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.     

Derivation and implications of MMPI cluster groups in clinically depressed inpatient females.

The purpose of this study was to subclassify clinically depressed patients based on a cluster-analytic examination of the MMPI. Subjects were 79 female inpatients with major depression. A cluster analysis of the MMPI validity and clinical scales resulted in three clusters labeled psychotic (287 MMPI profile), hostile (24 MMPI profile), and histrionic (32 MMPI profile) depression. The psychotic group exhibited the greatest depression as measured by the Beck Depression Inventory (BDI). The psychotic and hostile groups, however, did not differ on other associated aspects of depression, such as negative cognitions, nonassertiveness, or personality style. The hostile group reported the fewest physical difficulties and the most excessive alcohol use. The groups, however, did not differ on other aspects of depression history or presentation such as family history of depression or previous hospitalizations. A repeated measures ANOVA for the three cluster groups on the BDI at admission, discharge, and 6 months after discharge indicated that all groups showed improvement at discharge but that only the hostile depressive group continued to show improvement at the 6-month follow-up.     

Derivation and Implications of MMPI Cluster Groups in Clinically Depressed Inpatient Females

The purpose of this study was to subclassify clinically depressed patients based on a cluster-analytic examination of the MMPI. Subjects were 79 female inpatients with major depression. A cluster analysis of the MMPI validity and clinical scales resulted in three clusters labeled psychotic (287 MMPI profile), hostile (24 MMPI profile), and histrionic (32 MMPI profile) depression. The psychotic group exhibited the greatest depression as measured by the Beck Depression Inventory (BDI). The psychotic and hostile groups, however, did not differ on other associated aspects of depression, such as negative cognitions, nonassertiveness, or personality style. The hostile group reported the fewest physical difficulties and the most excessive alcohol use. The groups, however, did not differ on other aspects of depression history or presentation such as family history of depression or previous hospitalizations. A repeated measures ANOVA for the three cluster groups on the BDI at admission, discharge, and 6 months after discharge indicated that all groups showed improvement at discharge but that only the hostile depressive group continued to show improvement at the 6-month follow-up.     

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.     

MMPI response-set characteristics among adolescents

This study examined the Minnesota Multiphasic Personality Inventory (MPPI) profile characteristics for five different response sets in adolescent populations employing adolescent MMPI norms. In general, findings for "all-true" and "all-false" adolescent profiles were highly similar in shape and elevation to those reported in the adult literature (Graham, 1977; Lachar, 1974), whereas random profiles on adolescent norms differed substantially from adult-norm random profiles in shape but not elevation. The characteristics of "fake good" or "fake bad" response sets were investigated by the use of adolescent subjects in two settings. Ninety-four public high-school students were administered the MMPI with standard and "fake bad" instructions, and 24 adolescents in inpatient psychiatric treatment were administered the MMPI under standard and "fake good" instructions. The MMPI profiles generated by special instructional sets were analyzed in relation to the subject's age, sex, race, and actual MMPI profile features. Findings indicated that although sex and race effects were evident in normal adolescents' attempts to simulate psychopathology on the MMPI, teenagers generally produce profiles containing grossly exaggerated symptom patterns that are relatively easy to detect as invalid. In contrast, it was found that a substantial number of psychiatrically disturbed adolescents may effectively simulate normal profiles and that effectiveness in these attempts was related to greater age and lower actual MMPI T-score values on the Hs and Hy scales.     

MMPI Response-Set Characteristics Among Adolescents

This study examined the Minnesota Multiphasic Personality Inventory (MPPI) profile characteristics for five different response sets in adolescent populations employing adolescent MMPI norms. In general, findings for "all-true" and "all-false" adolescent profiles were highly similar in shape and elevation to those reported in the adult literature (Graham, 1977; Lachar, 1974), whereas random profiles on adolescent norms differed substantially from adult-norm random profiles in shape but not elevation. The characteristics of "fake good" or "fake bad" response sets were investigated by the use of adolescent subjects in two settings. Ninety-four public high-school students were administered the MMPI with standard and "fake bad" instructions, and 24 adolescents in inpatient psychiatric treatment were administered the MMPI under standard and "fake good" instructions. The MMPI profiles generated by special instructional sets were analyzed in relation to the subject's age, sex, race, and actual MMPI profile features. Findings indicated that although sex and race effects were evident in normal adolescents' attempts to simulate psychopathology on the MMPI, teenagers generally produce profiles containing grossly exaggerated symptom patterns that are relatively easy to detect as invalid. In contrast, it was found that a substantial number of psychiatrically disturbed adolescents may effectively simulate normal profiles and that effectiveness in these attempts was related to greater age and lower actual MMPI T-score values on the Hs and Hy scales.     

