Utility of the MMPI in a geriatric population

Despite the popularity of the Minnesota Multiphasic Personality Inventory (MMPI), there exists a relative dearth of normative and validity research regarding its use with persons over the age of 60. Our investigation was designed to examine the MMPI performance of both a normal and a clinical sample of older men and women. Specifically, a nonpatient community sample of 204 subjects and an outpatient psychiatric sample of 30 subjects, between the ages of 60 and 90, were administered the MMPI as well as structured psychiatric interview, the Psychiatric Status Schedule (PSS). Results revealed that, on most of the MMPI scales, the mean scores were well above the norms (i.e., 5-10 t-score points). Through comparisons between the clinical and community subjects as well as between MMPI and PSS performance, the MMPI demonstrated substantial discriminative and concurrent criterion validity within this geriatric sample. The results of the study suggest that, with a few important exceptions, the MMPI, as generally utilized, is valid for use in the geriatric population.     

Utility of the MMPI in a Geriatric Population

Despite the popularity of the Minnesota Multiphasic Personality inventory (MMPI), there exists a relative dearth of normative and validity research regarding its use with persons over the age of 60. Our investigation was designed to examine the MMPI performance of both a normal and a clinical sample of older men and women. Specifically, a nonpatient community sample of 204 subjects and an outpatient psychiatric sample of 30 subjects, between the ages of 60 and 90, were administered the MMPI as well as a structured psychiatric interview, the Psychiatric Status Schedule (PSS). Results revealed that, on most of the MMPI scales, the mean scores were well above the norms (i.e., 5-10 t-score points), Through comparisons between the clinical and community subjects as well as between MMPI and PSS performance, the MMPI demonstrated substantial discriminative and concurrent criterion validity within this geriatric sample. The results of the study suggest that, with a few important exceptions, the MMPI, as generally utilized, is valid for use in the geriatric population.     

Racial bias in prediction with the MMPI for a juvenile delinquent population

Relationships between MMPI scales and criteria were evaluated to determine if the MMPI is racially biased with a juvenile delinquent population. The MMPI was administered to 333 white and 107 black male juvenile delinquents, and criterion data were collected. The regression equations developed for Blacks and whites resulted in similar accuracies. However, the weights of the regression equations tended to differ for the two races. How they differed depended on the criterion predicted by the equations. Consequently, it was impossible to state unconditionally that the use of the MMPI with Black delinquents will have an adverse impact. In fact, one interpretation of the results suggested that the MMPI may not be racially biased for predictions with juvenile delinquents because the amount of constant error in prediction for a racial group decreased toward zero as the apparent objectivity of the criteria increased.     

Subtle-Obvious Scales of the MMPI: Indicators of Profile Validity in a Psychiatric Population

This study explored the usefulness of the Minnesota Multiphasic Personality Inventory (MMPI) Subtle-Obvious scales as profile validity indicators with a inpatient psychiatric population. Some 292 MMPI profiles were utilized and divided into overreporters, underreporters, and standard reporters, based on their Subtle-Obvious scale scores. Reporting style was shown to be unrelated to actual patient pathology because of the lack of relationship between reporting style and diagnostic categorization according to the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, I987) Axis I and II. Comparisons of MMPI profiles of the three groups revealed that overreporters endorsed more pathology on the MMPI clinical scales than did either underreporters or standard reporters. The same pattern of response style was demonstrated by subjects on another objective measure, the Beck Depression Inventory, whereas on a projective measure, the Rorschach Inkblot Test, there were no differences between groups. These findings suggest that clinicians may want to utilize the Subtle-Obvious scales to gain information about MMPI profile validity. Specifically, profiles of patients identified as overreporters should be interpreted with caution so as to not overstate their level of pathology.     

Subtle-obvious scales of the MMPI: indicators of profile validity in a psychiatric population.

This study explored the usefulness of the Minnesota Multiphasic Personality Inventory (MMPI) Subtle-Obvious scales as profile validity indicators with a inpatient psychiatric population. Some 292 MMPI profiles were utilized and divided into overreporters, underreporters, and standard reporters, based on their Subtle-Obvious scale scores. Reporting style was shown to be unrelated to actual patient pathology because of the lack of relationship between reporting style and diagnostic categorization according to the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, 1987) Axis I and II. Comparisons of MMPI profiles of the three groups revealed that overreporters endorsed more pathology on the MMPI clinical scales than did either underreporters or standard reporters. The same pattern of response style was demonstrated by subjects on another objective measure, the Beck Depression Inventory, whereas on a projective measure, the Rorschach Inkblot Test, there were no differences between groups. These findings suggest that clinicians may want to utilize the Subtle-Obvious scales to gain information about MMPI profile validity. Specifically, profiles of patients identified as overreporters should be interpreted with caution so as to not overstate their level of pathology.     

