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.     

An ethnocultural study of posttraumatic stress disorder in African-American and white American Vietnam War veterans

This study examined the intensity of Posttraumatic Stress Disorder (PTSD) symptoms as measured by the Mississippi Scale, the Keane (PK), and the PTSD (PS) Scales of the MMPI-2 in a sample of 34 African-American and 34 White American Vietnam War Veterans who sought treatment in a Specialized Inpatient PTSD Unit. The scores of the two groups on the Beck Depression Inventory and the clinical scales of the MMPI-2 were also compared. The ethnoculturally different sample was matched on intensity of combat exposure, marital status, employment status, age, and education. No significant differences on the measures of PTSD symptoms were noted and no significant differences were found on the Beck scale or the MMPI-2 clinical scales.     

A cultural-contextual perspective on the validity of the MMPI-2 with American Indians

This study investigated the normative validity of the MMPI-2 with two distinct American Indian tribes. Differences occurred on 8 of the 13 basic validity and clinical scales (F, 1, 4, 5, 6, 7, 8, 9) between the MMPI-2 norms and both tribal samples. Elevated MMPI-2 scores of American Indians may not only reflect the possibility of psychological distress spurred by historical oppression and present adversity, but also an expression of a divergent worldview. Considering the context of the historical and social production of knowledge about American Indians, it is argued that researchers and practitioners, when interpreting MMPI-2 results for American Indians, should seriously consider their interpretive points of reference, which may be impacted by dominant cultural belief systems.     

External correlates of the MMPI-2 content component scales in mental health inpatients

External correlates of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Content Component Scales were identified using an inpatient sample of 544 adults. The Brief Psychiatric Rating Scale (BPRS) and Symptom Checklist 90-Revised (SCL-90-R) produced correlates of the Content Component Scales, demonstrating external validity with clinician-rated and self-report scales. Relationships between MMPI-2 Content Component Scales and patient hospital chart variables were also examined. Results demonstrated cross-criterion validity in that most MMPI-2 Content Component Scales correlated with appropriate BPRS dimensions, SCL-90-R items, and other patient variables. Discriminant validity of the Content Component Scales was also demonstrated. In addition, the finding that similar patterns of correlates are produced when the component scales are correlated with a self-report measure, as well as clinician ratings and medical chart variables, provides converging lines of evidence supporting the construct validity of the Content Component Scales.     

Empirical correlates of the MMPI-2 Restructured Clinical (RC) Scales in a nonclinical setting

We examined the empirical correlates of the MMPI-2 Restructured Clinical (RC; Tellegen et al., 2003) scales in a nonclinical setting. We administered 12 criterion measures assessing variables expected to be associated differentially with the RC Scales along with the MMPI-2 to a sample of 1,038 college students (Men, N = 407; Women, N = 631). Criteria included measures of somatization, depression, Machiavellian negativism, drug and alcohol abuse, anger, anxiety, social phobias, obsessive-compulsive tendencies, magical ideation, perceptual aberration, lability, and impulsivity. Results demonstrate good convergent and discriminant validity for the RC scales and add to a growing body of empirical correlates of these scales.     

Comparability and validity of computerized adaptive testing with the MMPI-2

The comparability and validity of a computerized adaptive (CA) Minnesota Multiphasic Personality Inventory-2 (MMPI-2) were assessed in a sample of 571 undergraduate college students. The CA MMPI-2 administered adaptively Scales L, E the 10 clinical scales, and the 15 content scales, utilizing the countdown method (Butcher, Keller, & Bacon, 1985). All subjects completed the MMPI-2 twice, with three experimental conditions: booklet test-retest, booklet-CA, and conventional computerized (CC)-CA. Profiles across administration modalities show a high degree of similarity, providing evidence for the comparability of the three forms. Correlations between MMPI-2 scales and other psychometric measures (Beck Depression Inventory; Symptom Checklist-Revised; State-Trait Anxiety and Anger Scales; and the Anger Expression Scale) support the validity of the CA MMPI-2. Substantial item savings may be realized with the implementation of the countdown procedure.     

Comparison of MMPI-2 profiles of Gulf War veterans with epileptic and nonepileptic seizure patients

As part of a larger study of illnesses related to service in the Gulf War, MMPI-2 profiles of epileptic seizure (ES) patients; nonepileptic seizure (NES) patients; Gulf War veterans with unexplained cognitive, psychological, musculoskeletal, fatigue, or dermatologic symptoms; and asymptomatic Gulf War veterans (Controls) were analyzed. There were 70 people in each group. Seizure diagnosis was based upon intensive EEG monitoring. Gulf War cases were mildly abnormal on MMPI-2 Scales Hs and D and significantly higher than controls on 8 of 10 MMPI-2 clinical scales, but they were significantly lower than NES patients on several scales including Hs and Hy.     

