A cross-validation of MMPI-2 substance abuse scales.

We evaluated the efficacy of the Addiction Potential Scale (APS) and the Addiction Acknowledgement Scale (AAS), two new scales designed to assess substance abuse problems with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), in samples from settings different from those used in their development. Results replicate earlier findings that both scales discriminate between psychiatric and substance abuse samples and do so more effectively than other substance abuse scales designed for use with the MMPI and carried over to the MMPI-2. Results also suggest that APS may be more resistant than AAS to response distortion.     

MMPI-2 scores of patients with insomnia

Although the MMPI-2 has been employed since 1989, to date no study has been reported on its use with patients with insomnia. The MMPI-2 was administered to 104 insomnia patients. The T scores of all the MMPI-2 scales fell below the cut-off score of T = 65. Although the group profile was within the normal range, the percentages of patients who had MMPI-2 scores above T = 65 for each scale indicated that a substantial portion of the insomnia patients obtained elevated scores, particularly in the Hs, D, Hy, and Pt scales. Thus, the results suggest that many of the insomnia patients exhibit psychological distress and would benefit from brief psychological interventions, such as sleep hygiene education and relaxation training. In view of the large number of insomnia patients who obtained abnormal MMPI-2 scores, a psychological measure such as the MMPI-2 remains an important assessment tool in identifying insomnia patients who may need extensive psychotherapeutic intervention.     

Associations between Symptom Validity Test failure and scores on the MMPI-2-RF validity and substantive scales

This study examined the association between Symptom Validity Test (SVT) failure and the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008), in the Forensic Disability Claimant samples described in the MMPI-2-RF Technical Manual (Tellegen & Ben-Porath, 2008 a, 2008b). SVTs used included the Word Memory Test (Green, 2003), the Computerized Assessment of Response Bias (Allen, Conder, Green, & Cox, 1997), the Medical Symptom Validity Test (Green, 2004), and the Test of Memory Malingering (Tombaugh, 1996). SVT failure was associated with significant elevations throughout the MMPI-2-RF overreporting validity scales and substantive scales. Pairwise contrasts between groups failing 0 and 3 SVTs revealed predominantly large effect sizes for the overreporting validity scales (d = 0.78-1.11), and many of the substantive scales, including the Cognitive Complaints (COG) scale. Results of this study demonstrate an association between SVT performance and elevated scores on the MMPI-2-RF. These results suggest that exaggeration of cognitive symptoms as demonstrated by SVT failure is also associated with overreported emotional, somatic, and neurocognitive complaints on the MMPI-2-RF.     

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.     

Profile validity standards for MMPI and MMPI-2 F scales

Although numerous indices of validity have been developed for the MMPI and MMPI-2, interest in the F scale and its variants continues, especially among practicing clinicians. The use of the binomial for assessing standards for random answering and possibly for judgments of malingering offers another approach for the interpretation of F-scale scores. The theoretical binomial distribution and Monte Carlo data are in accord. Cut-off scores of 24 for the MMPI and 23 for the MMPI-2 suggest random responses, and scores of 40 and 37, respectively, suggest clinical interpretation rather than randomness of responding.     

Comparability of MMPI-2 scales and profiles over time

This study investigated Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) scale and profile comparablilty for MMPI-2 profiles completed on 2 separate occasions by mental health patients receiving treatment at a Veterans Affairs Medical Center (n = 114). Patients were predominantly men (96.5%), with an average age of 44.08 and an average of 12.39 years of education at the time of initial testing. MMPI-2 tests were completed on 2 separate occasions as a routine part of treatment with a mean interval between test administrations of 688 days. Findings were analyzed for the complete sample and for 3 subsamples with different test-retest intervals. MMPI-2 scale test-retest correlation coefficients for the entire sample ranged from .48 to .69 for the Basic scales, .49 to .80 for the Supplementary scales, and .56 to .78 for the Content scales with scale high-point agreement = 38.60%, high 2-point agreement = 16.67%, and high 3-point agreement = 19.30%. High-point agreement for subsets of participants with well-defined high points, 2-points and 3-points was 41.07%, 27.50%, and 25.93% respectively. Pearson r correlation coefficients for T scores across the Basic scales for pairs of profiles averaged .78, suggesting similarity of profile shape across testing occasions. MMPI-2 profiles were also examined in relation to Skinner and Jackson's 3 modal MMPI profile types.     

