Psychometric properties of the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A) Clinical, Content, and Supplementary scales in a forensic sample

In this study, we evaluated the internal psychometric properties and external correlates of scores on the Clinical, Content, and Supplementary scales in a forensic sample of 496 adolescents (315 boys and 181 girls) who were court-ordered to receive psychological evaluations. We examined Cronbach's alpha coefficients, scale intercorrelation matrices, and frequencies of scale elevations. Further, we found varying degrees of support for the convergent and discriminant validity of scores on the MMPI-A (Butcher et al., 1992 ) Clinical, Content, and Supplementary scales. This study adds to the body of literature establishing the utility of the MMPI-A in forensic evaluations.     

What do the MMPI-2 restructured clinical scales reliably measure? Answers from multiple research settings

The Restructured Clinical (RC; Tellegen et al., 2003) scales were developed to improve measurement of the core constructs of the MMPI-2 (Butcher et al., 2001) Clinical scales by removing "demoralization," hypothesized to affect these scales adversely. Using 25 samples with MMPI-2 responses from 78,159 subjects across diverse clinical settings, we found that each RC scale was highly correlated with a Supplementary, Content, or Personality Psychopathology 5 (PSY-5; Harkness, McNulty, & Ben-Porath, 1995) scale: higher, in fact, than the correlation between the RC scale and its parent scale. Furthermore, for over half the RC scales (i.e., RC1, RC3, RC7, RC8, and RCd), the correlations were strong enough to conclude that the RC scales replicate MMPI-2 scales with rich empirical foundations; the remaining RC scales were not redundant. Next, we examined reliability estimates using alpha coefficients and interitem correlations and did not reveal superior reliability for most of the RC scales over existing MMPI-2 scales.     

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.     

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.     

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 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.     

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.     

Psychometric evaluation of the MMPI-2 Restructured Clinical scales in two Dutch samples

In this article, we evaluate internal validity, internal consistency, and test-retest reliability of the MMPI-2 Restructured Clinical (RC) scales in the Dutch MMPI-2 normative sample (N = 1,244) and a Dutch outpatient psychiatric sample (N = 1,066). We pay special attention to a critique regarding construct drift of RC3 and the redundancy of the RC scales with existing MMPI-2 scales. The results indicate that the RC scales in both samples show comparable or better internal consistencies than the Clinical scales. Also, in both samples, the RC scales demonstrate lower scale-level intercorrelations than the Clinical scales. As to the structural characteristics, principal component analysis of the RC scales provided a clearer pattern than an analysis of the Clinical scales. Furthermore, mean raw scores on the RC scales for men in the Dutch normative sample corresponded highly with those in the U.S. normative sample except for RC2 and RC4. Less correspondence was found for women. Overall, we conclude that the RC scales show satisfactory reliability and promising internal validity in our Dutch samples. We suggest that U.S. validation studies on the RC scales may be generalized to the Dutch-language version of the MMPI-2 RC scales.     

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.     

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.     

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.     

Mapping the MMPI-2 Restructured Clinical scales onto normal personality traits: evidence of construct validity

The MMPI-2 Restructured Clinical (RC; Tellegen et al., 2003) scales were developed to remove common factor variance that saturates the clinical scales and create a more distinct set of measures, yielding a new set of scales with improved convergent and discriminant validity. In this study, we examined the relation between RC scale scores and scores on the Multidimensional Personality Questionnaire (MPQ; Tellegen, in press), a measure of normal personality, using a sample of 811 college students. The results indicate strong convergence between the RC scales and expected MPQ higher order factors and primary scales. The RC scales also demonstrated expected improved convergent and discriminant validity over the clinical scales.     

