Factor structure of the MCMI basic personality scales and common-item artifact

The eight basic personality scales of the Millon Clinical Multiaxial Inventory (MCMI) were derived from Millon's theory of personality, but the adequacy of the MCMI for measuring Millon's personality constructs has never been assessed. One major problem with using factor analysis to illuminate the structure of the MCMI personality scales is that artifactual structure may result from item overlap among the scales. To analyze this, item-overlap coefficients were factored and compared to the factor structures of five subject samples. For the eight basic personality scales, three factors emerged for the overlap matrix and each of the five sample matrices: Aloof-Social, Aggressive-Submissive, and Lability-Restraint. It was concluded that these three factors are inconsistent with Millon's theory and that they will be found artifactually across a wide variety of populations due to overlapping items.     

Development and Validation of an Adjective Check List to Assess the Millon Personality Types in a Normal Population

A 405-item experimental Personality Adjective Check List (PACL) was refined into a 153-item form to assess the personality types outlined by Millon (1969, 1981) in a normal population. Scale construction and validation followed a method outlined by Loevinger (1957, 1972). Nine scales were developed based on the responses of 459 men and women, one for each of Milton's eight basic personalities plus an Experimental scale measuring aspects of his three more severe types. Extensive reliability and validity analyses were conducted involving over 2,200 men and women from across the United States, including a factor analysis of scales. These revealed good internal consistency for each scale, good test-retest reliability over a 3-month period, adequate factor structure, and good convergent and discriminant validity based on self-report data. Results indicated that Millon's basic types exist in normal form much as they are postulated to exist as disorders. Research efforts focusing on Millon's theory as it applies to normals may bring a more complete understanding of the entire spectrum of personality.     

Stability of the personality and symptom scales of the Millon Clinical Multiaxial Inventory

This study examines the stability of the basic and pathological personality and symptom scales of the Millon Clinical Multiaxial Inventory (MCMI) in three clinical samples. Consistent with the theory upon which the MCMI is based, higher stability estimates were found among basic personality scales in comparison with symptom scales. However, stability estimates which included initial MCMI administrations at intake into treatment were generally lower than those based upon administrations which occurred later in the treatment process. This later finding suggests the need to consider timing of administration when interpreting the MCMI.     

Stability of the Personality and Symptom Scales of the Millon Clinical Multiaxial Inventory

This study examines the stability of the basic and pathological personality and symptom scales of the Millon Clinical Multiaxial Inventory (MCMI) in three clinical samples. Consistent with the theory upon which the MCMI is based, higher stability estimates were found among basic personality scales in comparison with symptom scales. However, stability estimates which included initial MCMI administration at intake into retreatment were generally lower than those based upon administrations which occurred later in the treatment process. This later finding suggests the need to consider timing of administration when interpreting the MCMI.     

Overview and Current Status of the Millon Clinical Multiaxial Inventory

The MCMI (Millon, 1983a, 1987, 1994, 1997a) was developed to operationalize Millon's (1969/1983b) model of psychopathology and has been revised 2 times over the past 20 years to keep pace with changes in theory as well as the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). Since its introduction in 1977, it has become one of the most widely used and researched clinical assessment instruments in history, generating over 500 articles and 6 books. It has been translated into several languages and is being used in cross-cultural research. This article presents a historical overview of the measure and summarizes its current status in the literature. I highlight Millon's original vision for the test, changes that have been made, and its strengths and limitations. Future refinement of the MCMI is already in the planning stages and includes trait subscales for the personality disorders and linking codetypes to theory-derived interventions.     

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.     

International Adaptations of the Millon Clinical Multiaxial Inventory: Construct Validity and Clinical Applications

This article examines the influence of the Millon Clinical Multiaxial Inventory (MCMI) as a clinical and research instrument beyond the borders of the United States. The MCMI's theoretical and empirical grounding, its alignment with the Diagnostic and Statistical Manual of Mental Disorders (DSM), and scales that can be interpreted both categorically and dimensionally, are the primary features that make the test attractive. We begin with studies that evaluated the construct equivalence of the different language adaptations. Data from the most widely researched non English-language forms (Danish, Dutch, and Spanish) show excellent comparability with Millon's original. Nevertheless, significant problems were noted in efforts to create clinical groups that would allow for equivalence of diagnostic accuracy when using the cutoff scores. Although dimensional aspects of the scale scores were not affected by this, the adapted measures might show attenuated diagnostic accuracy compared with Millon's original. Next, we present MCMI studies conducted in clinical settings to document where the adapted tests have made their greatest impact in the international literature. A wide variety of clinical applications demonstrated broad utility, and given the high number of issues addressed, we think Millon's influence will certainly stand the test of time in different domains and settings.     

