The relationship between the MCMI personality scales and DSM-III, axis II

Compared were the personality scales of the Millon Clinical Multiaxial Inventory (MCMI) to the diagnosis of personality disorder, according to the Diagnostic and Statistical Manual of Mental Disorders (3rd ed. [DSM-III]; American Psychiatric Association, 1980), obtained by means of the Structured Interview for the DSM-III Personality Disorders (SIDP). The results from 272 psychiatric outpatients show a good correspondence for the Avoidant and the Dependent scales, a fairly good correspondence for the Schizotypal, the Histrionic, the Borderline, the Narcissistic, and the Paranoid scales, and no correspondence for the Schizoid, the Passive-Aggressive, and the Compulsive scales. The Passive-Aggressive scale seems to be positively correlated to personality disorders in general, whereas the Compulsive scale seems to be negatively correlated to a number of personality disorders.     

The Relationship Between the MCMI Personality Scales and DSM-III,Axis II

Compared were the personality scales of the Millon Clinical Multiaxial Inventory (MCMI) to the diagnosis of personality disorder, according to the Diagnostic and Statistical Manual of Mental Disorders (3rd ed. [DSM-III]; American Psychiatric Association, 1980), obtained by means of the Structured Interview for the DSM-III Personality Disorders (SIDP). The results from 272 psychiatric outpatients show a good correspondence for the Avoidant and the Dependent scales, a fairly good correspondence for the Schizotypal, the Histrionic, the Borderline, the Narcissistic, and the Paranoid scales, and no correspondence for the Schizoid, the Passive-Aggressive, and the Compulsive scales. The Passive-Aggressive scale seems to be positively correlated to personality disorders in general, whereas the Compulsive scale seems to be negatively correlated to a number of personality disorders.     

Systemic work with clients with a diagnosis of Borderline Personality Disorder

Clients who are diagnosed with Borderline Personality Disorder are likely to engage with clinicians in compelling ways. They challenge us with an urgency that helps us to define ourselves as we work with them. They confront us with the limitations of our treatment approaches, requiring a genuineness of interaction and a flexibility that can be both challenging and uncomfortable. While therapists have made great strides over the past few decades in their treatment approaches with this population, there is a gap in the literature on the use of systemic approaches with these clients. This article examines some of the issues that arise in work with people with a diagnosis of Borderline Personality Disorder and offers an application of a larger systems perspective to the development of viable treatment options for these clients.     

The Rorschach and psychopathy: toward a more accurate understanding of the research findings

In this article we present the reader with an understandable essay on the relation between the Rorschach and psychopathy. Some degree of sophistication and applied knowledge of the Hare Psychopathy Checklist-Revised (Hare, 1991) and the Rorschach (Rorschach, 1921/1942) are necessary to wade through the literature, weigh the relative merits of arguments made by proponents and detractors of Rorschach assessment, and meaningfully interpret the findings of relevant studies. Often studies reviewing the Rorschach's utility in assessing Antisocial Personality Disorder (American Psychiatric Association, 1994) and psychopathy exhibit a flawed or superficial understanding of essential theoretical and methodological issues. Argument derived from a suspect or specious premise, such as the notion that the Rorschach was designed or aspires to correspond with formal diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1952, 1994), vitiates conclusions based on such a premise. In this article, we discuss theoretical and methodological issues that can aid the reader or reviewer in achieving a more accurate understanding of this body of research.     

