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.     

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.     

Kinetic Family Drawings and MMPI diagnostic indicators in adolescent psychiatric inpatients

Correlations among Kinetic Family Drawings and MMPI indicators of depressive, anxiety, behavioral, and thought disorders and diagnostic category were estimated for a group of 52 adolescent psychiatric inpatients. No statistically significant values were found between test indicators and corresponding MMPI scales or diagnoses, although MMPI D and Sc scales were significantly related to diagnosis. Results do not support the concurrent or construct validity of the drawings.     

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).     

Discriminant and convergent validity of the SCL-90 in psychiatric inpatients

Examined the convergent and discriminant validity of the SCL-90 in a group of 113 psychiatric inpatients and determined the degree of reactivity to several common response sets. The nine SCL-90 dimensions were found to correlate with analogous measures from other tests, and thus showed convergent validity, but were also found to correlate with nonanalogous measures, an indication of low discriminant validity. In addition, the dimensions correlated with the three MMPI validity scales, suggesting their reactivity to response bias. These findings were interpreted as indicating that the SCL-90 has limited use with psychiatric inpatients at present, although it may be useful as a brief screening device for disposition and referral.     

A taxometric analysis of the MMPI-2 Depression scales

The MMPI (Hathaway & McKinley, 1943) and MMPI-2 (Butcher et al., 2001) have long been used as measures of psychopathology. Both clinicians and researchers have noted the widespread existence of negative affectivity on the MMPI and MMPI-2 that may elevate scale scores and eclipse the tests' ability to differentiate depression from other clinical disorders. Using taxometric analyses, in this study we sought to test directly whether the MMPI-2 depression scales could differentiate patients with depressive symptoms from patients with other disorders. A large psychiatric sample (N = 2,000) was utilized and analyses were run separately for men and women. Taxometric analyses did not find a MMPI-2 Depression scale cut point that categorizes patients with depressive symptoms from other patients. Rather, these findings support previous studies finding an underlying dimensionality of depression. We discuss implications for MMPI-2 scale use and depression nosology in light of these findings.     

MMPI and Rorschach indices of schizophrenic and depressive diagnoses among adolescent inpatients

Although adolescent norms have been developed for the MMPI (e.g., Marks, Seeman, & Haller, 1974) and Rorschach (e.g., Exner, 1986a), little is known regarding the discriminate diagnostic validity of these measures with adolescents. This study investigated the usefulness of these measures in the detection of depression and schizophrenia among adolescent inpatients. Subjects (mean age = 15.3) consisted of 134 adolescents who received Rorschach and MMPI administrations at hospital admission. Clinical diagnoses resulted in the following groupings for this sample: schizophrenia = 15, dysthymic disorder = 41, major depression = 26, conduct disorder = 28, personality disorder = 18. MMPI scale Sc elevation was found to be the most effective single predictor of schizophrenic diagnoses, with a hit rate of .76, sensitivity of .62, and specificity of .78. Neither MMPI scale D scores nor Rorschach DEPI scores were found to be significantly related to patients' diagnoses. Results were interpreted in terms of prior findings in adult psychiatric populations and in relation to implications for the clinical assessment of adolescents.     

MMPI and Rorschach Indices of Schizophrenic and Depressive Diagnoses Among Adolescent Inpatients

Although adolescent norms have been developed for the MMPI (e.g., Marks, Seeman, & Haller, 1974) and Rorschach (e.g., Exner, 1986a), little is known regarding the discriminate diagnostic validity of these measures with adolescents. This study investigated the usefulness of these measures in the detection of depression and schizophrenia among adolescent inpatients. Subjects (mean age = 15.3) consisted of 134 adolescents who received Rorschach and MMPI administrations at hospital admission. Clinical diagnoses resulted in the following groupings for this sample: schizophrenia = 15, dysthymic disorder = 41, major depression = 26, conduct disorder = 28, personality disorder = 18. MMPI scale Sc elevation was found to be the most effective single predictor of schizophrenic diagnoses, with a hit rate of .76, sensitivity of .62, and specificity of .78. Neither MMPI scale D scores nor Rorschach DEPI scores were found to be significantly related to patients' diagnoses. Results were interpreted in terms of prior findings in adult psychiatric populations and in relation to implications for the clinical assessment of adolescents.     

Discriminating between alcoholic and nonalcoholic blacks and whites on the MMPI

The purpose of the present study was to investigate the influence of race (black, white) on the MMPI performance of alcoholic and nonalcoholic inpatients. Subjects were 73 (27 black, 46 white) male alcoholic inpatients and 73 (27 black, 46 white) male nonalcoholic psychiatric inpatients. While black and white alcoholics failed to differ on the MMPI, white alcoholics presented as less disturbed and black alcoholics as less defensive and distressed, compared to their respective nonalcoholic counterparts. Furthermore, only white alcoholics were accurately identified by the MMPI 2-4/4-2 high-point pair combination and only white alcoholics achieved more high-point pairs containing Scale 4 relative to nonalcoholic controls.     

Sensitivity of the Faschingbauer abbreviated MMPI to hospitalized adolescents

Comparisons were obtained between Faschingbauer's abbreviated MMPI (FAM) and the standard MMPI for a sample of hospitalized adolescent psychiatric patients. The results showed close statistical correspondence, highly correlated scale group means, and high comparability in identifying valid and invalid profiles. Additionally, the FAM was successful in predicting several gross indices of psychopathology as well as high-point elevations on the standard-form MMPI. A replication supported the stability of these findings.     

The Mezzich MMPI regression formula revisited

In a sample of depressed psychiatric inpatients, the Mezzich regression formula, based on five MMPI scales, correlated moderately with clinicians' judgments and yielded few false negative diagnoses in identifying patients with unipolar Major Depressive Disorder, but was less effective in eliminating false positives.     

