The incremental validity and clinical utility of the MMPI-2 infrequency posttraumatic stress disorder scale

The incremental validity and clinical utility of the recently developed Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Infrequency Posttraumatic Stress Disorder Scale (Fptsd) was examined in relation to the family of MMPI-2 F scales in distinguishing feigned post-traumatic stress disorder (PTSD) from disability claimants with PTSD. Research participants instructed to feign PTSD when completing the MMPI-2 scored significantly higher on the MMPI-2 family of F scales and the Fptsd scale compared with their responses when completing the MMPI-2 under standard instructions and the sample of claimants with PTSD. Although comparable in magnitude, effect sizes derived from mean group differences and hierarchical logistic regressions for the Fptsd scale never exceeded those for F(B), and F(P), F, F(B), and F(P) added incrementally to Fptsd in the prediction of feigned PTSD. These results suggest that the Fptsd scale does not afford any incremental predictive utility for detecting feigned PTSD relative to the complement of the existing family of F scales.     

The Infrequency-Posttraumatic Stress Disorder scale (Fptsd) for the MMPI-2: development and initial validation with veterans presenting with combat-related PTSD

Researchers have identified difficulties associated with the use of traditional Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) validity scales with survivors of traumatic events. A new scale, the Infrequency-Posttraumatic Stress Disorder scale (Fptsd), was created from MMPI-2 items that were infrequently endorsed by 940 male combat veterans presenting for treatment at the posttraumatic stress disorder (PTSD) clinics of 2 Veterans Affairs Medical Centers. A variety of statistical methods were implemented that preliminarily established Fptsd's validity with a validation sample of 323 additional PTSD-diagnosed combat veterans. Results indicate that, relative to previously established validity and overreporting scales (F, Fb, and Fp), Fptsd was significantly less related to psychopathology and distress and better at discriminating simulated from genuinely reported PTSD. Clinical implications are discussed concerning the use of Fptsd to assess disability-seeking veterans suspected of overreporting PTSD symptoms.     

Assessing posttraumatic stress disorder with the MMPI-2 in a sample of workplace accident victims

In this study, the predictive capacity of the Minnesota Multiphasic Personality Inventory-2 Posttraumatic Stress Disorder-Keane (MMPI-2 PK) scale was examined in a sample of trauma victims who experienced a serious workplace-related accident and subsequent injury. In keeping with a number of previous investigations, the PK scale was largely ineffective in identifying posttraumatic stress disorder (PTSD) beyond overall symptom and functional severity. In contrast, sets of clinical and content scales proved to be significant predictors of PTSD. These findings suggest that the PK scale is not particularly useful in detecting PTSD in civilian trauma samples. Clinicians might be best advised to use the MMPI-2 clinical and content scales in their assessment of PTSD in civilian patients presenting with a history of trauma.     

The validity and clinical utility of the MMPI-2 Malingering Depression scale

In this study, we examined the validity and clinical utility of the MMPI-2 (Butcher, Graham, Tellegen, Dahlstrom, & Kaemmer, 2001) Malingering Depression scale (Md) in relation to the MMPI-2 F scales (F, F(B), F(P)) to detect feigned depression. Overall, the F(B) scale and the F/F(P) scale combination were the best single predictors, although the Md scale did discriminate successfully cases of feigned depression from patients with bona fide depression. The Md scale added predictive capacity over the F scales, and the F(B) scale and the F/F(P) scale combination added predictive capacity over the Md scale; however, the actual increase in the number of cases predicted was minimal in each instance. In sum, although the Md scale is able to detect accurately feigned depression on the MMPI-2 (predictive validity), it does not confer a distinct advantage (incremental validity) over the existing standard validity scales-F, F(B), and F(P).     

A comparison of the PAI and MMPI-2 as predictors of faking bad in college students

Both the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher et al., 2001) and Personality Assessment Inventory (PAI; Morey, 1991) offer a large set of scales devoted to the identification of response styles. This study directly compared the effectiveness of the 2 inventories as indicators of overreporting. The 2 measures were administered to 52 college students instructed to fake bad under conditions describing either a forensic (n = 24) or psychiatric (n = 28) setting as well as to 432 psychiatric patients. Results indicated that the MMPI-2 F - K index and Fp Scale were the best single indicators of a faking bad response style and that the MMPI-2 scales were the better indicators as a set. However, the PAI scales demonstrated a significant level of incremental validity over the MMPI-2 indicators in every analysis conducted. The findings suggest that either inventory offers an effective approach to the detection of overreporting, and administering both inventories can enhance the accuracy of prediction further.     

