Assessing depression with the MMPI and MMPI-2

The usefulness of the MMPI (Hathaway & McKinley, 1951 ) and MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) for diagnosing and assessing symptomatic depression has been the subject of considerable debate for a number of years. In this article, we review the relative contributions of the MMPI and MMPI-2 clinical and content scales in predicting depression. Positive predictive power, negative predictive power, and overall classification rate were computed for Scale 2 (D) of the MMPI and MMPI-2 and the Depression content scale (DEP) of the MMPI-2. Scale 2 (D) of both the MMPI and MMPI-2 appears to be moderately accurate in predicting depression. Although some studies suggest that the content scale DEP provides incremental validity over Scale 2 (D) of the MMPI-2, the results of this review indicate that the content scale DEP of the MMPI-2 does not exceed the diagnostic efficiency of Scale 2 in predicting depression.     

How (not) to evaluate the comparability of MMPI and MMPI-2 profile configurations: a reply to Humphrey and Dahlstrom

Humphrey and Dahlstrom (1995) presented a study on the comparability of MMPI/MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) profiles in which they concluded that "the bases for clinical interpretation derived from the MMPI and MMPI-2 profiles were sufficiently at variance to require different conclusions" [sic] (p. 2). In this brief critique, we identify procedural and data-analytical deficiencies that invalidate Humphrey and Dahlstrom's argument. Their blanket recommendation based on this argument, namely, that clinicians routinely plot both MMPI and MMPI-2 profiles, is unwarranted.     

Comparison of the MMPI and MMPI-2 Among Job Applicants

The primary objective was to compare the MMPI-2 profiles for professional job applicants with corresponding profiles on the original MMPI. Male and female MMPI-2 profiles were also compared, and correlational and factor analyses were used to examine: A) Interscale correlations vis-à-vis item overlap, and B) The impact of K-corrections. The subjects were 82 auditor applicants, plus 212 sales and management applicants from an earlier study. The original MMPI was found to overpathologize applicant profiles. Male and female MMPI-2 profiles differed only on Mf. Scales L, K, and Hy formed a favorable cluster for job applicants, while F, Hs, Pt, Sc formed one unfavorable cluster—and D, Si a second. K-corrections consistently moved clinical scales in the direction of the favorable cluster.     

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.     

Code-Type Comparability of the MMPI and MMPI-2: Analysis of Recent Findings and Criticisms

The introduction of the MMPI-2 has stimulated studies of its comparability with the MMPI. Graham, Timbrook, Ben-Porath, and Butcher (1991) consider the congruence between MMPI-2 and MMPI code types substantial, but Dahlstrom (1992) has questioned their appraisal, criticizing their use of "well-defined" code types. Our own analysis supports Graham and colleagues' (1991) conclusions and provides reasons for favoring narrow code types (such as well- defined code types) over nonrestrictive ones. We also offer a brief historical review of MMPI code typology as background for our recommendation that future MMPI-2 research not be limited to studies of code-type correlates.     

Evaluating the Similarity of MMPI-2 and MMPI Profiles: Reply to Dahlstrom and Humphrey

We review issues that have arisen in exchanges with Dahlstrom and Humphrey (Dahlstrom & Humphrey, 1996; Humphrey & Dahlstrom, 1995) about assessing the comparability of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the MMPI. We point out the limitations of Q correlations (without contending that D² is "the only legitimate function of profile comparability," as Dahlstrom and Humphrey, 1996, p. 350, claim we do), and explain why Dahlstrom and Humphrey's (1996) new Q-correlational results, correctly interpreted, are consistent with our own previous observations and conclusions. We stress again the importance of both overall profile elevation and profile "definition" in making code-type assignments. Nonrestrictive code types ignore these profile characteristics, and their use needlessly lowers MMPI-2/MMPI code-type congruences and raises the incidence of profile misinterpretations. Our recommendation of well-defined MMPI-2 code types stands.     

Evaluating the similarity of MMPI-2 and MMPI profiles: reply to Dahlstrom and Humphrey

We review issues that have arisen in exchanges with Dahlstrom and Humphrey (Dahlstrom & Humphrey, 1996; Humphrey & Dahlstrom, 1995) about assessing the comparability of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the MMPI. We point out the limitations of Q correlations (without contending that D(2) is "the only legitimate function of profile comparability," as Dahlstrom and Humphrey, 1996, p. 350, claim we do), and explain why Dahlstrom and Humphrey's (1996) new Q-correlational results, correctly interpreted, are consistent with our own previous observations and conclusions. We stress again the importance of both overall profile elevation and profile "definition" in making code-type assignments. Nonrestrictive code types ignore these profile characteristics, and their use needlessly lowers MMPI-2/MMPI code-type congruences and raises the incidence of profile misinterpretations. Our recommendation of well-defined MMPI-2 code types stands.     

