MAPI code types in an inpatient crisis-unit sample

Limited data is available concerning the use of the Millon Adolescent Personality Inventory (MAPI; Millon, Green, & Meagher, 1982) and high-point code combinations of its personality style scales. Our study reports on the frequency of high-point codes in an inpatient crisis-unit sample. Data analyses comparing personality style codes using MAPI expressed concerns scale elevations and Rorschach data are reported. Results comparing the personality style codes and expressed concerns scales were consistent with the findings of Millon et al. (1982). Analyses comparing Rorschach and MAPI data revealed only the presence or absence of vista responses as having any appreciable relationship to MAPI codes or personality scales.     

The Utility of the MAPI in the Assessment of Depression

The relationships between the Millon Adolescent Personality inventory (MAPI; Millon, Green, & Meagher, 1982) and depression, as assessed by the Multiscore Depression Inventory (MDI; Berndt, 1968) were examined. Elevations on the MDI subscales were positively related to elevations on MAPI personality style Scale 2 (Inhibited) and Scale 8 (Sensitive) and on six of the eight MAPI expressed concerns scales. MAPI personality style Scale 4 (Sociable) and Scale 5 (Confident) were negatively correlated with the MDI. MAPI code types containing either Scale 2 or 8 were associated with a high MDI full-scale score. The subjects who received a MAPI computer-generated diagnosis of borderline personality disorder also had elevated MDI full-scale scores. The findings of this study appear consistent with the existing body of MAPI research, and the data suggest that the MAPI personality style scales may have both state and trait qualities.     

The utility of the MAPI in the assessment of depression

The relationships between the Millon Adolescent Personality Inventory (MAPI; Millon, Green, & Meagher, 1982) and depression, as assessed by the Multiscore Depression Inventory (MDI; Berndt, 1968) were examined. Elevations on the MDI subscales were positively related to elevations on MAPI personality style Scale 2 (Inhibited) and Scale 8 (Sensitive) and on six of the eight MAPI expressed concerns scales. MAPI personality style Scale 4 (Sociable) and Scale 5 (Confident) were negatively correlated with the MDI. MAPI code types containing either Scale 2 or 8 were associated with a high MDI full-scale score. The subjects who received a MAPI computer-generated diagnosis of borderline personality disorder also had elevated MDI full-scale scores. The findings of this study appear consistent with the existing body of MAPI research, and the data suggest that the MAPI personality style scales may have both state and trait qualities.     

The Millon Adolescent Personality Inventory and the Millon Adolescent Clinical Inventory

The theoretical grounds, purposes, and features of the Millon Adolescent Personality Inventory (MAPI; Millon, Green, & Meagher, 1982) and its forthcoming replacement the Millon Adolescent Clinical Inventory (MACI; Millon, in press) are reviewed. The rationale and procedure for the construction of the component scales are briefly explained, and the logic of configural or profile interpretation is examined and recommended. Uses and limitations of the MAPI and MAC1 are considered. Evaluative research, although limited in scope, points to the general utility of the MAPI and MACI as clinical tools, and to areas where further study may enhance their applicability in a counseling context.     

Stability of the Million Adolescent Personality Inventory in an Incarcerated Delinquent Population

Clinical use of the Millon Adolescent Personality Inventory (MAPI) depends on computerized interpretation of the pattern of scale score elevations in the profile beyond certain cutoff scores rather than the elevations of single scales. There has been no reported work on the stability of the scale scores or the stability of the 2-point codes in a delinquent population. The MAPI was administered to 46 incarcerated male juvenile delinquents and was readministered after a period of 2 to 4 weeks. The test-retest correlations of the base-rate scale scores ranged from .33 to .89 with a mean of .74, which compare favorably to Millon's (1982) standardization sample. However, only 41% of the 2-point codes were judged to be congruent between administrations. The poor congruence of the 2-point codes across administrations raises doubts about interpretive statements based on these codes.     

Stability of the Millon Adolescent Personality Inventory in an incarcerated delinquent population

Clinical use of the Millon Adolescent Personality Inventory (MAPI) depends on computerized interpretation of the pattern of scale score elevations in the profile beyond certain cutoff scores rather than the elevations of single scales. There has been no reported work on the stability of the scale scores or the stability of the 2-point codes in a delinquent population. The MAPI was administered to 46 incarcerated male juvenile delinquents and was readministered after a period of 2 to 4 weeks. The test-retest correlations of the base-rate scale scores ranged from .33 to .89 with a mean of .74, which compare favorably to Millon's (1982) standardization sample. However, only 41% of the 2-point codes were judged to be congruent between administrations. The poor congruence of the 2-point codes across administrations raises doubts about interpretive statements based on these codes.     

