Linking personality disorders and clinical syndromes on the MCMI-III

We examined the relationship between personality disorders (PDs) and clinical syndromes (CSs) as measured by the Millon Clinical Multiaxial Inventory-III (MCMI-III; Millon, 1997) in a large, heterogeneous sample of psychiatric patients (N = 2,366) who completed the instrument as part of routine assessment following presentation for treatment. Using separate sets of base rate (BR) and nonoverlapping scale scores, we factor analyzed the PD and CS scales together and then separately. We correlated results from the latter analyses to determine how trait dimensions were associated with syndrome dimensions. We also studied co-occurrence at the scale level by examining CS score profiles of patients who were grouped according to their highest PD scale elevation > or = BR75. Results for the two score sets were very similar and were consistent with previous research on the MCMI-III and its predecessors that identified 3 underlying dimensions loading both PD and CS scales. Three fourths (76.2%) of the sample had a highest PD scale > or = BR75, and among these, 90% had at least 1 CS scale > or = BR75, whereas 62.4% had 3 or more CS scales above this elevation. Findings underscore the substantial overlap between PDs and CSs along 3 dimensions that resemble Horney's (1945) tripartite interpersonal distinction of moving toward, away, and against, as well as Eysenck's (1994) higher order factors of neuroticism, extraversion, and psychoticism.     

Assessing dimensions of competency to stand trial: construct validation of the ECST-R

Four decades of forensic research have left unanswered a fundamental issue regarding the best conceptualization of competency to stand trial vis-à-vis the Dusky standard. The current study investigated three competing models (discrete abilities, domains, and cognitive complexity) on combined data (N = 411) from six forensic and correctional samples. Using the Evaluation of Competency to Stand Trial-Revised (ECST-R), items representative of the Dusky prongs were used to test the three models via maximum-likelihood confirmatory factor analyses (CFA). Of the three, only the discrete abilities model evidenced a good fit, indicating that competency to stand trial should consider separately each defendant's factual understanding of the proceedings, rational understanding of the proceedings, and ability to consult with counsel. ECST-R competency scales, based on the current CFA, have excellent alphas (.83 to .89) and interrater reliabilities (.97 to .98).     

Personality Psychology in Europe (Vol. 3) (Book)

This study explored the effect of defensive (i. e., fake-good) responding by substance-abusing patients on the scale scores of the Millon Clinical Multiaxial Inventory (MCMI-II; Millon, 1987). Patients asked to respond honestly (N = 62) had significantly higher scores on most of the scales than patients who were instructed to respond defensively (N = 62) and forensic subjects suspected of abusing psychoactive substances (N = 54). Significantly fewer subjects in the defensive responding simulation and the forensic group had elevated the Drug Dependence and Alcohol Dependence scales compared to the honestly responding patients. These results indicate that most drug-abusing individuals can conceal the presence of a substance-related disorder, as reflected by scale scores on the MCMI-II, if motivated to do so.     

Factor structure of the basic personality inventory with incarcerated offenders

The item and scale factor structure of the Basic Personality Inventory (BPI) was examined in a sample of 486 offenders incarcerated for violent and sexual crimes. Separate principal-component analyses of the items for each of the 11 clinical scales, critical item scale, and social desirability scale indicated a one-dimensional factor solution for all scales except Depression and Persecutory Ideation. The Depression scale's two factors were Hopelessness and Depressive Affect and the Persecutory Ideation scale's two factors were General Paranoia and Perception of External Control. Although the factors for these two scales may assist in interpretation, the correlations between the factors and the total score of their respective scale were high. Confirmatory factor analysis of the 220 items from the 11 clinical scales supported the factorial logic of the scoring key. Analysis of the 11 clinical scales resulted in two factors: General Psychopathology/Adjustment and Antisocial Orientation. The results suggest that all but two scales can be viewed as unidimensional thereby allowing for a straightforward clinical interpretation. These analyses support the internal structure of the BPI and lend credence to external validity work with forensic populations.     

