The MMPI-2 as a predictor of symptom change following treatment for posttraumatic stress disorder

This study sought to examine the impact of personality factors on symptom change following treatment for 141 Vietnam veterans with chronic combat-related posttraumatic stress disorder (PTSD) using the Minnesota Multiphasic Personality Inventory-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). A series of partial correlation and linear multivariate regression analyses identified social alienation, associated with anger and substance use, as the most potent negative predictor of symptom change. Of the scales assessing personality disorder, Borderline Personality was identified as the strongest negative predictor of outcome. Regression analyses examining the most salient scales identified 5 items that contributed 14% of the variance in the prediction of change scores independently of the 21% accounted for by pretreatment PTSD severity.     

Personal standards and evaluative concerns dimensions of "clinical" perfectionism: a reply to Shafran et al. (2002, 2003) and Hewitt et al. (2003)

Shafran, Cooper, and Fairburn (2002, 2003) provided a cognitive-behavioral analysis of "clinical" perfectionism, a construct they considered to involve both the determined pursuit of self-imposed standards and extremely vulnerable self-evaluation. They argued against a multidimensional perspective to studying perfectionism. We respond to Shafran et al. (2002, 2003) and Hewitt, Flett, Besser, Sherry, and McGee's (2003) reply to Shafran et al. (2002) by considering the theoretical, empirical, and clinical implications of findings identifying two higher-order dimensions of perfectionism reflecting personal standards (PS) and self-critical evaluative concerns. Analyses of data from two diverse study groups, a college student sample (N = 527) and a clinical sample of patients with binge eating disorder (N = 236), revealed that self-criticism accounts for the relation between perfectionism measures and depressive, anxious, and eating disorder symptoms. We conclude that possessing high PS is not by itself maladaptive. Rather, self-critical evaluative tendencies are more relevant than PS to the critical processes Shafran et al. (2002) suggested contribute to the maintenance of clinical perfectionism.     

Detecting symptom exaggeration in combat veterans using the MMPI-2 symptom validity scales: a mixed group validation

Although validity scales of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; J. N. Butcher, W. G. Dahlstrom, J. R. Graham, A. Tellegen, & B. Kaemmer, 1989) have proven useful in the detection of symptom exaggeration in criterion-group validation (CGV) studies, usually comparing instructed feigners with known patient groups, the application of these scales has been problematic when assessing combat veterans undergoing posttraumatic stress disorder (PTSD) examinations. Mixed group validation (MGV) was employed to determine the efficacy of MMPI-2 exaggeration scales in compensation-seeking (CS) and noncompensation-seeking (NCS) veterans. Unlike CGV, MGV allows for a mix of exaggerating and nonexaggerating individuals in each group, does not require that the exaggeration versus nonexaggerating status of any individual be known, and can be adjusted for different base-rate estimates. MMPI-2 responses of 377 male veterans were examined according to CS versus NCS status. MGV was calculated using 4 sets of base-rate estimates drawn from the literature. The validity scales generally performed well (adequate sensitivity, specificity, and efficiency) under most base-rate estimations, and most produced cutoff scores that showed adequate detection of symptom exaggeration, regardless of base-rate assumptions. These results support the use of MMPI-2 validity scales for PTSD evaluations in veteran populations, even under varying base rates of symptom exaggeration.     

Explicit mechanisms do not account for implicit localization and identification of change: An empirical reply to Mitroff et al. (2002)

Several recent findings support the notion that changes in the environment can be implicitly represented by the visual system. S. R. Mitroff, D. J. Simons, and S. L. Franconeri (see record 2002-15293-003) challenged this view and proposed alternative interpretations based on explicit strategies. Across 4 experiments, the current study finds no empirical support for such alternative proposals. Experiment 1 shows that subjects do not rely on unchanged items when locating an unaware change. Experiments 2 and 3 show that unaware changes affect performance even when they occur at an unpredictable location. Experiment 4 shows that the unaware congruency effect does not depend simply on the pattern of the final display. The authors point to converging evidence from other methodologies and highlight several weaknesses in Mitroff et al's theoretical arguments. It is concluded here that implicit representation of change provides the most parsimonious explanation for both past and present findings. ((c) 2003 APA, all rights reserved)     

Culture and basic psychological processes--toward a system view of culture: comment on Oyserman et al. (2002)

D. Oyserman, H. M. Coon, and M. Kemmelmeier (2002) provide a most comprehensive review of empirical studies that used attitudinal surveys to capture cultural variations in individualism and collectivism. In the present article, the author suggests that the cross-cultural validity of attitudinal surveys can no longer be taken for granted. Moreover, the meta-theory underlying this literature (called the entity view of culture) is called into question. The author presents an alternative meta-theory (called the system view of culture) and discusses its implications for future work in cultural and cross-cultural psychology.     

