A taxometric analysis of the MMPI-2 Depression scales

The MMPI (Hathaway & McKinley, 1943) and MMPI-2 (Butcher et al., 2001) have long been used as measures of psychopathology. Both clinicians and researchers have noted the widespread existence of negative affectivity on the MMPI and MMPI-2 that may elevate scale scores and eclipse the tests' ability to differentiate depression from other clinical disorders. Using taxometric analyses, in this study we sought to test directly whether the MMPI-2 depression scales could differentiate patients with depressive symptoms from patients with other disorders. A large psychiatric sample (N = 2,000) was utilized and analyses were run separately for men and women. Taxometric analyses did not find a MMPI-2 Depression scale cut point that categorizes patients with depressive symptoms from other patients. Rather, these findings support previous studies finding an underlying dimensionality of depression. We discuss implications for MMPI-2 scale use and depression nosology in light of these findings.     

Evaluating the latent structure of the MMPI-2 F(p) scale in a forensic sample: a taxometric analysis

P. A. Arbisi and Y. S. Ben-Porath (1995) originally proposed that the Infrequency Psychopathology scale, F(p), be used as the final step in an algorithm to determine the validity of a Minnesota Multiphasic Personality Inventory-2 (MMPI-2) protocol. The current study used taxometric procedures to determine the latent structure of F(p) among examinees with profiles that would necessitate the interpretation of F(p) when using Arbisi and Ben-Porath's proposed algorithm. Participants included a subsample of 289 consecutively referred pretrial forensic examinees adjudicated incompetent to stand trial with high Infrequency (F) scale scores, thereby providing a sample that would be expected to have a high base rate of persons with bona fide psychopathology and persons with incentive to overreport psychopathology. Using MAMBAC and MAXEIG, F(p) produced a taxonic latent structure within the subgroup of examinees who obtained raw scores on F of greater than 17. These results support Arbisi and Ben-Porath's original proposal to use F(p) to identify a distinct subgroup of overreported MMPI-2 protocols within forensic psychiatric examinees with high elevations on F. Implications and suggestions for future research are provided.     

Discriminating malingered from genuine civilian posttraumatic stress disorder: a validation of three MMPI-2 Infrequency scales (F, Fp, and Fptsd)

The Infrequency-Posttraumatic Stress Disorder scale (Fptsd), recently created for the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), has demonstrated incremental validity over other MMPI-2 scales in malingered posttraumatic stress disorder (PTSD) detection. Fptsd was developed with combat-exposed PTSD patients, potentially limiting its use with PTSD patients in general. The current study evaluated the MMPI-2's F, Infrequency-Psychopathology scale (Fp), and Fptsd scales in discriminating genuine civilian PTSD among 41 adult victims of child sexual abuse from a group of 39 students instructed to simulate PTSD. Analyses demonstrated Fptsd's incremental validity over F but not over Fp. Based on the two studies examining Fptsd, Fptsd may be more appropriate for combat trauma victims, and Fp may be more appropriate for civilian trauma victims.     

Profile validity standards for MMPI and MMPI-2 F scales

Although numerous indices of validity have been developed for the MMPI and MMPI-2, interest in the F scale and its variants continues, especially among practicing clinicians. The use of the binomial for assessing standards for random answering and possibly for judgments of malingering offers another approach for the interpretation of F-scale scores. The theoretical binomial distribution and Monte Carlo data are in accord. Cut-off scores of 24 for the MMPI and 23 for the MMPI-2 suggest random responses, and scores of 40 and 37, respectively, suggest clinical interpretation rather than randomness of responding.     

Psychometric evaluation of the restructured clinical scales of the MMPI-2

Conceptual overlap and heterogeneity have long been noted as weaknesses of the Minnesota Multiphasic Personality Inventory's clinical scales. Restructured clinical (RC) scales recently were developed to address these concerns (A. Tellegen et al., 2003). The authors evaluated the psychometric properties of the RC scales in psychology clinic clients (N=285) and military veterans (N=567). The RC scales were as internally consistent as the clinical scales and correlated strongly with their original counterparts (except for RC3/Hysteria). They also were less intercorrelated, produced conceptually clearer relations with measures of personality and psychopathology, and yielded somewhat greater incremental utility than the clinical scales. Thus, the RC scales demonstrated several psychometric strengths while utilizing 60% fewer items, but the 2 sets of scales cannot be used interchangeably. Interpretive considerations are discussed.     