Construction of Circumplex Scales for the Inventory of Interpersonal Problems

We constructed a set of circumplex scales for the Inventory of Interpersonal Problems (IIP; Horowitz, Rosenberg, Baer, Ureno, & Villasenor, 1988). Initial scale construction used all 127 items from this instrument in two samples of university undergraduates (n = 197; n = 273). Cross-sample stability of item locations plotted against the first two principal components was high. A final set of eight 8-item circumplex scales was derived from the combined sample (n = 470) and cross-validated in a third university sample (n = 974). Finally, we examined the structural convergence of the IIP circumplex scales with an established measure of interpersonal dispositions, the Revised Interpersonal Adjective Scales (IAS-R; Wiggins, Trapnell, & Phillips, 1988). Although both circumplex instruments were derived independently, they shared a common Circular space. Implications of these results are discussed with reference to current research methods for the study of interpersonal behavior.     

The effect of scale modifications on the factorial dimensions and reliability of super's work values inventory

On the basis of previous research findings, 32 new items were added to Super's Work Values Inventory (WVI) and the resulting 77 item instrument was administered to 611 high school sophmores. Guttman's rank-reduction procedure and separate image analyses were employed to examine empirically the effects of additional items on hypothesized item groupings, scale intercorrelations, factorial dimensions, and scale internal consistency reliabilities. Analyses supported the addition of items to the WVI. It was found that the item groupings on the modified instrument were reasonable; the scale intercorrelations and factorial dimensions of both versions were highly comparable; the addition of items had increased the scale internal consistency reliabilities. Comments were made regarding counselors' use of the WVI.     

Differential item functioning in a Spanish translation of the PTSD checklist: detection and evaluation of impact

This study demonstrated the application of an innovative item response theory (IRT) based approach to evaluating measurement equivalence, comparing a newly developed Spanish version of the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) with the established English version. Basic principles and practical issues faced in the application of IRT methods for instrument evaluation are discussed. Data were derived from a study of the mental health consequences of community violence in both Spanish speakers (n = 102) and English speakers (n = 284). Results of differential item functioning (DIF) analyses revealed that the 2 versions were not fully equivalent on an item-by-item basis in that 6 of the 17 items displayed uniform DIF. No bias was observed, however, at the composite PCL-C scale score, indicating that the 2 language versions can be combined for scale-level analyses.     

Construct-oriented Biodata Development for Selection to a Differentiated Performance Domain

This study describes the development of a multidimensional biodata form which used explicit constructs to guide item generation and rational scale development, construct validation, criterion measurement and empirical keying. These constructs were goal-orientation, teamwork, customer service, resourcefulness, learning ability and leadership. Exploratory and confirmatory factor analyses in both applicant and incumbent samples were used to identify and test the model which included the thirteen, more differentiated rational scales relating to these six, broader constructs. Empirical keying of the rationally developed scales was conducted against criterion construct scales conceptually related to each predictor construct. Empirical keying at the item level was found to result in higher validities and cross-validities than either empirical keying at the scale level, or rational keying. The item keyed instrument also demonstrated incremental validity over a test of cognitive ability for specific work performance domains as well as overall work performance.     

SA-45: a brief form of the SCL-90

The Symptom Assessment-45 Questionnaire (SA-45) is a 45-item self-report instrument of psychiatric symptomatology derived from the original SCL-90. The SA-45 consists of nine 5-item scales assessing each of the same symptom domains as its parent instrument with no item overlap across domains. This paper provides preliminary validation of the Spanish version of the questionnaire in an undergraduate sample. Exploratory and confirmatory factor analyses supported a 9-factor structure, which corresponds to the nine proposed scales. Normative data, reliability (internal consistency) and validity were also examined, finding support for sound psychometric properties.     

A multitrait-multimethod analysis of the MCMI-II clinical syndrome scales

Multitrait-multimethod procedures and factor analyses were utilized to assess convergent/discriminant validity of the revised version of the Millon Clinical Multiaxial Inventory (MCMI-II) clinical syndrome scales and effects of item overlap on scale performance. Except for the Delusional Disorder Scale (PP), convergent validity was supported, but poor discriminant validity was found for the Alcohol Dependence (B) scale, Drug Dependence (T) scale, and Scale PP. Item overlap did not influence performance for many scales. In fact, results indicate that some scales, such as Bipolar:Manic (N), may perform better in overlapping form, whereas others, such as Somatoform (H) and Scales B and T, are most affected by item overlap. Factor structure was generally stable, regardless of whether overlapping or nonoverlapping scales were utilized. However, substance abuse/dependence emerged as an independent factor when common item artifact was removed. Findings are discussed in terms of their implications for clinical practice and further research.     

