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.     

MCMI-III Diagnostic Validity: Bad Test or Bad Validity Study

Operating characteristics describe the validity of tests that attempt to dichotomously predict a diagnosis. These statistics are not fully published in the Millon Clinical Multiaxial Inventory-III Manual (MCMI-III manual Millon, 1994) When calculated from available statistics, the positive predictive powers of the MCMI-III scales are poor both in absolute terms and relative to the MCMI-II (Millon, 1987). There were a number of problems, however, with the initial MCMI-III validity study both inherently and in execution. Although it is doubtful that the MCMI-III is weaker than the MCMI-II, a new validity is needed.     

Contributions of Discriminant Analysis to Differential Diagnosis by Self-Report

We used discriminant function analyses of the Minnesota Multiphasic Personality Inventory (MMPI; Hathaway & McKinley, 1983), Millon Clinical Multiaxial inventory (MCMI; Milton, 1983), MCMI-II (Millon, 1987), and Symptom Checklist Ninety-Revised (SCL-90-R; Derogatis, 1983) profiles from a heterogenous group of 272 psychiatric inpatients to classify patients as depressed, manic, and/or psychotic, Most functions generated from these tests significantly discriminated depressed, manic (not MCMI-II), and psychotic (not MCMI) subjects from psychiatric controls. However. there was little improvement in diagnostic efficiency over the use of single scale elevations at specified cut scores. Functions derived from the MCMI for mania and the MCMI-II for psychosis show the most promise but require replication. The difficulty of using group profile differences for the diagnosis of individual psychiatric patients is discussed.     

Exploring the psychometric properties and construct validity of the MCMI-III anxiety and avoidant personality scales

The Millon Clinical Multiaxial Inventory (MCMI; Millon, 1983) is a commonly used self-report instrument designed to aid in the assessment of Axis I and Axis II disorders. Concerns have been expressed regarding the procedures used in the normative research for the current version of the MCMI (MCMI-III; Millon, 1994) leading to a call for additional validity research on the MCMI-III (Retzlaff, 1996). In this study, we investigated the psychometric properties of the MCMI-III's Anxiety and Avoidant personality scales in a sample of patients diagnosed with Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) anxiety disorders. Our results suggest that the MCMI-III Avoidant scale is reliable (r =.89) and it was found to demonstrate appropriate convergent and divergent validity with other self-report measures. The MCMI-III Anxiety scale also showed adequate reliability (r =.78); however, our findings raise some concerns about the discriminant validity of this scale. A scale composed of the MCMI-III core anxiety items was found to have better discriminant validity. These findings are consistent with those reported by other researchers regarding the relationship between self-report measures of anxiety, avoidance, and depression. We conclude that the MCMI-III measures of anxiety and avoidance are consistent with other measures of these constructs and may provide valuable clinical information in this regard.     

MMPI-2 and MCMI-III scores among dutch inpatient substance abusers: Assessing correspondence and cross-cultural equivalence

The Millon Clinical Multiaxial Inventory (MCMI-II and MCMI-III) and the Minnesota Multiphasic Personality Inventory (MMPI-2) were applied to 263 Dutch inpatient substance abusers with multiple psychiatric diagnoses, and the results compared with those of 306 North-American substance abusers studied by Ward (1995). We looked for structural similarity both across groups (per instrument) and across the two instruments (per sample), using principal components analysis and congruence analysis. The component structure found by Ward was partly replicated in the Dutch group, thus cross-validating the use of the two instruments with these patients. Moreover, as found by Ward, the MMPI-2 content and supplementary scales of the Dutch sample proved to be important determinants of the first three MMPI-2 components, adding to convergent validity. Questions remained about the influence of the (dis)continuity of MCMI-II and MCMI-III on the replicability of the MCMI components.     

MMPI-2 and MCMI-III scores among dutch inpatient substance abusers: Assessing correspondence and cross-cultural equivalence

The Millon Clinical Multiaxial Inventory (MCMI-II and MCMI-III) and the Minnesota Multiphasic Personality Inventory (MMPI-2) were applied to 263 Dutch inpatient substance abusers with multiple psychiatric diagnoses, and the results compared with those of 306 North-American substance abusers studied by Ward (1995). We looked for structural similarity both across groups (per instrument) and across the two instruments (per sample), using principal components analysis and congruence analysis. The component structure found by Ward was partly replicated in the Dutch group, thus cross-validating the use of the two instruments with these patients. Moreover, as found by Ward, the MMPI-2 content and supplementary scales of the Dutch sample proved to be important determinants of the first three MMPI-2 components, adding to convergent validity. Questions remained about the influence of the (dis)continuity of MCMI-II and MCMI-III on the replicability of the MCMI components.     

Circular structure of the MCMI-III personality disorder scales.