Supernumerary phantoms: a comment on Grossi, et al.'s (2002) spare thoughts on spare limbs

A recently published case report of a supernumerary phantom limb in a man with left-sided hemiplegia did not take note that this phenomenon has been extensively documented in the neurological literature for well over 100 years. The present comment provides a brief introduction to the clinical and experimental approaches to supernumerary phantom limbs. It also emphasizes the theoretical importance of this condition for understanding the neurological mechanisms subserving the experience of having a body.     

On the importance of models in interpreting remember-know experiments: comments on Gardiner et al.'s (2002) meta-analysis

From a meta-analysis of recognition experiments using the remember-know-guess paradigm, Gardiner, Ramponi, and Richardson-Klavehn (2002) reported two findings that they viewed as evidence against the one-dimensional model for that paradigm: (1) Memory strength increased when know responses were added to remember responses, decreasing when guess responses were also included. (2) The accuracy of guess responses was correlated with the location of the old-new criterion in the one-dimensional model for the paradigm, implying that guesses were influenced by decision processes. We question both findings. The first result is contradicted by a signal-detection (SDT) analysis, which shows that both know and guess responses reduced estimated memory strength. The discrepancy results from the properties of A', the measure of accuracy used by Gardiner et al., which we argue is flawed. The second result follows directly from the one-dimensional model, in which accuracy and response criteria are fixed. The authors' reasons for rejecting the one-dimensional model are thus not persuasive, but it can nonetheless be rejected because ROC curves implied by the data are inconsistent with ROCs derived from ratings experiments. A two-dimensional SDT model (Rotello, Macmillan, & Reeder, 2004) accounts for both sets of data. The analysis illustrates the importance of models in interpreting remember--know data.     

On the importance of models in interpreting remember-know experiments: Comments on Gardiner et al.'s (2002) meta-analysis

From a meta-analysis of recognition experiments using the remember-know-guess paradigm, Gardiner, Ramponi, and Richardson-Klavehn (2002) reported two findings that they viewed as evidence against the one-dimensional model for that paradigm: (1) Memory strength increased when know responses were added to remember responses, decreasing when guess responses were also included. (2) The accuracy of guess responses was correlated with the location of the old-new criterion in the one-dimensional model for the paradigm, implying that guesses were influenced by decision processes. We question both findings. The first result is contradicted by a signal-detection (SDT) analysis, which shows that both know and guess responses reduced estimated memory strength. The discrepancy results from the properties of A′, the measure of accuracy used by Gardiner et al., which we argue is flawed. The second result follows directly from the one-dimensional model, in which accuracy and response criteria are fixed. The authors' reasons for rejecting the one-dimensional model are thus not persuasive, but it can nonetheless be rejected because ROC curves implied by the data are inconsistent with ROCs derived from ratings experiments. A two-dimensional SDT model (Rotello, Macmillan, & Reeder, 2004) accounts for both sets of data. The analysis illustrates the importance of models in interpreting remember-know data.     

The validity of the PTSD checklist as a measure of symptomatic change in combat-related PTSD

Little research to date has examined the ability of self-report measures to assess changes in symptom severity and diagnostic status as a function of treatment. This study investigated the validity of the posttraumatic stress disorder (PTSD) checklist (PCL) as a measure of symptomatic change following programmatic treatment. A sample of 97 Vietnam veterans with combat-related PTSD was assessed using the clinician-administered PTSD scale (CAPS) and the PCL prior to, and 9 months following, participation in a PTSD treatment program. Using the CAPS as the "gold standard" measure of PTSD symptomatology, the PCL demonstrated high diagnostic accuracy pre- and posttreatment. However, significant variations in accuracy were evident in the ability of the PCL to determine the presence and severity of individual symptoms at each time point. In addition, as symptoms improved from pre- to posttreatment, and approached the threshold criteria, the PCL demonstrated reductions in diagnostic accuracy. As a measure of overall symptomatic change, the PCL underrated improvement in comparison to the CAPS. The results supported the use of an overall cut-off score of 50 on the PCL for a diagnosis, and an item score of 3 for symptom criterion, in this population.     