How (not) to evaluate the comparability of MMPI and MMPI-2 profile configurations: a reply to Humphrey and Dahlstrom

Humphrey and Dahlstrom (1995) presented a study on the comparability of MMPI/MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) profiles in which they concluded that "the bases for clinical interpretation derived from the MMPI and MMPI-2 profiles were sufficiently at variance to require different conclusions" [sic] (p. 2). In this brief critique, we identify procedural and data-analytical deficiencies that invalidate Humphrey and Dahlstrom's argument. Their blanket recommendation based on this argument, namely, that clinicians routinely plot both MMPI and MMPI-2 profiles, is unwarranted.     

MMPI ratings of suicide risk.

Among past attempts to use MMPI data to predict suicidal behavior, there has been a lack of research on the ability of clinicians to identify MMPI profiles of suicidal persons. In this study, the MMPI profiles of 20 male psychiatric patients who committed suicide and the MMPI profiles of 20 male patients who did not attempt or commit suicide were presented to six clinical psychologists with expertise in MMPI interpretation. The clinicians were asked to classify each MMPI profile as coming from a patient who did or did not later commit suicide, and to rate eight variables thought to be relevant to the assessment of suicide risk. Data analysis revealed that the clinicians could not identify suicide and nonsuicide patients from their MMPI profiles. Furthermore, the ratings of the eight suicide variable did not differentiate suicide and nonsuicide patients.     

Belief in an Unjust World: When Beliefs in a Just World Fail

Past research has attempted to delineate personality differences between insomniacs and good sleepers but has failed to control for type of insomnia or severity of the disorder. The purpose of this study was to compare MMPI scores of mild and severe sleep onset insomniacs with a control group of noninsomniacs. Results demonstrated that sleep onset insomniacs, regardless of degree of severity, differed significantly from noninsomniacs; and that mild and severe insomniacs differed from each other on only one MMPI scale.     

Rorschach movement and color responses and MMPI social extraversion and thinking introversion personality types

Results of an analysis of MMPI profiles and Rorschach protocols scored by the Exner method for 100 psychiatric patients provided partial support for Rorschach's hypotheses that perceptions of color (FC, CF, and C) and movement (M) tap separate personality dimensions. First, the proportion of M responses on a protocol correlated significantly (p < .01) to thinking introversion as defined in terms of a subject's MMPI profile similarity to a prototypic MMPI profile with peak PtSc elevations. Second, the proportion of FC responses correlated negatively (p < .01) to social extraversion defined in terms of MMPI profile similarity to a prototypic MMPI profile with peak PdMa elevations. Hence, use of FC signified a socially reserved, controlled behavior. The findings regarding CF and C were inconclusive. Third, color and movement responses did not correlate significantly with somatization defined in terms of similarity to a prototypic MMPI profile with peak Hs, D, Hy elevations. Finally, the nonsignificant correlations of FC with M and with MMPI thinking introversion plus the nonsignificant correlation of M with color responses and MMPI social extroversion further supported the hypotheses that movement and color responses tap essentially unique personality dimensions.     

Assessment of PIC and MMPI scales in adolescent psychosis: a caution

This study investigated the sensitivity of two frequently used multidimensional instruments--the Personality Inventory for Children (PIC) and the Minnesota Multiphasic Personality Inventory (MMPI)--in assessing psychotic states in adolescents. This issue arose as a result of the fact that the PSY scale on the PIC was constructed and cross-validated only on samples of children between the ages of 5 and 12 years. T-score comparisons between psychotic and nonpsychotic samples were performed, as well as Pearson correlations between PIC Psychosis (PSY) and MMPI Schizophrenia (Sc) scale T-scores. T-score comparisons indicated no significant differences between the groups on either PSY or Sc. A nonsignificant relationship between PSY and Sc scale elevations was also found. These results suggest the need for a profile-analytic approach to PIC and MMPI interpretation in identifying psychotic symptomatology in adolescents rather than PSY or Sc T-score elevation in isolation.     

Social desirability and Wiggin's MMPI content scales.

