The Bender Visual Motor Gestalt Test as an Index of Emotional Disturbance in Children

Millon (1985) presented eight criticisms of the article by Widiger, Williams, Spitzer, and Frances (1985) on the MCMI as a measure of DSM-III. This article is a brief rejoinder. The major point we wish to make is that one should be cautious in interpreting the MCMI as a measure of DSM-III disorders because there has not yet been any research published on the relationship between the MCMI and DSM-III. We believe this position has not been refuted by Millon's critique.     

The MCMI as a measure of DSM-III

The Millon Clinical Multiaxial Inventory (MCMI) has been interpreted as a measure of DSM-III disorders. However, the MCMI was constructed and validated primarily as a measure of Millon's (1969, 1981) taxonomy, not DSM-III. Comparison of the two taxonomies and examination of the MCMI's content validity for two of the MCMI scales indicate only a partial congruence between the Millon and DSM-III taxonomies. There has been no published empirical research concerning the relationship between the MCMI and DSM-III, and the derivation and cross-validation research for the MCMI scales employed Millon's taxonomy and not DSM-III. It is suggested that until such data have been presented one should be cautious in one's interpretation of the MCMI as a measure of DSM-III disorders.     

The convergent and discriminant validity of the MCMI as a measure of the DSM-III personality disorders

The personality scales of the Millon Clinical Multiaxial Inventory (MCMI) were constructed and validated to measure the typology developed by Millon (1981). The ability of the MCMI to measure the DSM-III personality disorders has not yet been empirically evaluated. The current study found better convergent validity for the DSM-III personality disorders that are consistent with Millon's typology (i.e., the avoidant and the dependent) than for the disorders that are inconsistent (i.e., the antisocial and the passive-aggressive). However, the results may reflect some advantages Millon's typology might have over the DSM-III. The discriminant validity of all four scales was limited, due in part to the overlap among the MCMI scales and the DSM-III personality disorders. We discuss implications of the results for the revision of the MCMI and the DSM-III.     

Validity of the Millon Clinical Multiaxial Inventory in the assessment of affective disorders

The Millon Clinical Multiaxial Inventory (MCMI) was administered to 270 adult outpatients with major affective disorders at the same time that a semistructured, diagnostic interview was conducted by a clinician. The mood of the patient was then rated, and the clinician completed the Hamilton Depression Rating Scale and the Mania Rating Scale. A consensual diagnosis was arrived at by the team of investigators using DSM-III criteria. Significant correlations were found between four MCMI affective scales and the global mood state of the patient. Analysis of covariance indicated that the MCMI affective scales are significantly related to DSM-III affective disorders even after the effect of the current mood of the patient is partialled out. The clinical usefulness of each of the scales is discussed.     

MCMI characteristics of DSM-III posttraumatic stress disorder in Vietnam veterans

Compared the MCMI profiles of 25 veterans with a diagnosis of Posttraumatic Stress Disorder (PTSD) with those of 25 veterans carrying psychiatric disorders which typically cause problems in the differential diagnosis of PTSD. The PTSD group had higher elevations on nine of the 20 MCMI scales (all ps less than .05). Profiles were also significantly different in shape and scatter. A discriminant analysis accounted for 100% of the variance and correctly classified 88% of the patients. Resulting MCMI profiles appear to be consistent with DSM-III criteria for PTSD.     

A Multitrait-multimethod examination of Minnesota Multiphasic Personality Inventory (MMPI) and Millon Clinical Multiaxial Inventory (MCMI)

Recently, certain Minnesota Multiphasic Personality Inventory (MMPI) and Millon Clinical Multiaxial Inventory (MCMI) scales have seen increasing usage for the measurement of DSM-III personality disorders. The current study sought to identify the convergent and discriminant validity of these two sets of scales for this purpose. In general, the results indicated significant convergence across the two instruments. However, better convergent validity was found for scales representing those DSM-III disorders which are most consistent with the typology upon which the MCMI was based. In particular, convergent and discriminant validity results were poorest for Compulsive, Antisocial, and Passive-Aggressive personality scales.     

