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.     

Malingering as a categorical or dimensional construct: the latent structure of feigned psychopathology as measured by the SIRS and MMPI-2

The 6 nonoverlapping primary scales of the Structured Interview of Reported Symptoms (SIRS) were subjected to taxometric analysis in a group of 1,211 criminal and civil examinees in order to investigate the latent structure of feigned psychopathology. Both taxometric procedures used in this study, mean above minus below a cut (MAMBAC) and maximum covariance (MAXCOV), produced dimensional results. A subgroup of participants (n = 711) with valid Minnesota Multiphasic Personality Inventory-2 (MMPI-2) protocols were included in a second round of analyses in which the 6 nonoverlapping primary scales of the SIRS and the Infrequency (F), Infrequency-Psychopathology (Fp), and Dissimulation (Ds) scales of the MMPI-2 served as indicators. Again, the results were more consistent with dimensional latent structure than with taxonic latent structure. On the basis of these findings, it is concluded that feigned psychopathology forms a dimension (levels of fabrication or exaggeration) rather than a taxon (malingering-honest dichotomy) and that malingering is a quantitative distinction rather than a qualitative one. The theoretical and clinical practice implications of these findings are discussed.     

Assessing psychopathic personality traits with the MMPI-2

In this study, we examined the utility of the MMPI-2 (Butcher et al., 2001) in assessing psychopathic personality traits. We explored whether MMPI-2 scales that measure affective and interpersonal traits add to the instrument's social deviance measures in assessing global psychopathy and its two facets. Our study of 281 male and female college students indicates that the MMPI-2 Social Deviance scales (e.g., Clinical Scales 4 and 9, ASP) predict substantial variance in the social deviance factor and affiliated subscales of the Psychopathic Personality Inventory (PPI; Lilienfeld & Andrews, 1996), whereas MMPI-2 measures of affective and interpersonal functioning predict substantial variance in the affective-interpersonal PPI factor. In addition, the results of two regression models indicate that the Restructured Clinical scales provide the most parsimonious assessment of psychopathic personality traits.     

Dimensions of deception in personality assessment: the example of the MMPI-2

The topic of deception in personality assessment is discussed along a number of dimensions relevant to clinical practice. The dimensions described are consistency versus accuracy of item endorsement, simulation versus dissimulation, genetic versus specific deception, crude versus sophisticated deception, intentional versus nonintentional deception, self-deception versus impression management, and selectivity versus inclusiveness, as these may be encountered using the revised version of the Minnesota Multiphasic Personality Inventory. The emphasis is placed on deceptive strategies as operations as distinct from the traditional categories of response style such as social desirability. Directions for future research are indicated.     

Item response theory in personality assessment: a demonstration using the MMPI-2 depression scale

Item response theory (IRT) analyses have, over the past 3 decades, added much to our understanding of the relationships among and characteristics of test items, as revealed in examinees response patterns. Assessment instruments used outside the educational context have only infrequently been analyzed using IRT, however. This study demonstrates the relevance of IRT to personality data through analyses of Scale 2 (the Depression Scale) on the revised Minnesota Multiphasic Personality Inventory (MMPI-2). A rich set of hypotheses regarding the items on this scale, including contrasts among the Harris-Lingoes and Wiener-Harmon subscales and differences in the items measurement characteristics for men and women, are investigated through the IRT analyses.     

Continuity and change in psychopathic traits as measured via normal-range personality: a longitudinal-biometric study

The discriminant validity of the interpersonal-affective and social deviance traits of psychopathy has been well documented. However, few studies have explored whether these traits follow distinct or comparable developmental paths. The present study used the Multidimensional Personality Questionnaire (A. Tellegen, in press) to examine the development of the psychopathic traits of Fearless Dominance (i.e., interpersonal-affective) and Impulsive Antisociality (i.e., social deviance) from late adolescence to early adulthood in a longitudinal-epidemiological sample of male and female twins. Results from mean- and individual-level analyses revealed stability in Fearless Dominance from late adolescence to early adulthood, whereas Impulsive Antisociality declined over this developmental period. In addition, biometric findings indicated greater genetic contributions to stability in these traits and greater nonshared environmental contributions to their change over time. Collectively, these findings suggest distinct developmental trends for psychopathic traits from late adolescence to early adulthood.     

