MMPI validity scales and behavioral disturbance in psychiatric inpatients.

Sixty psychiatric inpatients were assigned to one of three groups on the basis of F and K MMPI validity scales. Staff ratings of patient behavior and recorded incidents of "acting-out" behavior were obtained for patients with: (a) "plea for help" validity profiles, (b) hyper-defensive profiles, and (c) average profiles. Patients with "plea for help" profiles were perceived as "acting-out" more frequently and engendering more feelings of frustration than patients in the other groups. These patients account for 77% of the incidents of inappropriate, destructive behavior and 83% of the seclusions in the patients sampled. Although the "plea for help" profile is considered invalid in some scoring systems, results suggest that this validity profile may be useful in treatment planning.     

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.     

Scale 4 (Pd) of the MMPI and the diagnosis antisocial personality

The MMPI and a structured diagnostic interview were administered to 225 military offenders in an attempt to determine the relationship between Scale 4 (Pd) of the MMPI and a behavioral diagnosis of Antisocial Personality (AS). Individuals satisfying criteria for a diagnosis of AS were found to score significantly higher than inmates not satisfying these criteria on Scale 4, regardless of whether K- or non-K-corrected T scores were used. Several potential moderating variables were crossed with the AS measure but only confining offense (person crime vs nonperson crime) evidenced a statistically significant interaction with AS.     

Relationships between MMPI codetypes and MAC scale elevations in adolescent psychiatric samples.

This study investigated the relationship between subjects' MacAndrew Alcoholism Scale (MAC) elevations and their placement in various codetype classifications. The sample consisted of 1,347 adolescents receiving psychiatric services in Missouri, Virginia, or Texas. The frequency of MAC scores greater than or equal to 24 and greater than or equal to 28 was evaluated, separately by gender, for single-scale and two-point codetypes, containing a minimum of at least 10 subjects. Marked differences occurred in the frequency of MAC scale elevations depending on the adolescent's codetype classification. MAC scores for both genders, for example, were most frequently elevated for the 4-9/9-4 codetype and more rarely elevated for the 2-3/3-2 codetype. Results are discussed in terms of potential measurement overlap which may occur between the MAC scale and several MMPI standard clinical scales, including 4, 6, and 9. It was also noted that the sensitivity and specificity of the MAC scale may vary in relation to subjects' clinical scale profile characteristics.     

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.     

The diagnosis of brain-damage by the MMPI: a comprehensive evaluation.

A number of research studies have proposed various methods for using the MMPI to identify brain dysfunction. This previous research has taken one of three major approaches. The present study compared the major approaches in a population consisting of 30 schizophrenic, 30 brain-damaged and 30 hospitalized normal patients. The results indicated that the most effective diagnosis device was the use of the Sc scale alone or in conjunction with the remaining clinical scales and the F scale. None of the organic scales or keys were able to match the performance of the Sc scale alone. The poor results obtained bring into question the use of these scales in any other setting without an extensive research validation. An alternate method that might be used to employ the MMPI in the diagnosis of brain dysfunction was suggested.     

MMPI correlates of extreme field independence and field dependence in a psychiatric population.

34 male and 34 female hospitalized psychiatric patients were divided into field-independent and field-dependent groups on the basis of rod-and-frame test performance and their MMPI scores were compared. A multiple discriminant analysis followed by a series of 2 X 2 factorial analyses of variance was used to assess the results. As in previous studies, more similarities than differences were found between the two cognitive styles. However, field-independent subjects tended to be more unconventional, aggressive, antisocial, and perhaps defensive than field-dependent subjects. Explanations of results were explored in reference to previous findings.     

Validity and clinical scale comparisons between the MMPI and MMPI-2 with psychiatric inpatients.

