Relationship between the Millon Behavioral Health Inventory and the minnesota multiphasic personality inventory (MMPI) in low-back pain patients

The Millon Behavioral Health Inventory (MBHI) is being used with increasing frequency for the assessment of chronic pain, although there is a relative lack of evidence as to its utility, and prior studies have not examined low back pain. This investigation compared the MBHI to the MMPI in a sample of low-back pain patients and analyzed subgroups of pain patients based upon their MBHI responses. Subjects were 60 patients who had been admitted to outpatient multidisciplinary pain clinics of two Chicago-area hospitals. Patients completed both the MMPI and the MBHI and provided demographic information. Results of correlational analyses indicated strong relationships between the MBHI psychogenic attitude, psychosomatic correlate, and prognostic index scales and the validity scales of the MMPI. The MBHI Pain Treatment Responsivity scale (PP) correlated with 16 of the other 19 MBHI scales. PP did not demonstrate specificity with low back pain patients. The results of both the scale comparisons and the exploratory two-group cluster subgroup analysis support the notion that responses to the MBHI are largely affected by the respondent's tendency to deny psychopathology or to admit emotional distress.     

The Rorschach Technique (Book)

Minnesota Multiphasic Personality Inventory-2 (MMPI-2) overlapping and nonoverlapping scales were demonstrated to perform comparably to their original MMPI forms. They were then evaluated for convergent and discriminant validity with the Millon Clinical Multiaxial Inventory-II (MCMI-II) personality disorder scales. The MMPI-2 and MCMI-II personality disorder scales demonstrated convergent and discriminant coefficients similar to their original forms. However, the MMPI-2 personality scales classified significantly more of the sample as Dramatic, whereas the MCMI-II diagnosed more of the sample as Anxious. Furthermore, single-scale and 2-point code type classification rates were quite low, indicating that at the level of the individual, the personality disorder scales are not measuring comparable constructs. Hence, each instrument is providing similar and unique information, justifying their continued use together for the purpose of diagnosing personality disorders.     

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.     

Failed back surgeries and minnesota multiphasic personality inventory (MMPI) profiles

MMPI profiles were evaluated for 105 prospective surgical patients who had previously undergone surgery or other procedures for treatment of back pain. Patients were classified into groups having undergone zero, one, two, three, or four or more previous surgeries. While all groups demonstrated a characteristicsomatogenic profile, none of the MMPI validity or clinical scales significantly differentiated the groups and there was no relationship between increased number of surgeries and MMPI scale characteristics. These results support the nonoptimistic prognostication of thesomatogenic MMPI profile for surgical intervention for back pain but show no clear relationship of MMPI profile characteristics to degree of experience of previously failed surgery.     

Convergent validity of alternative MMPI-2 personality disorder scales

The Morey, Waugh, and Blashfield (1985) MMPI (Hathaway et al., 1989) personality disorder scales provided a significant contribution to personality disorder research and assessment. However, the subsequent revisions to the MMPI and the multiple revisions to the diagnostic criteria sets that have since occurred may have justified comparable revisions to these scales. Somwaru and Ben-Porath (1995) selected a substantially different set of items from the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) to assess Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) personality disorder diagnostic criteria. In our study, we compared the convergent validity of these alternative MMPI-2 personality disorder scales with respect to 3 self-report measures of personality disorder symptomatology in a sample of 82 psychiatric outpatients. The results suggested that Somwaru and Ben-Porath's scales are as valid as the original Morey et al. scales and might be even more valid for the assessment of borderline, antisocial, and schizoid personality disorder symptomatology.     

MCMI-II profiles of women with eating disorders: a cluster analytic investigation

A three-factor model of personality pathology was investigated in a clinical sample of 183 female patients in an outpatient eating disorders treatment program. Cluster analysis of MCMI-II personality scales (Millon, 1987) yielded three distinct personality profiles, which were consistent with previous studies. First, 16.9% of the sample comprised a High Functioning cluster, which manifested no clinical elevations on the MCMI-II and had significantly lower scores on the Eating Disorder Inventory (EDI; Garner; 1991) scales than the other two clusters. Second, 49.1% of the sample comprised an Undercontrolled/Dysregulated cluster. Finally, the remaining 34% of the sample comprised an Overcontrolled/Avoidant cluster. This final cluster had significantly higher EDI Ineffectiveness scale scores than the Undercontrolled/Dysregulated cluster group. Cluster membership was not associated with eating disorder subtype, suggesting that there is considerable variance in personality pathology within eating disorder diagnostic categories.     

