Development and validation of the Malingering Discriminant Function Index for the MMPI-2

The predictive capacity of the MMPI-2 (Butcher et al., 2001) "fake-bad" validity scales (F, FB, and FP) is diminished when respondents have knowledge (i.e., coached) about the operating characteristics of these scales. In this investigation, we endeavored to develop a MMPI-2 fake bad validity index that would be less vulnerable to validity-scale knowledge. Applying discriminant function procedures, we derived a set of weighted Clinical and Content scales that reliably distinguished large samples of validity-scale coached undergraduate research participants instructed to feign mental illness (n = 534) from psychiatric patient samples (n = 590). We subsequently validated this Malingering Discriminant Function Index (M-DFI) in independent samples of research participants (n = 230) and patients (n = 300) and showed relatively less attenuation in predictive capacity compared with F, FB, and FP across uncoached and validity scale coached feigning conditions.     

Classification accuracy of MMPI-2 validity scales in the detection of pain-related malingering: a known-groups study

The purpose of this study was to determine the accuracy of Minnesota Multiphasic Personality Inventory 2nd edition (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) validity indicators in the detection of malingering in clinical patients with chronic pain using a hybrid clinical-known groups/simulator design. The sample consisted of patients without financial incentive (n = 23), nonmalingering patients with financial incentive (n = 34), patients definitively determined to be malingering based on published criteria ( n = 32), and college students asked to simulate pain-related disability (n = 26). The MMPI-2 validity scales differentiated malingerers from nonmalingerers with a high degree of accuracy. Hypochondriasis and Hysteria were also effective. For all variables except Scale L, more extreme scores were associated with higher specificity. This study demonstrates that the MMPI-2 is capable of differentiating intentional exaggeration from the effects on symptom report of chronic pain, genuine psychological disturbance, and concurrent stress associated with pursuing a claim in a medico-legal context.     

The utility of the MMPI-2 malingering discriminant function index in the detection of malingering: a study of criminal defendants

This study examined the utility of the Minnesota Multiphasic Personality Inventory-2's (MMPI-2) malingering discriminant function index (M-DFI), recently developed by Bacchiochi and Bagby, in the detection of malingering in a forensic sample. Criminal defendants were divided into "malingering" and "not malingering" groups using the structured interview of reported symptoms (SIRS) criteria proposed by Rogers. Logistic regression analysis (LRA) revealed that the MMPI-2 infrequency (F) scale had the best predictive utility of the traditional infrequency scales. Although the M-DFI did significantly differentiate the malingering from the not malingering groups, it did not add significantly to the predictive utility of the MMPI-2 F scale. Receiver operating characteristics analyses demonstrated acceptable sensitivity and specificity for the MMPI-2 F scale, but poor sensitivity for the M-DFI scale. The results are discussed in terms of the utility of the M-DFI in detecting malingering and problems of extending the findings of simulation studies to the forensic context.     

Detection of coached general malingering on the MMPI-2

The current study examined the effects of validity-scale coaching on one's ability to feign general psychopathology. College students were coached on malingering strategies and completed the MMPI-2. Their responses were compared with students asked to malinger psychopathology without validity-scale coaching and with psychiatric inpatients completing the MMPI-2 under standard instructions. In accordance with previous research (e.g., J. R. Graham, D. Watts, & R. E. Timbrook, 1991), uncoached malingerers were adequately discriminated from patients by using the Infrequency (F) scale. However, as suggested by previous research (R. Rogers, R. M. Bagby, & D. Chakraborty, 1993), the F scale was not as effective at classifying coached malingerers. It was found that other validity indicators, such as the Infrequency Psychopathology Scale were more accurate at discriminating between coached malingerers and hospitalized patients.     

The validity and clinical utility of the MMPI-2 Malingering Depression scale

In this study, we examined the validity and clinical utility of the MMPI-2 (Butcher, Graham, Tellegen, Dahlstrom, & Kaemmer, 2001) Malingering Depression scale (Md) in relation to the MMPI-2 F scales (F, F(B), F(P)) to detect feigned depression. Overall, the F(B) scale and the F/F(P) scale combination were the best single predictors, although the Md scale did discriminate successfully cases of feigned depression from patients with bona fide depression. The Md scale added predictive capacity over the F scales, and the F(B) scale and the F/F(P) scale combination added predictive capacity over the Md scale; however, the actual increase in the number of cases predicted was minimal in each instance. In sum, although the Md scale is able to detect accurately feigned depression on the MMPI-2 (predictive validity), it does not confer a distinct advantage (incremental validity) over the existing standard validity scales-F, F(B), and F(P).     