Behavioral correlates of selected MMPI-2 clinical, content, and restructured clinical scales

In this study, we evaluated the validity of the Restructured Clinical (RC; Tellegen et al., 2003) scales by identifying and comparing behavioral correlates of selected RC scales (RCd, RC2, RC4), their original Clinical scale counterparts (Scale 2, Scale 4), and conceptually related Content scales (DEP, ASP, CYN) in an outpatient clinical sample (N = 150). The results of this study indicate that RC4 is a stronger predictor of several antisocial behaviors than Clinical Scale 4 or the Content Scales ASP and CYN. In contrast, RC2 demonstrated significantly lower correlations with several behaviors conceptually related to depression than its Clinical scale counterpart or DEP. DEP was highly correlated with RCd (r = .91, p < .0001), suggesting that the 2 scales may be measuring similar constructs. Overall, the results of this study demonstrate relatively few differences among the scales selected in their ability to predict extratest behaviors.     

Factor analysis of MMPI-2 basic scales among college students

The MMPI-2 was administered to 288 college students (178 women and 110 men) between the ages of 18 and 34 years. Scores on the basic 13 (three validity and ten clinical) scales were correlated and subjected to principal component analyses separately for men and women. In each case, four factors were retained and subjected to varimax rotation. Coefficients of congruence were calculated for all possible pairs of factors across two samples of college students and the normative adults, separately for men and women, and across genders within each sample. Results indicated that the factorial structure of the MMPI-2 basic scales seemed to possess considerable uniformity across samples and genders, but not without some notable exceptions.     

A comparison of the correlational structures and elevation patterns of the MMPI-2 restructured clinical (RC) and clinical scales

The relationship between the MMPI-2 restructured clinical scales and the original clinical scales was evaluated using an outpatient clinical sample (N = 150). Similar patterns of correlations to those reported by Tellegen et al. in 2003, such as high correlations between the restructured scales and their original scale counterparts and lower intercorrelations among the restructured scales than among the original scales, were found in the outpatient sample. The former provided evidence of convergence between the two sets of scales, whereas the latter increases the potential for discriminant validity in the restructured scale profiles. Mean T-scores of the restructured scales were significantly lower than their original scale counterparts for every clinical scale except Scale 1 (hypochondriasis). Individual profiles exhibited fewer scale elevations using the restructured clinical scales (M = 2.15, Mdn = 2.0) than the original clinical scales (M = 3.29, Mdn = 3.0). The majority of client profiles (56%) had fewer scale elevations when plotted using the restructured scales versus the original clinical scales.     

A cross-validation of MMPI-2 substance abuse scales.

We evaluated the efficacy of the Addiction Potential Scale (APS) and the Addiction Acknowledgement Scale (AAS), two new scales designed to assess substance abuse problems with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), in samples from settings different from those used in their development. Results replicate earlier findings that both scales discriminate between psychiatric and substance abuse samples and do so more effectively than other substance abuse scales designed for use with the MMPI and carried over to the MMPI-2. Results also suggest that APS may be more resistant than AAS to response distortion.     