Examining the construct validity of the Eating Disorder Inventory

The construct validity of the Eating Disorder Inventory (EDI) was examined in 3 samples. An archival clinic sample (n = 318) of women completed the EDI, a structured interview, and the Millon Clinical Multiaxial Inventory-II (MCMI-II). Confirmatory factor analyses (CFAs) indicated that neither null nor 1-factor models of the EDI fit item-level or item-parcel data. The proposed 8-factor model did not fit at the item level but did fit item-parcel data. Reliability estimates of the 8 scales ranged from .82 to .93, and low-to-moderate interscale correlations among the eating and weight-related scales provided partial support for convergent validity. EDI personality scales showed moderate interscale correlations and were associated with MCMI-II scales. A final CFA of the EDI scales supported a 2-factor model (Eating and Weight, Personality) of the 8 EDI scales. Strong associations between depression and several EDI scale scores were found in a treatment study sample (n = 50). The archival clinic sample scored significantly higher on the 8 EDI scales than the nonpatient college comparison sample (n = 487).     

Research validity scales for the NEO-PI-R: development and initial validation

The purpose of this investigation was to develop a set of research validity scales for use with the NEO Personality Inventory-Revised (NEO-PI-R; Costa & McCrae, 1992b). In study 1 we used the existing NEO-PI-R item pool to select items for three validity scales: positive presentation management, negative presentation management, and inconsistency. Several iterative item and scale analyses were conducted, using multiple criteria for item selection. These analyses resulted in 10-item scales. In Study 2, the internal consistency, interscale relationships, and normative characteristics were examined in a separate sample of working adults. In Study 3, the validity of the scales was examined by contrasting five sets of NEO-PI-R protocols: from a separate sample of working adults, from a sample of 100 NEO-PI-R protocols with randomly produced responses, and from three samples of undergraduates completing the NEO-PI-R under different instructional sets. Analyses revealed that both the research validity scales and the NEO-PI-R domain scales were sensitive to group differences. issues relating to the appropriate use of the scales are discussed.     

Psychometric Properties of the Wisconsin Schizotypy Scales in an Undergraduate Sample: Classical Test Theory,Item Response Theory,and Differential Item Functioning

The Wisconsin Schizotypy Scales are widely used for assessing schizotypy in nonclinical and clinical samples. However, they were developed using classical test theory (CTT) and have not had their psychometric properties examined with more sophisticated measurement models. The present study employed item response theory (IRT) as well as traditional CTT to examine psychometric properties of four of the schizotypy scales on the item and scale level, using a large sample of undergraduate students (n = 6,137). In addition, we investigated differential item functioning (DIF) for sex and ethnicity. The analyses revealed many strengths of the four scales, but some items had low discrimination values and many items had high DIF. The results offer useful guidance for applied users and for future development of these scales.     

A Multitrait-Multimethod Analysis of the MCMI-II Clinical Syndrome Scales

Multitrait-multimethod procedures and factor analyses were utilized to assess convergent/discriminant validity of the revised version of the Millon Clinical Multiaxial Inventory (MCMI-II) clinical syndrome scales and effects of item overlap on scale performance. Except for the Delusional Disorder Scale (PP), convergent validity was supported, but poor discriminant validity was found for the Alcohol Dependence (B) scale, Drug Dependence (T) scale, and Scale PP. Item overlap did not influence performance for many scales. In fact, results indicate that some scales, such as Bipolar: Manic (N), may perform better in overlapping form, whereas others, such as Somatoform (H) and Scales B and T, are most affected by item overlap. Factor structure was generally stable, regardless of whether overlapping or nonoverlapping scales were utilized. However, substance abuse/ dependence emerged as an independent factor when common item artifact was removed. Findings are discussed in terms of their implications for clinical practice and further research.     