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.     

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.     

Pain-related correlates of MMPI profile subgroups among back pain patients

The MMPI profiles of 96 male and 218 female patients attending a back pain clinic in a private university-affiliated, orthopedic hospital were analyzed by a hierarchical clustering procedure. The clustering procedure produced four male and four female profile subgroups. The subgroups were compared with one another on the basis of patients' responses to the Cornell Medical Index and revised McGill Pain Assessment Questionnaire. Within the male and female patient cohorts it was found that profile subgroups featuring elevated clinical scales showed greater disruptions of daily activities than did subgroups with relatively unelevated profiles. However, profile subgroups with elevations primarily on the neurotic triad scales reported greater affective disturbance and disruption of daily activities than did subgroups with elevations on both the neurotic triad and relatively psychotic scales. In addition, profile subgroups with subclinical elevations on the neurotic triad scales appeared to have adjusted to their pain experience more poorly than did subgroups that featured scores on nearly all clinical scales that were within one standard deviation of the mean. Suggestions are provided for the use of the MMPI in assessing chronic pain patients and future research regarding cluster analyses of patients' MMPI profiles.     

The MMPI-2: A Contemporary Normative Study of Midwestern Family Medicine Outpatients

For more than 60 years it has been known that profiles from the Minnesota Multiphasic Personality Inventory (MMPI), obtained from medical patients, are elevated when scores are plotted using general population norms. These elevations have been most apparent on the neurotic triad (NTd), the first 3 clinical scales on the MMPI profile. More than 45 years have passed since a nonreferred, normative sample of MMPIs was established from 50,000 consecutive medical outpatients. We present comparable but contemporary normative data for the revised MMPI (MMPI-2) based on a nonreferred sample of 1,243 family medicine outpatients (590 women; 653 men). As true for the original MMPI, contemporary medical outpatients have profiles that are significantly different, clinically and statistically, from the general population norms for the MMPI-2. This is particularly evident in elevations on the NTd. New normative tables of uniform medical T (UMT) scores were developed following the procedures used to create the uniform T scores for the MMPI-2. Measures of internal consistency are reported; test-retest reliability was established over a mean of 3.7 weeks, and results characterizing the stability of the validity and clinical scales are presented.     

Assessing the person reliability of an individual MMPI protocol

This study investigated various measures commonly employed to assess the person reliability of an individual Minnesota Multiphasic Personality Inventory (MMPB protocol. Specifically, relationships among indices of person reliability and the standard MMPI validity scales were examined using the responses of 82 subjects who completed the MMPI on two occasions separated by 1 week. Person reliability indices were based on within-occasion responses to identical and to psychologically similar items, and on three across-occasion response consistency measures. The validity scales, namely, the L, F, K, and Cannot Say scales, showed higher test-retest stability than the within-occasion person reliability indices. Further, the validity scales and person reliability indices appeared to reflect multiple facets of dependable responding. Interestingly, an individual's tendency to change responses to MMPI items from the test to the retest was significantly predictable. Clinical implications of these findings were derived.     

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.     

Development and Validation of a Dutch Translation of the Big Five Inventory (BFI)

The MMPI profiles of 74 low back pain patients who had previously been classified as "functional," "organic," or "mixed" were sorted into six profile groups. The six profile groups were those used by Pichot, Perse, Lekeous, Dureau, Perez, and Rychewaert (1972); denial, "conversion V" without defensiveness, "conversion V" with defensiveness, depressed/anxious, psychotic and normal. Results indicate that all six profile types are welt represented in the low back pain group. Evidence is also presented which shows that each of the pathological MMPI profile types examined across "functional," "organic," and "mixed" classification is significantly more elevated than a normal profile group on two scales (Lb, DOR) designed to measure functional aspects of pain. Pathological MMPI profile groups did not differ significantly from each other on the "functional," pain scales. The data presented in this study point to the relationship of various forms of psychopathology with "functional pain." The findings of this stud v would not support a homogeneous "pain personality" for low back pain patients. However, combined "conversion V" profiles accounted for 58% of the "functional" group, 45% of the "mixed" group and 35% of the "organic" group.     

Personality organization as an aspect of back pain in a medical setting.