MCMI Characteristics of DSM-II-R Bulimics

The literature on bulimia has suggested that bulimic women exhibit a number of pathological personality characteristics. However, the Millon Clinical Multiaxial Inventory (MCMI), an objective measure of personality functioning, has not previously been utilized to assess the personality characteristics of a bulimic population. The MCMI was administered to 37 female bulimics, 32 female general psychiatric outpatients, and 30 normal female controls in order to assess the relationship between bulimia and pathological personality traits. Bulimic women were found to score higher than the other groups on MCMI Scales 1 (Schizoid), 2 (Avoidant), and 3 (Dependent). They also scored lower than the other two groups on Scale 6 (Antisocial). Results are discussed within the framework of parallels between the MCMI profiles of bulimics and the existing literature on bulimics' personality characteristics.     

MCMI characteristics of DSM-III-R bulimics

The literature on bulimia has suggested that bulimic women exhibit a number of pathological personality characteristics. However, the Millon Clinical Multiaxial Inventory (MCMI), an objective measure of personality functioning, has not previously been utilized to assess the personality characteristics of a bulimic population. The MCMI was administered to 37 female bulimics, 32 female general psychiatric outpatients, and 30 normal female controls in order to assess the relationship between bulimia and pathological personality traits. Bulimic women were found to score higher than the other groups on MCMI Scales 1 (Schizoid), 2 (Avoidant), and 3 (Dependent). They also scored lower than the other two groups on Scale 6 (Antisocial). Results are discussed within the framework of parallels between the MCMI profiles of bulimics and the existing literature on bulimics' personality characteristics.     

Overview and Current Status of the Millon Clinical Multiaxial Inventory

The MCMI (Millon, 1983a, 1987, 1994, 1997a) was developed to operationalize Millon's (1969/1983b) model of psychopathology and has been revised 2 times over the past 20 years to keep pace with changes in theory as well as the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). Since its introduction in 1977, it has become one of the most widely used and researched clinical assessment instruments in history, generating over 500 articles and 6 books. It has been translated into several languages and is being used in cross-cultural research. This article presents a historical overview of the measure and summarizes its current status in the literature. I highlight Millon's original vision for the test, changes that have been made, and its strengths and limitations. Future refinement of the MCMI is already in the planning stages and includes trait subscales for the personality disorders and linking codetypes to theory-derived interventions.     

Stability of the MCMI among depressed psychiatric outpatients

The Millon Clinical Multiaxial Inventory (MCMI) is a promising, yet somewhat unproven psychometric inventory developed to identify clinical syndromes and personality traits consonant with the Diagnostic and Statistical Manual of Mental Disorders (3rd ed. [DSM-III]; American Psychiatric Association, 1980). The stability of its measures for both the theoretically more stable personality characteristics and the clinical syndromes was investigated in a group of depressed psychiatric outpatients. In this test-retest design with a 3-month interval between tests, clinical syndrome scales of relevance changed significantly as expected. However, many of the personality scales also changed significantly. Only four of the personality scales met a two-fold test of stability. Findings are discussed in terms of characteristics of self-report inventories such as the MCMI, the uniqueness of the depressed population, and characteristics of personality disorders.     

Stability of the MCMI Among Depressed Psychiatric Outpatients

The Milton Clinical Multiaxial Inventory (MCMI) is a promising, yet somewhat unproven psychometric inventory developed to identify clinical syndromes and personality traits consonant with the Diagnostic and Statistical Manual of Mental Disorders (3rd ed. [DSM-III]; American Psychiatric Association, 1980). The stability of its measures for both the theoretically more stable personality characteristics and the clinical syndromes was investigated in a group of depressed psychiatric outpatients. In this test-retest design with a 3-month interval between tests, clinical syndrome scales of relevance changed significantly as expected. However, many of the personality scales also changed significantly. Only four of the personality scales met a two-fold test of stability. Findings are discussed in terms of characteristics of self-report inventories such as the MCMI, the uniqueness of the depressed population, and characteristics of personality disorders.     

