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.     

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.     

Stability of the internal structure of the millon clinical multiaxial inventory

The Millon Clinical Multiaxial Inventory (MCMI) has become increasingly popular in clinical use. Along with this, there has been more interest in the internal structure of the 20 scales of the original 175-item MCMI-I. The literature reports some agreement on four components, although both three- and five-component solutions have been reported. The degree of similarity of these components across populations remains arguable, as none of the previous studies have used quantitative measures of component similarity. The present study reports on two new samples of psychiatric patients, one of 82 cases from a general hospital and the other of 145 inpatients from a psychiatric hospital. It also reanalyzes the data from nine samples from the literature, using Tucker's coefficient of congruence and ten Berge's analysis of principal component weights (PCW). The congruence analyses showed good agreement of the first three components across samples and notably lower agreement for the fourth. The PCW analyses showed two major types of structure matrices. In the first, there was a large and dominant first component, with three smaller ones. In the second, the variance was distributed more evenly across the four components. The results are discussed in terms of the overlapping scales of the MCMI-I.This work was supported by funds from the Departments of Psychiatry and Psychology, The University of Western Ontario.     

Factor invariance of the Millon Clinical Multiaxial Inventory

Several factor analyses of the Millon Clinical Multiaxial Inventory (MCMI) have resulted in very similar solutions. Interpretation of this consistency is hampered by the fact that the 20 scales of the inventory share items. Overlapping items cause the scales to be linearly dependent and may create structure in the interscale correlation matrix which is separate from the subject response patterns. A factor analysis was performed on the matrix of item-overlap coefficients which describes the underlying artifactual structure of the instrument. Data from two new subject samples were factor analyzed and compared to previously published studies. Similarity coefficients among factors across studies were calculated.     

Millon Clinical Multiaxial Inventory (MCMI) scores with a collegiate sample: Long-term stability and self-other agreement

This study examined (a) the stability of the personality and symptom scales of the Millon Clinical Multiaxial Inventory (MCMI) for a sample of university undergraduates and (b) the correspondence between MCMI scores from self-report versus scores obtained from knowledgeable others who responded by describing the subject rather than themselves. The MCMI was administered to subjects during their freshman year and then again during their senior year. As in clinical populations, stability estimates in this collegiate sample were greater for the basic personality scales than for the symptom scales. Comparison of the results with those from previous studies further showed that the stability coefficients for the collegiate sample were somewhat lower overall than those from treatment follow-up studies with clinical populations. The results also showed that reasonable agreement between self- and others' ratings was obtained on most MCMI scales. The greatest agreement was found for scales that reflect more observable behaviors and relate to an introversion-extroversion dimension, whereas the least agreement was found for scales related to a psychoticism dimension. Lower levels of agreement were also found for scales having a lower mean proportion of items endorsed.This study was sponsored in part by PHS Grant R01 MH31750-01-6, by PHS Grant 5R01 AA06754-01-03, and by funds from the University of Connecticut Research Foundation and Computer Center.     

Stability of the Millon Clinical Multiaxial Inventory among psychiatric inpatients

This study investigated the stability of the Millon Clinical Multiaxial Inventory (MCMI) in a sample of psychiatric inpatients over a longer time period and from different perspectives than previous reliability studies. Test-retest reliability was assessed from three perspectives: correlation/regression, equivalence of dimensional structures across testings upon different admissions, and stability of personality style across testings. Some stability from a correlational perspective was found, with higher stability estimates indicated for the basic personality scales in comparison with the clinical symptom scales which is consistent with Millon's theory. The internal structure of the MCMI was essentially identical across testings. Although source of reinforcement and instrumental or coping style were stable across testings beyond chance, the MCMI profiles of a considerable number of subjects were inconsistent across testings. Correspondingly, clinicians should be cautious in using the MCMI to make categorical decisions regarding personality style with inpatients who are tested at admission and who have had repeated hospitalizations.     

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.     