Validity of the Personality Assessment Inventory Aggression scales and Violence Potential index in veterans with PTSD

In this study, we examined the validity of the Personality Assessment Inventory (PAI; Morey, 1991) Aggression (AGG) scales and Violence Potential index (VPI) in 399 male combat veterans presenting for formal evaluation of posttraumatic stress disorder (PTSD). The AGG scales exhibited convergence with other measures of hostility and violence and demonstrated discriminant validity with alternative constructs. When we examined reports of interpersonal violence in the past year, the AGG composite scale displayed substantial incremental validity over the effects of PTSD severity, demographics, a simple dichotomous question regarding violence in the past 30 days, and MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) scales measuring aggression. The VPI, however, added no unique explanatory power over the AGG composite scale.     

Detection of feigned mental disorders: a meta-analysis of the MMPI-2 and malingering

The validity of test data from multiscale inventories is dependent on self-reports that may be easily distorted by malingering. In examining the Minnesota Multiphasic Personality Inventory-2's (MMPI-2) role in the assessment of feigning, this review provides a conceptual analysis of the detection strategies underlying the MMPI-2 validity scales. The conceptual analysis is augmented by comprehensive meta-analysis of 65 MMPI-2 feigning studies plus 11 MMPI-2 diagnostic studies. For the rare-symptoms strategy, Fp (Cohen's d = 2.02) appears especially effective across diagnostic groups; its cut scores evidence greater consistency than most validity indicators. The data supported the F as an effective scale but questioned the routine use of Fb. Among the specialized scales, Ds appeared especially useful because of its sophisticated strategy, consistent cut score, and minimalfalse-positives. General guidelines are offeredfor specific MMPI-2 validity scales in the assessment of malingering with specific diagnoses.     

The detection of feigned uncoached and coached posttraumatic stress disorder with the MMPI-2 in a sample of workplace accident victims

In this study research participants completed the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) under standard instructions and then were asked to fake posttraumatic stress disorder (PTSD) when completing the MMPI-2 for a 2nd time in 1 of 4 conditions with different instructions on how to fake PTSD: (a) uncoached, (b) coached about PTSD symptom information, (c) coached about MMPI-2 validity scales, or (d) coached about both symptoms and validity scales. These MMPI-2 protocols were then compared with protocols of claimants with workplace accident-related PTSD. Participants given information about the validity scales were the most successful in avoiding detection as faking. The family of F scales (i.e., F, FB, FP), particularly FP, produced consistently high rates of positive and negative predictive power.     

Detection of Feigned Posttraumatic Stress Disorder: A Comparison of the MMPI-2 and PAI

The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Personality Assessment Inventory (PAI) were compared for detecting feigned posttraumatic stress disorder (PTSD) in a simulation research design. Participants were 85 undergraduates in one of three groups: PTSDs (n = 23), Fakers (n = 31), and Controls (n = 31). As expected, both the MMPI-2 and PAI discriminated PTSDs and Controls, with PTSDs scoring significantly higher on fake-bad validity scales and PTSD-relevant clinical scales. However, only the MMPI-2 discriminated Fakers and PTSDs, with Fakers scoring significantly higher on all MMPI-2 scales considered, but on only one PAI scale. Further, in logistic regression analyses the MMPI-2 demonstrated higher overall correct classification of PTSDs and Fakers than did the PAI. Although the MMPI-2 outperformed the PAI in detecting feigned PTSD, a substantial proportion of Fakers avoided detection by MMPI-2 fake-bad validity scales, suggesting that both tests are vulnerable to feigning of PTSD by motivated respondents with relatively limited coaching.     

Validity rates of the MMPI-2 and PAI in a rural inpatient psychiatric facility

This study examines the validity rates of Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Personality Assessment Inventory (PAI) profiles in a rural inpatient population. The validity scales of 90 MMPI-2 and 90 PAI profiles were analyzed using published criteria for determining validity. Random responding, positive impression management, and negative impression management were also evaluated. The PAI had a higher number of valid profiles compared with the MMPI-2. Evidence suggests the primary source of the invalid profiles within the MMPI-2 is a higher level of endorsement of relatively rare statements. The substitution of the Infrequency-Psychopathology scale (Fp) for the Infrequency scale (F) on the MMPI-2 substantially reduced the number of invalid profiles. Contrary to expectations, the PAI did not demonstrate lower levels of invalid profiles due to random responding. Rates of invalid profiles for each scale are provided.     