An examination of three sets of MMPI-2 personality disorder scales

Three sets of personality disorder scales (PD scales) can be scored for the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). Two sets (Levitt & Gotts, 1995; Morey, Waugh, & Blashfield, 1985) are derived from the MMPI (Hathaway & McKinley, 1983), and a third set (Somwaru & Ben-Porath, 1995) is based on the MMPI-2. There is no validity research for the Levitt and Gotts scale, and limited validity research is available for the Somwaru and Ben-Porath scales. There is a large body of research suggesting that the Morey et al. scales have good to excellent convergent validity when compared to a variety of other measures of personality disorders. Since the Morey et al. scales have established validity, there is a question if additional sets of PD scales are needed. The primary purpose of this research was to determine if the PD scales developed by Levitt and Gotts and those developed by Somwaru and Ben-Porath contribute incrementally to the scales developed by Morey et al. in predicting corresponding scales on the MCMI-II (Millon, 1987). In a sample of 494 individuals evaluated at an Army medical center, a hierarchical regression analysis demonstrated that the Somwaru and Ben-Porath Borderline, Antisocial, and Schizoid PD scales and the Levitt and Gotts Narcissistic and Histrionic scales contributed significantly and meaningfully to the Morey et al. scales in predicting the corresponding MCMI-II (Millon, 1987) scale. However, only the Somwaru and Ben-Porath scales demonstrated acceptable internal consistency and convergent validity.     

Bias and Millon clinical multiaxial inventory (MCMI-II) diagnosis

In the current study, the degree of bias is calculated for each of the personality disorder and clinical syndrome scales of the MCMI-II. In general, most of the MCMI-II scales are prone to only mild or moderate biases. However, the paranoid personality disorder, somatoform, bipolar: manic, thought disorder, and delusional disorder scales are prone to severe biases. When the MCMI-II is utilized to make diagnostic decisions, bipolar and schizophrenic disorders are apt to be grossly underestimated. The implications of bias in diagnostic prevalence rates are discussed and an equation is offered which provides for adjustments to be made when the percentage of positive MCMI-II test results are used to determine prevalence rates for clinical or research populations. The observation is made that imperfect sensitivity and specificity for the MCMI-II scales will result in inaccurate estimates of personality disorders and clinical syndromes when the MCMI-II is used to survey various populations.     

Construct interpretation of Minnesota Multiphasic Personality Inventory (MMPI) clinical scales: An orthogonal transformation

The implications for personality test construction of the revolution in testing caused by construct validity considerations are outlined, with particular relevance to the assessment of psychopathology. These include (a) substantive definition of constructs; (b) concern for internal consistency reliability as well as generalizability; (c) evaluation of structural relationships among items and scales; (d) suppression of response biases; (e) emphasis on minimum redundancy among scales; (f) evaluation of convergent and discriminant validity of scales and profiles; and (g) evaluation of criterion validity for configurations of scales and profiles, as well as single scales. Benefits are seen as accruing to an increased understanding of psychopathology and higher levels of validity. Prior, and subsequent, to the forthcoming revision of the Minnesota Multiphasic Personality Inventory (MMPI), one approach to realizing some of the aims of construct measurement with an empirically based test is through an orthogonal transformation of the scales. Preliminary results for the extant MMPI clinical scales are reported, yielding evidence of (a) scale independence while retaining high correlations with uncorrected scales, (b) an appropriate pattern of correlations with a separate set of new scales of psychopathology, (c) a possible basis for new item analyses, and (d) freedom from correlations with a putative measure of response bias. Implications of the orthogonal transformation for profile interpretation are discussed.Portions of this paper were presnted at an invited address, 18th Annual Symposium on Recent Developments in the Use of the MMPI, Minneapolis, April 9, 1983. This paper was written while Douglas N. Jackson was distinguished visiting professor at the College of Education, The University of Iowa. This research has been supported by Research Grant 895-84/86 from the Ontario Mental Health Foundation, Research Grant 411-83-0014 from the Social Sciences and Humanities Research Council of Canada, and the Alberta Hospital Edmonton.     