This study was designed to investigate the comparability of the original MMPI (1950) and the MMPI-2 (1989) with a psychiatric patient population. 34 male and 3 female patients, shortly after admission to one of two acute psychiatry units, completed the old and revised versions of the MMPI. Paired t tests indicated but scant differences for raw scores, while many more differences were found among T scores for validity, clinical, and supplemental scales. Analyses, however, showed all scales on the two forms to be highly correlated. Analysis of the high-point and two-point codes across the two administrations also showed relative stability, although the proportion of Scales 2 (Depression) and 8 (Schizophrenia) decreased, while those for Scales 6 (Paranoia) and 7 (Psychasthenia) increased markedly in the MMPI-2 protocols. Examination of each version's discriminability among mood- and thought-disordered subsamples suggested that the MMPI provides slightly better delineation between diagnostic classes. Discriminant function analyses showed that there were essentially no differences between the two forms in the accurate classification of clinical and nonclinical groups. The findings reported here provide support for the MMPI-2; despite modification, the newer form retains the advantages of the original MMPI. Differences found here may be unique to psychiatric patients and their patterns of MMPI/MMPI-2 equivalence and may not generalize to other special populations.     

Calculating estimates of sensitivity from group data: Pooled versus averaged estimators

Two methods of estimating the value of populationd′ from a group of subjects were investigated to determine the conditions under which each would be the less biased estimator. The first method, calculatingd′ for each subject and then averaging the estimates, yields an estimate of populationd′ called averaged′. The second method requires that data from all subjects be pooled and then an estimate of populationd′ calculated. This estimator is called pooledd′. Monte Carlo simulations indicated that pooledd′ was the less biased estimator when the number of trials per subject was fairly low, whereas averaged′ was the less biased estimator when the number of trials per subject was fairly high. The crossover point at which averaged′ becomes less biased than pooledd′ is shown to depend on the value of populationd′, the average bias of subjects in the population, and also on the level of criterion variability within the population.     

Prediction of length of hospitalization of adolescent psychiatric inpatients utilizing the Pd Scale of the MMPI and demographic data

This study attempts to determine whether selected personality and demographic information can be utilized to predict the length of stay of adolescents in an inpatient therapeutic program. Predictor variables included scores on the five Harris-Lingoes Psychopathic-Deviate subscales of the Minnesota Multiphasic Personality Inventory (MMPI), Wechsler Intelligence Scale for Children-Revised (WISC-R scores, and sex, age, parent, and sibling information. Data were collected from case files of 140 adolescents, ages 12 to 18 years, who had been admitted to a state hospital from 1979 to 1985. Each of these adolescents had obtained a score of 70 or above on the Psychopathic-Deviate (Pd) Scale of the MMPI. A preliminary correlational investigation of the data was conducted, followed by stepwise regression analysis. Regression analysis revealed that only sex and the presence of an older sister(s) were significant in prediction of length of stay of inpatient adolescents with elevated Pd scores.     

Spreading activation versus compound cue accounts of priming: mediated priming revisited.

Spreading activation theories and compound cue theories have both been proposed as accounts of priming phenomena. According to spreading activation theories, the amount of activation that spreads between a prime and a target should be a function of the number of mediating links between the prime and target in a semantic network and the strengths of those links. The amount of activation should determine the amount of facilitation given by a prime to a target in lexical decision. To predict the amount of facilitation, it is necessary to measure the associative links between prime and target in memory. Free-association production probability has been the variable chosen in previous research for this measurement. However, in 3 experiments, the authors show priming effects that free-association production probabilities cannot easily predict. Instead, they argue that amount of priming depends on the familiarity of the prime and target as a compound, where the compound is formed by the simultaneous presence of the prime and target in short-term memory as a test item.     

The six most essential questions in psychiatric diagnosis: a pluralogue part 1: conceptual and definitional issues in psychiatric diagnosis

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances.     

胡庐山博约仁说

博文约礼为孔子、颜子所传仁学要旨.在儒学流衍过程中,朱子重博文,阳明偏约礼,由此导致了诸多偏失.胡直作为阳明再传弟子,不为其惜门面,亦不盲目尊朱子.在多年思考与修证的基础上,胡直以博文约礼为中心,纠朱、王之偏,复孔、颜之正,归根于仁学,其尊孔求仁思想在当时产生了较为广泛的影响.