Millon's (1987) circular model of personality disorders was examined in a large sample of psychiatric patients (N = 2,366) who completed the Millon Clinical Multiaxial Inventory-III (MCMI-III; Millon, 1997) as part of routine assessment after presentation for treatment. Principal components analyses were conducted to identify the first two dimensions in MCMI-III base rate scores, weighted and unweighted raw scores, and nonoverlapping scale scores. Similar analyses were made on these scores when acquiescence was partialled out. Circular plots of the scales were examined against Millon's hypothesized arrangement and the model was tested using confirmatory factor analysis. Results replicated those of Strack, Lorr, and Campbell (1990) with the MCMI-II. Millon's horizontal Impassive-Expressive dimension was recovered in both regular and residual scores but the vertical axis appeared to represent an Impulsivity-Compulsivity dimension rather than the Autonomous-Enmeshed continuum envisioned by Millon. Although scale order followed Millon's predictions for the most part, a number of departures from theoretical expectations were noted and none of the score sets yielded a good fit to the hypothetical structure. Millon's model appears to have promise as a circumplex that can encompass all of the personality disorders but changes are needed to rectify discrepancies between the theory and empirical findings.     

Comparison of MCMI-II and 16PF Validity Scales

We administered the Millon Clinical Multiaxial Inventory-II (MCMI-II; Millon, 1987) and the Sixteen Personality Factors Inventory (16PF; Cattell, Eber, & Tatsuoka, 1970) to 131 outpatients in marital therapy and tested the correlation between the validity scales of the two instruments. The results indicated that MCMI-II Disclosure and Debasement scales were positively correlated with the 16PF Fake-Bad scale and negatively correlated with the 16PF Fake-Good scale. The MCMI-II Desirability scale was significantly correlated with the 16PF Fake-Good scale.     

MCMI-II Item Weights: Their Lack of Effectiveness

Millon Clinical Multiaxial Inventory II (MCMI-II; Millon, 1987) results from 134 patients were scored twice; with and without the item weights. The results showed that the correlations between the weighted and unweighted versions of the same scales were extremely high, exceeding .90 in all cases. Furthermore, weighting did not significantly reduce the correlations among the scales, either within each of the four syndrome/pattern categories of the MCMI-II, or between categories. It is concluded that item weighting reduces the access of the MCMI-II by clinicians, without increasing its psychometric properties.     

Efficacy of the Millon Clinical Multiaxial Inventory–II in Discriminating Mental Health Patients With and Without Suicidal Ideation

A total of 42 mental health clinic patients with suicidal idweation and 89 patients without suicidal ideation were administered the Millon Clinical Multiaxial Inventory–II (MCMI–II; Millon, 1987 Millon, T. (1987). Millon Clinical Multiaxial Inventory (MCMI–II) manual. Minneapolis, MN: National Computer Systems. [Google Scholar]). All participants were active duty military personnel. A total of 15 MCMI–II scale elevations were significantly different between the 2 groups. A pair of discriminant analyses, the 1st utilizing all 25 MCMI–II scales, and the 2nd with only the 13 MCMI–II personality scales, produced correct classification rates of 80.92% and 75.57%, respectively. A total of 6 of 7 MCMI–II “suicide” items significantly differentiated suicidal ideation and nonsuicidal ideation groups. Results of this study offer initial support for the utility of the MCMI–II as a potential screening device for suicidal ideation.     

Diagnostic accuracy of the Millon test computer reports for bipolar affective disorder

The diagnostic accuracy of the Millon Clinical Multiaxial Inventory (MCMI) computer reports was assessed for the sample of 48 patients reliably identified as having bipolar affective disorder. Only 13 of the 48 reports were accurate in classifying the patients as having bipolar affective disorder, and this was significantly (p < .01) less than 50% of the cases. The diagnostic accuracy clearly left much to be desired. Additional research is needed to assess the validity of MCMI diagnostic suggestions for other patient groups.     

The Validity of the PAT in the Selection of Tabulating Machine Operators: An Analysis of Predictive Power

For the past 4 decades Theodore Millon has provided the field with a series of articles and books that illustrate his unprecedented effort to build a unified science of personology and psychopathology. Especially significant is the nonreductionist synthesis of personology with universal principles grounded in the concept of evolution. His theoretically derived personality disorder prototypes are most unusual in that they correspond in almost all regards to the official Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) Axis II classification schema. In this article, I summarize major elements of Millon's model, past and present, including the personality disorder types and stages of personality development. Perhaps best known to the readers of Journal of Personality Assessment is his publication of several objective diagnostic instruments (e.g., Millon Clinical Multiaxial Inventory-III; Millon, Millon, &; Davis, 1994; Millon Adolescent Clinical Inventory; Millon, Millon, &; Davis, 1993). Most recent is the construction of a clinician-rated checklist (Millon Personality Disorder Checklist; Millon, 1997) of structural and functional forms of psychic pathology. I touch on these measures as well as his very recent framework of personality-guided, synergistic treatment for both Axis I syndromes and Axis II disorders.     

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.     

Personality Psychology in Europe (Vol. 3) (Book)

This study explored the effect of defensive (i. e., fake-good) responding by substance-abusing patients on the scale scores of the Millon Clinical Multiaxial Inventory (MCMI-II; Millon, 1987). Patients asked to respond honestly (N = 62) had significantly higher scores on most of the scales than patients who were instructed to respond defensively (N = 62) and forensic subjects suspected of abusing psychoactive substances (N = 54). Significantly fewer subjects in the defensive responding simulation and the forensic group had elevated the Drug Dependence and Alcohol Dependence scales compared to the honestly responding patients. These results indicate that most drug-abusing individuals can conceal the presence of a substance-related disorder, as reflected by scale scores on the MCMI-II, if motivated to do so.     

