The MMPI,MMPI-2, and MMPI-A in Court (Book)

The factor structure of the Millon Clinical Multiaxial Inventory (Millon, 1994; MCMI-III) was assessed among 444 African American inpatient substance abusers and constitutes the first factor analysis of the MCMI-III. We found 3 main factors: General Maladjustment, Paranoid Behavior/Thinking With Detached Emotionality, and Antisocial Acting Out. These factors were essentially similar to previous findings of factor studies with the MCMI and MCMI-II across diverse populations. This factor invariance should lend credibility to the revised test and spur additional research into its psychometric properties.     

Exploring the psychometric properties and construct validity of the MCMI-III anxiety and avoidant personality scales

The Millon Clinical Multiaxial Inventory (MCMI; Millon, 1983) is a commonly used self-report instrument designed to aid in the assessment of Axis I and Axis II disorders. Concerns have been expressed regarding the procedures used in the normative research for the current version of the MCMI (MCMI-III; Millon, 1994) leading to a call for additional validity research on the MCMI-III (Retzlaff, 1996). In this study, we investigated the psychometric properties of the MCMI-III's Anxiety and Avoidant personality scales in a sample of patients diagnosed with Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) anxiety disorders. Our results suggest that the MCMI-III Avoidant scale is reliable (r =.89) and it was found to demonstrate appropriate convergent and divergent validity with other self-report measures. The MCMI-III Anxiety scale also showed adequate reliability (r =.78); however, our findings raise some concerns about the discriminant validity of this scale. A scale composed of the MCMI-III core anxiety items was found to have better discriminant validity. These findings are consistent with those reported by other researchers regarding the relationship between self-report measures of anxiety, avoidance, and depression. We conclude that the MCMI-III measures of anxiety and avoidance are consistent with other measures of these constructs and may provide valuable clinical information in this regard.     

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.     

Assessing Old Order Amish outpatients with the MCMI-III

In this study, we examined Millon Clinical Multiaxial Inventory-III (MCMI-III; Millon, 2009) characteristics in an Old Order Amish outpatient sample (n = 166), with a comparison group of Old Order Amish who were not receiving mental health treatment at the time of testing (n = 80). We also graphically compared the 2 Amish groups to a non-Amish psychiatric sample in the literature. Consistent with our hypotheses, the Old Order Amish outpatients scored significantly higher than the Old Order Amish comparison group on the majority of MCMI-III scales, with mostly medium effect sizes, suggesting that the MCMI-III is a useful personality instrument in discriminating between Old Order Amish clinical and nonclinical groups. In addition, the Amish outpatients scored similar to a non-Amish psychiatric sample in the literature on most personality scales. Future MCMI-III studies with the Amish are needed to replicate and generalize our findings.     

MMPI-2 and MCMI-III scores among dutch inpatient substance abusers: Assessing correspondence and cross-cultural equivalence

The Millon Clinical Multiaxial Inventory (MCMI-II and MCMI-III) and the Minnesota Multiphasic Personality Inventory (MMPI-2) were applied to 263 Dutch inpatient substance abusers with multiple psychiatric diagnoses, and the results compared with those of 306 North-American substance abusers studied by Ward (1995). We looked for structural similarity both across groups (per instrument) and across the two instruments (per sample), using principal components analysis and congruence analysis. The component structure found by Ward was partly replicated in the Dutch group, thus cross-validating the use of the two instruments with these patients. Moreover, as found by Ward, the MMPI-2 content and supplementary scales of the Dutch sample proved to be important determinants of the first three MMPI-2 components, adding to convergent validity. Questions remained about the influence of the (dis)continuity of MCMI-II and MCMI-III on the replicability of the MCMI components.     

MMPI-2 and MCMI-III scores among dutch inpatient substance abusers: Assessing correspondence and cross-cultural equivalence

The Millon Clinical Multiaxial Inventory (MCMI-II and MCMI-III) and the Minnesota Multiphasic Personality Inventory (MMPI-2) were applied to 263 Dutch inpatient substance abusers with multiple psychiatric diagnoses, and the results compared with those of 306 North-American substance abusers studied by Ward (1995). We looked for structural similarity both across groups (per instrument) and across the two instruments (per sample), using principal components analysis and congruence analysis. The component structure found by Ward was partly replicated in the Dutch group, thus cross-validating the use of the two instruments with these patients. Moreover, as found by Ward, the MMPI-2 content and supplementary scales of the Dutch sample proved to be important determinants of the first three MMPI-2 components, adding to convergent validity. Questions remained about the influence of the (dis)continuity of MCMI-II and MCMI-III on the replicability of the MCMI components.     