The consistency of scores and configural patterns between the MMPI and MMPI-2

This article is an extension of the Ben-Porath and Butcher (1989a) study, investigating the claim that the scores and configural patterns of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) are consistent with those of the Minnesota Multiphasic Personality Inventory (MMPI). College students (200 men and 200 women) were randomly assigned to either the original to original condition (O-O), in which they took the MMPI twice, or the original to revised condition (O-R), in which they took the MMPI and the MMPI-2. Correlations and configural patterns of the O-O condition were compared to those of the O-R condition. Results suggest some score changes between the MMPI and MMPI-2, particularly on Scales L, 5, and 8 for men and Scales L and 5 for women.     

The Consistency Between Scores of the Harris-Lingoes Subscales of the MMPI and MMPI-2

This study investigates the consistency between scores of the Harris-Lingoes subscales of the Minnesota Multiphasic Personality Inventory (MMPI) and the MMPI-2. College students (200 men and 200 women) were randomly assigned to either the original to original condition, where they took the MMPI twice, or the original to revised condition, where they took the MMPI and MMPI-2. Results indicate relative consistency in the item and normative changes between the Harris-Lingoes subscales of the MMPI and MMPI-2. These results suggest that the recommendation of a clinical significance score of T > 65 for the MMPI-2 scales should not be applied to the Harris-Lingoes subscales.     

Comparison of the MMPI and MMPI-2 administered to Anglo- and Hispanic-American university students

The MMPI and MMPI-2 were administered to White and Hispanic-American subjects. Multivariate analyses revealed significant differences for three main effects: test form, ethnicity, and gender. Two-way interactions between gender and test form and between gender and ethnicity were both significant, but the other two-way interaction (Test Form x Ethnicity) and the third-order interaction (Test Form x Ethnicity x Gender) were not significant. Univariate analyses comparing MMPI and MMPI-2 revealed significant differences on 12 of 13 scales, and comparison of Anglos and Hispanics resulted in significant differences on 4 scales. When Anglos and Hispanics taking the MMPI and MMPI-2 were compared, however, no significant differences on any scales occurred. Results suggest that, for these Hispanic subjects, the MMPI-2 introduces no new or additional differences and may be employed and interpreted essentially the same as the MMPI.     

Further validation of the MMPI-2 and MMPI-2-RF Response Bias Scale: findings from disability and criminal forensic settings

The present study extends the validation of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) Response Bias Scale (RBS; R. O. Gervais, Y. S. Ben-Porath, D. B. Wygant, & P. Green, 2007) in separate forensic samples composed of disability claimants and criminal defendants. Using cognitive symptom validity tests as response bias indicators, the RBS exhibited large effect sizes (Cohen's ds = 1.24 and 1.48) in detecting cognitive response bias in the disability and criminal forensic samples, respectively. The scale also added incremental prediction to the traditional MMPI-2 and the MMPI-2-RF overreporting validity scales in the disability sample and exhibited excellent specificity with acceptable sensitivity at cutoffs ranging from 90T to 120T. The results of this study indicate that the RBS can add uniquely to the existing MMPI-2 and MMPI-2-RF validity scales in detecting symptom exaggeration associated with cognitive response bias.     

Assessment feedback integrating MMPI-2 and Rorschach findings

Many clinicians are committed to giving feedback to clients about assessment results, but puzzle over how to integrate Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Rorschach findings when talking to clients. When the two tests agree, findings may be combined and assessors may use the language of clients' Rorschach percepts to frame findings from the MMPI-2 or the Structural Summary. When the Rorschach shows more disturbance than the MMPI-2, assessors may discuss "levels of personality," praise clients for their usual coping mechanisms, and raise the possibility of underlying problems. When the Rorschach depicts less psychopathology than the MMPI-2, clinicians may talk with Clients about factors influencing them to present as needing help. Alternatively, assessors may hypothesize that clients constrict emotionally in interpersonal, unstructured situations.     

Validity and clinical scale comparisons between the MMPI and MMPI-2 with psychiatric inpatients.

This study was designed to investigate the comparability of the original MMPI (1950) and the MMPI-2 (1989) with a psychiatric patient population. 34 male and 3 female patients, shortly after admission to one of two acute psychiatry units, completed the old and revised versions of the MMPI. Paired t tests indicated but scant differences for raw scores, while many more differences were found among T scores for validity, clinical, and supplemental scales. Analyses, however, showed all scales on the two forms to be highly correlated. Analysis of the high-point and two-point codes across the two administrations also showed relative stability, although the proportion of Scales 2 (Depression) and 8 (Schizophrenia) decreased, while those for Scales 6 (Paranoia) and 7 (Psychasthenia) increased markedly in the MMPI-2 protocols. Examination of each version's discriminability among mood- and thought-disordered subsamples suggested that the MMPI provides slightly better delineation between diagnostic classes. Discriminant function analyses showed that there were essentially no differences between the two forms in the accurate classification of clinical and nonclinical groups. The findings reported here provide support for the MMPI-2; despite modification, the newer form retains the advantages of the original MMPI. Differences found here may be unique to psychiatric patients and their patterns of MMPI/MMPI-2 equivalence and may not generalize to other special populations.     