Diagnostic accuracy and factor structure of the AAS and APS scales of the MMPI-2

Receiver operating characteristics analysis and sensitivity analysis were used to compare the diagnostic accuracy of the Addiction Acknowledgement Scale (AAS; Weed, Butcher, McKenna, & Ben-Porath, 1992) and Addiction Potential Scale (APS; Weed et al., 1992) of the Minnesota Multiphasic Personality Inventory-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) to that of the MacAndrew Alcoholism Scale-Revised (Butcher et al, 1989), the CAGE (Mayfield, McLeod, & Hall, 1974), and Svanum's scale (Svanum & McGrew, 1995) in a sample of 338 university students. The AAS was the most accurate of these 5 scales at identifying current alcohol dependence (as measured by a structured diagnostic interview) and appears to offer considerable promise as an alcohol screening instrument. In contrast, the APS performed the most poorly of the 5 scales being evaluated, yielding results that would be of minimal clinical utility. Factor analysis yielded a 2-factor solution for the AAS (Acknowledgement of Alcohol/Drug Problems; Positive Alcohol Expectancies) and a 4-factor solution for the APS (Satisfaction with Self; Cynicism/Pessimism; Impulsivity; Risk-Taking).     

Comparative validity of the MMPI-2 Wiener-Harmon subtle-obvious scales in male prison inmates

The Wiener-Harmon subtle-obvious MMPI subscales (Wiener, 1948; Wiener & Harmon, 1946) have been the subject of considerable debate. In this study, we examined the intercorrelations among full clinical scale T scores and their subtle and obvious subscales in an offender population. Low subtle to full-scale correlations were observed, suggesting that these items contribute little to full-scale scores. Further, we explored the criterion validity of the MMPI-2 subtle-obvious scales in this forensic sample. The results demonstrated that the obvious scales of the MMPI-2 had greater criterion validity than the subtle scales when compared to crime history data. Scores on the subtle subscales were unrelated to crime history. The Ma-O subscale demonstrated the strongest association to crime history data. The findings from this study add to a mounting body of evidence indicating that when respondents are in a position to understand item content, and can therefore provide a direct self-appraisal, responses are most predictive of clinical criteria.     

Detection of feigned mental disorders: a meta-analysis of the MMPI-2 and malingering

The validity of test data from multiscale inventories is dependent on self-reports that may be easily distorted by malingering. In examining the Minnesota Multiphasic Personality Inventory-2's (MMPI-2) role in the assessment of feigning, this review provides a conceptual analysis of the detection strategies underlying the MMPI-2 validity scales. The conceptual analysis is augmented by comprehensive meta-analysis of 65 MMPI-2 feigning studies plus 11 MMPI-2 diagnostic studies. For the rare-symptoms strategy, Fp (Cohen's d = 2.02) appears especially effective across diagnostic groups; its cut scores evidence greater consistency than most validity indicators. The data supported the F as an effective scale but questioned the routine use of Fb. Among the specialized scales, Ds appeared especially useful because of its sophisticated strategy, consistent cut score, and minimalfalse-positives. General guidelines are offeredfor specific MMPI-2 validity scales in the assessment of malingering with specific diagnoses.     

Specificity of the MMPI-2 Fake Bad Scale as a marker for personal injury malingering

Psychologists who evaluate patients in medicolegal contexts should utilize objective assessment data with empirically established sensitivity and specificity for identifying negative response bias. The purpose of this study was to investigate the specificity of the Fake Bad Scale for identifying negative response bias in personal injury claimants. The cutoff scores proposed by Lees-Haley and colleagues were applied a federal prison, medical outpatients, and patients from to inmate volunteers from substance abuse unit. Half of the inmates were given instructions to malinger psychopathology to affect the adjudication process, and the remaining inmates and all of the hospital patients were given standard instructions. The original cutoff scores correctly identified the majority of inmates instructed to malinger psychopathology, but these scores resulted in unacceptably high rates of false positive classifications. The revised cutoff scores resulted in fewer false positives, i.e., 8%-24%.     

