Empirical correlates of the MMPI-2 Restructured Clinical (RC) Scales in a nonclinical setting

We examined the empirical correlates of the MMPI-2 Restructured Clinical (RC; Tellegen et al., 2003) scales in a nonclinical setting. We administered 12 criterion measures assessing variables expected to be associated differentially with the RC Scales along with the MMPI-2 to a sample of 1,038 college students (Men, N = 407; Women, N = 631). Criteria included measures of somatization, depression, Machiavellian negativism, drug and alcohol abuse, anger, anxiety, social phobias, obsessive-compulsive tendencies, magical ideation, perceptual aberration, lability, and impulsivity. Results demonstrate good convergent and discriminant validity for the RC scales and add to a growing body of empirical correlates of these scales.     

Empirical correlates of the MMPI-2 Restructured Clinical (RC) Scales in mental health, forensic, and nonclinical settings: an introduction

We introduce 3 studies of the empirical correlates of the MMPI-2 Restructured Clinical (RC) Scales: a study by Arbisi, Sellbom, and Ben-Porath (2008/this issue) that expands the range of correlates of the RC scale in mental health settings; an investigation by Sellbom, Ben-Porath, Baum, Erez, and Gregory (2008/this issue) of the empirical correlates of the scales in a forensic setting; and a study by Forbey and Ben-Porath (2008/this issue) examining convergent and discriminant validities of the RC scale in a nonclinical setting. To serve as a general introduction to the 3 new empirical studies presented in this special section, we begin with a review of the existing literature on the RC scales and briefly describe these studies.     

Predictive validity of the MMPI-2 Restructured Clinical (RC) Scales in a batterers' intervention program

We examined the convergent and discriminant validity of the MMPI-2 Restructured Clinical (RC) scales in predicting relevant historical variables, treatment success, and recidivism in offenders enrolled in a batterers' intervention program. We used a sample studied previously by Petroskey, Ben-Porath, and Erez (2002), which included an ethnically diverse group of 483 men enrolled in a psychoeducational batterer's intervention program. We coded various historical variables (e.g., criminal history, substance abuse problems, mental health treatment, anger problems, and amount of partner violence), treatment dismissal, and recidivism up to 1 year posttreatment. Correlational analyses with the historical variables provided evidence of convergent and discriminant validity of the RC scales in this forensic sample. Regression analyses showed that these scales added to the historical variables in predicting treatment failure and recidivism. Relative risk analyses indicated the extent to which individuals entering treatment with elevated scores on RC4 and RC9 were at increased risk for these negative outcomes.     

Clinical utility of the MMPI-2 Restructured Clinical (RC) Scales in therapeutic assessment: a case study

In the following article, we provide a case study on a 25-year-old man who was released from a crisis stabilization unit following a suicide attempt. After completing a diagnostic intake, the client participated in a Therapeutic Assessment (Finn, 1996, 2003), which included the MMPI-2 (Butcher et al., 2001) and the Incomplete Sentences Blank (Rotter & Rafferty, 1950). In particular, in the article, we focus on how the Restructured Clinical (RC; Tellegen et al., 2003) scales can be used to form a personological conceptualization of the client. The RC scales measure important personality and affective trait dimensions including demoralization and both positive and negative affect, which allows for a clear explanation of the underlying etiological factors that influence a client's negative emotional experience. In this article, we highlight how explaining these underlying personality characteristics to the client within the framework of therapeutic assessment allowed for an increase in his insight.     

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.     

Empirical correlates of common MMPI-2 two-point codes in male psychiatric inpatients

Empirical correlates of common Minnesota Multiphasic Personality Inventory-2 (MMPI-2) 2-point codes were identified for a sample of 1,213 inpatient men. A comprehensive standardized review of the hospital record was undertaken, and clinically relevant demographic, diagnostic, and behavioral information was extracted from intake summaries obtained prior to administration of the MMPI-2. Nonmutually exclusive psychiatric diagnoses found in the sample included substance abuse or dependence, schizophrenia, depression, bipolar affective disorder post-traumatic stress disorder, and other anxiety disorders as well as personality disorders. Subsamples consisting of the five most frequently obtained well-defined 2-point code types were selected, and empirical correlates of each code type were then identified and described. Remarkable consistency was found between the empirical correlates of the code types obtained in this study and the correlates of the same code types described by other investigators 40 years ago.     