The Millon Adolescent Personality Inventory profiles of depressed adolescents

The evidence indicates that adolescent depression may be more difficult to recognize than its adult counterpart, although the reasons for this difficulty remain unclear. The research in this area is in part impeded by the lack of adolescent-specific measures of personality functioning. In this study the personality styles, expressed concerns, and behavioral tendencies of depressed adolescents were investigated by means of the Millon Adolescent Personality Inventory (MAPI), a relatively new personality inventory designed specifically for this age group. Three hundred sixty-six high school students completed the Beck Depression Inventory (BDI) and the MAPI, resulting in 332 valid and reliable MAPI profiles. The data were reduced to two factors, accounting for 65.1% of the total variance, by means of a principal components analysis. The two factors were interpreted as two dimensions of personality functioning associated with depression in adolescents. The first dimension suggested a socially withdrawn, overtly recognizable depression, whereas the second presents acting-out tendencies that may overshadow depressive symptomatology. The findings are integrated with the theoretical positions represented in the literature. Theoretical and practical implications for the use of the MAPI with depressed adolescents are discussed.     

Personality characteristics of a community sample of adolescents with conduct disorders

The Millon Adolescent Personality Inventory (MAPI) was used to compare the personality styles, expressed concerns, and behavioral correlates of a community sample of conduct-disordered (n = 13) and non-conduct-disordered (n = 137) adolescents. Structured interviews with adolescents and parents were used to classify subjects using DSM-III criteria. Significant differences were found between groups. Conduct-disordered youth reported being very critical, harsh, and not respectful of others. They tended to seek out the unpredictable and to be moody and pessimistic. They expressed a lack of confidence in school performance and dissatisfaction with family life. These results support the usefulness of self-report measurements with troubled adolescents in general, and the validity of the MAPI in particular. Implications for diagnosis and treatment are discussed.     

Relationships between the MAPI and the MMPI in the assessment of adolescent psychopathology.

Although the Minnesota Multiphasic Personality Inventory (MMPI) and the Millon Adolescent Personality Inventory (MAPI) are both widely used in the clinical assessment of adolescents, no research has examined the interrelationship between these two instruments. We investigated MMPI and MAPI responses from 199 adolescents assessed at entrance to inpatient or outpatient psychiatric programs in Florida and Virginia. Univariate correlation analyses identified areas of significant associations between these measures, with coefficients ranging widely from -.70 to .72. Substantial diagnostic differences were found between these instruments. The MAPI, for example, yielded no depression-related diagnoses, but produced many more adjustment disorder and personality disorder diagnoses than the MMPI. The rates of diagnostic assignment agreements between diagnoses produced by clinical judgment, MMPI findings, and MAPI interpretive reports were typically quite low.     

Graphomotor Interpretation of the MMPI-2?

Although clinicians may attribute various personality features to patients who complete paper-and-pencil instruments (e.g., the MMPI-2) with notable neatness (compulsivity?) or sloppiness (oppositionalism?), such inferences have not been empirically examined. In our investigation, MMPI-2 protocols of 154 psychiatric inpatients (74 female and 80 male, M age = 36.7) were examined. A scoring system was developed to categorize the degree of neatness with which each patient had filled in the MMPI-2 response sheet (interrater Cohen Kappa = 0.86). Degree of neatness was not found to be correlated with clinical or content scales on the MMPI-2, with any Millon Clinical Multiaxial Inventory-II (MCMI-II) scales, or with various Rorschach (Comprehensive System) variables. These results imply that, clinical lore notwithstanding, clinicians should refrain from drawing unwarranted inferences about patients' personality features on the basis of the apparent neatness or sloppiness of patients' protocols.     

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.     

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.     

Graphomotor interpretation of the MMPI-2?

Although clinicians may attribute various personality features to patients who complete paper-and-pencil instruments (e.g., the MMPI-2) with notable neatness (compulsivity?) or sloppiness (oppositionalism?), such inferences have not been empirically examined. In our investigation, MMPI-2 protocols of 154 psychiatric inpatients (74 female and 80 male, M age = 36.7) were examined. A scoring system was developed to categorize the degree of neatness with which each patient had filled in the MMPI-2 response sheet (interrater Cohen Kappa = 0.86). Degree of neatness was not found to be correlated with clinical or content scales on the MMPI-2, with any Millon Clinical Multiaxial Inventory-II (MCMI-II) scales, or with various Rorschach (Comprehensive System) variables. These results imply that, clinical lore notwithstanding, clinicians should refrain from drawing unwarranted inferences about patients' personality features on the basis of the apparent neatness or sloppiness of patients' protocols.     