The clinical utility of the MMPI-2 Antisocial Practices Content Scale

This study explored the ability of the MMPI-2 Antisocial Practices Content Scale (ASP) to correctly classify DSM-IV Antisocial Personality Disorder (APD). ASP scores and scores on the MMPI-2 Psychopathic Deviate (Pd) scale were compared in an APD group (n = 10), a Borderline Personality Disorder group (n = 16), a Narcissistic Personality Disorder group (n = 9), an Other Personality Disorder group (representing personality disorders from Clusters A and C; n = 14), and a nonclinical population (NC; n = 67). The ASP exhibited an ability to differentiate APD from other personality disorders and was significantly correlated to DSM-IV diagnostic criteria for APD while the Pd was not. Diagnostic efficiency statistics (sensitivity, specificity, positive predictive power, negative predictive power, overall correct classification rate, and kappa) were calculated under four different conditions in a clinically relevant manner (Kessel & Zimmerman, 1993. Psychological Assessment, 53, 395-399). The results of this study illustrate the usefulness of the ASP as a tool for the assessment of antisocial attitudes, beliefs, and behaviors in individuals suspected of having APD. This information may be valuable to clinicians who are planning treatment or assessing treatment outcome for clients with APD.     

Hoarding Disorder: Diagnosis,Assessment, and Treatment

Hoarding disorder (HD) is a newly added mental disorder in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013). In this article, the symptoms, characteristics, and features of HD are described, along with diagnosis and assessment strategies. The most efficacious treatments for counseling clients diagnosed with HD are also discussed.     

Heritability of personality disorders in childhood: a preliminary investigation

The heritability of personality disorder features was investigated in 112 child (ages 4-15 years) twin pairs (70 monozygotic and 42 dizygotic pairs). Parents assessed personality disorder features using the Coolidge Personality and Neuropsychological Inventory for Children (CPNI; Coolidge, 1998) that measures 12 personality disorders according to the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (American Psychiatric Association, 1994). Structural equation model-fitting methods indicated that the median heritability coefficient for the 12 scales was .75 (ranging from .81 for the Dependent and Schizotypal Personality Disorder scales to .50 for the Paranoid and Passive-Aggressive Personality Disorder scales). These results suggest that childhood personality disorders have a substantial genetic component and that they are similar to heritability estimates of personality disorder traits in adults and counter hypotheses that only temperaments and higher-order personality disorder traits have significant genetic components (Paris, 1997).     

Ethnic Match and Treatment Outcomes for Child and Adolescent Mental Health Center Clients

This study investigated the effects of client ethnicity and client‐counselor ethnic match on treatment outcomes (i.e., GAF‐difference [from the Global Assessment of Functioning Axis V rating of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, American Psychiatric Association, 1994] and client visitation) of 1,946 child and adolescent community mental health center clients. After controlling for 7 other variables, no differences were observed after adjustment among client ethnicities, age groups, or ethnic match on the GAF‐difference dependent measure. Ethnically matched African American child and adolescent clients had fewer mental health visits than did their nonmatched counterparts. Implications of these findings are discussed.     

Correspondence among observer ratings of Rorschach,Big Five Model,and DSM-IV personality disorder constructs

Observer ratings were collected using instruments designed to measure the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) personality disorders (Personality Diagnostic Questionnaire-4+ [PDQ-4+]; Hyler, 1994), the Big Five model (B5M; Goldberg's [1999] International Personality Item Pool), and Rorschach-derived constructs. For the latter, we revised the Rorschach Rating Scale (Meyer, Bates, & Gacono, 1999) to lower its reading level and renamed it the Rorschach Construct Scale (RCS) to emphasize its reliance on rated constructs. The RCS consists of 6 factors. Joint factor analysis of RCS, PDQ-4+, and B5M items also resulted in 6 factors: Self-Centeredly Exploitative, Poor Ego Resiliency, Extraversion, Task Conscientiousness, Openness to Ideas, and Emotional and Expressive Constriction. The first 2 factors received high loadings from RCS, PDQ-4+, and B5M variables. The sixth factor received high loadings from just RCS variables.     

DSM-IV: WhatY's New

The significant differences between the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R; American Psychiatric Association, 1987) and the DSM-IV (American Psychiatric Association, 1994) are described, focusing on the types of mental disorders counselors frequently diagnose and treat. These include several disorders included in the children's section as well as Adjustment Disorders, Substance-Related Disorders, Mood Disorders, Anxiety Disorders, and Personality Disorders.     