The MMPI-2 Clinical Scales and Restructured Clinical (RC) Scales: comparative psychometric properties and relative diagnostic efficiency in young adults

We examined the psychometric properties of the Restructured Clinical (RC) scales (Tellegen et al., 2003) of the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) in a large sample (N = 744) of 18-year-old college freshman. We found that the RC scales demonstrated good convergence with their Clinical scale counterparts and were more distinctive than the Clinical scales. The patterns of discriminant correlations for the RC scales were slightly clearer than those of the Clinical scales and a set of other existing MMPI-2 scales. Diagnostic efficiency statistics based on Clinical and RC scale elevation status did not differ appreciably. However, the diagnostic efficiency statistics of cutoff scores derived from mean RC and Clinical scale T scores improved on the traditional scale elevation measures. We consider the clinical implications of these findings.     

The factor structure of the MMPI-2 Restructured Clinical (RC) scales

We investigated the MMPI-2 Restructured Clinical (RC) scales (Tellegen et al., 2003) to determine if they had a more differentiated factor structure than the MMPI-2 Clinical scales. When factored alone, the RC scales had a 5-dimensional structure; the Clinical scales had 3 dimensions. When factored in combination with the Content scales, both sets of scales produced 5 dimensions. However, the RC and Content factors generally provided more efficient and logical markers of psychopathology than the Clinical and Content factors. We discuss interpretive considerations.     

Empirical correlates and expanded interpretation of the MMPI-2-RF Restructured Clinical Scale 3 (Cynicism)

The recent release of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) has received much attention from the clinical psychology community. Particular concerns have focused on Restructured Clinical Scale 3 (RC3; Cynicism). This article briefly reviews the major criticisms and responses regarding the restructuring of Clinical Scale 3. The primary purpose of the article is to provide expanded interpretive perspectives on RC3 by correlating it with a selection of external variables that are conceptually related. Forty undergraduate volunteers completed the MMPI-2-RF as well as measures of Machiavellianism, alienation, faith in people, and locus of control. Results showed strong correlations between RC3 and Machiavellianism (.47) and alienation (.60), with item-level information that may extend existing interpretive statements to include, not just a cynical view of others, but a willingness to intentionally lie, cheat, deceive, and manipulate (i.e., Machiavellianism).     

An investigation of the psychometric properties of the MMPI-2 Restructured Clinical (RC) scales with mental health inpatients

In this study, we compared the internal psychometric properties and external correlates of the MMPI-2 (Butcher et al., 2001; Tellegen et al., 2003) Restructured Clinical (RC) scales and corresponding MMPI-2 non-K-corrected Clinical scales in a sample of 280 men and 264 women admitted to inpatient psychiatric units. We evaluated the internal psychometric properties of the RC and Clinical scales by intercorrelation analyses and alpha coefficients. We investigated external correlates of scores from the RC and Clinical scales using selected chart variables, selected Symptom Checklist 90-Revised (Derogatis, 1983, 1994) items, and clinician ratings on the Brief Psychiatric Rating Scale (Overall & Gorham, 1988). Results showed psychometric support for the RC scales in terms of improved intercorrelation patterns and comparable or greater alpha coefficients. Further, external correlational analyses revealed varying degrees of evidence of improvement in convergent and discriminant validity.     