Reclaiming the individual from Hofstede's ecological analysis--a 20-year odyssey: comment on Oyserman et al. (2002)

D. Oyserman, H. M. Coon, and M. Kemmelmeier (2002) challenge the stereotype that European Americans are more individualistic and less collectivistic than persons from most other ethnic groups. The author contends that this stereotype took firm empirical root with G. Hofstede's (1980) monumental publication identifying the United States as the most individualistic of his then 40 nations. This empirical designation arose because of challengeable decisions Hofstede made about the analysis of his data and the labeling of his dimensions. The conflation of concepts under the rubric of cultural individualism plus psychologists' unwarranted psychologizing of the construct then combined with Hofstede's empirical location of America to set a 20-year agenda for data collection. Oyserman et al. disentangle and organize this mass of studies, enabling the discipline of cross-cultural psychology to forge ahead in more productive directions, less reliant on previous assumptions and measures.     

Autonomic and eyeblink conditioning are closely related to contingency awareness: reply to Wiens and Ohman (2002) and Manns et al. (2002)

S. Wiens and A. Ohman (2002) disputed the conclusion that Pavlovian conditioning is strongly related to contingency awareness (P. F. Lovibond & D. R. Shanks, 2002) on the basis that an inappropriate definition of awareness was used. J. R. Manns, R. E. Clark, and L. R. Squire (2002) contended that delay eyeblink conditioning is independent of awareness. The authors of the present article consider these arguments, highlight several problems in the new studies described by the commentators, and conclude that there is still little evidence for unconscious conditioning in either subliminal autonomic conditioning or eyeblink conditioning. The most parsimonious account of existing data is that a single learning process gives rise to both awareness and conditioned responding. Further progress in evaluating the possibility of unconscious conditioning would be facilitated by the development of more completely specified and testable dual-process models.     

Bringing culture to basic psychological theory--beyond individualism and collectivism: comment on Oyserman et al. (2002)

D. Oyserman, H. M. Coon, and M. Kemmelmeir (2002) offered a comprehensive literature review on individualism and collectivism that forwards valuable suggestions for ways to enhance future research conducted within this framework. The author argues that although their criticisms of much contemporary social psychological research on individualism and collectivism are valid, even more fundamental problems need to be recognized as characterizing work within this tradition, such as the insufficiently subtle nature of the views held of culture, the limited attention given to meanings, and the downplaying of contextual variation. The author suggests adopting more nuanced and process-oriented conceptions of culture and more contextually grounded views of its impact on psychological functioning as a way of realizing the promise of cultural psychology to broaden and provide insight into basic psychological theory.     

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.     

Objective age-of-acquisition (AoA) norms for a set of 230 object names in French: Relationships with psycholinguistic variables,the English data from Morrison et al. (1997), and naming latencies

Picture naming speed is strongly influenced by the age of acquisition (AoA) of words. Most studies of AoA have relied on adults' AoA ratings. However, objective AoA has been found to be a stronger determinant of picture naming latencies. Whereas objective AoA norms for words have been collected for some language communities, no objective AoA measures for words were previously available in French. The study provides objective AoA norms for a set of 230 object names following the procedures used by Morrison, Chappell, and Ellis (1997) to collect objective AoA measures in English. The relationships between objective AoA measures, rated AoA, other variables used in psycholinguistic experiments (name agreement, image agreement, conceptual familiarity, etc.), the English data collected by Morrison et al., and naming latencies are analysed and discussed. In addition, reanalyses of data on picture naming latencies (Bonin, Chalard, Méot, & Fayol, 2002) with the use of objective AoA norms are provided. Stepwise multiple analyses show that objective AoA is a stronger determinant of (spoken and written) naming latencies than rated AoA, whereas objective word frequency is not a reliable independent determinant and does not interact reliably with AoA in any of the analyses.     

The validity and appropriateness of methods, analyses, and conclusions in Rind et al. (1998): A rebuttal of victimological critique from Ondersma et al. (2001) and Dallam et al. (2001).

The authors respond to 2 victimological critiques of their 1998 meta-analysis on child sexual abuse (CSA). S. J. Dallam et al. (2001) claimed that B. Rind, P. Tromovitch, and R. Bauserman (1998) committed numerous methodological and statistical errors, and often miscoded and misinterpreted data. The authors show all these claims to be invalid. To the contrary, they demonstrate frequent bias in Dallam et al.'s criticisms. S. J. Ondersma et al. (2001) claimed that Rind et al.'s study is part of a backlash against psychotherapists, that its suggestions regarding CSA definitions were extrascientific, and that the moral standard is needed to understand CSA scientifically. The authors show their suggestions to have been scientific and argue that it is Ondersma et al.'s issue-framing and moral standard that are extrascientific. This reply supports the original methods, analyses, recommendations, and conclusions of Rind et al.     

