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.     

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.     

Cross-validation of a minnesota multiphasic personality inventory (MMPI) subscale for the assessment of combat-related post-traumatic stress disorder

We have examined the Minnesota Multiphasic Personality Inventory (MMPI) scores of 80 carefully diagnosed veterans with post-traumatic stress disorder (PTSD) in an attempt to cross-validate the PTSD subscale and three-point MMPI code of Keane, Malloy, and Fairbank (1984). In general, although we replicated Keane and co-workers'cutoff scores, our hit rates were slightly lower than those reported originally.This research was supported in part by NIMH Grant MH-37839 to Dr. Kolb.     

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.     

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.     

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.     

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.     

A resolution to the interpretive dilemmas created by the Minnesota Multiphasic Personality Inventory 2 (MMPI-2)? A reply to Ben-Porath and Graham

In my original article (Strassberg, 1991) I described (1)some of the changes introduced by the MMPI-2, (2) possible interpretive dilemmas created by these changes, and (3) strategies for dealing with these dilemmas. In their reply to my paper, Ben-Porath and Graham (preceding paper) suggest that the differences between the MMPI-2 and the MMPI (1) are to be expected, (2) are less important than I imply, and (3) when they do occur, will almost always reveal the superiority of the MMPI-2. In this reply to Ben-Porath and Graham, I explain why, despite their reassurances, I continue to contend that interpretive dilemmas can exist when using the MMPI-2, but these should not deter us from using this instrument.     

Psychological and sexual functioning among outpatient sexual offenders against children: A Minnesota Multiphasic Personality Inventory (MMPI) cluster analytic study

Multivariate clustering procedures were used to identify homogeneous subgroups of outpatient sex offenders against children (n=110)on the basis of the Minnesota Multiphasic Personality Inventory (MMPI). Results indicated a five-subgroup solution. Two within-normal-limits and two clinically elevated profile subgroups replicated subtypes found in previous cluster analytic studies of child sex offenders. The fifth subgroup appeared similar in MMPI profile pattern and elevation to a previously identified subtype of rapists. Discriminant analyses showed that subgroups differed along dimensions of cognitive disturbance and sexual functioning. Furthermore, levels of psychopathology corresponded with levels of sexual pathology. Results are discussed with reference to previous MMPI cluster analytic studies of sex offenders and theories of sexual aggression.Portions of this paper were presented at the meeting of the Midwestern Psychological Association, 1992, Chicago, Illinois.     

Minnesota Multiphasic Personality Inventory (MMPI)-derived psychopathology subtypes among former prisoners of war (POWs): Replication and extension

Psychopathology and symptom patterns identified among former prisoners of war (POWs) by Sutker, Winstead, Goist, Malow, and Allain (1986) were replicated in an independent sample of 51 former POWs with similar personal backgrounds and military experiences. Data collection instruments included the Minnesota Multiphasic Personality Inventory (MMPI), self-report measures of anxiety and depression, and a structured clinical interview including a POW Trauma Index. Two prototypic MMPI profile patterns were identified using modal profile analysis (Skinner & Lei, 1980). Both were highly similar in shape and elevation to those reported in the previous investigation. Multiprofile-multisample analysis produced prototypic profile patterns which were accurate representations of profiles identified in separate analyses of the derivation and replication samples (r's .96). Representing unique constellations of clinical features, profile subtypes were associated differentially with confinement stress severity, postservice adjustment, and nature and extent of stress-induced symptomatology.     

Behavioral,psychological, and historical correlates of MacAndrew scale scores among male alcoholics

Male alcoholic veterans (N=194) were divided into four groups on the basis of their scores on the MacAndrew scale (MAC) of the Minnesota Multiphasic Personality Inventory (MMPI) and compared on psychological and sociodemographic measures and self-reported alcohol, drug, and legal histories. Nineteen subjects scored in the nonalcoholic (NA) range of the MAC (i.e., false negatives, MAC23). Remaining subjects, scoring in the alcoholic range of the MAC, were divided into thirds by MAC scores (lowest third, L-MAC=24–28,n=53; middle third, M-MAC=29–31,n=63; highest third, H-MAC>31,n=59). Groups did not differ on age, any important sociodemographic variables, or scores on the Profile of Mood States, State-Trait Anxiety Inventory, Symptom Checklist-90, or Rod and Frame Test. Significant group differences were obtained on several MMPI scales. Lower MAC scores were associated with higher scores onL, K, D, andR, and lower scores onMa. There was also a tendency for subjects with lower MAC scores to score higher onSi. NA subjects began drinking and heavy drinking later than other subjects, although groups did not differ on duration, quantity, or frequency of drinking. Subjects with higher MAC scores more often reported drinking in bars, drinking liquor straight, alcohol-related job disruptions, and previous use of marijuana, hallucinogens, and barbiturates. Subjects with higher MAC scores had more often been arrested, convicted, fined, and jailed for alcohol-related offenses but not for other offenses. Results are examined with respect to MacAndrew's distinction between primary and secondary alcoholics and with respect to the possible relations of MAC to important person variables such as sensation seeking.The authors wish to thank Craig MacAndrew for his helpful critical reading of an early draft of this paper. We also thank Theresa Hilliard, Shirley White, Vicki Brumbelow, and Pam Thompson for editorial assistance and Audrey Jefferson for help with data preparation.     