Factor analysis of MCMI-II and PACL basic personality scales in a college sample

This study examined factor dimensions common to the eight basic personality scales of the Millon Clinical Multiaxial Inventory-II (MCMI-II; Millon, 1987) and Personality Adjective Check List (PACL; Strack, 1987, 1990). Subjects were 140 college students (65 men and 75 women). MCMI-II weighted raw scores (WRS) and WRS corrected for number of items endorsed true by regression were employed for analysis along with PACL T-scores. Principal components analyses with varimax and direct oblimin rotations were carried out separately on the two sets of MCMI-II and PACL scores. MCMI-II and PACL scales measuring the same personalities were usually correlated most highly with each other, although some divergences were noted. WRS yielded three bipolar dimensions and a fourth unipolar method factor that loaded only the five MCMI-II scales that were strongly correlated with number of items endorsed true. Residual scores yielded a more meaningful set of three bipolar dimensions labeled Social Introversion-Extraversion, Emotionality-Restraint, and Social Dominance-Submissiveness, without the method factor, that were very similar to personality dimensions found separately in the two tests. More research is needed to clarify the response bias issue in the MCMI-II and to further explicate similarities and differences between the MCMI-II and the PACL.     

Neuroticism,coping and change in MCMI-II clinical syndromes: test of a mediator model

The aim of the study was to examine prospectively whether coping mediated the relation between Neuroticism and change in different clinical mental syndromes. Assessments were conducted with 154 former psychiatric outpatients six and seven years after their initial contact with an outpatient clinic. Dispositional coping mediated the relation between Neuroticism and change in four of the nine clinical scales of the Millon Clinical Multiaxial Inventory (MCMI-II) (Millon, 1987). High Neuroticism led to coping strategies of disengagement and the venting of emotions and to a lack of problem-focused coping, which in turn translated into a relative increase on the MCMI-II scales. The mediator model of coping was found to apply to the MCMI-II scales "somatoform disorder’, ‘dysthymia’, ‘alcohol dependence’ and ‘thought disorder’. Results are discussed under the perspective of an integration of the positions of the transactional theory of stress and personality psychology. .     

The MCMI as a measure of DSM-III

The Millon Clinical Multiaxial Inventory (MCMI) has been interpreted as a measure of DSM-III disorders. However, the MCMI was constructed and validated primarily as a measure of Millon's (1969, 1981) taxonomy, not DSM-III. Comparison of the two taxonomies and examination of the MCMI's content validity for two of the MCMI scales indicate only a partial congruence between the Millon and DSM-III taxonomies. There has been no published empirical research concerning the relationship between the MCMI and DSM-III, and the derivation and cross-validation research for the MCMI scales employed Millon's taxonomy and not DSM-III. It is suggested that until such data have been presented one should be cautious in one's interpretation of the MCMI as a measure of DSM-III disorders.     

Factor analysis of the Dutch-language version of the MCMI-III

We analyzed the factor structure of the Dutch-language version of the MCMI-III (Millon, Millon, Davis, & Grossman, 2006) using exploratory factor analysis on data obtained from a heterogeneous White sample (n = 1,210). We identified 4 factors: General Maladjustment, Aggression/Social Deviance, Paranoid/Delusional Thinking, and Emotional Instability/Detachment. This structure was invariant across scale composition (linear dependent vs. independent scales), factor analytic method (principal factor vs. principal component solutions), and sample characteristics (gender 'male-female' and setting 'clinical-forensic.' Studies that have used previous MCMI (Millon, 1969/1983b) versions have also found 4 similar factors, whereas studies that have used the American version of the MCMI-III have only found 3 factors. However, differences between the Dutch and American version were completely determined by factor analytic decisions. The factor structure of the MCMI-III appeared to be cross-culturally invariant.     

Factor Structure of the Million Clinical Multiaxial Inventory (MCMI) With an Offender Sample

One thousand two hundred inmates were given the Millon Clinical Multiaxial Inventory (MCMI; Millon, 1984) in a midwestern reception and diagnostic center. Two groups of 600 were randomly divided, and their test results were subjected to a principal components factor analysis. Four factors were derived in both groups and were similar, indicating successful cross-validation. Three of the four factors bore similarity to factors found in other samples (drug abusers, psychiatric population, Viet Nam veterans), and the fourth was unique to the offender population.     

The relationship between MCMI subtlety and severity

Wierzbicki (Wierzbicki & Daleiden, 1993; Wierzbicki & Howard, 1992) has suggested that the Subtle-Obvious distinction may be useful for detecting faking on the Millon Clinical Multiaxial Inventory (MCMI; Millon, 1983). This study examined Schretlen's (1990) criticism that, on the MMPI, subtlety is confounded with severity. Nine clinical psychology graduate students rated MCMI items for severity. Severity was significantly correlated (r = -.48) with item subtlety. However, this association was lower than that reported by Schretlen on the MMPI.