Specific Personality Traits and General Personality Dysfunction as Predictors of the Presence and Severity of Personality Disorders in a Clinical Sample

This study examined the associations of specific personality traits and general personality dysfunction in relation to the presence and severity of Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM–IV]; American Psychiatric Association, 1994) personality disorders in a Dutch clinical sample. Two widely used measures of specific personality traits were selected, the Revised NEO Personality Inventory as a measure of normal personality traits, and the Dimensional Assessment of Personality Pathology-Basic Questionnaire as a measure of pathological traits. In addition, 2 promising measures of personality dysfunction were selected, the General Assessment of Personality Disorder and the Severity Indices of Personality Problems. Theoretically predicted associations were found between the measures, and all measures predicted the presence and severity of DSM–IV personality disorders. The combination of general personality dysfunction models and personality traits models provided incremental information about the presence and severity of personality disorders, suggesting that an integrative approach of multiple perspectives might serve comprehensive assessment of personality disorders.     

Self‐Injurious Behaviors: Assessment and Diagnosis

This article examines the diagnosis and assessment of self‐injurious behaviors. A classification model for conceptualizing self‐injury is discussed, and the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision; American Psychiatric Association, 2000) diagnoses associated with self‐injury are addressed. Assessment questions and issues to consider when assessing clients who self‐injure are provided.     

Correlations Between the MMPI and the Scale for the Assessment of Positive Symptoms and the Scale for the Assessment of Negative Symptoms in Schizophrenic Patients

Our study examined the relationship between the Minnesota Multiphasic Personality Inventory (MMPI) and the Scale for the Assessment of Positive Symptoms (SAPS; Andreason, 1984) and the Scale for the Assessment of Negative Symptoms (SANS, Andreason, 1983) in patients who met the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; American Psychiatric Association, 1987) diagnostic criteria for schizophrenia (n = 125). A significant correlation was found between the SAPS Delusions scale and Scale 6 (Paranoia), the SAPS Positive Thought Disorder Scale and Scale F (Infrequency), and the SAPS Positive Thought Disorder and Scale 9 (Hypomania). Additional analysis also shows, however, that severity of symptoms was the best predictor of MMPI scores. Consistent with previous studies, the MMPI appears useful for screening but not for the detailed evaluation of symptomatology of schizophrenic patients.     

Rorschach protocols from children and adolescents with Asperger's disorder

Rorschach protocols from 24 boys with Asperger's Disorder matched by age to 24 boys with other emotional or behavioral disorders (the contrast group) were compared to each other and to Exner' s (1995) normative data. Eight variables based on Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) criteria and a review of the literature for Asperger's Disorder were predicted to discriminate between groups with the Asperger's group having more extreme scores. Five variables (COP, CDI, H, M, and EA) were significantly different from the contrast group and T and WSumC were significantly different from the normative data in both the Asperger's group and the contrast group.     

Narcissism,sex roles,and self-functioning

This study examined the relationship between gender, sex role, and narcissism. Two hundred and three students completed the Bem Sex Role Inventory, the Narcissistic Personality Inventory, and the Narcissistic Personality Disorder Scale, along with several measures of self-esteem and depression. Overall, the data indicated that males and masculine individuals were not higher in their levels of maladaptive narcissism, that an adjusted narcissism was more obvious in males and in masculine subjects, and that femininity appeared to inhibit the display of an unhealthy exploitive self-concern. Androgyny failed to appear as the healthiest sex role, although multiple regression analyses suggested that future research may need to further explore this possibility.     

