Convergent validity of the MCMI-III personality disorder scales and the MMPI-2 scales

The MCMI-III personality disorder scales (Millon, 1994) were empirically validated in a sample of prisoners, psychiatric inpatients, and outpatients (N = 477). The scale intercorrelations were congruent with those obtained by Millon, Davis, and Millon (1997). We conclude that our Flemish/Dutch version shows no significant differences with the original version of the MCMI-III as far as intercorrelations are concerned. Convergent validity of the MCMI-III personality disorder scales was evaluated by the correlational data between the MCMI-III personality disorder scales and the MMPI-2 clinical (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) and personality disorder (Somwaru & Ben-Porath, 1995) scales. Improved convergence was obtained compared with previous versions of the MCMI-I. Only the compulsive MCMI-III personality disorder scale remains problematic. The scale even showed negative correlations with some of the related clinical scales and with the corresponding personality disorder scales of the MMPI-2.     

Overreport on the MCMI-III: concurrent validation with the MMPI-2 using a psychiatric inpatient sample

The MCMI-III (Millon, Davis, & Millon, 1997) is a widely used measure of personality often used in inpatient psychiatric settings. Although patients in such settings often overreport or exaggerate their symptoms, relatively little is known about how such a response set presents on the validity indexes of the MCMI-II. In this study, we used a sample of 191 psychiatric inpatients and compared MCMI-III modifier indices (Disclosure, Desirability, and Debasement) with the validity measures (L, F, Fb, F(p), K, and F - K) of the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). In addition, the MCMI-III Disclosure Index (Scale X, which imposes a set cutoff score for invalidity due to overreport) was compared to several cutoff scores on the validity scales of the MMPI-2. Although the MCMI-III indexes generally performed as expected, the MCMI-III had a very high tolerance for overreport. When contrasted with MMPI-2 F scale, the MCMI-II Disclosure Index (which gauges overreport) remained valid until scores on MMPI-2 F scale approached a T score of 120. In addition, the Disclosure Index was at the upper end or slightly exceeded the highest recommended cutoff scores on all other MMPI-2 validity scales except F - K. Clinicians using the MCMI-III alone are cautioned to consider the high tolerance the MCMI-III has for overreport.     

MMPI-2 and MCMI-III characteristics of parental competency examinees

The MMPI-2 (Butcher et al., 2001) and the MCMI-III (Millon, Davis, & Millon, 1997) may contribute to understanding psychological functioning in parental competency examinees. In this study, we sought to identify MMPI-2 and MCMI-III characteristics of this population. We collected data regarding 127 individuals who underwent court-ordered parental competency evaluations. Although test results were generally consistent with findings from the child custody literature, MMPI-2 results indicated the highest Validity scale elevation on the L scale in contrast to the K scale elevations that have often been reported in the custody literature.     

An Empirical Evaluation of Millon's Dimensional Polarities

LASTPAGE study investigated the theoretical consistency for Millon's dimensional polarities (T. Millon &; R. D. Davis, 1996; T. A. Widiger, 1999) by administering the Millon Index of Personality Styles (MIPS; T. Millon, 1994) and Millon Clinical Multiaxial Inventory-III (MCMI-III; T. Millon, 1997) to 50 university counseling center students. Data were analyzed by correlating the MIPS polarity dimension scales with the personality disorder scales of the MCMI-III. Findings suggested more inconsistencies than consistencies with the underlying theoretical model. The greatest discrepancies were found for the expected relationships between the polarity dimensions and the narcissistic and compulsive scales, and to a lesser degree, the schizoid, avoidant, schizotypal, and negativistic scales. Discussion concerned how these divergencies might best be understood in light of Millon's conceptualization of Axis II disorders.     

Empirical evaluation of the MCMI-III personality disorder scales

The MCMI-III personality disorder scales were empirically validated with a sample of 870 clinical patients and inmates. Prevalence rates of personality disorders were in general lower on the MCMI-III than clinical ratings, but trait prevalence was generally higher; thus a base rate of 75 on the MCMI-III could be a guideline in the screening of trait prevalence. However, the sensitivity of some MCMI-III scales was very low. Moreover, the correlations of most personality disorder scales of the MCMI-III were significant and positive with corresponding measures on clinical ratings and MMPI-2 personality disorder scales, but these were, in general, not significantly higher than some other correlations. As a consequence the discriminant validity seems to be questionable. The MCMI-III alone cannot be used as a diagnostic inventory, but the test could be useful as a screening device as a part of a multimethod approach that allows aggregation over measures in making diagnostic decisions.     