Personality and psychopathology: mapping the MMPI-2 Restructured Clinical (RC) Scales onto the Five Factor Model of personality

The MMPI-2 Restructured Clinical (RC) Scales (Tellegen et al., 2003) reflect a recent shift for this instrument toward the measurement of contemporary conceptualizations of psychopathology. The current investigation aimed to replicate and extend the theoretical and empirical linkage between the RC scales and dimensional models of personality and to investigate how well the RC scales conform to a higher-order structure of psychopathology. Participants were 271 psychiatric patients who had been administered the MMPI-2 and revised NEO Personality Inventory (Costa & McCrae, 1992) as part of a routine psychological evaluation. The results indicated that the RC scales map onto the Five Factor Model of personality as hypothesized and in congruence with previous findings in personality and psychopathology. The RC scales conformed to a higher-order structure of internalizing, externalizing, and thought disturbance, replicating and extending previous work concerning hierarchical structures of psychopathology.     

Incremental validity of the MMPI-2 Restructured Clinical (RC) scales in a private practice sample

Building on results reported in Sellbom, Graham, and Schenk (2005), in this study, we examined the incremental validity of the newly introduced MMPI-2 (Butcher et al., 2001) Restructured Clinical (RC) scales (Tellegen et al., 2003) over both the Clinical and Content scales. Participants were 647 clients in private practice who were administered the MMPI-2 and the Multiaxial Diagnostic Inventory (Doverspike, 1990) early in therapy. The results indicate that the RC scales had acceptable internal consistency, reduced intercorrelations (compared to the Clinical scales), and promising convergent and discriminant validity. Hierarchical regression analyses revealed that the RC scales added incrementally to both the Clinical and Content scales in predicting self reported clinical symptoms. These findings suggest that the RC scales are relatively homogenous measures of core clinical constructs that can add unique information to the understanding of private practice clients above and beyond the Clinical and Content scales.     

Bridging the divide: comments on the Restructured Clinical Scales of the MMPI-2

In this comment, I discuss the target articles written by Nichols (2006/this issue) and Rogers, Sewell, Harrison, and Jordan (2006/this issue) regarding the Restructured Clinical (RC) Scales (Tellegen et al., 2003) of the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). Both articles provide thoughtful discussion of the extent to which the RC Scales achieved the primary goals set forth by Tellegen et al., but they set different tones and come to somewhat different conclusions. I argue that the initial studies conducted on the RC Scales suggest a promising future for them. However, further studies are needed to explore the construct validity of the scales, assess their incremental validity with respect to other more established MMPI-2 scale sets, and determine their interpretive meaning in clinical contexts.     

The MMPI-2 Restructured Clinical Scales: a paradigmatic shift in scale development

Tellegen et al. (2003) proposed fundamental changes in MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) scale development by discarding empirical scale development in favor of construct validation via Jackson's (1970) sequential system of scale development. As a result of their efforts, a general distress factor (Demoralization) was identified and 8 Restructured Clinical (RC) Scales were developed. Using 7,330 clinical cases from Caldwell's (1997) data set, in this study, we sought to cross-validate the MMPI-2 RC Scales. Scale homogeneity was confirmed with high alpha coefficients and interitem correlations in the expected range. We also achieved a major objective of reducing interscale correlations. In replicating Tellegen et al.'s principal components analysis, we achieved a high concordance for 6 of the 8 RC Scales. We critically examine these results in light of Jackson's construct validation. We discuss the clinical usefulness of the MMPI-2 RC Scales within the context of current and future research.     

False assumptions about psychopathology, hysteria and the MMPI-2 Restructured Clinical Scales

The MMPI-2 Restructured Clinical scales rest on the common behavioral assumption that consistent items can be added to assess all psychopathologies. This may be the case for some unitary symptoms such as anxiety or anger, but not for complex diagnostic conditions such as Hysteria, Post Traumatic Stress Disorder, and Borderline Personality Disorder. These are better understood with a psychodynamic formulation. Psychodynamic theory assumes that internal conflicts and contradictions are a significant feature of many psychopathologies. For example, the new MMPI-2 Restructured Clinical scales eliminated a measure of hysteria. The RC3 Cynicism scale is not an improvement over the MMPI-2 Hysteria scale, as the new scale serves as an example of a failure of the behaviorism to account for complex psychopathology. Making scales more internally consistent and distinct from each other has not produced more external validity and useful measures for many of the psychopathologies found in clinical practice.     