The deconstruction of the Hy Scale of MMPI-2: failure of RC3 in measuring somatic symptom expression

The MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) Clinical Scales have a long history in psychological assessment. Recently, Tellegen et al. (2003) conducted a series of analyses to restructure the scales to reduce what they considered to be problems that limit scale functioning. In a critique of the Restructured Clinical (RC) Scales published in this issue, Nichols (2006/this issue) questions a number of aspects of the approach Tellegen et al. took including their theoretical assumptions, methods of analysis, and failures to report important information needed for scale evaluation such as relationships with existing scales. We concur with many points raised by Nichols. In our analysis of the performance of the RC3 scale, we found that it has "drifted" so far from the original Hy scale as to be a completely different measure- a scale of cynical attitudes that is already well represented in existing MMPI-2 measures. In this article, we take these concerns a step further and examine the history and construct validity of the Hy scale in evaluating the somatic expression of problems that the original authors (McKinley & Hathaway, 1944) intended. We also include new information from a medical setting, an application not represented in Tellegen et al.'s RC Scale monograph. In agreement with Rogers et al. (2006/this issue), it is our conclusion that some RC Scales do not represent the measurement domain of the original scales and should not be relied on for or used to refine traditional interpretation, particularly in medical or forensic situations (such as personal injury cases) because of their confusing and conflicting results.     

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.     

Behavioral correlates of selected MMPI-2 clinical, content, and restructured clinical scales

In this study, we evaluated the validity of the Restructured Clinical (RC; Tellegen et al., 2003) scales by identifying and comparing behavioral correlates of selected RC scales (RCd, RC2, RC4), their original Clinical scale counterparts (Scale 2, Scale 4), and conceptually related Content scales (DEP, ASP, CYN) in an outpatient clinical sample (N = 150). The results of this study indicate that RC4 is a stronger predictor of several antisocial behaviors than Clinical Scale 4 or the Content Scales ASP and CYN. In contrast, RC2 demonstrated significantly lower correlations with several behaviors conceptually related to depression than its Clinical scale counterpart or DEP. DEP was highly correlated with RCd (r = .91, p < .0001), suggesting that the 2 scales may be measuring similar constructs. Overall, the results of this study demonstrate relatively few differences among the scales selected in their ability to predict extratest behaviors.     

Syndromal complexity, paradigm shifts, and the future of validation research: comments on Nichols and Rogers, Sewell, Harrison, and Jordan

In this comment, I address a number of the points raised in the reviews of the MMPI-2 Restructured Clinical (RC; Tellegen et al., 2003) Scales by Nichols (2006/this issue) and Rogers, Sewell, Harrison, and Jordan (2006/this issue), and I advocate for changes in assessment validation research. There is little evidence that the "syndromal complexity" Nichols ascribes to the original MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) Clinical Scales is worth preserving. Although their construction does not constitute the paradigm shift claimed by Rogers et al., the RC Scales are promising, psychometrically defensible measures of core features of the original MMPI-2 Clinical Scales. However, validation of inferences from multiscale inventories such as the MMPI-2 is limited at present by a disconnection between the integrative manner in which MMPI-2 profiles are interpreted and the scale-by-scale nature of most MMPI-2 validation studies. Q-sort procedures show promise for operationalizing integrated MMPI-2 interpretations, with both research and teaching applications.     

The MMPI-2 Restructured Clinical (RC) Scales and restraints to innovation, or "what have they done to my song?"

Rogers, Sewell, Harrison, and Jordan (2006/this issue) largely replicate in an independent clinical sample the MMPI-2 Restructured Clinical (RC) Scales developed by Tellegen et al. (2003). Nichols (2006/this issue) raises numerous concerns about the development and utility of the RC Scales, which on close appraisal did not change our view that the scales are well conceived and potentially valuable to researchers and clinicians alike. We present two case studies in which the RC Scales helped clarify complex MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) profiles with multiple elevations on the Clinical, Content, Supplementary, and Personality Psychopathology Five (Harkness, McNulty, Ben-Porath, & Graham, 2001) scales. When interpretations refined by the RC Scales were discussed with the clients, each seemed to feel deeply understood. Reservations about instrument innovation can be appreciated as helping to counterbalance change and thereby ensure the MMPI-2's successful ongoing evolution. We discuss specific ways the MMPI-2 community could avoid polarization about the RC Scales.