Validation of selected MMPI-2 basic and content scales

To investigate whether some of the MMPI-2 basic and/or content scales measure the factor structure represented by the Big-Five, 288 undergraduates (178 women and 110 men), between the ages of 18 and 34 years, were administered MMPI-2 and MARS (Michill Adjective Rating Scale) which measures four factors that are conceptually similar to the first four of the Big-Five. It was hypothesized that (a) three MMPI-2 scales (basicDepression or D, contentAnxiety or ANX, and contentDepression or DEP) would be correlated with MARSUnhappiness; (b) two MMPI-2 scales (basicSocial Introversion or Si and contentSocial Discomfort or SOD) would be correlated with MARSExtraversion; (c) two MMPI-2 scales (contentAnger or ANG and contentType A Behavior or TPA) would be correlated with MARSAssertiveness; and (d) two MMPI-2 scales (contentWork Interference or WRK and supplementaryDominance or DOM) would be correlated with MARSProductive Persistence. Results corroborated the hypothesized relationships between the components of the aforementioned four dyads.     

Convergent validity of alternative MMPI-2 personality disorder scales

The Morey, Waugh, and Blashfield (1985) MMPI (Hathaway et al., 1989) personality disorder scales provided a significant contribution to personality disorder research and assessment. However, the subsequent revisions to the MMPI and the multiple revisions to the diagnostic criteria sets that have since occurred may have justified comparable revisions to these scales. Somwaru and Ben-Porath (1995) selected a substantially different set of items from the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) to assess Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) personality disorder diagnostic criteria. In our study, we compared the convergent validity of these alternative MMPI-2 personality disorder scales with respect to 3 self-report measures of personality disorder symptomatology in a sample of 82 psychiatric outpatients. The results suggested that Somwaru and Ben-Porath's scales are as valid as the original Morey et al. scales and might be even more valid for the assessment of borderline, antisocial, and schizoid personality disorder symptomatology.     

A taxometric analysis of the MMPI-2 Depression scales

The MMPI (Hathaway & McKinley, 1943) and MMPI-2 (Butcher et al., 2001) have long been used as measures of psychopathology. Both clinicians and researchers have noted the widespread existence of negative affectivity on the MMPI and MMPI-2 that may elevate scale scores and eclipse the tests' ability to differentiate depression from other clinical disorders. Using taxometric analyses, in this study we sought to test directly whether the MMPI-2 depression scales could differentiate patients with depressive symptoms from patients with other disorders. A large psychiatric sample (N = 2,000) was utilized and analyses were run separately for men and women. Taxometric analyses did not find a MMPI-2 Depression scale cut point that categorizes patients with depressive symptoms from other patients. Rather, these findings support previous studies finding an underlying dimensionality of depression. We discuss implications for MMPI-2 scale use and depression nosology in light of these findings.     

The effect of MMPI-2 on scoring of special scales derived from MMPI-1.

Twenty-nine special scales derived from the Minnesota Multiphasic Personality Inventory (MMPI-1; Hathaway & McKinley, 1983) were scored from MMPI-I and MMPI++-2 (Hathaway et al., 1989) items for a normal and a psychiatric sample. Resulting pairs of mean scores were compared. Absolute differences were found to be small but statistically significant. We concluded that, despite the statistical significance, the small absolute differences suggest that most of the MMPI-I special scales probably can be scored and interpreted from MMPI-2 items. Further research along this line is necessary.     