Diagnosis of major depression by self-report

The Symptom Checklist-90 (SCL-90), Millon Clinical Multiaxial Inventory (MCMI), and Minnesota Multiphasic Personality Inventory (MMPI) test profiles of inpatients and outpatients with DSM-III major depression (n = 48) were contrasted with the test profiles of a control group of patients with diverse psychiatric disorders (n = 68). In addition, the diagnostic efficiency of the relevant depression subscales for the diagnosis of major depression were examined. The results indicated that the three self-report tests may be used to diagnose DSM-III major depression, and that the depressed patients had characteristic test profiles.     

Evolution of the Millon Clinical Multiaxial Inventory

Dr. Theodore Millon (1928–2014) was a primary architect for the personality disorders in the DSM–III, a structure that has endured into the DSM–5. His 1969 book, Modern Psychopathology, created an elegant framework into which the well-known personality prototypes could be fitted and understood. His theoretical work soon led into the creation of several psychological inventories, most notably the Millon Clinical Multiaxial Inventory (MCMI). The MCMI, now in preparation for its 4th major edition, has been a very popular instrument among clinicians. This article explores the history of the MCMI's development from its origins, through 2 distinct theoretical phases, and to its current status as the MCMI–IV is finalized.     

Maximum likelihood estimates of the ability of the MMPI and MCMI personality disorder scales and the SIDP to identify personality disorders.

The ability of the Minnesota Multiphasic Personality Inventory (MMPI) and Millon Clinical Multiaxial Inventory (MCMI) personality disorder scales and the Structured Interview for DSM-III Personality Disorders (SIDP) to identify personality disorders was estimated statistically using 122 subjects. Each technique was reasonably accurate when various diagnoses were excluded, but they were quite variable in identifying members of specific diagnostic categories. The same general pattern was seen when the disorders were combined into three general diagnostic clusters. The techniques excluded cluster membership fairly well, although there was little agreement across techniques for identifying cluster membership. The MCMI, however, was moderately adept at identifying membership in all three clusters. It was suggested that these instruments should be used cautiously in clinical settings and that additional data on their performance be obtained.     

The relationship between the MCMI personality scales and DSM-III, axis II

Compared were the personality scales of the Millon Clinical Multiaxial Inventory (MCMI) to the diagnosis of personality disorder, according to the Diagnostic and Statistical Manual of Mental Disorders (3rd ed. [DSM-III]; American Psychiatric Association, 1980), obtained by means of the Structured Interview for the DSM-III Personality Disorders (SIDP). The results from 272 psychiatric outpatients show a good correspondence for the Avoidant and the Dependent scales, a fairly good correspondence for the Schizotypal, the Histrionic, the Borderline, the Narcissistic, and the Paranoid scales, and no correspondence for the Schizoid, the Passive-Aggressive, and the Compulsive scales. The Passive-Aggressive scale seems to be positively correlated to personality disorders in general, whereas the Compulsive scale seems to be negatively correlated to a number of personality disorders.     

The Relationship Between the MCMI Personality Scales and DSM-III,Axis II

Compared were the personality scales of the Millon Clinical Multiaxial Inventory (MCMI) to the diagnosis of personality disorder, according to the Diagnostic and Statistical Manual of Mental Disorders (3rd ed. [DSM-III]; American Psychiatric Association, 1980), obtained by means of the Structured Interview for the DSM-III Personality Disorders (SIDP). The results from 272 psychiatric outpatients show a good correspondence for the Avoidant and the Dependent scales, a fairly good correspondence for the Schizotypal, the Histrionic, the Borderline, the Narcissistic, and the Paranoid scales, and no correspondence for the Schizoid, the Passive-Aggressive, and the Compulsive scales. The Passive-Aggressive scale seems to be positively correlated to personality disorders in general, whereas the Compulsive scale seems to be negatively correlated to a number of personality disorders.