An evaluation of the usefulness of the MMPI-2 F(p) scale

The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) F(p) scale was developed by Arbisi and Ben-Porath (1995) by identification of 27 items endorsed by fewer than 20% of individuals in both normal and psychiatric samples. The F(p) scale was designed for applications in settings characterized by high base rates of serious psychopathology, such as psychiatric inpatient units, and is proposed as a useful scale in discriminating overreported protocols from those produced by patients with serious psychopathology. In this study we investigated the characteristics of this scale in a sample of 617 psychiatric inpatients who responded to the MMPI-2 under standard conditions, and 203 overreported protocols derived in research studies conducted with normal adult participants instructed to simulate various forms of serious psychopathology. Results of this study are consistent with prior reports of a relatively low frequency of item endorsement for F(p) scale items in psychiatric samples, and intercorrelations between the F(p) scale and the MMPI-2 basic clinical scales in clinical samples that are generally lower than those produced between either F or Fb and the basic clinical scales. However, this intercorrelational pattern between F(p) and the MMPI-2 basic scales was not as consistent for the overreported sample. Additionally, the F(p) scale appears to be effective in discriminating overreported from accurate MMPI-2 protocols, with some evidence that the optimal cutting scores for this and other MMPI-2 infrequency scales may differ as a function of gender. Finally, these findings do not show clear evidence of improved group prediction derived from the use of the F(p) scale in contrast to results obtainable through the use of the MMPI-2 F scale.     

Susceptibility of the MMPI-2 clinical, restructured clinical (RC), and content scales to overreporting and underreporting

The authors examined and compared the susceptibility of three Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scale sets (Clinical, Restructured Clinical [RC], and Content) to over- and underreporting using five analog samples. Two samples of 85 and 191 undergraduate students, respectively, took the MMPI-2 under underreporting versus standard instructions. Three samples consisting of 42 undergraduates, 73 psychiatric inpatients, and 84 medical patients took the MMPI-2 under overreporting versus standard instructions. A comparison of the effect sizes across the three sets of scales indicated that Clinical Scale scores are not less susceptible to distortion than the Content or RC Scales. An apparent lesser susceptibility to underreporting for the Clinical Scales was an artifact of the subtle items' effect on these scales.     

MMPI-2 validity scales in child custody evaluations: clinical versus statistical significance

The MMPI-2 is commonly used in the psychological assessment of parents within child custody evaluations. Due to the interface of mental health practitioners with non-mental-health professionals in the context of child custody cases, careful attention must be paid to the potential misunderstanding or misuse of data from psychological testing. While traditional clinical lore has maintained an expectation of clinically significant defensiveness on the MMPI-2 with this population, the research data does not support this view. Despite empirical findings that identify patterns of elevations on the MMPI-2 validity scales with parents involved in child custody disputes, these patterns have been demonstrated to reach statistical but not clinical significance. That is, MMPI-2 profiles that contain elevations on scales L or K that either invalidate or notably suppress clinical scales are not to be expected in the child custody population. False causal attributions contributing to the potential mischaracterization or loss of important data related to personality functioning within this population are identified and discussed. Potential dangers associated with such false causal attributions are reviewed.     

Examination of racial differences on the MMPI-2 clinical and restructured clinical scales in an outpatient sample

The current study examined the possibility of differential predictive accuracy of selected Minnesota Multiphasic Personality Inventory-Second Edition (MMPI-2) clinical and Restructured Clinical (RC) scales in a group of Black and White mental health center clients. Results indicate that Black clients scored higher than White clients on one non-K-corrected clinical scale and 4 RC scales. All these differences produced medium effect sizes and were clinically significant according to Greene's (1987) criterion. These differences, however, were not accompanied by differential predictive accuracy of the scales in Black versus White clients. Although additional research is needed, especially on the RC scales, this study indicates that the MMPI-2 is not a biased predictor of symptomatology for Black versus White test takers.     

Normative data for the F(p) scale of the MMPI-2: implications for clinical and forensic assessment of malingering

Data from several clinical samples and the Minnesota Multiphasic Personality Inventory--2 standardization group are presented to familiarize the reader with response patterns of different groups on a new validity scale designed to assist in the identification of exaggeration or fabrication of psychological disturbance. Sensitivity-specificity analyses are included along with suggestions for use of the F(p) Scale with other validity scales. Cautions about setting single cutoff scores are also discussed.     

