Utility of the MMPI in a geriatric population

Despite the popularity of the Minnesota Multiphasic Personality Inventory (MMPI), there exists a relative dearth of normative and validity research regarding its use with persons over the age of 60. Our investigation was designed to examine the MMPI performance of both a normal and a clinical sample of older men and women. Specifically, a nonpatient community sample of 204 subjects and an outpatient psychiatric sample of 30 subjects, between the ages of 60 and 90, were administered the MMPI as well as structured psychiatric interview, the Psychiatric Status Schedule (PSS). Results revealed that, on most of the MMPI scales, the mean scores were well above the norms (i.e., 5-10 t-score points). Through comparisons between the clinical and community subjects as well as between MMPI and PSS performance, the MMPI demonstrated substantial discriminative and concurrent criterion validity within this geriatric sample. The results of the study suggest that, with a few important exceptions, the MMPI, as generally utilized, is valid for use in the geriatric population.     

A validity scale sign calling for caution in the interpretation of MMPIs among psychiatric inpatients

Three expert MMPI judges classified 100 psychiatric inpatients as psychotic or non-psychotic on the basis of their MMPIs. Validity scale data, as well as clinical scale scores, were included for 50 of the profiles, while the validity scale scores were withheld from the judges for the remaining 50 profiles. Within each of the above two groups, half had a "positive" validity scale sign (a defensive validity scale configuration defined as L or K greater than or equal to 70, or both greater than or equal to 60) and half had a negative validity scale sign, indicating a lack of defensiveness. Using actual diagnosis as the external criterion, results indicated that the majority of defensive psychotic patients produced clinical scale configurations which appeared nonpsychotic to the judges. Conversely, the majority of nondefensive nonpsychotics produced psychotic-appearing clinical scale configurations. These two types of test misses suggest that K corrections on MMPI scales relating to psychosis are not optimal for psychiatric inpatients. Guidelines were developed for interpreting defensive profiles.     

Comparison of three abbreviated MMPIs for psychiatric patients and normals.

Two studies, one using 242 psychiatric patients and the other 120 normal college students, were conducted to evaluate the predictive potential of three abbreviated MMPIs namely the Midi-Mult, Hugo abbreviated MMPI and Faschingbauer abbreviated MMPI. With regard to psychiatric inpatients, the Faschingbauer abbreviated MMPI-scale group means were markedly similar, highly correlated, and seemed to be a fairly accurate substitute for the MMPI in predicting clinical types. Numerous deficiencies were evident when using the Midi-Mult or Hugo abbreviated MMPI, especially with regard to classification analysis concerning validity, mean raw score scale differences and high point codes. In contrast, results from a normal college sample showed close statistical correspondence, high comparability in identifying valid and invalid profiles as well as high correspondence with respect to high point codes and general profile elevations regardless of which abbreviated form was used.     

Fantasy proneness and psychopathology

Fantasy prone persons ("fantasizers") selected from "normal" populations report experiences associated with psychopathology in clinical populations (e.g., fantasies that reach hallucinatory proportions, difficulty discriminating reality from fantasy). In Study 1, we administered objective (MMPI) and projective (Rorschach) measures to high fantasy prone individuals (upper 4% of college population), medium fantasy prone individuals (middle range), and nonfantasizers (lowest 4%). Subjects who were fantasizers appeared to use fantasy for defensive or adaptive purposes compared with others and produced 8/9 modal code types on the MMPI. On the basis of the MMPI findings, a subset of fantasizers could be described as exhibiting a significant degree of psychopathology. In Study 2, a second sample of fantasy prone individuals could not be distinguished from comparison groups in contacts with professionals for help with psychological problems, use of psychotropic medication, or number of close friendships. Although fantasizers perceived themselves as less well adjusted than comparison subjects and reported greater difficulty in distinguishing fantasy from reality, most fantasizers rated their psychological functioning as adequate and above and did not differ from less fantasy prone subjects in ratings of positivity of self-concept. As demonstrated in Study 1, a subset of fantasizers did appear to be more pathological than other subjects were, with three fantasizers reporting a history of psychiatric hospitalizations. It is estimated that between 10 and 20% of fantasizers exhibit significant signs of maladjustment/psychopathology; however, as a rule, fantasy proneness does not appear to be antecedent to severe manifestations of psychopathology.     

Subtle-obvious scales of the MMPI: indicators of profile validity in a psychiatric population.