An examination of the relationship between personality patterns and symptom/mood patterns

Relationships between various personality styles measured by the basic and pathological personality scales of the Millon Clinical Multiaxial Inventory (MCMI) and mood or symptom states measured by the Profile of Mood State scales were examined. The MCMI personality scale-POMS symptom/mood scale relationships found in this study are compared with MCMI personality scale-MMPI and SCL-90 symptom/mood scale relationships reported in the MCMI manual. Consistent associations of moderate strength were found between: (a) the MCMI Compulsive-Conforming and Passive-Aggressive (Negativistic) scales (negative and positive associations, respectively) and various measures of depression, anxiety and hostility; (b) the MCMI Avoidant, Schizotypal and Borderline-Cycloid scales and various measures of depression and anxiety; (c) the MCMI Schizoid-Asocial scale and various measures of depression; and (d) the Histrionic-Gregarious scale and various measures of high energy-activity. These MCMI personality scale-symptom/mood scale relationships are generally consistent both with the underlying theory of personality and psychopathology upon which the MCMI is based and with the personality-symptom scale relationships found within the MCMI.     

The Bender Visual Motor Gestalt Test as an Index of Emotional Disturbance in Children

Millon (1985) presented eight criticisms of the article by Widiger, Williams, Spitzer, and Frances (1985) on the MCMI as a measure of DSM-III. This article is a brief rejoinder. The major point we wish to make is that one should be cautious in interpreting the MCMI as a measure of DSM-III disorders because there has not yet been any research published on the relationship between the MCMI and DSM-III. We believe this position has not been refuted by Millon's critique.     

Overload (Book)

Relationships between various personality styles measured by the basic and pathological personality scales of the Millon Clinical Multiaxial Inventory (MCMI) and mood or symptom states measured by the Profile of Mood State scales were examined. The MCMI personality scale-POMS symptom/mood scale relationships found in this study are compared with MCMI personality scale-MMPI and SCL-90 symptom/mood scale relationships reported in the MCMI manual. Consistent associations of moderate strength were found between: (a) the MCMI Compulsive-Conforming and Passive-Aggressive (Negativistic) scales (negative and positive associations, respectively) and various measures of depression, anxiety and hostility: (b) the MCMI Avoidant, Schizotypal and Borderline-Cycloid scales and various measures of depression and anxiety; (c) the MCMI Schizoid-Asocial scale and various measures of depression; and (d) the Histrionic-Gregarious scale and various measures of high energy-activity. These MCMI personality scale-symptom/mood scale relationships are generally consistent both with the underlying theory of personality and psychopathology upon which the MCMI is based and with the personality-symptom scale relationships found within the MCMI.     

Three Approaches to Interpersonal Behavior and Their Common Factors

This study examined the factor dimensions common to three different approaches to interpersonal behavior- the interpersonal circle, Millon's theory of personality, and a factor analytic (FA) approach. These were compared with the Norman (1963) "Big Five" factors. Measures employed were the revised Wiggins (1979) Interpersonal Adjective Scales, Strack's Personality Adjective Check List (1990), and the short form of the Lorr (1986) Interpersonal Style Inventory. Subjects were 146 college students (83 men and 63 women). A principal components analysis with varimax rotation revealed four distinct factors, based on a scree test, that accounted for 55.4% of the variance: Dominance-Submission, Extraversion-Introversion, Conscientiousness, and Agreeable-Disagreeable. Each of the models measured the circumplex axes of dominance and affiliation, but only the Millon (1969/1983) and FA approaches measured more than these elements, with the FA paradigm most sufficiently addressing all four. Dominance-Submission, the largest factor, was not explicit in the Big Five. Results suggest that earlier studies isolating five factors of personality may not have adequately represented this dimension.     

The convergent and discriminant validity of the MCMI as a measure of the DSM-III personality disorders

The personality scales of the Millon Clinical Multiaxial Inventory (MCMI) were constructed and validated to measure the typology developed by Millon (1981). The ability of the MCMI to measure the DSM-III personality disorders has not yet been empirically evaluated. The current study found better convergent validity for the DSM-III personality disorders that are consistent with Millon's typology (i.e., the avoidant and the dependent) than for the disorders that are inconsistent (i.e., the antisocial and the passive-aggressive). However, the results may reflect some advantages Millon's typology might have over the DSM-III. The discriminant validity of all four scales was limited, due in part to the overlap among the MCMI scales and the DSM-III personality disorders. We discuss implications of the results for the revision of the MCMI and the DSM-III.     