Comparison of the MMPI and MMPI-2 Among Job Applicants

The primary objective was to compare the MMPI-2 profiles for professional job applicants with corresponding profiles on the original MMPI. Male and female MMPI-2 profiles were also compared, and correlational and factor analyses were used to examine: A) Interscale correlations vis-à-vis item overlap, and B) The impact of K-corrections. The subjects were 82 auditor applicants, plus 212 sales and management applicants from an earlier study. The original MMPI was found to overpathologize applicant profiles. Male and female MMPI-2 profiles differed only on Mf. Scales L, K, and Hy formed a favorable cluster for job applicants, while F, Hs, Pt, Sc formed one unfavorable cluster—and D, Si a second. K-corrections consistently moved clinical scales in the direction of the favorable cluster.     

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.     

Objective personality assessment of people in diverse cultures: European adaptations of the MMPI-2

This article examines the cross-national application of psychological tests and examines the generalizability of objective psychological assessment instruments. The most widely used and internationally adapted personality instrument, the Minnesota Multiphasic Personality Inventory (MMPI-2), is highlighted to illustrate the adaptation of psychological tests across the barriers of language and culture. The problems and limitations of using questionnaire methods were noted and effective strategies for translating, adapting, and standardizing questionnaires in languages and cultures different from their country of origin are reviewed. The history of several European adaptations of the original MMPI and MMPI-2 is surveyed to illustrate the extensive research base for the test in Europe. Applications of the MMPI-2 in clinical and non-clinical (e.g. industrial) settings were noted. Current research is described and recommendations for future research are provided.     

MMPI Profiles of Liver and Heart Transplant Candidates With and Without Significant Histories of Heavy Alcohol Use

This study compared the Minnesota Multiphasic Personality Inventory (MMPI) profiles of liver and heart transplant candidates with (n = 104) and without (n = 253) significant histories of heavy alcohol consumption. The alcohol and nonalcohol groups had similar overall mean profiles with significant or marginally significant (i.e., T 69) clinical elevations on Scales 1, 2, and 3. However, significantly higher proportions of those in the liver transplant group than in the heart transplant group scored within the clinical range on Scales F, 4, 6, and 8. In addition, the proportions of respondents obtaining clinically elevated scores were significantly higher for the alcohol than for the nonalcohol group on Scale 4 and the MacAndrew Scale; the proportion was higher for the nonalcohol than for the alcohol group on Scale K. The overall similarity of the mean profiles indicates that candidates for liver or heart transplantation with and without histories of heavy alcohol use generally display similar psychological presentations. The observed differences between the liver and the heart transplant groups may reflect impairments in mental status among liver transplant candidates due to metabolic consequences of liver disease. The differences between the alcohol and the nonalcohol groups may be more a reflection of past behavioral patterns than present psychological status.     

Bias and Millon clinical multiaxial inventory (MCMI-II) diagnosis

In the current study, the degree of bias is calculated for each of the personality disorder and clinical syndrome scales of the MCMI-II. In general, most of the MCMI-II scales are prone to only mild or moderate biases. However, the paranoid personality disorder, somatoform, bipolar: manic, thought disorder, and delusional disorder scales are prone to severe biases. When the MCMI-II is utilized to make diagnostic decisions, bipolar and schizophrenic disorders are apt to be grossly underestimated. The implications of bias in diagnostic prevalence rates are discussed and an equation is offered which provides for adjustments to be made when the percentage of positive MCMI-II test results are used to determine prevalence rates for clinical or research populations. The observation is made that imperfect sensitivity and specificity for the MCMI-II scales will result in inaccurate estimates of personality disorders and clinical syndromes when the MCMI-II is used to survey various populations.     

Total number of MMPI-2 clinical scale elevations predicts premature termination after controlling for intake symptom severity and personality disorder diagnosis

Premature termination of therapy by patients is a common phenomenon that can be deleterious to treatment outcome for patients and also negatively affect therapists, treatment centers, and research programs. Therefore, a method of identifying patients at risk for premature termination could have widespread benefits. This study investigated whether patients’ MMPI-2 profiles, including clinical scale elevations and Negative Treatment Indicator (TRT) scores, could predict premature termination in an outpatient sample, controlling for personality disorder diagnosis and symptom severity at intake. Results indicated that while TRT scores were not incrementally predictive of premature termination, the total number of clinical scale elevations was significantly incrementally predictive of dropout. Clinical implications are discussed.     

Examination of the MMPI-2 Restructured Clinical (RC) Scales in a Sample of Bariatric Surgery Candidates

The current study examined the MMPI-2 Restructured Clinical (RC) scales (Tellegen et al., MMPI-2 Restructured Clinical (RC) scales: Development, validation, and interpretation. Minneapolis: University of Minnesota Press, 2003) in a sample of 1,091 bariatric surgery candidates. The RC scales were developed to address concerns about limited discriminant validity of the Clinical scales. Internal consistency and external validity analyses were conducted to evaluate the RC scales in this setting. Results indicated that the RC scales are generally more internally consistent than the Clinical scales and display significantly better convergent and discriminant validity in predicting a variety of behavioral, psychological, and developmental variables relevant to preoperative bariatric psychological evaluations. Implications of the results and recommendations for future research with the RC scales in medical settings are discussed.