factor elevations on Factors 4 (Social Discomfort) and 5 (Health Concerns) compared to adolescents with conduct disorder diagnoses and other diagnoses. The findings of this study are discussed with reference to recommended procedures for using the Structural Summary in clinical assessment practice.

Adolescent↗

Effects of acculturation on the MMPI-2 scores of Asian American students.

The use of the MMPI-2 (Butcher, Dahlstron, Graham, Tellegen, & Kaemmer, 1989) with minorities has been questioned due to potential misinterpretations related to cultural differences. This study examined acculturative differences among Asian American college students and their scores on the validity and clinical scales. A sample of Asian American students (n = 90) was assigned to groups based on acculturation level. Analysis of variance tests indicated that low-acculturated, bicultural, and high-acculturated Asian Americans yielded different profiles. Compared to a matched White student sample, low-acculturated Asian Americans scored significantly higher on 9 scales, and bicultural Asian Americans had 6 significantly different scores. These differences were clinically interpretable with a range from 6.46 to 21.65 T-score points. High-acculturated Asian Americans did not differ from Whites. Cultural variables to be considered when interpreting Asian American profiles are discussed.

Acculturation↗

MMPI-2 Personality Psychopathology Five (PSY-5) and prediction of treatment outcome for patients with chronic back pain.

This study investigated the utility of the MMPI-2-based Personality Psychopathology Five (PSY-5) scales (Harkness, McNulty, & Ben-Porath, 1995) in the outcome prediction of behaviorally oriented chronic-pain treatment. The PSY-5 is a dimensional descriptive system for personality and its disorders. The sample consisted of 120 consecutive chronic-back-pain patients who followed a 4-week multimodal treatment program aimed at achieving a normal pattern of functioning, including return to regular work. The psychometric properties of the PSY-5 scales (Aggressiveness, Psychoticism, Constraint, Negative Emotionality/Neuroticism, and Positive Emotionality/Extraversion) were highly similar to the data reported by Harkness et al. (1995) and also corresponded to the characteristics of chronic-pain patients. The results of the hierarchical regression analyses provided support for the utility of the PSY-5 Positive Emotionality/Extraversion scale for the prediction of emotionally oriented outcome. We conclude that the PSY-5 model of personality psychopathology provides a solid basis for the more systematic study of the complex relation between personality characteristics and multidimensional treatment.

Adult↗

Use of the MMPI-A to detect substance abuse in a juvenile correctional setting.

In this study, we examined the ability of the MMPI-A (Butcher et al., 1992) to detect substance abuse problems in a juvenile correctional setting. Specifically, we evaluated the Alcohol/Drug Problem Acknowledgment scale (ACK; Weed, Butcher, & Williams, 1994), the Alcohol/Drug Problem Proneness scale (PRO; Weed et al., 1994), and the MacAndrew Alcoholism Scale-Revised (MAC-R; Butcher et al., 1992) in the prediction of substance abuse. In addition, the incremental validity of ACK in comparison to PRO was evaluated, as was the incremental validity of PRO in comparison to ACK. The sample consisted of 123 boys and girls from ajuvenile correctional facility in Northeastern Ohio. Results indicate that ACK and PRO, but not MAC-R, were related to interviewer ratings of substance abuse. Results point to the superiority of ACK over PRO in substance abuse identification.

Adolescent↗

Adherence to substance abuse treatment: clinical utility of two MMPI-2 scales.

In this study, we examined the ability of the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) Addiction Acknowledgment scale (AAS; Weed, Butcher, McKenna, & Ben-Porath, 1992) and Negative Treatment Indicators scale (TRT; Butcher, Graham, Williams, & Ben-Porath, 1990) to predict adherence to and outcomes from substance abuse treatment. There was no evidence that the AAS was related to treatment adherence or outcome in our sample. However, results did reveal a significant positive relation between scores on the TRT scale and readmission to the hospital. Further analyses identified an optimal score for use in similar clinical populations and settings, and characteristics of high and low scorers. Compared to low scorers, high TRT scorers were more likely to not return for treatment after an initial screening interview. If they did return for treatment, high TRT scorers were more likely to experience fewer treatment days and to be rated as having lower motivation, poorer participation, and poorer comprehension of program materials. These findings provide promising initial evidence of the utility of the TRT scale for identifying patients who may be at a high risk for unsuccessful substance abuse treatment.

Adult↗

Narcissism and depression: MMPI-2 evidence for the continuum hypothesis in clinical samples.

According to one hypothesis, self-report measures of narcissism help describe a psychological continuum related to self-esteem. Most of the previous support for this idea appeared in studies of undergraduates responding to the Narcissistic Personality Inventory (NPI; Raskin & Hall, 1981) along with other self-report instruments. In this project, results consistent with the continuum hypothesis were obtained when Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) narcissism scales were correlated with depression in adults receiving treatment for alcoholism. Essentially identical outcomes emerged in a second sample of state psychiatric hospital patients. A third study upheld the hypothesis when narcissism scales were correlated with clinical assessments rather than self-reports of depression. None of these findings were easily explained in terms of alternative interpretations of self-reported narcissism, and these data demonstrate that empirical support for the continuum hypothesis was not limited to the NPI, undergraduates, or self-report measures.

Adult↗