Using the Minnesota Multiphasic Personality Inventory (MMPI) item pool, Wiggins (1966) developed 13 scales, each with a homogeneous content. The 13 scales, along with marker scales for the 1st 3 MMPI factors, Edward's social desirability (SD), Welsh's repression (R), and Wiggins's social desirability (Sd) respectively were scored in the MMPI. The same scales were scored in an Experimental Multiphasic Personality Inventory (EMPI). A principal-components analysis of the 16 scales when scored in the MMPI resulted in 4 factors. A principal-components analysis of these same scales when scored in the MMPI and when scored in the EMPI were found to be highly congruent. The SD, R, and Sd scales proved to be excellent markers for the 1st 3 factors of the MMPI and also for the 1st 3 factors of the EMPI. Results provide further evidence that the 1st MMPI factor is a social desirability factor rather than a content factor.     

Using the MMPI–2–RF to Discriminate Psychometrically Identified Schizotypic College Students From a Matched Comparison Sample

This study investigates the extent to which the Minnesota Multiphasic Personality Inventory–2 Restructured Form (MMPI–2–RF) profiles of 52 individuals making up a psychometrically identified schizotypes (SZT) sample could be successfully discriminated from the protocols of 52 individuals in a matched comparison (MC) sample. Replication analyses were performed with an additional 53 pairs of SZT and MC participants. Results showed significant differences in mean T-score values between these 2 groups across a variety of MMPI–2–RF scales. Results from discriminant function analyses indicate that schizotypy can be predicted effectively using 4 MMPI–2–RF scales and that this method of classification held up on replication. Additional results demonstrated that these MMPI–2–RF scales nominally outperformed MMPI–2 scales suggested by previous research as being indicative of schizophrenia liability. Directions for future research with the MMPI–2–RF are suggested.     

MMPI validity measures: a comparative study of original with alternative indices.

A comparison was made of the original MMPI validity scales (L,F,K,F - K) with validity scales devised subsequently (TR, Ca, Ds, Mp, Ws - Wo) to determine which scales, the older or newer, were better, either alone or combined, in detecting fake-good, fake-bad, and careless responding. This was accomplished by having groups of subjects answer the MMPI first under standard conditions and then, 1 week later, under one of the falsifying conditions. A group of 40 psychiatric patients responded under standard and then fake-good conditions; a group of 40 university students responded under standard and then fake-bad conditions; and a group of 20 students responded under standard and then fake-careless conditions. Results indicate that both the traditional and newer validity indices were equally good at detecting fake-good responding. None of the indices was adequate in detecting careless responses. We conclude, as a consequence of this study, that the newer scales perform a clinically useful function when faking good is suspected on the MMPI.     

MMPI scale development methodology

A multitude of special MMPI scales have been developed without sufficient consideration for the methodology of empirical scale construction. Suggestions are presented in this article regarding the selection of items for a new MMPI scale and the tasks needed for the evaluation of a new scale. An investigator who develops a new MMPI scale should consider (a) the need for K corrections of scale scores, and (b) the possibility that the information provided by the special scale can also be obtained from the standard MMPI scales.     

Whither goest our redoubtable mentor, the MMPI/MMPI-2?

Four areas of MMPI use and development toward the year 2000 and beyond are discussed. First, although the MMPI-2 booklet is a clear improvement, we will continue to need to use both profiles, the MMPI-2 for normative purposes and the MMPI profile for pattern interpretation. Applying MMPI expectations to MMPI-2 profiles is a violation of Meehl's basic actuarial prediction concepts. Secondly, as psychologists begin prescribing medications, we may be able to substantially refine drug choices. Thirdly, the measurement of socioeconomic status levels appears to be the major, missing moderator variable in MMPI/MMPI-2 interpretation. Lastly, an effective and positive MMPI/MMPI-2 feedback paradigm is discussed that fits well within the managed care context.     

The Depressive Experiences Questionnaire: Validity and Psychological Correlates in a Clinical Samples

This study sought to compare the original and revised scoring systems of the Depressive Experiences Questionnaire (DEQ) and to assess the construct validity of the Dependent and Self-critical subscales of the DEQ in a clinically depressed sample. Subjects were 103 depressed inpatients who completed the DEQ the Beck Depression Inventory (BDI), the Hopelessness Scale, the Automatic Thoughts Questionnaire (ATQ), the Rathus Assertiveness Schedule (RAS), and the Minnesota Multiphasic Personality Inventory (MMPI). The original and revised scoring systems of the DEQ evidenced good concurrent validity for each factor scale, but the revised system did not sufficiently discriminate dependent and self-critical dimensions. Using the original scoring system, self-criticism was significantly and positively related to severity of depression, whereas dependency was not, particularly for males. Factor analysis of the DEQ scales and the other scales used in this study supported the dependent and self-critical dimensions. For men, the correlation of the DEQ with the MMPI scales indicated that self-criticism was associated with psychotic symptoms, hostility/conflict, and a distress/exaggerated response set, whereas dependency did not correlate significantly with any MMPI scales. Females, however, did not exhibit a differential pattern of correlations between either the Dependency or the Self-criticism scales and the MMPI. These findings suggest possible gender differences in the clinical characteristics of male and female dependent and self-critical depressive subtypes.     