Stability of the Millon Clinical Multiaxial Inventory among psychiatric inpatients

This study investigated the stability of the Millon Clinical Multiaxial Inventory (MCMI) in a sample of psychiatric inpatients over a longer time period and from different perspectives than previous reliability studies. Test-retest reliability was assessed from three perspectives: correlation/regression, equivalence of dimensional structures across testings upon different admissions, and stability of personality style across testings. Some stability from a correlational perspective was found, with higher stability estimates indicated for the basic personality scales in comparison with the clinical symptom scales which is consistent with Millon's theory. The internal structure of the MCMI was essentially identical across testings. Although source of reinforcement and instrumental or coping style were stable across testings beyond chance, the MCMI profiles of a considerable number of subjects were inconsistent across testings. Correspondingly, clinicians should be cautious in using the MCMI to make categorical decisions regarding personality style with inpatients who are tested at admission and who have had repeated hospitalizations.     

A comparison of MMPI-2 high-point coding strategies

High-point coding refers to the popular practice of classifying Minnesota Multiphasic Personality Inventory (Hathaway & McKinley, 1983) profiles based on which clinical scales are the most elevated. A previous review of high-point code studies (McGrath & Ingersoll, 1999a) noted marked discrepancies across studies in the rules used to define high-point codes. This study was conducted to evaluate the costs and benefits of different strategies for high-point coding. The impact of 4 rules for high-point coding on effect sizes and group sizes was evaluated. The 4 rules included requiring a minimum elevation, excluding potentially invalid protocols, restricting coding to well-defined codes, and replacing the lower scale in infrequently occurring codes with the next most elevated scale. The evidence supported the clinical utility of requiring a minimum elevation for code scales. The results were more equivocal concerning the value of well-defined coding and for not replacing the lower scale in infrequent codes. Results were surprisingly negative concerning the utility of excluding potentially invalid protocols, suggesting that guidelines developed in situations in which there is a clear motivation to distort results may not generalize to other settings.     

Integrating psychopathology and personality disorders conceptualized by the MMPI-2-RF and the MCMI-III: a structural validity study

The Minnesota Multiphasic Personality Inventory-2-Restructured Form (Ben-Porath & Tellegen, 2008 ) Restructured Clinical scales and Higher Order scales were linked to the Millon Clinical Multiaxial Inventory-III (Millon, Millon, Davis, & Grossman, 2009 ) personality disorder scales and clinical syndrome scales in a Flemish/Dutch sample of psychiatric inpatients and outpatients, substance abuse patients, correctional inmates, and forensic psychiatric patients (N = 968). Structural validity of psychopathology and personality disorders as conceptualized by both instruments was investigated by means of principal component analysis. Results reveal a higher order structure with 4 dimensions (internalizing disorders, externalizing disorders, paranoid ideation/thought disturbance, and pathological introversion) that parallels earlier research on pathological personality dimensions as well as research linking pathological personality traits with mental disorders. Theoretical and clinical implications are considered.     

Adult Attachment and Developmental Personality Styles: An Empirical Study

The current study was designed to test specific hypotheses associated with W. J. Lyddon and A. Sherry's (2001) attachment theory model of developmental personality styles. More specifically, 4 adult attachment dimensions were correlated with 10 personality scales on the Millon Clinical Multiaxial Inventory‐III (T. Millon, R. Davis, & C. Millon, 1997) with a sample of 273 men and women. Findings indicated that the adult attachment dimensions were able to predict 7 of the 10 personality styles.     

Beginning and Succeeding in Graduate School

Alcohol-dependent outpatients were clustered on the basis of their responses on the Millon Clinical Multiaxial Inventory (MCMI; Millon, 1983) personality disorder scales; male and female patients were clustered separately. The clusters were compared with respect to self-reported psychiatric, interpersonal, and drinking problems. The results, along with those of previous cluster analyses with male inpatients, suggest several reliable personality subtypes. One type (more common in inpatient settings) scores high on Negativistic and Avoidant/Schizoid or Dependent scales and reports numerous problems and intense distress. A second type (more common in outpatient settings) reports few problems and scores highest on Compulsive or Histrionic/Narcissistic scales. A third group (found in all and only male samples) scores high on Narcissism and Antisocial scales, readily admits substance problems, and may be interpersonally controlling and distancing.     

The rorschach search for the borderline Holy Grail: an examination of personality structure, personality style, and situation

Much of the research on the use of the Rorschach to diagnose borderline disturbance has sought to discover a specific borderline pattern or Rorschach configuration. Given our increased understanding of borderline functioning representing a level of personality organization (or personality structure), this single pattern approach is excessively simplistic. It fails to consider the complex interaction between personality structure, personality style, and situational variables. An approach to the Rorschach assessment of borderline functioning is presented using a clinical example. The patient was tested at the onset of psychotherapy and then some 4 years into treatment. Results from the two testings were compared using Weiner and Exner's (1991) Rorschach variable clusters for assessing change in psychotherapy.     

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.