Correlational Structure of the MCMI-III Personality Disorder Scales and Comparisons With Other Data Sets

We examine the correlational structure of the personality disorder (PD) scales from the MCMI-III (Millon, 1994) among 614 college students. The correlation matrix from our nonclinical sample was highly similar to the clinical sample matrices reported by Millon (1994). Further analyses revealed that the correlation matrices from a variety of MCMI data sets are generally similar to one another, but are only moderately similar to PD correlation matrices based on other assessment techniques. PD correlation matrices based on different assessment techniques are generally not very similar to one another. Two-, 3-, and 4-factor solutions for the MCMI-III PD scales are reported and provide a framework for integrating apparently conflicting findings from previous work. The 4-factor solution was most meaningful and was consistent with the 5-factor model of PD.     

The MCMI-III: present and future directions

Both the original Millon Clinical Multiaxial Inventory (MCMI-I; Millon, 1977) and the Millon Clinical Multiaxial Inventory-II (MCMI-II; Millon, 1987) were refined and strengthened on a regular basis by both theoretic logic and research data. This aspiration has continued. The new Millon Clinical Multiaxial Inventory-III (MCMI-III; Millon, 1994) has been further coordinated with the most recent official diagnostic schema, the Diagnostic and Statistical Manual of Mental Disorders (4th ed., [DSM-IV]; American Psychiatric Association [APA], 1994) in an even more explicit way than before. Although the publication of the first version of the MCMI preceded the publication of the DSM-IV, its author played a major role in formulating the official manual's personality disorders, contributing thereby to their conceptual correspondence. The DSM-III-R (APA, 1987) was subsequently published in the same year as the MCMI-II; the inventory was modified in its final stages to make it as consonant as possible with the conceptual changes introduced in the then forthcoming official classification. The present version of the MCMI, the MCMI-III, strengthens these correspondences further by drawing on many of the diagnostic criteria of the DSM-IV to serve as the basis for drafting the inventory's items. This article reports on a select set of theoretical and empirical developments that are being carefully weighed for possible inclusion in future MCMIs, or as a guide in the refinement process of future MCMIs.     

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.     

Factorial Validity of the Personality Adjective Checklist in a Dutch-Speaking Sample

We examined the factorial structure of the Dutch version of the Personality Adjective Checklist (PACL–D) in a Belgian sample of 3,012 community-dwelling adults. Exploratory factor analyses revealed a 5-factor structure (Neurotic, Aggressive/Dominant, Introverted vs. Extraverted, Conscientious, and Cooperative), that showed considerable overlap with 3 of the Big Five factors (i.e., Neuroticism, Extraversion, and Conscientiousness). Moreover, the 5-factor structure closely resembled the structure found in the original American PACL and was equivalent across gender and age.     

Overreport on the MCMI-III: concurrent validation with the MMPI-2 using a psychiatric inpatient sample

The MCMI-III (Millon, Davis, & Millon, 1997) is a widely used measure of personality often used in inpatient psychiatric settings. Although patients in such settings often overreport or exaggerate their symptoms, relatively little is known about how such a response set presents on the validity indexes of the MCMI-II. In this study, we used a sample of 191 psychiatric inpatients and compared MCMI-III modifier indices (Disclosure, Desirability, and Debasement) with the validity measures (L, F, Fb, F(p), K, and F - K) of the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). In addition, the MCMI-III Disclosure Index (Scale X, which imposes a set cutoff score for invalidity due to overreport) was compared to several cutoff scores on the validity scales of the MMPI-2. Although the MCMI-III indexes generally performed as expected, the MCMI-III had a very high tolerance for overreport. When contrasted with MMPI-2 F scale, the MCMI-II Disclosure Index (which gauges overreport) remained valid until scores on MMPI-2 F scale approached a T score of 120. In addition, the Disclosure Index was at the upper end or slightly exceeded the highest recommended cutoff scores on all other MMPI-2 validity scales except F - K. Clinicians using the MCMI-III alone are cautioned to consider the high tolerance the MCMI-III has for overreport.     