The MMPI-2 Restructured Clinical (RC) Scales and restraints to innovation, or "what have they done to my song?"

Rogers, Sewell, Harrison, and Jordan (2006/this issue) largely replicate in an independent clinical sample the MMPI-2 Restructured Clinical (RC) Scales developed by Tellegen et al. (2003). Nichols (2006/this issue) raises numerous concerns about the development and utility of the RC Scales, which on close appraisal did not change our view that the scales are well conceived and potentially valuable to researchers and clinicians alike. We present two case studies in which the RC Scales helped clarify complex MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) profiles with multiple elevations on the Clinical, Content, Supplementary, and Personality Psychopathology Five (Harkness, McNulty, Ben-Porath, & Graham, 2001) scales. When interpretations refined by the RC Scales were discussed with the clients, each seemed to feel deeply understood. Reservations about instrument innovation can be appreciated as helping to counterbalance change and thereby ensure the MMPI-2's successful ongoing evolution. We discuss specific ways the MMPI-2 community could avoid polarization about the RC Scales.     

A comparison of MMPI-2 validity in African American and Caucasian psychiatric inpatients

This study investigated ethnic differences on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) in 229 African American and 1,558 Caucasian psychiatric inpatients. Mean differences were found on several MMPI-2 validity and clinical scales. These were generally consistent with differences between the groups, indicated by the available extratest criterion data. To identify potential bias, the authors conducted 65 step-down hierarchical multiple regression analyses, predicting conceptually relevant clinical criteria from either MMPI-2 clinical or content scales for each gender. A number of MMPI-2 scales evidenced bias reflecting minor underprediction of psychopathology in African Americans. It is important to note that, in almost all cases, the magnitude of these differences was small and not clinically significant.     

Associations between Symptom Validity Test failure and scores on the MMPI-2-RF validity and substantive scales

This study examined the association between Symptom Validity Test (SVT) failure and the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008), in the Forensic Disability Claimant samples described in the MMPI-2-RF Technical Manual (Tellegen & Ben-Porath, 2008 a, 2008b). SVTs used included the Word Memory Test (Green, 2003), the Computerized Assessment of Response Bias (Allen, Conder, Green, & Cox, 1997), the Medical Symptom Validity Test (Green, 2004), and the Test of Memory Malingering (Tombaugh, 1996). SVT failure was associated with significant elevations throughout the MMPI-2-RF overreporting validity scales and substantive scales. Pairwise contrasts between groups failing 0 and 3 SVTs revealed predominantly large effect sizes for the overreporting validity scales (d = 0.78-1.11), and many of the substantive scales, including the Cognitive Complaints (COG) scale. Results of this study demonstrate an association between SVT performance and elevated scores on the MMPI-2-RF. These results suggest that exaggeration of cognitive symptoms as demonstrated by SVT failure is also associated with overreported emotional, somatic, and neurocognitive complaints on the MMPI-2-RF.     

Incremental Validity of the MMPI-2 Content Scales in the Assessment of Personality and Psychopathology by Self-Report

The incremental contribution of the MMPI-2 Content Scales to the prediction of scores on self-report measures of personality and psychopathology was investigated. The MMPI-2, Beck Depression Inventory, State-Trait Personality Inventory, anti Symptom Checklist-90-Revised were administered to 596 subjects: 339 women anti 257 men. Zero-order correlational analyses indicated that both clinical and Content Scales correlated with each of the criterion measures. In all but one case, an MMPI-2 Content Scale was found to have the highest correlation with the extratest variables. Combined hierarchical, stepwise regression analyses demonstrated that the MMPI-2 Content Scales possess incremental validity vis-a-vis the clinical scales for both genders in relation to all of the criterion measures. Additional analyses indicated that the MMPI-2 clinical scales also possess incremental validity vis-a-vis the Content Scales. However, the incremental contribution of the clinical scales was of lesser magnitude. Implications of these findings for test interpretation and future research with the MMPI-2 are discussed.     

Syndromal complexity, paradigm shifts, and the future of validation research: comments on Nichols and Rogers, Sewell, Harrison, and Jordan

In this comment, I address a number of the points raised in the reviews of the MMPI-2 Restructured Clinical (RC; Tellegen et al., 2003) Scales by Nichols (2006/this issue) and Rogers, Sewell, Harrison, and Jordan (2006/this issue), and I advocate for changes in assessment validation research. There is little evidence that the "syndromal complexity" Nichols ascribes to the original MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) Clinical Scales is worth preserving. Although their construction does not constitute the paradigm shift claimed by Rogers et al., the RC Scales are promising, psychometrically defensible measures of core features of the original MMPI-2 Clinical Scales. However, validation of inferences from multiscale inventories such as the MMPI-2 is limited at present by a disconnection between the integrative manner in which MMPI-2 profiles are interpreted and the scale-by-scale nature of most MMPI-2 validation studies. Q-sort procedures show promise for operationalizing integrated MMPI-2 interpretations, with both research and teaching applications.     