An examination of procedures for determining the number of clusters in a data set

A Monte Carlo evaluation of 30 procedures for determining the number of clusters was conducted on artificial data sets which contained either 2, 3, 4, or 5 distinct nonoverlapping clusters. To provide a variety of clustering solutions, the data sets were analyzed by four hierarchical clustering methods. External criterion measures indicated excellent recovery of the true cluster structure by the methods at the correct hierarchy level. Thus, the clustering present in the data was quite strong. The simulation results for the stopping rules revealed a wide range in their ability to determine the correct number of clusters in the data. Several procedures worked fairly well, whereas others performed rather poorly. Thus, the latter group of rules would appear to have little validity, particularly for data sets containing distinct clusters. Applied researchers are urged to select one or more of the better criteria. However, users are cautioned that the performance of some of the criteria may be data dependent.The authors would like to express their appreciation to a number of individuals who provided assistance during the conduct of this research. Those who deserve recognition include Roger Blashfield, John Crawford, John Gower, James Lingoes, Wansoo Rhee, F. James Rohlf, Warren Sarle, and Tom Soon.     

The Infrequency-Posttraumatic Stress Disorder scale (Fptsd) for the MMPI-2: development and initial validation with veterans presenting with combat-related PTSD

Researchers have identified difficulties associated with the use of traditional Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) validity scales with survivors of traumatic events. A new scale, the Infrequency-Posttraumatic Stress Disorder scale (Fptsd), was created from MMPI-2 items that were infrequently endorsed by 940 male combat veterans presenting for treatment at the posttraumatic stress disorder (PTSD) clinics of 2 Veterans Affairs Medical Centers. A variety of statistical methods were implemented that preliminarily established Fptsd's validity with a validation sample of 323 additional PTSD-diagnosed combat veterans. Results indicate that, relative to previously established validity and overreporting scales (F, Fb, and Fp), Fptsd was significantly less related to psychopathology and distress and better at discriminating simulated from genuinely reported PTSD. Clinical implications are discussed concerning the use of Fptsd to assess disability-seeking veterans suspected of overreporting PTSD symptoms.     

Weighing evidence for the Rorschach's validity: a response to Wood et al. (1999)

Wood, Nezworski, Stejskal, Garven, and West (1999) challenged Ganellen's (1996) characterization of the revised Rorschach Depression Index (DEPI; Exner, 1991) as a promising psychometric marker of depression that deserves serious attention by researchers and clinicians. To the contrary, however, a careful examination of existing studies indicates that no compelling empirical evidence exists indicating that Ganellen's conclusions should be modified at the present time, although no firm conclusions about the DEPI can be reached until further evidence accumulates. Furthermore, although Wood et al. (1999) suggested that evidence supporting the reliability and validity of the Rorschach in general is weak, ample evidence exists demonstrating that the Rorschach can be scored reliably (Meyer, 1997), that Rorschach variables in general have respectable levels of criterion-related validity (Bornstein, 1996; Hiller, Rosenthal, Bornstein, Berry, & Brunnel-Neuleib, 1999), and that the Minnesota Multiphasic Personality Inventory (MMPI; Hathaway & McKinley, 1943) and Rorschach have comparable levels of criterion-related validity, with the MMPI outperforming the Rorschach in certain respects and the Rorschach outperforming the MMPI in others (Bornstein, 1999; Hiller et al, 1999).     

Evolving science in adolescence: comment on Ellis et al. (2012)

Ellis et al. (2012) bring an evolutionary perspective to bear on adolescent risky behavioral development, clinical practice, and public policy. The authors offer important insights that (a) some risky behaviors may be adaptive for the individual and the species by being hard-wired due to fitness benefits and (b) interventions might be more successful if they move with, rather than against, the natural tendencies of an adolescent. Ellis and colleagues criticize the field of developmental psychopathology, but we see the 2 fields as complementary. Their position would be enhanced by integrating it with contemporary perspectives on dynamic cascades through which normative behavior turns into genuinely maladaptive outcomes, dual processes in adolescent neural development, and adolescent decision making. Finally, they rightly note that innovation is needed in interventions and policies toward adolescent problem behavior.     

An L1-script-transfer-effect fallacy: a rejoinder to Wang et al. (2003)

Do different L1 (first language) writing systems differentially affect word identification in English as a second language (ESL)? Wang, Koda, and Perfetti [Cognition 87 (2003) 129] answered yes by examining Chinese students with a logographic L1 background and Korean students with an alphabetic L1 background for their phonological and orthographic processing skills on English word identification. Such a conclusion is premature, however. We propose that the L1 phonological system (rather than the L1 writing system) of the learner largely accounts for cognitive processes in learning to read a second language (L2).