Borderline and schizophrenic patients: A comparison using the MCMI-II

In the present study we examined the Millon Clinical Multiaxial Inventory-II scores of psychiatric patients with a diagnosis of either borderline personality disorder (BPD;n=13) or schizophrenia (n=13). The analyses revealed that the BPD patients were significantly elevated on a number of scales in addition to the Borderline scale. The second goal of this study was to assess the discriminative validity of the Borderline and Thought Disorder Scales with both base rate (BR) cutoffs and the number of endorsed prototypic items. The Borderline scale demonstrated the most diagnostic power when using BR cutoffs, whereas the Thought Disorder scale performed poorly, no better than chance levels, with all cutoffs.This research was supported by Social Sciences and Humanities Research Council of Canada Grant 410-89-0335 and by a grant from the Department of Research and Programme Evaluation, Brockville Psychiatric Hospital. The authors thank Renate Simmons for her assistance.     

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.     

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.     

Millon Clinical Multiaxial Inventory (MCMI) computer-generated diagnoses: How do they compare to clinician judgment?

During the past several decades, computers have achieved increasing prominence in psychological assessment procedures. This is particularly true for computer-based test interpretation and diagnosis. This study reports on a study designed to compare the accuracy of computer-based diagnoses with clinician-generated diagnoses. The Millon Clinical Multiaxial Inventory (MCMI) was administered to 151 consecutively admitted inpatients at a large private psychiatric hospital. The computer-generated diagnoses were compared with those generated by admitting psychiatrists. The results indicated that the MCMI diagnostic impressions underestimated the severity of depressive disorders when compared with clinician diagnoses on Axis I. Specifically, clinicians diagnosed major depression much more frequently than did the MCMI. In addition, clinicians diagnosed anxiety disorders much less frequently than did the MCMI.     

Personality disorders and response to outpatient treatment of chronic pain

As part of a comprehensive interdisciplinary evaluation conducted prior to participation in an outpatient chronic pain treatment program, the psychological status of 101 persons was assessed. The majority of participants was found to have a form of personality disorder, determined by conservative cutoff scores applied to their Millon Clinical Multiaxial Inventory (MCMI) profiles. DSM-III-R Cluster C disorders (i.e., Avoidant, Dependent, Obsessive-Compulsive, and Passive-Aggressive) were overrepresented in this sample. Subsequent analyses revealed that personality disorders were related to higher levels of self-reported distress and pain at both the beginning and the end of outpatient treatment. Differential responses to treatment were observed on self-report measures; however, few relations were found between personality disorder and physical therapist ratings of impairment and improvement. Implications for the assessment of personality disorders in outpatient pain treatment programs are discussed and appropriate intervention strategies are considered.     

A General Factor of Personality in the Millon Clinical Multiaxial Inventory-III, the Dimensional Assessment of Personality Pathology, and the Personality Assessment Inventory

A General Factor of Personality (GFP) occupies the apex of the hierarchy in three prominent personality disorder inventories. On the Millon Clinical Multiaxial Inventory-III, a GFP accounted for 41% of the variance in two second-order factors, 31% of the variance in five first-order factors, and 26% of the variance in all 24 scales. On the Dimensional Assessment of Personality Pathology, a GFP accounted for 61% of the variance in six first-order factors and 36% of the variance in all 18 scales. In a cross-validation study of the Personality Assessment Inventory, a GFP accounted for 65% of the variance in two second-order factors, 47% of the variance in five first-order factors, and 27% of the variance in all 18 scales.     