Screening for Maladjustment in College Students: An Application of Receiver Operating Characteristic Curve to MMPI Scales

The ability of two scales derived from the Minnesota Multiphasic Personality Inventory (MMPI) to identify emotional maladjustment in a college setting was examined. The scales were the College Maladjustment scale (Mr) developed by Kleinmuntz (1961) and the Health Opinion Survey based Emotional Disorder scale (Ed). Emotional maladjustment was defined by criteria established in the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, 1987) and assessed through a computerized Diagnostic Interview Schedule. Subjects were 94 female and 62 male students, 51 of whom (33%) met criteria for at least one DSM-III-R disorder. Substance use disorders were most frequent (13.5%), followed by anxiety disorders (11.5%) and depressive disorders (7.1%). Both Mt and Ed had no relationship to substance use disorders but were moderately related to nonsubstance use maladjustment (r = ≈47); receiver operating characteristic (ROC) analysis was employed, and Mt and Ed proved to be a fair-to-good indicator of nonsubstance use maladjustment. Types of decision errors are discussed, and tables provide information concerning predictive accuracy across the entire range of scores.     

Sensitivity and specificity of depression questionnaires in a college-age sample

The authors evaluated the sensitivity and specificity of the Beck Depression Inventory-II (BDI-II; A. T. Beck, R. A. Steer, & G. K. Brown, 1996) and Center for Epidemiological Studies-Depression Scale (CESD; L. S. Radloff, 1977) questionnaires for a college-student sample. Results indicate that the BDI-II and CES-D evidenced satisfactory levels of specificity and positive predictive value for current, past-year, and lifetime depressive disorder ratings on the Diagnostic Interview Schedule-IV (American Psychiatric Association, 1994). Researchers can use the questionnaires as valid initial screens in a two-stage process designed to identify individuals meeting Diagnostic and Statistical Manual of Mental Disorders-IV (American Psychiatic Association) criteria for depressive disorders. However, if the questionnaires are the only method used to select participants, the resulting sample may include a number of false positives.     

A preliminary look at loneliness as a moderator of the link between perfectionism and depressive and anxious symptoms in college students: does being lonely make perfectionistic strivings more distressing?

An integrative model involving perfectionism [Hewitt, P. L., & Flett, G. L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60, 456-470] and loneliness as predictors of depressive and anxious symptoms was proposed and tested in 383 college students. Beyond the expected additive influences of the two predictors in the prediction of symptoms, loneliness was also hypothesized to moderate the link between perfectionism and symptoms. Results indicated that other-oriented perfectionism predicted anxious symptoms, whereas socially prescribed perfectionism predicted both depressive and anxious symptoms. Loneliness was found to add incremental validity to these predictions. Moreover, the Perfectionism x Loneliness interaction was found to further augment the prediction of depressive and anxious symptoms. These findings are taken to offer support for a more contextual model of perfectionism. Some implications of the present findings are discussed.     

IS A LITTLE (PSYCHIATRIC) KNOWLEDGE A DANGEROUS THING?

One hundred thirty-four participants completed a revised Menstrual Distress Questionnaire (MDQ), which included criteria for premenstrual dysphoric disorder (PMDD). Two weeks later the participants again completed the revised MDQ after reading either the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) diagnostic criteria for the PMDD or a copy of the same criteria retitled "Episodic Dysphoric Disorder," with all menstrual cycle references removed. Knowledge of the diagnosis did not affect women's perceptions of their own menstrual cycle-related symptoms, but it increased participants' perceptions of premenstrual changes as a problem for women in general. Chi-square analyses revealed that participants were more willing to attach a psychiatric diagnosis to women they know if they believed the diagnosis was related to the menstrual cycle.     

Perfectionism in the self and social contexts: conceptualization, assessment, and association with psychopathology

This article attempted to demonstrate that the perfectionism construct is multidimensional, comprising both personal and social components, and that these components contribute to severe levels of psychopathology. We describe three dimensions of perfectionism: self-oriented perfectionism, other-oriented perfectionism, and socially prescribed perfectionism. Four studies confirm the multidimensionality of the construct and show that these dimensions can be assessed in a reliable and valid manner. Finally, a study with 77 psychiatric patients shows that self-oriented, other-oriented, and socially prescribed perfectionism relate differentially to indices of personality disorders and other psychological maladjustment. A multidimensional approach to the study of perfectionism is warranted, particularly in terms of the association between perfectionism and maladjustment.