Factor invariance of the Millon Clinical Multiaxial Inventory

Several factor analyses of the Millon Clinical Multiaxial Inventory (MCMI) have resulted in very similar solutions. Interpretation of this consistency is hampered by the fact that the 20 scales of the inventory share items. Overlapping items cause the scales to be linearly dependent and may create structure in the interscale correlation matrix which is separate from the subject response patterns. A factor analysis was performed on the matrix of item-overlap coefficients which describes the underlying artifactual structure of the instrument. Data from two new subject samples were factor analyzed and compared to previously published studies. Similarity coefficients among factors across studies were calculated.     

Millon Clinical Multiaxial Inventory (MCMI) scores with a collegiate sample: Long-term stability and self-other agreement

This study examined (a) the stability of the personality and symptom scales of the Millon Clinical Multiaxial Inventory (MCMI) for a sample of university undergraduates and (b) the correspondence between MCMI scores from self-report versus scores obtained from knowledgeable others who responded by describing the subject rather than themselves. The MCMI was administered to subjects during their freshman year and then again during their senior year. As in clinical populations, stability estimates in this collegiate sample were greater for the basic personality scales than for the symptom scales. Comparison of the results with those from previous studies further showed that the stability coefficients for the collegiate sample were somewhat lower overall than those from treatment follow-up studies with clinical populations. The results also showed that reasonable agreement between self- and others' ratings was obtained on most MCMI scales. The greatest agreement was found for scales that reflect more observable behaviors and relate to an introversion-extroversion dimension, whereas the least agreement was found for scales related to a psychoticism dimension. Lower levels of agreement were also found for scales having a lower mean proportion of items endorsed.This study was sponsored in part by PHS Grant R01 MH31750-01-6, by PHS Grant 5R01 AA06754-01-03, and by funds from the University of Connecticut Research Foundation and Computer Center.     

A Multitrait-multimethod examination of Minnesota Multiphasic Personality Inventory (MMPI) and Millon Clinical Multiaxial Inventory (MCMI)

Recently, certain Minnesota Multiphasic Personality Inventory (MMPI) and Millon Clinical Multiaxial Inventory (MCMI) scales have seen increasing usage for the measurement of DSM-III personality disorders. The current study sought to identify the convergent and discriminant validity of these two sets of scales for this purpose. In general, the results indicated significant convergence across the two instruments. However, better convergent validity was found for scales representing those DSM-III disorders which are most consistent with the typology upon which the MCMI was based. In particular, convergent and discriminant validity results were poorest for Compulsive, Antisocial, and Passive-Aggressive personality scales.     

A response Consistency statistic for the millon clinical multiaxial inventory (MCMI)

Response style in objective psychological testing is an important issue in the reliability and validity of tests as well as in the interpretation of test results. The MCMI provides two response-style indices, the validity scale and the weight factor. The present work presents an additional statistic to assess random response in subjects. The Consistency Coefficient is the correlation between the subjects' endorsement of even and odd items across the 20 MCMI scales. The distributions of 500 patient and 500 randomly generated profiles were compared. Good separation between these distributions was found. The subject data were extremely negatively skewed, whereas the randomly generated data were normally distributed. Data are presented that display positive and negative predictive values, as well as sensitivity and specificity across ranges of prevalence and cut score. These data facilitate the identification of subjects who respond to the MCMI in a random manner so that their scores can be interpreted accordingly.     

Diagnostic accuracy of the Millon test computer reports for bipolar affective disorder

The diagnostic accuracy of the Millon Clinical Multiaxial Inventory (MCMI) computer reports was assessed for the sample of 48 patients reliably identified as having bipolar affective disorder. Only 13 of the 48 reports were accurate in classifying the patients as having bipolar affective disorder, and this was significantly (p < .01) less than 50% of the cases. The diagnostic accuracy clearly left much to be desired. Additional research is needed to assess the validity of MCMI diagnostic suggestions for other patient groups.     

Bias and Millon clinical multiaxial inventory (MCMI-II) diagnosis

In the current study, the degree of bias is calculated for each of the personality disorder and clinical syndrome scales of the MCMI-II. In general, most of the MCMI-II scales are prone to only mild or moderate biases. However, the paranoid personality disorder, somatoform, bipolar: manic, thought disorder, and delusional disorder scales are prone to severe biases. When the MCMI-II is utilized to make diagnostic decisions, bipolar and schizophrenic disorders are apt to be grossly underestimated. The implications of bias in diagnostic prevalence rates are discussed and an equation is offered which provides for adjustments to be made when the percentage of positive MCMI-II test results are used to determine prevalence rates for clinical or research populations. The observation is made that imperfect sensitivity and specificity for the MCMI-II scales will result in inaccurate estimates of personality disorders and clinical syndromes when the MCMI-II is used to survey various populations.     