Circular structure of the MCMI-III personality disorder scales.

Millon's (1987) circular model of personality disorders was examined in a large sample of psychiatric patients (N = 2,366) who completed the Millon Clinical Multiaxial Inventory-III (MCMI-III; Millon, 1997) as part of routine assessment after presentation for treatment. Principal components analyses were conducted to identify the first two dimensions in MCMI-III base rate scores, weighted and unweighted raw scores, and nonoverlapping scale scores. Similar analyses were made on these scores when acquiescence was partialled out. Circular plots of the scales were examined against Millon's hypothesized arrangement and the model was tested using confirmatory factor analysis. Results replicated those of Strack, Lorr, and Campbell (1990) with the MCMI-II. Millon's horizontal Impassive-Expressive dimension was recovered in both regular and residual scores but the vertical axis appeared to represent an Impulsivity-Compulsivity dimension rather than the Autonomous-Enmeshed continuum envisioned by Millon. Although scale order followed Millon's predictions for the most part, a number of departures from theoretical expectations were noted and none of the score sets yielded a good fit to the hypothetical structure. Millon's model appears to have promise as a circumplex that can encompass all of the personality disorders but changes are needed to rectify discrepancies between the theory and empirical findings.     

Linking personality disorders and clinical syndromes on the MCMI-III

We examined the relationship between personality disorders (PDs) and clinical syndromes (CSs) as measured by the Millon Clinical Multiaxial Inventory-III (MCMI-III; Millon, 1997) in a large, heterogeneous sample of psychiatric patients (N = 2,366) who completed the instrument as part of routine assessment following presentation for treatment. Using separate sets of base rate (BR) and nonoverlapping scale scores, we factor analyzed the PD and CS scales together and then separately. We correlated results from the latter analyses to determine how trait dimensions were associated with syndrome dimensions. We also studied co-occurrence at the scale level by examining CS score profiles of patients who were grouped according to their highest PD scale elevation > or = BR75. Results for the two score sets were very similar and were consistent with previous research on the MCMI-III and its predecessors that identified 3 underlying dimensions loading both PD and CS scales. Three fourths (76.2%) of the sample had a highest PD scale > or = BR75, and among these, 90% had at least 1 CS scale > or = BR75, whereas 62.4% had 3 or more CS scales above this elevation. Findings underscore the substantial overlap between PDs and CSs along 3 dimensions that resemble Horney's (1945) tripartite interpersonal distinction of moving toward, away, and against, as well as Eysenck's (1994) higher order factors of neuroticism, extraversion, and psychoticism.     

MMPI-2 and MCMI-III characteristics of parental competency examinees

The MMPI-2 (Butcher et al., 2001) and the MCMI-III (Millon, Davis, & Millon, 1997) may contribute to understanding psychological functioning in parental competency examinees. In this study, we sought to identify MMPI-2 and MCMI-III characteristics of this population. We collected data regarding 127 individuals who underwent court-ordered parental competency evaluations. Although test results were generally consistent with findings from the child custody literature, MMPI-2 results indicated the highest Validity scale elevation on the L scale in contrast to the K scale elevations that have often been reported in the custody literature.     

MCMI-III Diagnostic Validity: Bad Test or Bad Validity Study

Operating characteristics describe the validity of tests that attempt to dichotomously predict a diagnosis. These statistics are not fully published in the Millon Clinical Multiaxial Inventory-III Manual (MCMI-III manual Millon, 1994) When calculated from available statistics, the positive predictive powers of the MCMI-III scales are poor both in absolute terms and relative to the MCMI-II (Millon, 1987). There were a number of problems, however, with the initial MCMI-III validity study both inherently and in execution. Although it is doubtful that the MCMI-III is weaker than the MCMI-II, a new validity is needed.     

An Empirical Evaluation of Millon's Dimensional Polarities

LASTPAGE study investigated the theoretical consistency for Millon's dimensional polarities (T. Millon &; R. D. Davis, 1996; T. A. Widiger, 1999) by administering the Millon Index of Personality Styles (MIPS; T. Millon, 1994) and Millon Clinical Multiaxial Inventory-III (MCMI-III; T. Millon, 1997) to 50 university counseling center students. Data were analyzed by correlating the MIPS polarity dimension scales with the personality disorder scales of the MCMI-III. Findings suggested more inconsistencies than consistencies with the underlying theoretical model. The greatest discrepancies were found for the expected relationships between the polarity dimensions and the narcissistic and compulsive scales, and to a lesser degree, the schizoid, avoidant, schizotypal, and negativistic scales. Discussion concerned how these divergencies might best be understood in light of Millon's conceptualization of Axis II disorders.     