Depression, anxiety, and the MCMI-III: construct validity and diagnostic efficiency

This study aimed to enhance knowledge of the construct validity and diagnostic efficiency of the depression- and anxiety-related scales of the MCMI-III (Millon, 1994). The MCMI-III, various concurrent depression and anxiety measures, and an Axis I structured diagnostic interview were administered in a total sample of 696 outpatients with depressive disorders, anxiety disorders, or both. Sound construct validity was found for the Dysthymia and Major Depression clinical syndrome scales and the Avoidant and Depressive personality disorder scales. The validity of the Anxiety scale was poor, showing moderate convergence with panic and worry-related anxiety measures, but problems discriminating from depression. Operating characteristics for discriminating depressed patients from anxious patients were fair for the Major Depression scale, but poor for the Anxiety and Dysthymia scales.     

Integrating psychopathology and personality disorders conceptualized by the MMPI-2-RF and the MCMI-III: a structural validity study

The Minnesota Multiphasic Personality Inventory-2-Restructured Form (Ben-Porath & Tellegen, 2008 ) Restructured Clinical scales and Higher Order scales were linked to the Millon Clinical Multiaxial Inventory-III (Millon, Millon, Davis, & Grossman, 2009 ) personality disorder scales and clinical syndrome scales in a Flemish/Dutch sample of psychiatric inpatients and outpatients, substance abuse patients, correctional inmates, and forensic psychiatric patients (N = 968). Structural validity of psychopathology and personality disorders as conceptualized by both instruments was investigated by means of principal component analysis. Results reveal a higher order structure with 4 dimensions (internalizing disorders, externalizing disorders, paranoid ideation/thought disturbance, and pathological introversion) that parallels earlier research on pathological personality dimensions as well as research linking pathological personality traits with mental disorders. Theoretical and clinical implications are considered.     

Exploring the psychometric properties and construct validity of the MCMI-III anxiety and avoidant personality scales

The Millon Clinical Multiaxial Inventory (MCMI; Millon, 1983) is a commonly used self-report instrument designed to aid in the assessment of Axis I and Axis II disorders. Concerns have been expressed regarding the procedures used in the normative research for the current version of the MCMI (MCMI-III; Millon, 1994) leading to a call for additional validity research on the MCMI-III (Retzlaff, 1996). In this study, we investigated the psychometric properties of the MCMI-III's Anxiety and Avoidant personality scales in a sample of patients diagnosed with Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) anxiety disorders. Our results suggest that the MCMI-III Avoidant scale is reliable (r =.89) and it was found to demonstrate appropriate convergent and divergent validity with other self-report measures. The MCMI-III Anxiety scale also showed adequate reliability (r =.78); however, our findings raise some concerns about the discriminant validity of this scale. A scale composed of the MCMI-III core anxiety items was found to have better discriminant validity. These findings are consistent with those reported by other researchers regarding the relationship between self-report measures of anxiety, avoidance, and depression. We conclude that the MCMI-III measures of anxiety and avoidance are consistent with other measures of these constructs and may provide valuable clinical information in this regard.     

Detecting random, partially random, and nonrandom Minnesota Multiphasic Personality Inventory-2 protocols

The ability of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; J. N. Butcher et al., 2001) validity scales to detect random, partially random, and nonrandom MMPI-2 protocols was investigated. Investigations included the Variable Response Inconsistency scale (VRIN), F, several potentially useful new F and VRIN subscales, and Fb- F>or=30 and Fb>or=90. Protocols completed by 150 adults participating in custody evaluations at a juvenile court setting, screened for randomness with a matched-pair Millon Clinical Multiaxial Inventory-III (T. Millon, R. Davis, & C. Millon, 1997), were compared with 500 computer-generated all-random protocols and with three levels of partially random protocols. VRIN was the most effective scale in detecting uninterpretable random protocols; however, VRIN >or= 80 failed to identify 37% of them. Fb- F>or=30 and Fb>or=90 misidentified 41% of the 50%-65% random protocols as partially interpretable. Using the new scales, a decision algorithm was described that correctly classified 97%-100% of the protocols as interpretable, partially interpretable, or uninterpretable.     