Bridging the divide: comments on the Restructured Clinical Scales of the MMPI-2

In this comment, I discuss the target articles written by Nichols (2006/this issue) and Rogers, Sewell, Harrison, and Jordan (2006/this issue) regarding the Restructured Clinical (RC) Scales (Tellegen et al., 2003) of the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). Both articles provide thoughtful discussion of the extent to which the RC Scales achieved the primary goals set forth by Tellegen et al., but they set different tones and come to somewhat different conclusions. I argue that the initial studies conducted on the RC Scales suggest a promising future for them. However, further studies are needed to explore the construct validity of the scales, assess their incremental validity with respect to other more established MMPI-2 scale sets, and determine their interpretive meaning in clinical contexts.     

Susceptibility of the MMPI-2 clinical, restructured clinical (RC), and content scales to overreporting and underreporting

The authors examined and compared the susceptibility of three Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scale sets (Clinical, Restructured Clinical [RC], and Content) to over- and underreporting using five analog samples. Two samples of 85 and 191 undergraduate students, respectively, took the MMPI-2 under underreporting versus standard instructions. Three samples consisting of 42 undergraduates, 73 psychiatric inpatients, and 84 medical patients took the MMPI-2 under overreporting versus standard instructions. A comparison of the effect sizes across the three sets of scales indicated that Clinical Scale scores are not less susceptible to distortion than the Content or RC Scales. An apparent lesser susceptibility to underreporting for the Clinical Scales was an artifact of the subtle items' effect on these scales.     

Further evidence on the validity of the MMPI-2 Restructured Clinical (RC) Scales: addressing questions raised by Rogers, Sewell, Harrison, and Jordan and Nichols

The reviews by Rogers, Sewell, Harrison, and Jordan (2006/this issue), and by Nichols (2006/this issue) offer markedly contrasting appraisals of the MMPI-2 Restructured Clinical (RC) Scales introduced by Tellegen et al. (2003). The one common feature is that both reviews draw on the same atypical MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) data set for their empirical analyses, with results warranting critical scrutiny. Rogers et al.'s critique provides an evaluation of the RC Scales from the perspective of Jackson's (1970) method of test development. One significant issue in Rogers et al.'s review concerns social desirability, prompting us to clarify our own views on this topic. We also highlight and discuss problems associated with Rogers et al.'s use of the unrepresentative data set. Nichols's polemical critique neglects empirical and theoretical support for demoralization as a central construct and misconstrues as "construct drift" the purposeful process of developing the RC scales. Nichols's criticisms and proposals overlook requirements for assessing syndromes and for construct validation and even rudiments of scale development. Our reply incorporates evidence, including new findings, refuting his criticisms and confirming that demoralization is a pervasive MMPI dimension, that the RC Scales capture the major distinctive features of the original Clinical Scales, and that they generate correspondingly meaningful validity patterns.     

Personality and psychopathology: mapping the MMPI-2 Restructured Clinical (RC) Scales onto the Five Factor Model of personality

The MMPI-2 Restructured Clinical (RC) Scales (Tellegen et al., 2003) reflect a recent shift for this instrument toward the measurement of contemporary conceptualizations of psychopathology. The current investigation aimed to replicate and extend the theoretical and empirical linkage between the RC scales and dimensional models of personality and to investigate how well the RC scales conform to a higher-order structure of psychopathology. Participants were 271 psychiatric patients who had been administered the MMPI-2 and revised NEO Personality Inventory (Costa & McCrae, 1992) as part of a routine psychological evaluation. The results indicated that the RC scales map onto the Five Factor Model of personality as hypothesized and in congruence with previous findings in personality and psychopathology. The RC scales conformed to a higher-order structure of internalizing, externalizing, and thought disturbance, replicating and extending previous work concerning hierarchical structures of psychopathology.     

An investigation of the psychometric properties of the MMPI-2 Restructured Clinical (RC) scales with mental health inpatients

In this study, we compared the internal psychometric properties and external correlates of the MMPI-2 (Butcher et al., 2001; Tellegen et al., 2003) Restructured Clinical (RC) scales and corresponding MMPI-2 non-K-corrected Clinical scales in a sample of 280 men and 264 women admitted to inpatient psychiatric units. We evaluated the internal psychometric properties of the RC and Clinical scales by intercorrelation analyses and alpha coefficients. We investigated external correlates of scores from the RC and Clinical scales using selected chart variables, selected Symptom Checklist 90-Revised (Derogatis, 1983, 1994) items, and clinician ratings on the Brief Psychiatric Rating Scale (Overall & Gorham, 1988). Results showed psychometric support for the RC scales in terms of improved intercorrelation patterns and comparable or greater alpha coefficients. Further, external correlational analyses revealed varying degrees of evidence of improvement in convergent and discriminant validity.