This study explored the usefulness of the Minnesota Multiphasic Personality Inventory (MMPI) Subtle-Obvious scales as profile validity indicators with a inpatient psychiatric population. Some 292 MMPI profiles were utilized and divided into overreporters, underreporters, and standard reporters, based on their Subtle-Obvious scale scores. Reporting style was shown to be unrelated to actual patient pathology because of the lack of relationship between reporting style and diagnostic categorization according to the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, 1987) Axis I and II. Comparisons of MMPI profiles of the three groups revealed that overreporters endorsed more pathology on the MMPI clinical scales than did either underreporters or standard reporters. The same pattern of response style was demonstrated by subjects on another objective measure, the Beck Depression Inventory, whereas on a projective measure, the Rorschach Inkblot Test, there were no differences between groups. These findings suggest that clinicians may want to utilize the Subtle-Obvious scales to gain information about MMPI profile validity. Specifically, profiles of patients identified as overreporters should be interpreted with caution so as to not overstate their level of pathology.     

Subtle-Obvious Scales of the MMPI: Indicators of Profile Validity in a Psychiatric Population

This study explored the usefulness of the Minnesota Multiphasic Personality Inventory (MMPI) Subtle-Obvious scales as profile validity indicators with a inpatient psychiatric population. Some 292 MMPI profiles were utilized and divided into overreporters, underreporters, and standard reporters, based on their Subtle-Obvious scale scores. Reporting style was shown to be unrelated to actual patient pathology because of the lack of relationship between reporting style and diagnostic categorization according to the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, I987) Axis I and II. Comparisons of MMPI profiles of the three groups revealed that overreporters endorsed more pathology on the MMPI clinical scales than did either underreporters or standard reporters. The same pattern of response style was demonstrated by subjects on another objective measure, the Beck Depression Inventory, whereas on a projective measure, the Rorschach Inkblot Test, there were no differences between groups. These findings suggest that clinicians may want to utilize the Subtle-Obvious scales to gain information about MMPI profile validity. Specifically, profiles of patients identified as overreporters should be interpreted with caution so as to not overstate their level of pathology.     

Development and Validation of Personality Disorder Spectra Scales for the MMPI–2–RF

The purpose of this study was to develop and validate a set of MMPI–2–RF (Ben-Porath &; Tellegen, 2008/2011) personality disorder (PD) spectra scales. These scales could serve the purpose of assisting with DSM–5 PD diagnosis and help link categorical and dimensional conceptions of personality pathology within the MMPI–2–RF. We developed and provided initial validity results for scales corresponding to the 10 PD constructs listed in the DSM–5 using data from student, community, clinical, and correctional samples. Initial validation efforts indicated good support for criterion validity with an external PD measure as well as with dimensional personality traits included in the DSM–5 alternative model for PDs. Construct validity results using psychosocial history and therapists' ratings in a large clinical sample were generally supportive as well. Overall, these brief scales provide clinicians using MMPI–2–RF data with estimates of DSM–5 PD constructs that can support cross-model connections between categorical and dimensional assessment approaches.     

The construct validity of the MMPI alexithymia scale with psychiatric inpatients

Relatively few studies have addressed the issue of the Minnesota Multiphasic Personality Inventory (MMPI) alexithymia scale's construct validity. In this study, the validity of the scale is supported by the finding of a significantly lower percentage of alexithymic individuals in a large sample of psychiatric inpatients than in samples of patients with a variety of physical disorders (i.e., migraine headaches, asthma bronchitis/emphysema, and hypertension). Validity of the scale is further supported through a comparison of the alexithymic and nonalexithymic psychiatric inpatients on a series of Rorschach and MMPI variables. As predicted, alexithymics were less verbally productive, displayed less ability to fantasize, and demonstrated greater defensive pseudonormality. Results suggest the measure may be of value in studies of psychiatric patients as well as those with physical disorders.     

The Construct Validity of the MMPI Alexithymia Scale With Psychiatric Inpatients

Relatively few studies have addressed the issue of the Minnesota Multiphasic Personality Inventory (MMPI) alexithymia scale's construct validity. In this study, the validity of the scale is supported by the finding of a significantly lower percentage of alexithymic individuals in a large sample of psychiatric inpatients than in samples of patients with a variety of physical disorders (i.e., migraine headaches, asthma bronchitis/emphysema, and hypertension). Validity of the scale is further supported through a comparison of the alexithymic and nonalexithymic psychiatric inpatients on a series of Rorschach and MMPI variables. As predicted, alexithymics were less verbally productive, displayed less ability to fantasize, and demonstrated greater defensive pseudonormality. Results suggest the measure may be of value in studies of psychiatric patients as well as those with physical disorders.     