The MMPI profiles of 74 low back pain patients who had previously been classified as "functional,"organic," or "mixed" were sorted into six profile groups. The six profile groups were those used by Pichot, Perse, Lekous, Dureau, Perez, and Rychewaert (1972); denial, "conversion V" without defensiveness, "conversion V" with defensiveness, depressed/anxious, psychotic and normal. Results indicate that all six profile types are well represented in the low back pain group. Evidence is also presented which shows that each of the pathological MMPI profile types examined across "functional," "organic," and "mixed" classification is significantly more elevated than a normal profile group on two scales (Lb, DOR) designed to measure functional aspects of pain. Pathological MMPI profile groups did not differ significantly from each other on the "functional" pain scales. The data presented in this study point to the relationship of various forms of psychopathology with "functional pain." The findings of this study would not support a homogeneous "pain personality" for low back pain patients. However, combined "conversion V" profiles accounted for 58% of the "functional" group, 45% of the "mixed" group and 35% of the "organic" group.     

The derivation of gender-role scales GM and GF for MMPI-2 and their relationship to Scale 5 (Mf).

Separate scales for masculine and feminine gender roles (GM and GF, respectively) were developed for the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) based on the item endorsements of men and women in the restandardization sample. Each scale reflects the pattern of answers of a majority of the members of the respective sexes. There are no items in common between the two scales, and they correlate -.10 with each other for both men and women. Distributional, temporal stability, and internal consistency characteristics were analyzed, as well as their item overlap and correlations with the basic profile scales. These separate unipolar scales were contrasted with Scale 5 (the Masculinity-Femininity scale, Mf), the traditional measure of these constructs in the Minnesota Multiphasic Personality Inventory (MMPI). The conjoint use of GM and GF to form gender-role groups is recommended to supplement and clarify the ambiguity of midlevel scores on Scale 5.     

The Derivation of Gender-Role Scales GM and GF for MMPI-2 and Their Relationship to Scale 5 (Mf)

Separate scales for masculine and feminine gender roles (GM and GF, respectively) were developed for the Minnesota Multiphasic Personality inventory-2 (MMPI-2) based on the item endorsements of men and women in the restandardization sample. Each scale reflects the pattern of answers of a majority of the members of the respective sexes. There are no items in common between the two scales, and they correlate -.10 with each other for both men and women. Distributional, temporal stability, and internal consistency characteristics were analyzed, as well as their item overlap and correlations with the basic profile scales. These separate unipolar scales were contrasted with Scale 5 (the Masculinity-Femininity scale, Mf), the traditional measure of these constructs in the Minnesota Multiphasic Personaaty Inventory (MMPI). The conjoint use of GM and GF to form gender-role groups is recommended to supplement and clarify the ambiguity of midleveI scores on Scale 5.     

The validity and utility of the positive presentation management and negative presentation management scales for the Revised NEO Personality Inventory

Schinka, Kinder, and Kremer developed "validity" scales for the Revised NEO Personality Inventory (NEO PI-R; Costa & McCrae) to detect underreporting-the Positive Presentation Management (PPM) Scale and overreporting-the Negative Presentation Management (NPM) Scale. In this investigation, the clinical utility of these scales was examined using the established validity scales from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher et al.) as the referent. The sample was composed of 370 psychiatric patients who completed the NEO PI-R and the MMPI-2 as part of a routine evaluation. Results indicated that response distortion compromised the utility of the NEO PI-R domain scales. Moreover, the PPM and NPM scales and an NPM-PPM index significantly differentiated invalid under-and overreporting groups from a valid responding group. The PPM and NPM-PPM index were adequate in classifying under- and overreporters, respectively.     

A new approach to the assessment of structural personality pathology: Theory-driven profile interpretation of the Dutch Short Form of the MMPI

This article presents a new approach to the assessment of structural personality pathology: theory-driven profile interpretation of the Dutch Short Form of the MMPI (DSFM). The assessment method integrates results of a self-report personality questionnaire with psychodynamic theoretical concepts to yield a working hypothesis about underlying structural features of personality. As an illustration, results of a validation study with psychotic phenomena in projective drawings as the external criterion are described. Results show that the DSFM profiles, that are presumed to measure psychotic vulnerability predict psychotic phenomena in projective drawings, after statistically controlling for the effect of age, the single scales that are being used to construct the profiles and their statistical interaction.Results suggest that theory-driven profile interpretation of the DSFM may be considered a time and cost efficient method to derive a working hypothesis about structural vulnerability.