Convergent validity of the MCMI-III personality disorder scales and the MMPI-2 scales

The MCMI-III personality disorder scales (Millon, 1994) were empirically validated in a sample of prisoners, psychiatric inpatients, and outpatients (N = 477). The scale intercorrelations were congruent with those obtained by Millon, Davis, and Millon (1997). We conclude that our Flemish/Dutch version shows no significant differences with the original version of the MCMI-III as far as intercorrelations are concerned. Convergent validity of the MCMI-III personality disorder scales was evaluated by the correlational data between the MCMI-III personality disorder scales and the MMPI-2 clinical (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) and personality disorder (Somwaru & Ben-Porath, 1995) scales. Improved convergence was obtained compared with previous versions of the MCMI-I. Only the compulsive MCMI-III personality disorder scale remains problematic. The scale even showed negative correlations with some of the related clinical scales and with the corresponding personality disorder scales of the MMPI-2.     

The impact of emotional priming on MMPI-2 scale scores

The current study investigated potential emotional priming effects on Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scale scores. Participants included 98 college students who completed a personal narrative intended to induce temporary mood states, the MMPI-2, and a mood rating inventory. Results of the mood manipulation indicated that the individuals who first wrote a negative personal narrative reported a less positive mood (d = -.79). However, analysis of variance results indicated no statistically significant differences on MMPI-2 scale scores between groups (median η(2) = .005). Limitations and future directions are discussed.     

Factor analysis of MMPI-2 basic scales among college students

The MMPI-2 was administered to 288 college students (178 women and 110 men) between the ages of 18 and 34 years. Scores on the basic 13 (three validity and ten clinical) scales were correlated and subjected to principal component analyses separately for men and women. In each case, four factors were retained and subjected to varimax rotation. Coefficients of congruence were calculated for all possible pairs of factors across two samples of college students and the normative adults, separately for men and women, and across genders within each sample. Results indicated that the factorial structure of the MMPI-2 basic scales seemed to possess considerable uniformity across samples and genders, but not without some notable exceptions.     

MMPI-2 validity scales in child custody evaluations: clinical versus statistical significance

The MMPI-2 is commonly used in the psychological assessment of parents within child custody evaluations. Due to the interface of mental health practitioners with non-mental-health professionals in the context of child custody cases, careful attention must be paid to the potential misunderstanding or misuse of data from psychological testing. While traditional clinical lore has maintained an expectation of clinically significant defensiveness on the MMPI-2 with this population, the research data does not support this view. Despite empirical findings that identify patterns of elevations on the MMPI-2 validity scales with parents involved in child custody disputes, these patterns have been demonstrated to reach statistical but not clinical significance. That is, MMPI-2 profiles that contain elevations on scales L or K that either invalidate or notably suppress clinical scales are not to be expected in the child custody population. False causal attributions contributing to the potential mischaracterization or loss of important data related to personality functioning within this population are identified and discussed. Potential dangers associated with such false causal attributions are reviewed.     

An examination of three sets of MMPI-2 personality disorder scales

Three sets of personality disorder scales (PD scales) can be scored for the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). Two sets (Levitt & Gotts, 1995; Morey, Waugh, & Blashfield, 1985) are derived from the MMPI (Hathaway & McKinley, 1983), and a third set (Somwaru & Ben-Porath, 1995) is based on the MMPI-2. There is no validity research for the Levitt and Gotts scale, and limited validity research is available for the Somwaru and Ben-Porath scales. There is a large body of research suggesting that the Morey et al. scales have good to excellent convergent validity when compared to a variety of other measures of personality disorders. Since the Morey et al. scales have established validity, there is a question if additional sets of PD scales are needed. The primary purpose of this research was to determine if the PD scales developed by Levitt and Gotts and those developed by Somwaru and Ben-Porath contribute incrementally to the scales developed by Morey et al. in predicting corresponding scales on the MCMI-II (Millon, 1987). In a sample of 494 individuals evaluated at an Army medical center, a hierarchical regression analysis demonstrated that the Somwaru and Ben-Porath Borderline, Antisocial, and Schizoid PD scales and the Levitt and Gotts Narcissistic and Histrionic scales contributed significantly and meaningfully to the Morey et al. scales in predicting the corresponding MCMI-II (Millon, 1987) scale. However, only the Somwaru and Ben-Porath scales demonstrated acceptable internal consistency and convergent validity.     