An examination of three sets of MMPI-2 personality disorder scales

Three sets of personality disorder scales (PD scales) can be scored for the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). Two sets (Levitt & Gotts, 1995; Morey, Waugh, & Blashfield, 1985) are derived from the MMPI (Hathaway & McKinley, 1983), and a third set (Somwaru & Ben-Porath, 1995) is based on the MMPI-2. There is no validity research for the Levitt and Gotts scale, and limited validity research is available for the Somwaru and Ben-Porath scales. There is a large body of research suggesting that the Morey et al. scales have good to excellent convergent validity when compared to a variety of other measures of personality disorders. Since the Morey et al. scales have established validity, there is a question if additional sets of PD scales are needed. The primary purpose of this research was to determine if the PD scales developed by Levitt and Gotts and those developed by Somwaru and Ben-Porath contribute incrementally to the scales developed by Morey et al. in predicting corresponding scales on the MCMI-II (Millon, 1987). In a sample of 494 individuals evaluated at an Army medical center, a hierarchical regression analysis demonstrated that the Somwaru and Ben-Porath Borderline, Antisocial, and Schizoid PD scales and the Levitt and Gotts Narcissistic and Histrionic scales contributed significantly and meaningfully to the Morey et al. scales in predicting the corresponding MCMI-II (Millon, 1987) scale. However, only the Somwaru and Ben-Porath scales demonstrated acceptable internal consistency and convergent validity.     

The Rorschach Technique (Book)

Minnesota Multiphasic Personality Inventory-2 (MMPI-2) overlapping and nonoverlapping scales were demonstrated to perform comparably to their original MMPI forms. They were then evaluated for convergent and discriminant validity with the Millon Clinical Multiaxial Inventory-II (MCMI-II) personality disorder scales. The MMPI-2 and MCMI-II personality disorder scales demonstrated convergent and discriminant coefficients similar to their original forms. However, the MMPI-2 personality scales classified significantly more of the sample as Dramatic, whereas the MCMI-II diagnosed more of the sample as Anxious. Furthermore, single-scale and 2-point code type classification rates were quite low, indicating that at the level of the individual, the personality disorder scales are not measuring comparable constructs. Hence, each instrument is providing similar and unique information, justifying their continued use together for the purpose of diagnosing personality disorders.     

The effect of personality pathology on treatment outcome for Axis I disorders in dysfunctional clergy

The relationship between Narcissistic, Compulsive, Dependent, and Antisocial personality traits, as measured by the MCMI-III, and the clinical presentation and the treatment outcome for Axis I disorders, as measured by the MMPI-II was investigated. The subjects were 86 Roman Catholic priests and nuns who participated in 6 to 8 months of residential treatment. Pretreatment evaluation of the patients included the MCMI-III and the MMPI-2. Clinical presentation of Axis I disorders was measured by pretreatment scores on MMPI scales 2 (Depression), 7 (Psychasthenia), content scale DEP (Depression), and content scale ANX (Anxiety). Treatment outcome was measured by posttreatment MMPI-2 scores on these four variables. The results of this study suggest that the level of personality traits a patient possesses can significantly impact the clinical presentation of an Axis I disorder. Although the 48 patients with MCMI-III base rate scores above 74 had significantly higher pretreatment MMPI-2 scores than the patients with lower MCMI-III scores, both groups obtained posttreatment MMPI scores well within normal limits. The intensive individual and group therapy, extended length of stay, and emphasis on community living that the residential program provides may account for these results.     

MMPI-2 and MCMI-III scores among dutch inpatient substance abusers: Assessing correspondence and cross-cultural equivalence

The Millon Clinical Multiaxial Inventory (MCMI-II and MCMI-III) and the Minnesota Multiphasic Personality Inventory (MMPI-2) were applied to 263 Dutch inpatient substance abusers with multiple psychiatric diagnoses, and the results compared with those of 306 North-American substance abusers studied by Ward (1995). We looked for structural similarity both across groups (per instrument) and across the two instruments (per sample), using principal components analysis and congruence analysis. The component structure found by Ward was partly replicated in the Dutch group, thus cross-validating the use of the two instruments with these patients. Moreover, as found by Ward, the MMPI-2 content and supplementary scales of the Dutch sample proved to be important determinants of the first three MMPI-2 components, adding to convergent validity. Questions remained about the influence of the (dis)continuity of MCMI-II and MCMI-III on the replicability of the MCMI components.     