A General Factor of Personality in the Millon Clinical Multiaxial Inventory-III, the Dimensional Assessment of Personality Pathology, and the Personality Assessment Inventory

A General Factor of Personality (GFP) occupies the apex of the hierarchy in three prominent personality disorder inventories. On the Millon Clinical Multiaxial Inventory-III, a GFP accounted for 41% of the variance in two second-order factors, 31% of the variance in five first-order factors, and 26% of the variance in all 24 scales. On the Dimensional Assessment of Personality Pathology, a GFP accounted for 61% of the variance in six first-order factors and 36% of the variance in all 18 scales. In a cross-validation study of the Personality Assessment Inventory, a GFP accounted for 65% of the variance in two second-order factors, 47% of the variance in five first-order factors, and 27% of the variance in all 18 scales.     

Millon Clinical Multiaxial Inventory (MCMI) computer-generated diagnoses: How do they compare to clinician judgment?

During the past several decades, computers have achieved increasing prominence in psychological assessment procedures. This is particularly true for computer-based test interpretation and diagnosis. This study reports on a study designed to compare the accuracy of computer-based diagnoses with clinician-generated diagnoses. The Millon Clinical Multiaxial Inventory (MCMI) was administered to 151 consecutively admitted inpatients at a large private psychiatric hospital. The computer-generated diagnoses were compared with those generated by admitting psychiatrists. The results indicated that the MCMI diagnostic impressions underestimated the severity of depressive disorders when compared with clinician diagnoses on Axis I. Specifically, clinicians diagnosed major depression much more frequently than did the MCMI. In addition, clinicians diagnosed anxiety disorders much less frequently than did the MCMI.     

The stability of the Millon Clinical Multiaxial Inventory for psychiatric inpatients

This study investigated the stability of the personality and symptom scales of the Millon Clinical Multiaxial Inventory (MCMI) for a sample of psychiatric inpatients. Patients were administered the MCMI shortly following admission and shortly preceding discharge. As would be expected theoretically, results indicated that stability estimates were greater for the basic personality scales than for the symptom scales. These results were also compared with results from a previous study investigating the stability of MCMI scales. Overall, stability coefficients for the inpatient sample were lower than those reported for other samples. Possible explanations for this and other findings are discussed.     

The factor structure of the Millon Clinical Multiaxial Inventory (MCMI) for psychiatric inpatients

This study examines the factor structure of the Millon Clinical Multiaxial Inventory (MCMI) for a sample of psychiatric inpatients. The results are compared and contrasted with previous studies that have examined the factor structure of the MCMI. Factors identified for the inpatient sample include Interpersonal Withdrawal/Avoidance, Emotional Distress, Impulsivity/Negativism, Paranoid Distrust/Delusions, and Dependency/Submission. In general, results from this study are consistent with previous findings. However, there is evidence that the factor structure for this inpatient sample demonstrated more discrimination between symptoms and personality traits than had been demonstrated in previous studies.     

Evolution of the Millon Clinical Multiaxial Inventory

Dr. Theodore Millon (1928–2014) was a primary architect for the personality disorders in the DSM–III, a structure that has endured into the DSM–5. His 1969 book, Modern Psychopathology, created an elegant framework into which the well-known personality prototypes could be fitted and understood. His theoretical work soon led into the creation of several psychological inventories, most notably the Millon Clinical Multiaxial Inventory (MCMI). The MCMI, now in preparation for its 4th major edition, has been a very popular instrument among clinicians. This article explores the history of the MCMI's development from its origins, through 2 distinct theoretical phases, and to its current status as the MCMI–IV is finalized.     

Stability of the internal structure of the millon clinical multiaxial inventory

The Millon Clinical Multiaxial Inventory (MCMI) has become increasingly popular in clinical use. Along with this, there has been more interest in the internal structure of the 20 scales of the original 175-item MCMI-I. The literature reports some agreement on four components, although both three- and five-component solutions have been reported. The degree of similarity of these components across populations remains arguable, as none of the previous studies have used quantitative measures of component similarity. The present study reports on two new samples of psychiatric patients, one of 82 cases from a general hospital and the other of 145 inpatients from a psychiatric hospital. It also reanalyzes the data from nine samples from the literature, using Tucker's coefficient of congruence and ten Berge's analysis of principal component weights (PCW). The congruence analyses showed good agreement of the first three components across samples and notably lower agreement for the fourth. The PCW analyses showed two major types of structure matrices. In the first, there was a large and dominant first component, with three smaller ones. In the second, the variance was distributed more evenly across the four components. The results are discussed in terms of the overlapping scales of the MCMI-I.This work was supported by funds from the Departments of Psychiatry and Psychology, The University of Western Ontario.     