A response Consistency statistic for the millon clinical multiaxial inventory (MCMI)

Response style in objective psychological testing is an important issue in the reliability and validity of tests as well as in the interpretation of test results. The MCMI provides two response-style indices, the validity scale and the weight factor. The present work presents an additional statistic to assess random response in subjects. The Consistency Coefficient is the correlation between the subjects' endorsement of even and odd items across the 20 MCMI scales. The distributions of 500 patient and 500 randomly generated profiles were compared. Good separation between these distributions was found. The subject data were extremely negatively skewed, whereas the randomly generated data were normally distributed. Data are presented that display positive and negative predictive values, as well as sensitivity and specificity across ranges of prevalence and cut score. These data facilitate the identification of subjects who respond to the MCMI in a random manner so that their scores can be interpreted accordingly.     

The MMPI–2 Restructured Form Personality Psychopathology Five Scales: Bridging DSM–5 Section 2 Personality Disorders and DSM–5 Section 3 Personality Trait Dimensions

This study examined in a college sample and a sample of non-treatment-seeking, trauma-exposed veterans the association between the MMPI–2 Restructured Form (MMPI–2–RF) Personality Psychopathology Five (PSY–5) Scales and DSM–5 Section 2 personality disorder (PD) criteria, the same system used in DSM–IV–TR, and the proposed broad personality trait dimensions contained in Section 3 of DSM–5. DSM–5 Section 2 PD symptoms were assessed using the SCID–II–PQ, and applying a replicated rational selection procedure to the SCID–II–PQ item pool, proxies for the DSM–5 Section 3 dimensions and select facets were constructed. The MMPI–2–RF PSY–5 scales demonstrated appropriate convergent and discriminant associations with both Section 2 PDs and Section 3 dimensions in both samples. These findings suggest the MMPI–2–RF PSY–5 scales can serve both conceptually and practically as a bridge between the DSM–5 Section 2 PD criteria and the DSM–5 Section 3 personality features.     

Predicting personality disorder traits with the Defense Style Questionnaire in a normal sample.

This research examined the efficacy of the 40-item Defense Style Questionnaire (DSQ-40), measuring mature, neurotic and immature defense styles, to predict DSM-III-R personality disorders. The Coolidge Axis II Inventory, the Millon Clinical Multiaxial Inventory-II, and the MMPI personality disorder scales were used to measure 11 personality disorders in a nonclinical sample. The results show that most personality disorders are positively associated with the highly maladaptive immature defense style, and negatively associated with the mature defense style. Multiple regression analyses reveal that the combined variance accounted for by the defense styles range from 12% to 42% on the CATI, 3% to 42% on the MCMI-II, and 2% to 32% on the MMPI-PD. However, specific personality disorders cannot be predicted with the defense styles on any measure.     

Psychometric properties of the mobility inventory for agoraphobia: convergent, discriminant, and criterion-related validity

Aims of this study were (a) to summarize the psychometric literature on the Mobility Inventory for Agoraphobia (MIA), (b) to examine the convergent and discriminant validity of the MIA's Avoidance Alone and Avoidance Accompanied rating scales relative to clinical severity ratings of anxiety disorders from the Anxiety Disorders Interview Schedule (ADIS), and (c) to establish a cutoff score indicative of interviewers’ diagnosis of agoraphobia for the Avoidance Alone scale. A meta-analytic synthesis of 10 published studies yielded positive evidence for internal consistency and convergent and discriminant validity of the scales. Participants in the present study were 129 people with a diagnosis of panic disorder. Internal consistency was excellent for this sample, α = .95 for AAC and .96 for AAL. When the MIA scales were correlated with interviewer ratings, evidence for convergent and discriminant validity for AAL was strong (convergent r with agoraphobia severity ratings = .63 vs. discriminant rs of .10–.29 for other anxiety disorders) and more modest but still positive for AAC (.54 vs. .01–.37). Receiver operating curve analysis indicated that the optimal operating point for AAL as an indicator of ADIS agoraphobia diagnosis was 1.61, which yielded sensitivity of .87 and specificity of .73.     

Personality characteristics of drug addicts and alcoholics on the Millon Clinical Multiaxial Inventory

The Million Clinical Multiaxial Inventory (MCMI) was administered to 106 alcoholics and 100 addicts in separate VA inpatient rehabilitation treatment programs. The alcoholics scored higher on the personality style scales of Avoidant, Passive-Aggressive, Schizotypal, Borderline and Paranoid, while the opiate addicts scored higher on the Narcissistic personality disorder scale. Separate cluster analyses for both groups further revealed common personality styles among both groups. Several MCMI scales showed significant correlations with age, but in no case were the effects attributed to age larger than 5% of the total variance. The MCMI may alert clinicians to subtle similarities and differences between and among alcoholics and opiate addicts.     