Comparability of MMPI-2 scales and profiles over time

This study investigated Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) scale and profile comparablilty for MMPI-2 profiles completed on 2 separate occasions by mental health patients receiving treatment at a Veterans Affairs Medical Center (n = 114). Patients were predominantly men (96.5%), with an average age of 44.08 and an average of 12.39 years of education at the time of initial testing. MMPI-2 tests were completed on 2 separate occasions as a routine part of treatment with a mean interval between test administrations of 688 days. Findings were analyzed for the complete sample and for 3 subsamples with different test-retest intervals. MMPI-2 scale test-retest correlation coefficients for the entire sample ranged from .48 to .69 for the Basic scales, .49 to .80 for the Supplementary scales, and .56 to .78 for the Content scales with scale high-point agreement = 38.60%, high 2-point agreement = 16.67%, and high 3-point agreement = 19.30%. High-point agreement for subsets of participants with well-defined high points, 2-points and 3-points was 41.07%, 27.50%, and 25.93% respectively. Pearson r correlation coefficients for T scores across the Basic scales for pairs of profiles averaged .78, suggesting similarity of profile shape across testing occasions. MMPI-2 profiles were also examined in relation to Skinner and Jackson's 3 modal MMPI profile types.     

Detection of overreported psychopathology with the MMPI-2-RF [corrected] validity scales

We examined the utility of the validity scales on the recently released Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2 RF; Ben-Porath & Tellegen, 2008) to detect overreported psychopathology. This set of validity scales includes a newly developed scale and revised versions of the original MMPI-2 validity scales. We used an analogue, experimental simulation in which MMPI-2 RF responses (derived from archived MMPI-2 protocols) of undergraduate students instructed to overreport psychopathology (in either a coached or noncoached condition) were compared with those of psychiatric inpatients who completed the MMPI-2 under standardized instructions. The MMPI-2 RF validity scale Infrequent Psychopathology Responses best differentiated the simulation groups from the sample of patients, regardless of experimental condition. No other validity scale added consistent incremental predictive utility to Infrequent Psychopathology Responses in distinguishing the simulation groups from the sample of patients. Classification accuracy statistics confirmed the recommended cut scores in the MMPI-2 RF manual (Ben-Porath & Tellegen, 2008).     

Validation of selected MMPI-2 basic and content scales

To investigate whether some of the MMPI-2 basic and/or content scales measure the factor structure represented by the Big-Five, 288 undergraduates (178 women and 110 men), between the ages of 18 and 34 years, were administered MMPI-2 and MARS (Michill Adjective Rating Scale) which measures four factors that are conceptually similar to the first four of the Big-Five. It was hypothesized that (a) three MMPI-2 scales (basicDepression or D, contentAnxiety or ANX, and contentDepression or DEP) would be correlated with MARSUnhappiness; (b) two MMPI-2 scales (basicSocial Introversion or Si and contentSocial Discomfort or SOD) would be correlated with MARSExtraversion; (c) two MMPI-2 scales (contentAnger or ANG and contentType A Behavior or TPA) would be correlated with MARSAssertiveness; and (d) two MMPI-2 scales (contentWork Interference or WRK and supplementaryDominance or DOM) would be correlated with MARSProductive Persistence. Results corroborated the hypothesized relationships between the components of the aforementioned four dyads.     

A comparison of the MCMI-III personality disorder and modifier indices with the MMPI-2 clinical and validity scales

In this study, we examined the relationship of the MCMI-III (Millon, Davis, & Millon, 1997; Millon, Millon, & Davis, 1994) modifier indices and personality disorder scales to the validity and basic clinical scales of the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). The MCMI-III modifier indices highly correlated with all of the MMPI-2 validity scales except for the F(p) scale. Similarly, the MCMI-III personality disorder scales strongly covaried with the MMPI-2 validity and clinical scales except for the F(p) and 5 (Mf) scales. A factor analysis with Promax rotation revealed substantial relationships between the MMPI-2 and MCMI-III. However, the MMPI-2 F(p) scale did not tend to correlate with MMPI-2 or MCMI-III scales, indicating that F(p) scale variance was largely independent of other scales. The results suggest that clinicians should consider the interrelationship between personality characteristics and dissimulation.