Diagnosing personality disorders: an examination of the MMPI-2 and MCMI-II

Personality disorders are highly prevalent in clinical populations and affect outcomes across all forms of intervention. This investigation examined the diagnostic efficiency of two widely used, self-report measures of personality disorder (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989; MCMI-II; Millon, 1987), as compared to a structured interview (SCID-II; Spitzer et al., 1987) diagnosis. The measures were administered to 150 residential and outpatient volunteer subjects. Persons with primary organic or psychotic-spectrum disorders were excluded from participation. Results were variable across disorders measured, with low to moderate levels of diagnostic agreement observed. The MCMI-II appears to be a more sensitive measure, whereas the MMPI-2 is more specific. The two self-report measures demonstrated greater convergence with each other than with the interview measure. Both the MMPI-2 and MCMI-II were more accurate at identifying the absence of a given disorder. Although overall diagnostic powers exist at acceptable levels. the results suggest that diagnoses generated by self-report versus interview are not interchangeable.     

Couples treatment of agoraphobia: changes in marital satisfaction

Six agoraphobic women and their husbands participated in a group therapy program consisting of exposure and cognitive restructuring. The husbands acted as co-therapists. Ratings of marital satisfaction as well as severity of phobia were filled out independently by both clients and their husbands throughout the course of therapy and at follow-up. Two patterns of relationships among marital satisfaction and severity of phobia emerged. For four couples a parallel relationship was observed in that as phobia improved marital satisfaction increased. For two couples the inverse relationship was noted where improvements in phobia were correlated with decreases in marital satisfaction. The importance of the interpersonal context of agoraphobia and implications for treatment are suggested.     

Interpretive dilemmas created by the minnesota multiphasic personality inventory 2 (MMPI-2)

While the new MMPI-2 has the potential to provide more and better clinically relevant information than its predecessor, its introduction also creates several important problems for clinicians and researchers. In particular, the new norms and the use of uniform (rather than linear) T-scores result in the same raw scores on the two tests yielding clinical profiles that can be quite different, both qualitatively and quantitatively. These differences can result in difficulty in MMPI-2 profile interpretation when the user is relying on MMPI interpretive strategies. This paper addresses these concerns and offers some temporary remedial strategies.     

Convergent validity of alternative MMPI-2 personality disorder scales

The Morey, Waugh, and Blashfield (1985) MMPI (Hathaway et al., 1989) personality disorder scales provided a significant contribution to personality disorder research and assessment. However, the subsequent revisions to the MMPI and the multiple revisions to the diagnostic criteria sets that have since occurred may have justified comparable revisions to these scales. Somwaru and Ben-Porath (1995) selected a substantially different set of items from the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) to assess Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) personality disorder diagnostic criteria. In our study, we compared the convergent validity of these alternative MMPI-2 personality disorder scales with respect to 3 self-report measures of personality disorder symptomatology in a sample of 82 psychiatric outpatients. The results suggested that Somwaru and Ben-Porath's scales are as valid as the original Morey et al. scales and might be even more valid for the assessment of borderline, antisocial, and schizoid personality disorder symptomatology.     

Objective personality assessment of people in diverse cultures: European adaptations of the MMPI-2

This article examines the cross-national application of psychological tests and examines the generalizability of objective psychological assessment instruments. The most widely used and internationally adapted personality instrument, the Minnesota Multiphasic Personality Inventory (MMPI-2), is highlighted to illustrate the adaptation of psychological tests across the barriers of language and culture. The problems and limitations of using questionnaire methods were noted and effective strategies for translating, adapting, and standardizing questionnaires in languages and cultures different from their country of origin are reviewed. The history of several European adaptations of the original MMPI and MMPI-2 is surveyed to illustrate the extensive research base for the test in Europe. Applications of the MMPI-2 in clinical and non-clinical (e.g. industrial) settings were noted. Current research is described and recommendations for future research are provided.     