Reliability, diagnostic efficiency, and validity of the Millon adolescent clinical inventory: examination of selected scales in psychiatrically hospitalized adolescents

This study examined the internal consistency, diagnostic efficiency, and validity of selected scales of the Millon adolescent clinical inventory (MACI; Millon et al., Manual for the Millon Adolescent Clinical Inventory, National Computer Systems, Minneapolis, MN, 1993). 241 psychiatrically hospitalized adolescents were administered the MACI and a battery of established self-report measures and a multidisciplinary team independently assigned DSM-IV psychiatric diagnoses at the time of discharge. The internal consistency of MACI scales ranged from 0.71 to 0.93. Conditional probabilities (sensitivity, specificity, positive predictive power, and negative predictive power) were calculated for selected disorders using independently generated clinical diagnoses as the standard. The diagnostic efficiencies for the selected scales were variable, with adequate performance for predicting classes of diagnoses but not for specific diagnoses. The MACI showed good criterion validity for most disorders, with participants with a clinical diagnosis having a significantly higher corresponding MACI scale score than participants not assigned that diagnosis. Concurrent validity, tested by correlating MACI scale scores with those of relevant, validated measures, was generally good. The MACI appears to be a psychometrically sound self-report instrument and appears valuable as a screening instrument for many problems found in adolescent psychiatric inpatients.     

Interpretive dilemmas created by the minnesota multiphasic personality inventory 2 (MMPI-2)

While the new MMPI-2 has the potential to provide more and better clinically relevant information than its predecessor, its introduction also creates several important problems for clinicians and researchers. In particular, the new norms and the use of uniform (rather than linear) T-scores result in the same raw scores on the two tests yielding clinical profiles that can be quite different, both qualitatively and quantitatively. These differences can result in difficulty in MMPI-2 profile interpretation when the user is relying on MMPI interpretive strategies. This paper addresses these concerns and offers some temporary remedial strategies.     

Personality disorder correspondence between the million behavioral health inventory (MBHI) and the minnesota multiphasic personality inventory (MMPI)

The MBHI and MMPI personality disorder scales were analyzed for convergent and discriminant validity. Correlational data demonstrated that six of the eight scales were significantly related, while the remaining two scales approached significance. Further analyses of these data, however, demonstrated that none of the scales correlated significantly better with its convergent scale compared to nonconvergent scales. The MBHI classified significantly more of the sample as personality disordered (93%) compared to the MMPI personality disorder scales (17%). Furthermore, the MBHI tended to describe the sample as falling within the Anxious cluster of personality disorders, whereas the MMPI described them within the Dramatic cluster. Single scale codetype correspondence was found to be 15%, while two-point concordance was 12.5%, indicating very low congruence between personality style codetypes. These two measures do not appear to be measuring the same personality style constructs.     

Perfectionism and multiphasic personality inventory (MMPI) indices of personality disorder

The present research tested the hypothesis that personal and social aspects of the perfectionism construct are related differentially to indices of personality disorders. A sample of 90 psychiatric patients was examined with respect to their scores on the Multidimensional Perfectionism Scale (MPS) and the personality disorder subscales (PDS) of the Minnesota Multiphasic Personality Inventory. The MPS provides measures of self-oriented, other-oriented, and socially prescribed perfectionism, whereas the PDS assess levels of various personality disorder symptoms. Zero-order and partial correlations indicated that the perfectionism dimensions of the MPS were related to various subscales of the PDS and, perhaps more importantly, that the findings vary as a function of the perfectionism dimension in question. The results are discussed in terms of the importance of perfectionism in personality disorder symptom patterns.     

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.     

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.     

Resolutions to interpretive dilemmas created by the minnesota multiphasic personality inventory 2 (MMPI-2): A reply to Strassberg

We discuss the interpretive dilemmas identified by Strassberg (1991) and propose to resolve these dilemmas by pointing out that some change has indeed been introduced in the MMPI-2 and that change is a necessary requisite for improvement. Changes in administration procedures used with the MMPI-2 normative sample should only improve the quality of the normative data; changes in the way T-scores were developed lead to minimal change in the profile but enable more accurate interpretation of differences between scales on an individual's profile; normative changes have a differential effect on the clinical scales and this is to be expected; and the problem of codetype congruence has been overestimated and overstated. We conclude that the change introduced in the MMPI-2 can only serve to improve the test.