Diagnostic construct validity of MMPI-2 Restructured Form (MMPI-2-RF) scale scores

In the current investigation, the authors examined the diagnostic construct validity of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in a patient sample. All participants were diagnosed via the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I/P). The data set used in this study was composed of 544 patients--67 with bipolar disorder, 407 with major depressive disorder, and 70 with schizophrenia. Multivariate analyses revealed a pattern of mean scale differences among patient groups that was mostly consistent with the prominent features of each diagnostic group; logistic regression analyses identified a number of scales that were strong, unique predictors in the differentiation between pairs of diagnostic groups. The higher order scales (H-O)--the Emotional/Internalizing Dysfunction (EID) and Thought Dysfunction (THD) scales were most useful in differentiating between patient groups. For differentiating bipolar disorder patients from the other diagnostic groups, the Activation (ACT) Specific Problem scale was most useful. Although not all hypothesized scale differences emerged; overall, the pattern of results provides support for the diagnostic construct validity of the MMPI-2-RF scales.     

The development and classification accuracy of the life assessment questionnaire in the detection of pain-related malingering

This paper describes three phases of the development and validation of the Life Assessment Questionnaire (LAQ), a multi-scale inventory for assessing potential malingering in adults reporting chronic pain. Study 1 involved scale construction and item analysis. Discriminant validity was investigated in Study 2 by comparing scores for the clinical reference group with participants instructed to simulate chronic pain. Study 3 examined the convergent validity of the LAQ with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Behavioral Assessment of Pain (BAP). Results revealed that the simulation groups scored significantly higher than the clinical reference group across all scales. Receiver operating characteristic analysis revealed sensitivity and specificity scores ranging from 0.44 to 0.57 and 0.88 to 0.93, respectively. Positive predictive power values ranged between 0.79 and 0.88. Strong convergent validity was found for the LAQ. These studies demonstrated the effectiveness of the LAQ in classifying individuals who feign pain complaints, supporting the utility of the LAQ for reaching conclusions about the presence of malingering. Copyright ? 2012 John Wiley & Sons, Ltd.     

Effect of symptom information and validity scale information on the malingering of depression on the MMPI-2

MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) data from college students who were attempting to malinger depression (199 women and 171 men) were compared to MMPI-2 data from students who responded honestly (50 women and 45 men). Mean MMPI-2 scores were compared with analyses of variance, and students' success in malingering depression was evaluated with criteria based on cutting scores for validity indexes and on the clinical scales commonly associated with depression. Students who were given information about the validity scales or about the symptoms of depression were more successful at malingering than students who received no information, indicating that malingerers of depression may be able to elude detection by the MMPI-2 if they are informed about the validity scales or the symptoms of depression.     

Comparative accuracy of the MMPI-2 and the MMPI-A in the diagnosis of psychopathology in 18-year-olds

Both the Minnesota Multiphasic Personality Inventory--2 (MMPI-2) and the Minnesota Multiphasic Personality Inventory--Adolescent (MMPI-A) may be administered to 18-year-olds. Each test was administered to 18-year-old participants classified as psychopathology present (PP) or psychopathology absent (PA) to assess (a) the degree of correspondence between the 2 test versions in yielding clinically elevated or nonclinically elevated profiles and (b) the relative accuracy of the 2 test versions in identifying the presence of psychopathology. The 2 tests produced profiles that were inconsistent in clinical elevation status in 70 of 152 participants (46%). All 70 participants with incongruent profiles had clinically elevated MMPI-2 scores and normal-range MMPI-A scores. Analyses of incongruent profiles obtained by PP and PA participants indicated that 18-year-olds were overpathologized by the MMPI-2 and underpathologized by the MMPI-A.     

The detection of malingering in neuropsychological assessment

Although malingering, or the manipulation of data by the patient, is a problem commonly faced by neuropsychologists, there has been little systematic investigation of this problem. This paper reviews the literature on the detection of malingering in assessment instruments commonly used by clinical neuropsychologists. Criticism of previous research is discussed, and suggestions are made both for future research and for clinical practice.     