MMPI taxonomies of child sexual and nonsexual offenders: a cross-validation and extension.

In a court clinic sample of 107 child sexual and nonsexual offenders, Minnesota Multiphasic Personality Inventory (MMPI) profiles did not differ as a function of arrests for sexual versus nonsexual offending. However, a three-group cluster-analytic solution was generated. Two of these clusters replicated those derived by Hall, Graham, and Shepherd (1991). The first cluster was unelevated, with Scales 4 and 9 as high points. The second cluster had MMPI Scales 4, 8, 2, and 7 as the highest scales. The third cluster was even more elevated than the other two clusters, characterized by extreme elevations on MMPI Scales F, 2, 4, 6, 7, and 8. The somewhat different results of this study versus previous studies (e.g., Hall et al., 1991) may be a function of the different populations sampled. The results provide evidence of within-group heterogeneity among sexual and nonsexual offenders that may be as important as between-group differences.     

The Depressive Experiences Questionnaire: validity and psychological correlates in a clinical sample

This study sought to compare the original and revised scoring systems of the Depressive Experiences Questionnaire (DEQ) and to assess the construct validity of the Dependent and Self-Critical subscales of the DEQ in a clinically depressed sample. Subjects were 103 depressed inpatients who completed the DEQ, the Beck Depression Inventory (BDI), the Hopelessness Scale, the Automatic Thoughts Questionnaire (ATQ), the Rathus Assertiveness Schedule (RAS), and the Minnesota Multiphasic Personality Inventory (MMPI). The original and revised scoring systems of the DEQ evidenced good concurrent validity for each factor scale, but the revised system did not sufficiently discriminate dependent and self-critical dimensions. Using the original scoring system, self-criticism was significantly and positively related to severity of depression, whereas dependency was not, particularly for males. Factor analysis of the DEQ scales and the other scales used in this study supported the dependent and self-critical dimensions. For men, the correlation of the DEQ with the MMPI scales indicated that self-criticism was associated with psychotic symptoms, hostility/conflict, and a distress/exaggerated response set, whereas dependency did not correlate significantly with any MMPI scales. Females, however, did not exhibit a differential pattern of correlations between either the Dependency or the Self-Criticism scales and the MMPI. These findings suggest possible gender differences in the clinical characteristics of male and female dependent and self-critical depressive subtypes.     

MMPI code types and the fantasy prone personality

We administered the MMPI and the Inventory of Childhood Memories and Imagining (ICMI) to 1,200 college students. Application of diagnostic efficiency statistics for the ability of differing ICMI cutoff scores to identify college students producing a schizophrenia spectrum MMPI code type revealed that scores greater than or equal to 29 on the ICMI had good positive predictive power. Scores less than 29 on the ICMI had very good negative predictive power. ICMI scores were also used to form a group of fantasizers (n = 30) and a control group (n = 30). Fantasizers were much more likely to produce MMPI codes associated with a vulnerability to schizophrenia (70%) than were controls (3.33%). Although most controls(70%) produced non-elevated MMPI scores, 66.67% of the fantasizers produced three or more elevated clinical scales on the MMPI. The modal MMPI profile for the fantasizers was an 8-9 code, indicating that fantasizers appear at heightened risk for eccentric thinking and a Cluster A or B personality organization.     

The convergent validity of MMPI and Rorschach scales: an extension using profile scores to define response and character styles on both methods and a reexamination of simple Rorschach response frequency

Past research indicated the convergence of Rorschach and MMPI scales may be a function of (a) simple Rorschach response frequency (R) or (b) complex response-character styles on both methods. In this study, new criteria were developed for defining the second assumption using F and K from the MMPI and R and Lambda from the Rorschach. Although substantially different from the factor criteria used previously (KS = .45 and .30), the new criteria still produced the expected pattern of correlations among MMPI and Rorschach scales. Averaged across 17 constructs, the new criteria produced strong validity coefficients for patients with similar styles (M composite r = .50), though they were less effective for patients with discordant styles (M composite r = -.27). It was also demonstrated that R by itself does not moderate convergent validity. Rather, statistical modeling with two sets of 300 random samples (a) demonstrated the prior findings related to R were the result of sampling error and (b) supported the general hypothesis that Rorschach and MMPI scales correlate to the extent response-character styles correlate. Implications are considered.