Psychometric appraisal of the Scale for Interpersonal Behavior (SIB) in France.

The present study was carried out in France to evaluate the reliability and validity of the Scale for Interpersonal Behavior (SIB), a multidimensional measure of difficulty and distress in assertiveness that was originally developed in The Netherlands. This appraisal was conducted with a clinical sample (N = 166) and a general population sample (N = 150). The clinical series comprised 115 patients with social phobia and 51 patients with personality disorder, 28 of whom were of the avoidant type. Support was found for internal consistency and test-retest reliability of the French SIB. Compared to controls, both social phobics and patients with an avoidant personality disorder had significantly lower mean scores on all performance scales and significantly higher ones on all distress scales, with the social phobics occupying a position in between. Findings in relation to convergent and divergent validity were quite satisfactory. Sensitivity of the French SIB for detecting change was demonstrated in a subgroup of the clinical Ss who had undergone 15 sessions of cognitive-behavioral group therapy for underassertiveness.     

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.     

Development and Validation of Personality Disorder Spectra Scales for the MMPI–2–RF

The purpose of this study was to develop and validate a set of MMPI–2–RF (Ben-Porath &; Tellegen, 2008/2011) personality disorder (PD) spectra scales. These scales could serve the purpose of assisting with DSM–5 PD diagnosis and help link categorical and dimensional conceptions of personality pathology within the MMPI–2–RF. We developed and provided initial validity results for scales corresponding to the 10 PD constructs listed in the DSM–5 using data from student, community, clinical, and correctional samples. Initial validation efforts indicated good support for criterion validity with an external PD measure as well as with dimensional personality traits included in the DSM–5 alternative model for PDs. Construct validity results using psychosocial history and therapists' ratings in a large clinical sample were generally supportive as well. Overall, these brief scales provide clinicians using MMPI–2–RF data with estimates of DSM–5 PD constructs that can support cross-model connections between categorical and dimensional assessment approaches.     

Detection of a Psychiatric Diagnosis in Heart Transplant Candidates with the MBHI

The utility of the Millon Behavioral Health Inventory (MBHI) in screening for the formal diagnosis of a psychiatric disorder was investigated in a sample of 90 heart transplant candidates, a population at risk for psychiatric disturbance. Psychiatric disorders were identified in 71% of patients, the majority being adjustment disorder. Sensitivity and specificity rates of >70% were determined in discriminant function analyses, for presence or absence of a psychiatric condition. When Axis I conditions were differentiated as mild (adjustment reaction only) or severe (all other Axis I conditions, including comorbid Axis II disorders), the MBHI correctly identified every severe case as a probable psychiatric diagnosis. The rate of clinically significant elevations on certain MBHI scales and severity of Axis I psychiatric condition was also significantly associated. These findings suggest that the MBHI may have potential utility in identifying high-risk patients with diagnosable psychiatric conditions and help justify mental health consultation referrals at a time when managed care entities are vigorously rationing ancillary services with medically ill populations.     

Factor structure of the basic personality inventory with incarcerated offenders

The item and scale factor structure of the Basic Personality Inventory (BPI) was examined in a sample of 486 offenders incarcerated for violent and sexual crimes. Separate principal-component analyses of the items for each of the 11 clinical scales, critical item scale, and social desirability scale indicated a one-dimensional factor solution for all scales except Depression and Persecutory Ideation. The Depression scale's two factors were Hopelessness and Depressive Affect and the Persecutory Ideation scale's two factors were General Paranoia and Perception of External Control. Although the factors for these two scales may assist in interpretation, the correlations between the factors and the total score of their respective scale were high. Confirmatory factor analysis of the 220 items from the 11 clinical scales supported the factorial logic of the scoring key. Analysis of the 11 clinical scales resulted in two factors: General Psychopathology/Adjustment and Antisocial Orientation. The results suggest that all but two scales can be viewed as unidimensional thereby allowing for a straightforward clinical interpretation. These analyses support the internal structure of the BPI and lend credence to external validity work with forensic populations.