Detection of overreported psychopathology with the MMPI-2-RF [corrected] validity scales

We examined the utility of the validity scales on the recently released Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2 RF; Ben-Porath & Tellegen, 2008) to detect overreported psychopathology. This set of validity scales includes a newly developed scale and revised versions of the original MMPI-2 validity scales. We used an analogue, experimental simulation in which MMPI-2 RF responses (derived from archived MMPI-2 protocols) of undergraduate students instructed to overreport psychopathology (in either a coached or noncoached condition) were compared with those of psychiatric inpatients who completed the MMPI-2 under standardized instructions. The MMPI-2 RF validity scale Infrequent Psychopathology Responses best differentiated the simulation groups from the sample of patients, regardless of experimental condition. No other validity scale added consistent incremental predictive utility to Infrequent Psychopathology Responses in distinguishing the simulation groups from the sample of patients. Classification accuracy statistics confirmed the recommended cut scores in the MMPI-2 RF manual (Ben-Porath & Tellegen, 2008).     

The predictive capacity of the MMPI-2 and PAI validity scales and indexes to detect coached and uncoached feigning

The objective of this study was to examine the relative effectiveness of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the Personality Assessment Inventory (PAI) validity scales and indexes to detect malingering. Research participants were either informed (coached) or not informed (uncoached) about the presence and operating characteristics of the validity scales and instructed to fake bad on both the MMPI-2 and PAI. The validity scale and index scores produced by these research participants were then compared to those scores from a bona fide sample of psychiatric patients (n = 75). Coaching had no effect on the ability of the research participants to feign more successfully than those participants who received no coaching. For the MMPI-2, the Psychopathology F scale, or F(p), proved to be the best at distinguishing psychiatric patients from research participants instructed to malinger, although the other F scales (i.e., F and Fb) were also effective. For the PAI, the Rogers Discriminant Function index (RDF) was clearly superior to the other PAI fake-bad validity indicators; neither the Negative Impression Management scale nor Malingering Index were effective at detecting malingered profiles in this study. Overall, RDF proved to be marginally superior to F and F(p) in distinguishing MMPI-2 and PAI protocols produced by research participants asked to malinger and psychiatric patients. Both the RDF and the F and F(p) scales, however, were able to increase the predictive capability of one another.     

The Use of the MMPI-2 Infrequency–Psychopathology Scale in the Assessment of Posttraumatic Stress Disorder in Male Veterans

This study evaluated the use of the F_P (Infrequency–Psychopathology) scale of the Minnesota Multiphasic Personality Inventory—2 (MMPI-2) as a measure of symptom overreporting among 423 service-seeking male veterans with and without PTSD. Results were consistent with several predictions based on the logic of the F_P scale. F_P produced lower scores for PTSD and non-PTSD patients than the other two MMPI-2 measures of infrequent responding; F and F_B. F_P also resulted in fewer invalid protocols than did F or F_B. Finally, F_P yielded lower correlations with MMPI-2 and other measures of psychopathology than did F or F_B. Consistent with previous studies, compensation-seeking status was associated with extreme elevations across clinical and validity scales. Contrary to previous findings, however, compensation-seeking veterans were also more likely to receive a PTSD diagnosis. Implications for the relationship between compensation seeking and symptom overreporting are discussed.     

Differentiating Overreporting and Extreme Distress: MMPI-2 Use With Compensation-Seeking Veterans With PTSD

This purpose of this study was to examine overreporting on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) in compensation-seeking veterans with posttraumatic stress disorder (PTSD). A sample of veterans tested during a V.A. hospital compensation and pension exam were given the MMPI-2 and measures of PTSD, depression, and combat exposure. Veteran's MMPI-2s were only included in the analyses if their profile was extremely exaggerated, as measured by an F scale T score above 80, did not elevate the MMPI-2 VRIN and TRIN scales, and had a primary diagnosis of PTSD (n = 127). Using the Infrequency-Psychopathology, F(p), scale to distinguish overreporting from distress, it was found that 98 veterans elevated profiles due to distress, whereas 29 elevated due to overreporting, F(p) below and above 7, respectively. Differences between groups on MMPI-2 clinical scales and the other measures were assessed. Implications of these findings for assessing veteran response style and using the MMPI-2 with a PTSD population are discussed.     

Differentiating overreporting and extreme distress: MMPI-2 use with compensation-seeking veterans with PTSD

This purpose of this study was to examine overreporting on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) in compensation-seeking veterans with posttraumatic stress disorder (PTSD). A sample of veterans tested during a V.A. hospital compensation and pension exam were given the MMPI-2 and measures of PTSD, depression, and combat exposure. Veteran's MMPI-2s were only included in the analyses if their profile was extremely exaggerated, as measured by an F scale T score above 80, did not elevate the MMPI-2 VRIN and TRIN scales, and had a primary diagnosis of PTSD (n = 127). Using the Infrequency-Psychopathology, F(p), scale to distinguish overreporting from distress, it was found that 98 veterans elevated profiles due to distress, whereas 29 elevated due to overreporting, F(p) below and above 7, respectively. Differences between groups on MMPI-2 clinical scales and the other measures were assessed. Implications of these findings for assessing veteran response style and using the MMPI-2 with a PTSD population are discussed.     