MMPI-2 and MCMI-III scores among dutch inpatient substance abusers: Assessing correspondence and cross-cultural equivalence

The Millon Clinical Multiaxial Inventory (MCMI-II and MCMI-III) and the Minnesota Multiphasic Personality Inventory (MMPI-2) were applied to 263 Dutch inpatient substance abusers with multiple psychiatric diagnoses, and the results compared with those of 306 North-American substance abusers studied by Ward (1995). We looked for structural similarity both across groups (per instrument) and across the two instruments (per sample), using principal components analysis and congruence analysis. The component structure found by Ward was partly replicated in the Dutch group, thus cross-validating the use of the two instruments with these patients. Moreover, as found by Ward, the MMPI-2 content and supplementary scales of the Dutch sample proved to be important determinants of the first three MMPI-2 components, adding to convergent validity. Questions remained about the influence of the (dis)continuity of MCMI-II and MCMI-III on the replicability of the MCMI components.     

Assessing Old Order Amish outpatients with the MCMI-III

In this study, we examined Millon Clinical Multiaxial Inventory-III (MCMI-III; Millon, 2009) characteristics in an Old Order Amish outpatient sample (n = 166), with a comparison group of Old Order Amish who were not receiving mental health treatment at the time of testing (n = 80). We also graphically compared the 2 Amish groups to a non-Amish psychiatric sample in the literature. Consistent with our hypotheses, the Old Order Amish outpatients scored significantly higher than the Old Order Amish comparison group on the majority of MCMI-III scales, with mostly medium effect sizes, suggesting that the MCMI-III is a useful personality instrument in discriminating between Old Order Amish clinical and nonclinical groups. In addition, the Amish outpatients scored similar to a non-Amish psychiatric sample in the literature on most personality scales. Future MCMI-III studies with the Amish are needed to replicate and generalize our findings.     

Factor analysis of the Dutch-language version of the MCMI-III

We analyzed the factor structure of the Dutch-language version of the MCMI-III (Millon, Millon, Davis, & Grossman, 2006) using exploratory factor analysis on data obtained from a heterogeneous White sample (n = 1,210). We identified 4 factors: General Maladjustment, Aggression/Social Deviance, Paranoid/Delusional Thinking, and Emotional Instability/Detachment. This structure was invariant across scale composition (linear dependent vs. independent scales), factor analytic method (principal factor vs. principal component solutions), and sample characteristics (gender 'male-female' and setting 'clinical-forensic.' Studies that have used previous MCMI (Millon, 1969/1983b) versions have also found 4 similar factors, whereas studies that have used the American version of the MCMI-III have only found 3 factors. However, differences between the Dutch and American version were completely determined by factor analytic decisions. The factor structure of the MCMI-III appeared to be cross-culturally invariant.     

Incremental validity of the MMPI-2 PSY-5 scales in assessing self-reported personality disorder criteria

The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Personality Psychopathology-Five (PSY-5) scales were developed to measure abnormal personality symptomatology. The present study examines the incremental validity of the PSY-5 scales beyond the clinical and content scales in assessing criteria associated with personality disorders. The current sample includes 240 male and 407 female clients from private practice settings who completed the MMPI-2 and the Multiaxial Diagnostic Inventory (MDI), a self-report checklist of Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised) symptoms. Six of the MDI personality disorder scales, conceptually related to the PSY-5 scales, are used as criteria. Hierarchical regression analyses determine the incremental validity of each PSY-5 scale. In most analyses, PSY-5 scales add a significant increment of variance to the clinical and content scales. Implications of the results are discussed.     

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).     

Correlational Structure of the MCMI-III Personality Disorder Scales and Comparisons With Other Data Sets

We examine the correlational structure of the personality disorder (PD) scales from the MCMI-III (Millon, 1994) among 614 college students. The correlation matrix from our nonclinical sample was highly similar to the clinical sample matrices reported by Millon (1994). Further analyses revealed that the correlation matrices from a variety of MCMI data sets are generally similar to one another, but are only moderately similar to PD correlation matrices based on other assessment techniques. PD correlation matrices based on different assessment techniques are generally not very similar to one another. Two-, 3-, and 4-factor solutions for the MCMI-III PD scales are reported and provide a framework for integrating apparently conflicting findings from previous work. The 4-factor solution was most meaningful and was consistent with the 5-factor model of PD.