Psychometric evaluation of the restructured clinical scales of the MMPI-2

Conceptual overlap and heterogeneity have long been noted as weaknesses of the Minnesota Multiphasic Personality Inventory's clinical scales. Restructured clinical (RC) scales recently were developed to address these concerns (A. Tellegen et al., 2003). The authors evaluated the psychometric properties of the RC scales in psychology clinic clients (N=285) and military veterans (N=567). The RC scales were as internally consistent as the clinical scales and correlated strongly with their original counterparts (except for RC3/Hysteria). They also were less intercorrelated, produced conceptually clearer relations with measures of personality and psychopathology, and yielded somewhat greater incremental utility than the clinical scales. Thus, the RC scales demonstrated several psychometric strengths while utilizing 60% fewer items, but the 2 sets of scales cannot be used interchangeably. Interpretive considerations are discussed.     

Using reliability generalization methods to explore measurement error: an illustration using the MMPI-2 PSY-5 scales

Reliability generalization (RG) is a meta-analytic technique that allows for the systematic examination of variation in score reliability for different samples of test takers; this procedure is based on the recognition that reliability is not a stable property of a test but is sample dependent. As a demonstration of an RG analysis, I obtained 63 reliability coefficients for each of the MMPI-2 (Butcher et al., 2001) Personality Psychopathology 5 (Harkness, McNulty, & Ben-Porath, 1995) scales. The overall variability of alpha coefficients supports the argument that reliability is sample dependent and underscores the need for researchers to calculate reliability estimates based on their research samples rather than simply citing published alpha coefficients as evidence of score reliability. I observed statistically significant mean reliability differences for scores across the 5 scales, with the highest level of reliability observed for scores on the measure of Negative Emotionality and the lowest levels of reliability observed for scores on the measures of Aggression and Disconstraint. There was no evidence that the sex-composition of a sample was systematically related to score reliability, and there were no statistically significant differences in reliability between scores obtained with the English version of the test and those obtained with translated forms. However, reliability was consistently lower for scores on some scales when the data were obtained in nonclinical settings as opposed to clinical ones. Sample size was not significantly correlated with reliability estimates. RG methods have the potential for deepening the level of understanding about the role of reliability in the evaluation and use of personality tests.     

Adherence to substance abuse treatment: clinical utility of two MMPI-2 scales.

In this study, we examined the ability of the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) Addiction Acknowledgment scale (AAS; Weed, Butcher, McKenna, & Ben-Porath, 1992) and Negative Treatment Indicators scale (TRT; Butcher, Graham, Williams, & Ben-Porath, 1990) to predict adherence to and outcomes from substance abuse treatment. There was no evidence that the AAS was related to treatment adherence or outcome in our sample. However, results did reveal a significant positive relation between scores on the TRT scale and readmission to the hospital. Further analyses identified an optimal score for use in similar clinical populations and settings, and characteristics of high and low scorers. Compared to low scorers, high TRT scorers were more likely to not return for treatment after an initial screening interview. If they did return for treatment, high TRT scorers were more likely to experience fewer treatment days and to be rated as having lower motivation, poorer participation, and poorer comprehension of program materials. These findings provide promising initial evidence of the utility of the TRT scale for identifying patients who may be at a high risk for unsuccessful substance abuse treatment.     

Effects of acculturation on the MMPI-2 scores of Asian American students

The use of the MMPI-2 (Butcher, Dahlstron, Graham, Tellegen, & Kaemmer, 1989) with minorities has been questioned due to potential misinterpretations related to cultural differences. This study examined acculturative differences among Asian American college students and their scores on the validity and clinical scales. A sample of Asian American students (n = 90) was assigned to groups based on acculturation level. Analysis of variance tests indicated that low-acculturated, bicultural, and high-acculturated Asian Americans yielded different profiles. Compared to a matched White student sample, low-acculturated Asian Americans scored significantly higher on 9 scales, and bicultural Asian Americans had 6 significantly different scores. These differences were clinically interpretable with a range from 6.46 to 21.65 T-score points. High-acculturated Asian Americans did not differ from Whites. Cultural variables to be considered when interpreting Asian American profiles are discussed.