Examining the impact of unscorable item responses on the validity and interpretability of MMPI-2/MMPI-2-RF Restructured Clinical (RC) Scale scores

This article examined the impact of unscorable item responses on the psychometric validity and practical interpretability of scores on the Restructured Clinical (RC) Scales of the Minnesota Multiphasic Personality Inventory-2/Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2/MMPI-2-RF). In analyses conducted with five archival samples, we found that relatively large proportions of unscorable responses (defined as 10% or more of the items scored on a scale) were relatively uncommon, occurring most often in forensic samples. Simulated unscorable responses were inserted in varying proportions (10% to 90%) in place of the responses of participants in two of the archival samples for which criterion data were available. Analyses were conducted to gauge the impact of unscorable responses on the criterion validity of scores on these scales and their interpretability. Impact on validity was evaluated by examining correlations with extra-test variables as a function of increasing levels of unscorable responding. Interpretability was evaluated by examining the proportion of participants who produced clinically elevated RC Scale scores as a function of unscorable responding. Results indicate that whereas scale score validity was relatively robust up to a level of 50% unscorable responses, interpretability was substantially compromised at only 10% unscorable responding. This suggests that prorated scores may be used to correct for the impact of unscorable responses on the interpretability of RC Scale scores at levels as high as 50% unscorable responses. Classification analyses supported this possibility. Further steps needed to explore the feasibility of using prorated scores are discussed.     

Further evidence on the validity of the MMPI-2 Restructured Clinical (RC) Scales: addressing questions raised by Rogers, Sewell, Harrison, and Jordan and Nichols

The reviews by Rogers, Sewell, Harrison, and Jordan (2006/this issue), and by Nichols (2006/this issue) offer markedly contrasting appraisals of the MMPI-2 Restructured Clinical (RC) Scales introduced by Tellegen et al. (2003). The one common feature is that both reviews draw on the same atypical MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) data set for their empirical analyses, with results warranting critical scrutiny. Rogers et al.'s critique provides an evaluation of the RC Scales from the perspective of Jackson's (1970) method of test development. One significant issue in Rogers et al.'s review concerns social desirability, prompting us to clarify our own views on this topic. We also highlight and discuss problems associated with Rogers et al.'s use of the unrepresentative data set. Nichols's polemical critique neglects empirical and theoretical support for demoralization as a central construct and misconstrues as "construct drift" the purposeful process of developing the RC scales. Nichols's criticisms and proposals overlook requirements for assessing syndromes and for construct validation and even rudiments of scale development. Our reply incorporates evidence, including new findings, refuting his criticisms and confirming that demoralization is a pervasive MMPI dimension, that the RC Scales capture the major distinctive features of the original Clinical Scales, and that they generate correspondingly meaningful validity patterns.     

Diagnostic construct validity of MMPI-2 Restructured Form (MMPI-2-RF) scale scores

In the current investigation, the authors examined the diagnostic construct validity of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in a patient sample. All participants were diagnosed via the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I/P). The data set used in this study was composed of 544 patients--67 with bipolar disorder, 407 with major depressive disorder, and 70 with schizophrenia. Multivariate analyses revealed a pattern of mean scale differences among patient groups that was mostly consistent with the prominent features of each diagnostic group; logistic regression analyses identified a number of scales that were strong, unique predictors in the differentiation between pairs of diagnostic groups. The higher order scales (H-O)--the Emotional/Internalizing Dysfunction (EID) and Thought Dysfunction (THD) scales were most useful in differentiating between patient groups. For differentiating bipolar disorder patients from the other diagnostic groups, the Activation (ACT) Specific Problem scale was most useful. Although not all hypothesized scale differences emerged; overall, the pattern of results provides support for the diagnostic construct validity of the MMPI-2-RF scales.