Comparability of MMPI and MMPI-2 profile patterns: Ben-Porath and Tellegen's inappropriate invocation of Mahalanobis's D2 function

Ben-Porath and Tellegen (1995) claimed that the data in the article by Humphrey and Dahlstrom (1995) were improperly analyzed by means of Q correlations between raw scores earned by the individuals in the forensic sample to establish pattern comparability between the original Minnesota Multiphasic Personality Inventory (MMPI; Hathaway & McKinley, 1943) and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989), which were then contrasted with Q correlations between the corresponding T-score patterns. Ben-Porath and Tellegen (1995) contended that the Q correlation is affected by random factors and that a generalized distance function, D2, is the only legitimate index of profile comparability. Data are presented here to show that the Q correlation serves as a reliable index of pattern comparability, relatively unaffected by differences in profile elevation. The Mahalanobis (1936) D2 index is too heavily weighted with differences in profile elevation serve as the proper index of equivalence in profile patterning. The findings in the Humphrey and Dahlstrom (1995) article were based on appropriate data-analytic procedures because the primary concern is their investigation was the extent to which the patterns of T-score profiles from the original MMPI and the MMPI-2 are comparable when the raw-score patterns are virtually identical.     

Correspondence of the MMPI and MMPI-168 among incarcerated female felons

This study was designed to assess the correspondence between the MMPI and MMPI-168 for a sample of adult incarcerated female felons. The results indicated a high degree of agreement, median correlation of .79, between corresponding validity and clinical scales of the MMPI-168 and the full MMPI. The MMPI-168 significantly overestimated scales L, F, and D, while it underestimated scales K, Hy, Pd, and Mf. Configural correspondence between the two instruments in terms of profile high points was somewhat less than has been reported for psychiatric populations. However, the MMPI-168 appeared to be a useful short screening instrument for incarcerated female felons with respect to accurate assessment of profile validity, configural correspondence to the full MMPI, and correlations between corresponding scales. Its utility in these respects far exceeds prior attempts to employ the Mini-Mult with a similar sample of incarcerated females.     

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.     

Similarities and differences between MMPI and MMPI-2 applications to the assessment of posttraumatic stress disorder

The purpose of this study was to address the question: Is the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) comparable to the original MMPI in its applicability to the assessment of posttraumatic stress disorder (PTSD) among Vietnam combat veterans? The question was addressed by administering both the original MMPI and MMPI-2 to 29 subjects classified as meeting Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; DSM-III-R) criteria for PTSD and comparing MMPI and MMPI-2 scores in terms of: degree of association, code-type congruence, diagnostic hit rates (when compared to two other clinical samples, and one normal sample), and congruence of the Keane PTSD Scale (PK). Results reveal highly significant correlations between MMPI and MMPI-2 basic scales for the PTSD sample as well as congruence in 2-point codes comparable to previous studies. The MMPI-2 was found to identify effectively PTSD subjects from the other groups. Results also showed a high degree of association between the MMPI and MMPI-2 in regard to PK scores, although minor differences were found in PK raw scores between the two tests. Overall, the findings suggest a high degree of comparability between the MMPI and MMPI-2 in the assessment of PTSD.     

Comparison of MMPI-2 and MMPI Clinical Scales and High-Point Scores Among Methadone Maintenance Clients

Methadone client volunteers completed the Minnesota Multiphasic Personality Inventory (MMPI; Hathaway & McKinley, 1967) and MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) on consecutive days. MMPI2 T-scores were lower by a mean of 4.7 on the clinical scales; when 5 points were added to MMPI-2 T-scores the mean difference was 2.3. Rank order of subjects on scale T-scores was not significantly different between the two instruments. High-point similarity for clinically elevated profile pairs ranged from 61% to 92%, depending upon definition of similarity.     

Use of the MMPI-2 in American Indians: I. Comparability of the MMPI-2 between two tribes and with the MMPI-2 normative group

The comparability of the MMPI-2 in American Indians with the MMPI-2 normative group was investigated in a sample of 535 Southwestern and 297 Plains American Indian tribal members with contrasting sociocultural and historical origins. Both American Indian tribal groups had clinically significant higher T scores (> 5 T points) on 5 validity and clinical scales, 6 content scales, and 2 supplementary scales than did the MMPI-2 normative group. There were no significant differences between the 2 tribal groups on any of the MMPI-2 clinical, content, or supplementary scales. Matching members of both tribes with persons in the MMPI-2 normative group on the basis of age, gender, and education reduced the magnitude of the differences between the 2 groups on all of these scales, although the differences in T scores still exceeded 5 T points. It appears likely that the MMPI-2 differences of these 2 American Indian groups from the normative group may reflect their adverse historical, social, and economic conditions.