MMPI validity scales and behavioral disturbance in psychiatric inpatients.

Sixty psychiatric inpatients were assigned to one of three groups on the basis of F and K MMPI validity scales. Staff ratings of patient behavior and recorded incidents of "acting-out" behavior were obtained for patients with: (a) "plea for help" validity profiles, (b) hyper-defensive profiles, and (c) average profiles. Patients with "plea for help" profiles were perceived as "acting-out" more frequently and engendering more feelings of frustration than patients in the other groups. These patients account for 77% of the incidents of inappropriate, destructive behavior and 83% of the seclusions in the patients sampled. Although the "plea for help" profile is considered invalid in some scoring systems, results suggest that this validity profile may be useful in treatment planning.     

Validation of a Theory-Driven Profile Interpretation of the Dutch Short Form of the MMPI Using the TAT Social Cognitions and Object Relations Scale (SCORS)

Sixty psychiatric inpatients were assigned to one of three groups on the basis of F and K MMPI validity scales. Staff ratings of patient behavior and recorded incidents of "acting-out" behavior were obtained for patients with: (a) "plea for help" validity profiles, (b) hyper-defensive profiles, and (c) average profiles. Patients with "plea for help"profiles were perceived as "acting out" more frequently and engendering more feelings of frustration than patients in the other groups. These patients account for 77% of the incidents of inappropriate, destructive behavior and 83% of the seclusions in the patients sampled. Although the "plea for help"profile is considered invalid in some scoring systems, results suggest that this validity profile may be useful in treatment planning.     

Differentiating between schizophrenic and manic inpatients by means of the MMPI

Forty-five psychiatric inpatients with DSM-III diagnoses of schizophrenia and 31 inpatients with DSM-III diagnoses of bipolar disorder (and currently manic) were compared on the MMPI. Results indicated that although the schizophrenic patients achieved significantly higher scores on several of the MMPI scales (F, Pt, Sc, Si), these findings were of questionable clinical significance. On the other hand, the schizophrenic group did produce a significantly greater percentage of MMPI high-point pairs containing Scale 8(Sc): that is, 64.4% versus 35.5%.     

Stability of MMPI scale scores within four codetypes across forty years

The changes in the standard validity and clinical scales on the Minnesota Multiphasic Personality Inventory (MMPI) were examined within four frequently occurring codetypes (Spike 4, 2-4/4-2, 2-7/7-2, and 6-8/8-6) in samples of psychiatric patients over a time span of 40 years. The validity and clinical scale scores within these four codetypes were very stable over this time span with differences in the range of only a few T-score points. These results are very similar to those reported by Pancoast and Archer (1989) who found remarkable stability in the MMPI scale scores of normal adult samples across 40 years.     

Concordance of the MCMI-II, the MMPI, and Axis I discharge diagnosis in psychiatric inpatients.

Discriminant functions of the MMPI and the MCMI-II were compared in a sample of 166 hospitalized psychiatric patients with discharge diagnoses of affective disorder (63), schizophrenia (26), substance abuse (35), and other disorders (42). Of special interest was the comparative diagnostic utility of the two instruments in regards to DSM-III-R Axis I diagnoses. Both tests performed reasonably well in the discriminant function analyses; however, the MCMI-II achieved a somewhat superior overall hit rate with this sample of inpatients (79% to 68%). This difference was tied to greater accuracy of the MCMI-II for identifying the affective disorders group.     

Concordance of the MCMI-II,the MMPI,and Axis I Discharge Diagnosis in Psychiatric Inpatients

Discriminant functions of the MMPI and the MCMI-II were compared in a sample of 166 hospitalized psychiatric patients with discharge diagnoses of affective disorder (63), schizophrenia (26), substance abuse (35), and other disorders (42). Of special interest was the comparative diagnostic utility of the two instruments in regards to DSM-III-R Axis I diagnoses, Both tests performed reasonably well in the discriminant function analyses; however, the MCMI-II achieved a somewhat superior overall hit rate with this sample of inpatients (79% to 68%). This difference was tied to greater accuracy of the MCMI-II for identifying the affective disorders group.     

Discriminant validity of the MMPI for borderline personality disorder

This study explores the discriminant validity of the MMPI in relationship to the DSM-III and the Diagnostic Interview for Borderlines (DIB) constructs of Borderline Personality Disorder (BPD). A two-way analysis of variance model assessed differences between inpatients (n = 42) and outpatients (n = 42) and between BPD and nonBPD patients. We compare the best discriminant model for the current samples with previous BPD discriminant functions. The present study assesses a wider range of psychopathology in which the MMPI appears to be relatively insensitive to the BPD construct while retaining the high specificity reported in previous studies. Implications for the use of the MMPI as a diagnostic instrument are discussed.     

Development of a short form for the MMPI-2 based on scale elevation congruence

The length of the Minnesota Multiphasic Personality Inventory (MMPI) is often considered a barrier to its use, leading to the development of short forms. Two methods of abbreviating the revised MMPI have now been developed. One agrees poorly with the long form in terms of which scales are elevated. The second ensures perfect congruence in which scales are elevated but requires computer administration. This article describes the development of a short form representing a compromise approach. The short form was derived using 800 psychiatric inpatients and cross-validated with samples of 658 inpatients and 266 outpatients. It is briefer than the computerized short form but does not achieve perfect congruence with the full inventory. It is longer than earlier noncomputerized short forms but demonstrates greater scale elevation congruence with the full inventory and allows estimates of more scales. The short form offers a reasonable alternative when the full inventory is impractical.