A Confirmatory Comparison of the Factor Structure of the Children's Depression Inventory between European American and African American Youth

We examined the factor structure of the Children's Depression Inventory (CDI) among a sample of 523 African American children (m age = 12.76) and a sample of 564 European American youth (m age = 12.43). Previous investigations have produced discrepant factor structures among samples of predominantly majority-culture children, but fewer investigations of the factor structure of the CDI have been conducted among non-European American samples. Confirmatory factor analyses of the original 5 factors identified by Kovacs (1983, 1991) revealed that the items had invariant measurement properties across the samples. The latent factor structure, however, revealed telling differences between the two samples. For European American youth, only one of the original five factors was meaningfully differentiated from the others, whereas for the African American youth, two of the factors clearly emerged as unique facets of depression. Consistent with other reports, between-group mean differences on the CDI and its factors were noted. We argue that further validation of the CDI among traditionally underserved populations is warranted. Predictive validation investigations, in particular, are needed to examine the relationship between CDI factor scores and clinical outcomes.     

The detection of fake-bad and fake-good responding on the Millon Clinical Multiaxial Inventory III

The purpose of this study was to examine the effectiveness of the 3 Modifying Indices of the Millon Clinical Multiaxial Inventory III (MCMI-III) in the detection of fake-bad and fake-good responding. The sample consisted of 160 psychiatric outpatients. Paired t tests were performed to examine the effects of instructional set (faking vs. standard instructions). As hypothesized, instructional set produced significant differences on Scale X, Scale Y, and Scale Z in both fake-bad and fake-good analyses. Single-scale cutoff scores were as effective as multiple-scale cutoffs. The overall rates of successful classification indicated moderate effectiveness and utility of the MCMI-III Modifying Indices in the detection of dissimulated responding. When base rates were varied to more closely approximate a general clinical population, overall classification accuracy increased, but identification of faking (positive predictive power) gradually eroded with declining base-rate estimates. At lower base rates of faking, MCMI-III standard cutoff points yielded a high number of false positives.     

Facets of the Childhood Anxiety Sensitivity Index Among Serbian Youth

Data from factor analytic studies using the Child Anxiety Sensitivity Index (CASI) suggest that global anxiety sensitivity (AS) is best represented by three or four underlying factors or facets. The aim of this study was to identify facets best representing the CASI structure in its Serbian version. Confirmatory factor analysis was used on data collected from 456 non-referred children in Serbia. A 13-item version of the CASI provided a better fit to the data than the original 18-item version. The four-factor model of the CASI-13 with disease, unsteady, mental incapacitation, and social concerns facets provided the best fits for the data and it was found to be fully invariant (configural, metric, and scalar invariance) across gender and age. Among Serbian children, hierarchical structure was found for a 13-item CASI version with a single higher-order factor of global AS represented by four underlying facets. Future research will consider these AS facets and their role in the development, maintenance, and exacerbation of anxiety symptoms in children.     

How useful are indices of personality pathology when assessing domestic violence perpetrators?

There has been considerable debate about profiling personality pathology when assessing and treating male perpetrators of domestic violence (DV). This study used the Millon Clinical Multiaxial Inventory (MCMI-III) to explore the severity and diversity of male perpetrator personality pathology and response bias in a group of DV perpetrators being assessed for a treatment program (N = 177). We analyzed the sample using the interpretive guidelines of White and Gondolf (2000); 54% of profiles in our sample fell into categories indicative of a personality disorder, and 37% of the total sample provided profiles indicative of severe personality pathology. These percentages were higher than White and Gondolf's findings but lower than some others. There was considerable diversity of personality pathology as well, supporting the contention that there is no one male DV perpetrator profile. Because of debate concerning the manner of responding on self-report instruments, we paid special attention to response biases in our sample. Twenty-six percent of our sample exaggerated (12%) or minimized (14%) their responses. We also found that response biases on the MCMI-III Modifying Indices were related to self-reported severity of psychopathology. This suggests that assessing severity of psychopathology is inadequate without reference to such biases.