A comparison of the MCMI-III personality disorder and modifier indices with the MMPI-2 clinical and validity scales

In this study, we examined the relationship of the MCMI-III (Millon, Davis, & Millon, 1997; Millon, Millon, & Davis, 1994) modifier indices and personality disorder scales to the validity and basic clinical scales of the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). The MCMI-III modifier indices highly correlated with all of the MMPI-2 validity scales except for the F(p) scale. Similarly, the MCMI-III personality disorder scales strongly covaried with the MMPI-2 validity and clinical scales except for the F(p) and 5 (Mf) scales. A factor analysis with Promax rotation revealed substantial relationships between the MMPI-2 and MCMI-III. However, the MMPI-2 F(p) scale did not tend to correlate with MMPI-2 or MCMI-III scales, indicating that F(p) scale variance was largely independent of other scales. The results suggest that clinicians should consider the interrelationship between personality characteristics and dissimulation.     

Can the MMPI-2 validity scales detect depression feigned by experts?

Major depression is one of the most frequently presented disorders for claims of psychiatric disability. Evidence also suggests that many individuals making claims of disability exaggerate or even fabricate mental illness. These facts suggest that the detection of feigned depression is an important task in psychiatric disability claim assessments. In this study, the capacity of a number of MMPI-2 validity scales and indicators to detect feigned depression was examined. Twenty-three mental health professionals with specific expertise and significant experience in assessing and treating major depression were asked to complete the MMPI-2 as if they were suffering from major depression. The MMPI-2 protocols of this sample were compared to those of a sample of patients diagnosed with major depression. Results indicated that the validity scales F, back F (FB), and the Dissimulation scale (Ds) were highly successful at distinguishing MMPI-2 protocols of feigned depression from bona fide depression. Replicating results from previous studies, however, FB proved most effective, outperforming all other validity scales and indicators, including F and Ds. These findings suggest that even experts are unable to feign major depression successfully on the MMPI-2, and that the FB scale might be the most effective indicator for detecting feigned depression.     

The Minnesota Multiphasic Personality Inventory-2 Restructured Form in National Guard soldiers screening positive for posttraumatic stress disorder and mild traumatic brain injury

The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2 RF) was administered to 251 National Guard soldiers who had recently returned from deployment to Iraq. Soldiers were also administered questionnaires to identify posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). On the basis of responses to the screening instruments, the National Guard soldiers who produced a valid MMPI-2 RF were classified into four groups: 21 soldiers who screened positive for PTSD only, 33 soldiers who screened positive for mTBI only, 9 soldiers who screened positive for both conditions, and 166 soldiers who did not screen positive for either condition. Results showed that the MMPI-2 RF was able to differentiate across the groups with the MMPI-2 RF specific problem scale Anxiety adding incrementally to MMPI-2 Restructured Clinical scales in predicting PTSD. Both MMPI-2 RC1 (Somatic Complaints) and MMPI-2 RF head pain complaints predicted mTBI screen but did not add incrementally to each other. Of note, all of the MMPI-2 RF validity scales associated with overreporting, including Symptom Validity-Revised (FBS-r), were not significantly elevated in the mTBI group. These findings support the use of the MMPI-2 RF in assessing PTSD in non-treatment-seeking veterans. This further suggests that a positive screen for mTBI alone is not associated with significant emotional disturbance.     

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-11; 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 inits 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.     

Effective cutoffs for detecting random, partially random, and nonrandom 370-item MMPI-2 short form protocols

The ability of the 370-item short form MMPI-2 (Butcher, Graham, Ben-Porath, Tellegen, Dahlstrom, & Kaemmer, 2001) validity scales to detect random protocols was investigated using samples of 500 nonrandom protocols, 250 half-random protocols, and 250 all-random protocols. The long-form cutoff of VRIN ≥ 80 was unable to detect protocols with either level of randomness. The long-form cutoffs of Fp ≥ 100 or F ≥ 100 were able to detect all-random but not half-random protocols. Alternative cutoffs for VRIN, Fp, and F were investigated and short-form subscales of those scales were developed to improve detection of partially random protocols. An algorithm using alternative cutoffs for the scales and the new subscales was highly effective, detecting almost all of the random protocols as well as the nonrandom protocols. A follow-up cross-validation study was conducted that confirmed the effectiveness of the algorithm.