The stability of the Millon Clinical Multiaxial Inventory for psychiatric inpatients

This study investigated the stability of the personality and symptom scales of the Millon Clinical Multiaxial Inventory (MCMI) for a sample of psychiatric inpatients. Patients were administered the MCMI shortly following admission and shortly preceding discharge. As would be expected theoretically, results indicated that stability estimates were greater for the basic personality scales than for the symptom scales. These results were also compared with results from a previous study investigating the stability of MCMI scales. Overall, stability coefficients for the inpatient sample were lower than those reported for other samples. Possible explanations for this and other findings are discussed.     

The Big Five personality factors as a model for the structure of children's peer nominations

The validity and usefulness of the five‐factor theory of personality as a model for children's peer nominations is assessed. Eighty‐nine groups of ten school children, attending the same class, aged 9 to 12 years, nominated the pupil that was the most or the least typical example for 25 bipolar trait pairs, covering the ‘Big Five’ personality factors. Factor analysis of summed and transformed peer nominations for the total sample shows that children's nominations can be represented by three factors: Agreeableness, a combined Extraversion–Emotional Instability component, and a combined Intellect–Conscientiousness factor. A second study with a smaller but independent sample confirms the factorial structure of the peer nomination scales. The reasons for the less differentiated peer nomination structure of children and the relevance of multidimensional assessment of peer perception are discussed. Copyright © 2000 John Wiley & Sons, Ltd.     

Evolution of Millon's Personality Prototypes

In 1969, Millon proposed 8 personality prototypes that could be conceptualized at lower levels of severity than the level of the personality disorders. These personalities were fit into a theoretical system that emphasized the strength of the interpersonal attachment and the mode of accommodation. Disorders such as schizophrenia and depression were pictured as a decompensation of the basic personality. This article traces the evolution of Millon's theory from the original inception, through the influence of the 3rd and 4th editions of the Diagnostic and Statistical Manual of Mental Disorders, and onto its present form. Now visualized as resulting from 3 polarities, the model has expanded the number of personalities to include 3 additional prototypes.     

Effects of Theodore Millon's Teaching,Mentorship, Theory,and Scientific Contributions on Health Psychology and Behavioral Medicine Research and Practice

This article summarizes the impact of Theodore Millon's work on the disciplines of health psychology and behavioral medicine over the past 5 decades spanning from the late 1960s to present. The article is written from my perspectives as a graduate student mentored by Millon on through my faculty career as a collaborator in test construction and empirical validation research. Several of the most recent entries in this summary reflect projects that were ongoing at the time of his passing, revealing the innovation and visionary spirit that he demonstrated up until the end of his life. Considering that this summary is restricted to Millon's contributions to the disciplines of health psychology and behavioral medicine, this work comprises only a small portion of his larger contribution to the field of psychology and the areas of personality theory and psychological assessment more broadly.     

Neuroticism: how does one slice the PI(e)?

Costa and McCrae's operationalization of the Five-Factor Model, the Neuroticism, Extraversion, and Openness Personality Inventory—Revised (NEO-PI-R; Costa and McCrae, 1992a), measures five broad dimensions of personality: Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness. According to Costa and McCrae, the Neuroticism (N) domain scale subsumes six facets. Although derived rationally and tested factor analytically, the factorial structure of the facet scales has yet to be unequivocally confirmed with analytic methods imposed at the item level. Using confirmatory and exploratory factor-analytic techniques, this study examines and tests the structure of the N domain scale of the NEO-PI-R. Confirmatory factor analysis indicates poor replication of the structure of the N scale. Results of the exploratory factor analysis indicate that while three of the facets replicated quite well, the other three factors did not correspond to Costa and McCrae's formulation. Future research should elaborate on the factorial structure and construct validity of the N facet scales, especially if they are to be used and interpreted in personality and clinical assessment. © 1997 by John Wiley & Sons, Ltd.     

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.     

Theodore Millon's Contributions to Conceptualizing Personality Disorders

We review Theodore Millon's contributions to conceptualizing personality disorders in contemporary clinical science and practice. Millon worked tirelessly across professional domains and theoretical orientations, developing a rich integrative theory of personality and its pathology, directly and indirectly impacting the evolving iterations of the Diagnostic and Statistical Manual of Mental Disorders (DSM–III through DSM–5), and advocating for the personality disorders through his contributions to cofounding the International Society for the Study of Personality Disorders and the Journal of Personality Disorders. We conclude with a closer look at Millon's final major contributions to conceptualizing personality disorders as well as the strengths and limitations of his approach.