MMPI-2 configurations among victims of bullying at work

Bullying at work, the systematic exposure to psychological violence and harassment in the workplace, places a serious strain on many employees. The aim of this study was to investigate psychological correlates of bullying among former and current victims using the MMPI-2. A total of 85 individuals, recruited among members of two Norwegian associations of bullying victims, participated in the study. Two hypotheses were tested: (1) Bullied victims have an elevated personality profile on the MMPI-2, although different kinds of personality profiles may be distinguished; (2) the personality profiles of the victims are related to the type of behaviour and the intensity of the behaviours experienced by the victim. Both hypotheses were confirmed. The study demonstrated, using cluster analysis, that the sample of bullied victims can be divided into three personality groups (“The seriously affected”, “The disappointed and depressed”, and “The common”.) The elevated 3-2-1 personality profile was most typical. Surprisingly, the victims of the common cluster reported the highest level of exposure to bullying, suggesting a vulnerability factor among the other victims. The scores on the new MMPI-2 Content scales were also analysed. The seriously affected group reported a high level of generalized anxiety, fear of specific incidences, and many health concern worries.     

Malingering as a categorical or dimensional construct: the latent structure of feigned psychopathology as measured by the SIRS and MMPI-2

The 6 nonoverlapping primary scales of the Structured Interview of Reported Symptoms (SIRS) were subjected to taxometric analysis in a group of 1,211 criminal and civil examinees in order to investigate the latent structure of feigned psychopathology. Both taxometric procedures used in this study, mean above minus below a cut (MAMBAC) and maximum covariance (MAXCOV), produced dimensional results. A subgroup of participants (n = 711) with valid Minnesota Multiphasic Personality Inventory-2 (MMPI-2) protocols were included in a second round of analyses in which the 6 nonoverlapping primary scales of the SIRS and the Infrequency (F), Infrequency-Psychopathology (Fp), and Dissimulation (Ds) scales of the MMPI-2 served as indicators. Again, the results were more consistent with dimensional latent structure than with taxonic latent structure. On the basis of these findings, it is concluded that feigned psychopathology forms a dimension (levels of fabrication or exaggeration) rather than a taxon (malingering-honest dichotomy) and that malingering is a quantitative distinction rather than a qualitative one. The theoretical and clinical practice implications of these findings are discussed.     

Normative data for the F(p) scale of the MMPI-2: implications for clinical and forensic assessment of malingering

Data from several clinical samples and the Minnesota Multiphasic Personality Inventory--2 standardization group are presented to familiarize the reader with response patterns of different groups on a new validity scale designed to assist in the identification of exaggeration or fabrication of psychological disturbance. Sensitivity-specificity analyses are included along with suggestions for use of the F(p) Scale with other validity scales. Cautions about setting single cutoff scores are also discussed.     

Factor analysis of MMPI-2 basic scales among college students

The MMPI-2 was administered to 288 college students (178 women and 110 men) between the ages of 18 and 34 years. Scores on the basic 13 (three validity and ten clinical) scales were correlated and subjected to principal component analyses separately for men and women. In each case, four factors were retained and subjected to varimax rotation. Coefficients of congruence were calculated for all possible pairs of factors across two samples of college students and the normative adults, separately for men and women, and across genders within each sample. Results indicated that the factorial structure of the MMPI-2 basic scales seemed to possess considerable uniformity across samples and genders, but not without some notable exceptions.     

Validity of the Personality Diagnostic Questionnaire-4 (PDQ-4+) among mentally ill prison inmates in Singapore

We examined the validity of the Personality Diagnostic Questionnaire--4+ (PDQ-4+) as a screening instrument for personality disorders among mentally ill prison inmates in Singapore. A total of 313 prison inmates completed the PDQ-4+ and the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II). The subjects were 303 (96.8%) males and 10 (3.2%) females with a mean (SD) age of 40.7 (8.8) years. Kappa agreement between PDQ-4+ and SCID-II for the presence at least one personality disorder was moderate with high sensitivity and low specificity. For specific personality disorders and clusters, we found that the PDQ-4+ diagnosed more subjects as having each of the personality disorders than SCID-II with high negative predictive values. The area under the curve indicated moderate discriminatory capabilities. Our results suggest that the PDQ-4+ could be used as a potential screening instrument for personality disorders in prison inmates.     

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.