The Strengths and Difficulties Questionnaire: the self-report version in American urban and suburban youth

This study examined the factor structure of the Strengths and Difficulties Questionnaire (SDQ) in urban inner-city and suburban general population samples of American youth. The SDQ was administered to 4,661 predominantly minority urban youth (mean age = 13.0 years, SD = 2.02) and 937 predominantly Caucasian suburban youth (mean age = 14.0 years, SD = 1.56). The authors examined SDQ factor structure using structural equation modeling techniques. The fit for the 5-factor models in both samples was very good (comparative fit index = .96-.97). However, the factor loadings and, correspondingly, the scale reliabilities for most of the SDQ scales (except for Emotional Problems) were low, which suggests poor specificity of the items. Subsequent exploratory and confirmatory factor analyses suggested that a 3-factor structure had a comparable model fit and better internal consistency of the scales. The study concluded that, although the SDQ scales do conform reasonably well to a 5-factor model, the scales are unsatisfactory in other respects and that, in its present form, the instrument has inadequate psychometric characteristics. Future research is needed for further scale development.     

The SIMS Screen for Feigned Mental Disorders: the Development of Detection‐based Scales

Time‐efficient screens for feigned mental disorders (FMDs) constitute important tools in forensic assessments. The Structured Inventory of Malingered Symptomatology (SIMS) is a 75‐item true–false questionnaire that has been extensively studied as an FMD screen. However, the SIMS scales are not based on established detection strategies, and only its total score is utilized as a feigning screen. This investigation develops two new feigning scales based on well‐established detection‐strategies: rare symptoms (RS) and symptom combinations (SC). They are studied in a between‐subjects simulation design using inpatients with partial‐malingering (i.e., patients with genuine disorders asked to feign greater disabilities) conditions. Subject to future cross‐validation, the SC scale evidenced the highest effect size (d = 2.01) and appeared the most effective at ruling out examinees, who have a high likelihood of genuine responding. Copyright © 2014 John Wiley & Sons, Ltd.     

An Examination of the Factor Structure and Scale Reliability of the Work Motivation Scale,the Motivation Sources Inventory

This study examined the factor structure and scale reliability of the Motivation Sources Inventory (MSI; Barbuto & Scholl, 1998 ), an instrument designed to measure the motivational concepts contained within the meta‐theory of motivation ( Leonard, Beauvais, & Scholl, 1999 ). Participants were comprised of financial‐service professionals, health‐industry administrators, and retail and distribution workers, all engaged in full‐time employment in Ireland. Data were collected through the administration of the Motivation Source Inventory (MSI) to a sample of working professionals (N = 252). Factor analyses, scale reliabilities, and inter‐item correlations were conducted. Results of the current study did not support the scale structure reported by the instrument developers. The implications of these results and suggestions for future research are presented.     

Rasch analysis of the Hospital Anxiety and Depression Scale in spinal cord injury

Purpose: The purpose of this study was to evaluate the psychometric properties of the Hospital Anxiety and Depression Scale (HADS), applied among persons with spinal cord injury (SCI), using Rasch analysis. Methods: A cross-sectional multicenter study was conducted and the data of 102 people with SCI were analyzed. Rasch analyses were performed to assess dimensionality, overall and individual item fit, response scale structure, targeting, and differential item functioning. Results: The anxiety and depression subscales showed unidimensionality, that is, model and item fit. The two subscales are reliable (r = .72, 0.82) in SCI. No disordered structure of the response scales or differential item functioning in age, gender, education, relationship status, level of spinal lesion were found. Stepwise deletion of the misfitting items did not produce a total score that fulfilled the statistical criteria for unidimensionality. Conclusions: The results of the Rasch analyses support the use of the anxiety and depression subscales among people with SCI. However, further research is needed to confirm these findings and examine sensitivity to change of the HADS in SCI, which would support its use in longitudinal observational and intervention studies. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

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.     

Assessment of the hypochondriasis domain: the multidimensional inventory of hypochondriacal traits (MIHT)

Although hypochondriasis is associated with the costly use of unnecessary medical resources, this mental health problem remains largely neglected. A lack of clear conceptual models and valid measures has impeded accurate assessment and hindered progress. The Multidimensional Inventory of Hypochondriacal Traits (MIHT) addresses these deficiencies with scales that correspond to a 4-factor model. The MIHT was built with construct validity as a guiding principle and began with an item pool that broadly assessed dimensions identified in the literature. The items were administered to large samples; factor analyses of the responses led to item pool revisions and scale refinements. Multiple studies validated the final MIHT scales and 4-factor model; these findings suggest that the MIHT will contribute to theory and research.