Retest reliability of the Millon Clinical Multiaxial Inventory

This article reports on two studies which examined the temporal stability of the personality disorder subscales from the Millon Clinical Multiaxial Inventory (MCMI). The scales demonstrated adequate stability in psychiatric inpatients (retested with an average of just over 1 year between testings). Furthermore, a separate sample of depressed inpatients assessed when depressed and 6 weeks later showed that the stability of MCMI personality scales was observed even after patients displayed an initial reduction in depression severity. Although stability is vital to the accurate assessment of personality disorders, both studies also found high retest correlations for the MCMI clinical syndrome subscales. In general, these results suggest that patients displayed similar symptom patterns over time, whether construed as personality traits or characteristic patterns of responding when symptomatic.     

Stability of the personality and symptom scales of the Millon Clinical Multiaxial Inventory

This study examines the stability of the basic and pathological personality and symptom scales of the Millon Clinical Multiaxial Inventory (MCMI) in three clinical samples. Consistent with the theory upon which the MCMI is based, higher stability estimates were found among basic personality scales in comparison with symptom scales. However, stability estimates which included initial MCMI administrations at intake into treatment were generally lower than those based upon administrations which occurred later in the treatment process. This later finding suggests the need to consider timing of administration when interpreting the MCMI.     

Stability of the Personality and Symptom Scales of the Millon Clinical Multiaxial Inventory

This study examines the stability of the basic and pathological personality and symptom scales of the Millon Clinical Multiaxial Inventory (MCMI) in three clinical samples. Consistent with the theory upon which the MCMI is based, higher stability estimates were found among basic personality scales in comparison with symptom scales. However, stability estimates which included initial MCMI administration at intake into retreatment were generally lower than those based upon administrations which occurred later in the treatment process. This later finding suggests the need to consider timing of administration when interpreting the MCMI.     

The operating characteristics of the Millon Clinical Multiaxial Inventory

The operating characteristics of the 20 scales of the Millon Clinical Multiaxial Inventory (MCMI) were analyzed with respect to the construction sample data as presented in the test manual. Sensitivity, specificity, positive predictive power, negative predictive power, and overall diagnostic power of each scale were derived. Results indicated that eight scales show excellent characteristics, nine were classified as fair, and three were determined to have poor positive predictive power for identifying the presence of a syndrome in an individual patient. Five scales had good positive predictive power for identifying the most prominent syndrome in a patient's clinical picture, eleven scales were classified as fair, and four were seen as poor on this dimension. We suggest a method for determining the utility of individual scales for different clinical populations and discuss implications of this type of analysis of the MCMI for diagnosis of the individual case.     

The Operating Characteristics of the Millon Clinical Multiaxial Inventory

The operating characteristics of the 20 scales of the Millon Clinical Multiaxial Inventory (MCMI) were analyzed with respect to the construction sample data as presented in the test manual. Sensitivity, specificity, positive predictive power, negative predictive power, and overall diagnostic power of each scale were derived. Results indicated that eight scales show excellent characteristics, nine were classified as fair, and three were determined to have poor positive predictive power for identifying the presence of a syndrome in an individual patient. Five scales had good positive predictive power for identifying the most prominent syndrome in a patient's clinical picture, eleven scales were classified as fair, and four were seen as poor on this dimension. We suggest a method for determining the utility of individual scales for different clinical populations and discuss implications of this type of analysis of the MCMI for diagnosis of the individual case.     

Relationship between the Millon Behavioral Health Inventory and the minnesota multiphasic personality inventory (MMPI) in low-back pain patients

The Millon Behavioral Health Inventory (MBHI) is being used with increasing frequency for the assessment of chronic pain, although there is a relative lack of evidence as to its utility, and prior studies have not examined low back pain. This investigation compared the MBHI to the MMPI in a sample of low-back pain patients and analyzed subgroups of pain patients based upon their MBHI responses. Subjects were 60 patients who had been admitted to outpatient multidisciplinary pain clinics of two Chicago-area hospitals. Patients completed both the MMPI and the MBHI and provided demographic information. Results of correlational analyses indicated strong relationships between the MBHI psychogenic attitude, psychosomatic correlate, and prognostic index scales and the validity scales of the MMPI. The MBHI Pain Treatment Responsivity scale (PP) correlated with 16 of the other 19 MBHI scales. PP did not demonstrate specificity with low back pain patients. The results of both the scale comparisons and the exploratory two-group cluster subgroup analysis support the notion that responses to the MBHI are largely affected by the respondent's tendency to deny psychopathology or to admit emotional distress.