Correspondence of the MMPI and MMPI-168 among incarcerated female felons

This study was designed to assess the correspondence between the MMPI and MMPI-168 for a sample of adult incarcerated female felons. The results indicated a high degree of agreement, median correlation of .79, between corresponding validity and clinical scales of the MMPI-168 and the full MMPI. The MMPI-168 significantly overestimated scales L, F, and D, while it underestimated scales K, Hy, Pd, and Mf. Configural correspondence between the two instruments in terms of profile high points was somewhat less than has been reported for psychiatric populations. However, the MMPI-168 appeared to be a useful short screening instrument for incarcerated female felons with respect to accurate assessment of profile validity, configural correspondence to the full MMPI, and correlations between corresponding scales. Its utility in these respects far exceeds prior attempts to employ the Mini-Mult with a similar sample of incarcerated females.     

Correlates of the Egocentricity Index in child and adolescent outpatients

This study examined the Rorschach and MMPI covariates of Exner's Egocentricity Index, 3r + (2): R, in a sample of child and adolescent outpatients (n = 46). Consistent with previous findings on adult psychiatric inpatients (Barley, Dorr, & Reid, 1985), significant positive correlations were obtained between the Index and M, FM, X + %, and D when controlled for the number of protocol responses. The Egocentricity Index was negatively associated with lambda and, in a subsample of adolescents (n = 19), depression scores. The index bore no significant relationship to either Minnesota Multiphasic Personality Inventory (MMPI) validity or clinical scales, also congruent with earlier investigations. Implications for the interpretation of childrens' Egocentricity Indices are discussed.     

MMPI comparisons of Hispanic- and white-American veterans seeking treatment for alcoholism

Scores of 29 Hispanic- and 46 white-American alcoholics, who voluntarily sought psychiatric treatment for their alcoholism, were compared on the MMPI. It was hypothesized that Hispanic-American alcoholics would be better adjusted than white alcoholics on the validity and clinical scales of the MMPI. The hypothesis was supported, with Hispanic-Americans obtaining significantly lower scores than white veterans on the Pd, Mf, and Si scales. Hispanic and white patients did not differ on the remaining MMPI scales. The mean two-point code for Hispanic subjects was 2-8 (Depression-Schizophrenia) and for white patients 8-2 (Schizophrenia-Depression).     

Correlates of the Egocentricity Index in Child and Adolescent Outpatients

This study examined the Rorschach and MMPI covariates of Exner's Egocentricity Index, 3γ + (2): R, in a sample of child and adolescent outpatients (n = 46). Consistent with previous findings on adult psychiatric inpatients (Barley, Doff, & Reid, 1985), significant positive correlations were obtained between the Index and M, FM, χ + %, and D when controlled for the number of protocol responses. The Egocentricity Index was negatively associated with lambda and, in a subsample of adolescents (n = 19), depression scores. The index bore no significant relationship to either Minnesota Multiphasic Personality Inventory (MMPI) validity or clinical scales, also congruent with earlier investigations. Implications for the interpretation of childrens' Egocentricity Indices are discussed.     

Similarities and differences between MMPI and MMPI-2 applications to the assessment of posttraumatic stress disorder

The purpose of this study was to address the question: Is the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) comparable to the original MMPI in its applicability to the assessment of posttraumatic stress disorder (PTSD) among Vietnam combat veterans? The question was addressed by administering both the original MMPI and MMPI-2 to 29 subjects classified as meeting Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; DSM-III-R) criteria for PTSD and comparing MMPI and MMPI-2 scores in terms of: degree of association, code-type congruence, diagnostic hit rates (when compared to two other clinical samples, and one normal sample), and congruence of the Keane PTSD Scale (PK). Results reveal highly significant correlations between MMPI and MMPI-2 basic scales for the PTSD sample as well as congruence in 2-point codes comparable to previous studies. The MMPI-2 was found to identify effectively PTSD subjects from the other groups. Results also showed a high degree of association between the MMPI and MMPI-2 in regard to PK scores, although minor differences were found in PK raw scores between the two tests. Overall, the findings suggest a high degree of comparability between the MMPI and MMPI-2 in the assessment of PTSD.     