Computerized adaptive personality testing: a review and illustration with the MMPI-2 Computerized Adaptive Version

Computerized adaptive testing in personality assessment can improve efficiency by significantly reducing the number of items administered to answer an assessment question. Two approaches have been explored for adaptive testing in computerized personality assessment: item response theory and the countdown method. In this article, the authors review the literature on each and report the results of an investigation designed to explore the utility, in terms of item and time savings, and validity, in terms of correlations with external criterion measures, of an expanded countdown method-based research version of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), the MMPI-2 Computerized Adaptive Version (MMPI-2-CA). Participants were 433 undergraduate college students (170 men and 263 women). Results indicated considerable item savings and corresponding time savings for the adaptive testing modalities compared with a conventional computerized MMPI-2 administration. Furthermore, computerized adaptive administration yielded comparable results to computerized conventional administration of the MMPI-2 in terms of both test scores and their validity. Future directions for computerized adaptive personality testing are discussed.     

MMPI-2 assessment of malingered emotional distress related to a workplace injury: a mixed group validation

In this study, we examined the capacity of MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 2001) validity indexes to identify malingered depression associated with a workplace injury. We compared 27 graduate students simulating depression with archival records of 33 inpatients diagnosed with major depressive disorder. We employed a mixed-group validation design to generate true positive rates (TPR) and false positive rates (FPR) for the various MMPI-2 validity scales [F, FB, F(p), FBS, F - K, Ds2] while we accounted for base rates of malingering in each sample. The Fake Bad scale (FBS) was the only validity measure that produced acceptable TPR and FPR or a significant correlation with malingering status.     

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.     

Personality and aging: a study of the MMPI-2 among older men

We examined whether separate norms for older men are necessary for the revised Minnesota Multiphasic Personality Inventory (MMPI-2). Scores from 1,459 men in the Normative Aging Study (NAS) (age: M = 61.27, SD = 8.37) were contrasted with those from 1,138 men from the MMPI Restandardization Study (age: M = 41.71, SD = 15.32). Results showed that scores on the MMPI-2 validity, clinical, and content scales for the NAS men were highly similar to those from the MMPI-2 Restandardization sample. There were also few differences between the two groups at the item level. Within-sample analyses revealed some differences between age groups. However, the magnitudes of these differences were small and may represent the single or combined effects of cohort factors and age-related changes in physical health status rather than age-related changes in psychopathology per se. We concluded that special, age-related norms for the MMPI-2 are not needed for older men.     

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.     

MMPI-2 personality profiles of high-functioning adults with autism spectrum disorders

The Minnesota Multiphasic Personality Inventory-Second Edition was administered to 20 adults with autism spectrum disorders (ASD) who fell in the average to above average range of intelligence and 24 age-, intelligence-, and gender-matched college students. Large group differences, with the ASD group scoring higher, were found on the L validity scale, Clinical Scales 2 (D) and 0 (Si), Content scale Social Discomfort (SOD), Supplementary scale Repression (R), and Personality Psychopathology Five (PSY-5) scale INTR (Introversion). The proportion of ASD adults scoring in the clinical range on these scales was between 25% and 35%. High scores on these scales are consistent with the clinical picture of Asperger syndrome and high-functioning autism in adulthood. Future directions and implications for identifying adults in need of a specialized autism assessment are discussed.     

Coping as a personality process: a prospective study

The study tested the proposition that coping is personality in action under stress. Using a stressful medical school entrance examination, the study examined (a) whether neuroticism emerged in coping patterns over time and (b) whether the influence of neuroticism on coping accounted for changes in anxiety and examination performance. Fifty premedical students reported their coping efforts at 35 days before, 10 days before, and 17 days after the examination. They provided daily reports of anxiety for 35 days surrounding the examination. Neuroticism influenced coping efforts and increases in daily anxiety under stress. Two types of coping, wishful thinking and self-blame, explained over half the relationship between neuroticism and increases in preexamination anxiety. Consistent with previous research, neither neuroticism nor specific coping efforts influenced examination performance.