Psychometric Stability of Rewritten MMPI Items

The current form of the Minnesota Multiphasic Personality Inventory (MMPI) has been in use for over 50 years with no revisions in its item content or wording. As part of the MMPI Restandardization Project (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer 1989), 82 of the original items were rewritten. Subjects in this study were administered either the original booklet twice to serve as a baseline or the original and the experimental form (MMPI-AX) in a counterbalanced order. Comparisons were made between the percentage of subjects who responded similarly to the two administrations of the original items and the percentage of subjects responding similarly to the original and rewritten versions of the items. Of the 82 items, only 9 changed significantly and only for one gender. None of the correlations between these 9 items and the MMPI validity, clinical, or special scales they are scored on changed significantly for the rewritten items as compared with the original items.     

The Perceived Stress Scale: Factor structure and relation to depression symptoms in a psychiatric sample

The present study sought to examine the factor structure and psychometric properties of the Perceived Stress Scale (PSS) when administered to psychiatric patients. We also examined predictive validity of the PSS by assessing the association between the Perceived Stress Scale and the Beck Depression Inventory. A heterogeneous sample of 96 psychiatric patients (48 men, 48 women) completed the Perceived Stress Scale (PSS) and the Beck Depression Inventory. Factor analysis of the PSS established that the scale consisted of two factors. The first factor was comprised primarily of items reflecting adaptational symptoms. In contrast, the second factor consisted of items reflecting coping ability. Both factors had an adequate degree of internal consistency. Finally, a series of regression analyses predicting depression found that both factors accounted for unique variance in depression scores in women, but only the first factor accounted for unique variance in men. It is concluded that the PSS is a multidimensional and internally consistent measure of perceived stress.This research was supported by Grant 410-91-1690 from the social sciences and Humanities Research Council of Canada as well as by grants from the Research and Program Evaluation Committee Brockville Psychiatric Hospital.     

Detecting Fake-Good and Fake-Bad MMPI-2 Profiles

This study examined the extent to which the validity scales of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) could identify subjects who were faking bad or faking good and differentiate between psychiatric patients and normal subjects who were faking bad. Subjects were 106 undergraduate college students and 50 psychiatric patients. Results indicate that the mean profiles and optimal cutoff scores resembled those previously reported for the original MMPI. Accurate identification of persons who were faking bad or faking good was achieved. It was possible to differentiate between the psychiatric patients and normal persons who were faking bad, but different cutoff scores were needed to differentiate between normals taking the test under standard instructions and those instructed to fake bad. Optimal cutoff scores were suggested.     

Detecting fake-good and fake-bad MMPI-2 profiles

This study examined the extent to which the validity scales of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) could identify subjects who were faking bad or faking good and differentiate between psychiatric patients and normal subjects who were faking bad. Subjects were 106 undergraduate college students and 50 psychiatric patients. Results indicate that the mean profiles and optimal cutoff scores resembled those previously reported for the original MMPI. Accurate identification of persons who were faking bad or faking good was achieved. It was possible to differentiate between the psychiatric patients and normal persons who were faking bad, but different cutoff scores were needed to differentiate between normals taking the test under standard instructions and those instructed to fake bad. Optimal cutoff scores were suggested.     

Psychometric evaluation of the Dutch Persecutory Ideation Questionnaire (PIQ) and its relation to aggression

Patients with schizophrenia and a violent past more often have persecutory delusions than other types of delusions. The main aim of the present study was to examine the relation between persecutory ideation and self-reported aggression in a community based and clinical population. A second aim was to evaluate the psychometric properties of the Dutch version of the Persecutory Ideation Questionnaire (PIQ; McKay, Langdon, & Coltheart, 2006). From the general population, 269 persons were included as well as 79 inpatients from different psychiatric facilities. In the community based sample, the PIQ appeared to be a reliable and valid instrument to measure persecutory ideation. Evaluation of the PIQ in a sample with patients with a psychotic disorder showed that the PIQ had good criterion validity. In addition, results showed that persecutory ideation was significantly related to self-reported aggression in the community based, and in the clinical sample. Moreover, in the community based sample, this association was higher than that between positive psychopathological experiences in general and aggression in the community based sample. In sum, persecutory ideation can be measured reliably with the PIQ, and there seems a robust relation between persecutory ideation in particular and aggression in both clinical and community based samples.