Empirical evaluation of the MCMI-III personality disorder scales

The MCMI-III personality disorder scales were empirically validated with a sample of 870 clinical patients and inmates. Prevalence rates of personality disorders were in general lower on the MCMI-III than clinical ratings, but trait prevalence was generally higher; thus a base rate of 75 on the MCMI-III could be a guideline in the screening of trait prevalence. However, the sensitivity of some MCMI-III scales was very low. Moreover, the correlations of most personality disorder scales of the MCMI-III were significant and positive with corresponding measures on clinical ratings and MMPI-2 personality disorder scales, but these were, in general, not significantly higher than some other correlations. As a consequence the discriminant validity seems to be questionable. The MCMI-III alone cannot be used as a diagnostic inventory, but the test could be useful as a screening device as a part of a multimethod approach that allows aggregation over measures in making diagnostic decisions.     

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.     

A comparison of the MCMI-III personality disorder and modifier indices with the MMPI-2 clinical and validity scales

In this study, we examined the relationship of the MCMI-III (Millon, Davis, & Millon, 1997; Millon, Millon, & Davis, 1994) modifier indices and personality disorder scales to the validity and basic clinical scales of the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). The MCMI-III modifier indices highly correlated with all of the MMPI-2 validity scales except for the F(p) scale. Similarly, the MCMI-III personality disorder scales strongly covaried with the MMPI-2 validity and clinical scales except for the F(p) and 5 (Mf) scales. A factor analysis with Promax rotation revealed substantial relationships between the MMPI-2 and MCMI-III. However, the MMPI-2 F(p) scale did not tend to correlate with MMPI-2 or MCMI-III scales, indicating that F(p) scale variance was largely independent of other scales. The results suggest that clinicians should consider the interrelationship between personality characteristics and dissimulation.     

Exploring the psychometric properties and construct validity of the MCMI-III anxiety and avoidant personality scales

The Millon Clinical Multiaxial Inventory (MCMI; Millon, 1983) is a commonly used self-report instrument designed to aid in the assessment of Axis I and Axis II disorders. Concerns have been expressed regarding the procedures used in the normative research for the current version of the MCMI (MCMI-III; Millon, 1994) leading to a call for additional validity research on the MCMI-III (Retzlaff, 1996). In this study, we investigated the psychometric properties of the MCMI-III's Anxiety and Avoidant personality scales in a sample of patients diagnosed with Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) anxiety disorders. Our results suggest that the MCMI-III Avoidant scale is reliable (r =.89) and it was found to demonstrate appropriate convergent and divergent validity with other self-report measures. The MCMI-III Anxiety scale also showed adequate reliability (r =.78); however, our findings raise some concerns about the discriminant validity of this scale. A scale composed of the MCMI-III core anxiety items was found to have better discriminant validity. These findings are consistent with those reported by other researchers regarding the relationship between self-report measures of anxiety, avoidance, and depression. We conclude that the MCMI-III measures of anxiety and avoidance are consistent with other measures of these constructs and may provide valuable clinical information in this regard.     

Validation of two scales for narcissistic personality disorder

The many theoretical accounts of narcissistic personality disorder (NPD) provide no widely accepted method of identifying persons having this syndrome. Undergraduate scores on the Narcissistic Personality Inventory (NPI) and the Millon Clinical Multiaxial Inventory (MCMI) Narcissistic scale were intercorrelated and were also correlated with the Marlowe-Crowne Social Desirability Scale (MCSDS). NPI and the MCMI subtests correlated significantly with each other, r(146) = .55, p less than .001, but not with the MCSDS. These results further the search for a reliable, valid, and easily administered test for NPD while leaving open the question of the relationship between this syndrome and concern with self-presentation.     

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.     

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.     

Maximum likelihood estimates of the ability of the MMPI and MCMI personality disorder scales and the SIDP to identify personality disorders.

The ability of the Minnesota Multiphasic Personality Inventory (MMPI) and Millon Clinical Multiaxial Inventory (MCMI) personality disorder scales and the Structured Interview for DSM-III Personality Disorders (SIDP) to identify personality disorders was estimated statistically using 122 subjects. Each technique was reasonably accurate when various diagnoses were excluded, but they were quite variable in identifying members of specific diagnostic categories. The same general pattern was seen when the disorders were combined into three general diagnostic clusters. The techniques excluded cluster membership fairly well, although there was little agreement across techniques for identifying cluster membership. The MCMI, however, was moderately adept at identifying membership in all three clusters. It was suggested that these instruments should be used cautiously in clinical settings and that additional data on their performance be obtained.     

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.     

Factor structure of the MCMI basic personality scales and common-item artifact

The eight basic personality scales of the Millon Clinical Multiaxial Inventory (MCMI) were derived from Millon's theory of personality, but the adequacy of the MCMI for measuring Millon's personality constructs has never been assessed. One major problem with using factor analysis to illuminate the structure of the MCMI personality scales is that artifactual structure may result from item overlap among the scales. To analyze this, item-overlap coefficients were factored and compared to the factor structures of five subject samples. For the eight basic personality scales, three factors emerged for the overlap matrix and each of the five sample matrices: Aloof-Social, Aggressive-Submissive, and Lability-Restraint. It was concluded that these three factors are inconsistent with Millon's theory and that they will be found artifactually across a wide variety of populations due to overlapping items.     

The comparative validity of MCMI-II and MMPI-2 personality disorder scales with forensic examinees.

This study demonstrated the convergent and discriminant validity of the MMPI-2 and MCMI-II personality disorder scales with forensic examinees. Based on averaged correlational data, the scales performed comparably with previous findings in psychiatric samples. Furthermore, the scales demonstrated increased convergent correlations. Improved convergence was obtained for the Antisocial, Sadistic, Borderline, Schizotypal and Paranoid scales. Decreased convergence on the Dependent and Avoidant scales was also obtained.     

Incremental validity of the MMPI-2 PSY-5 scales in assessing self-reported personality disorder criteria

The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Personality Psychopathology-Five (PSY-5) scales were developed to measure abnormal personality symptomatology. The present study examines the incremental validity of the PSY-5 scales beyond the clinical and content scales in assessing criteria associated with personality disorders. The current sample includes 240 male and 407 female clients from private practice settings who completed the MMPI-2 and the Multiaxial Diagnostic Inventory (MDI), a self-report checklist of Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised) symptoms. Six of the MDI personality disorder scales, conceptually related to the PSY-5 scales, are used as criteria. Hierarchical regression analyses determine the incremental validity of each PSY-5 scale. In most analyses, PSY-5 scales add a significant increment of variance to the clinical and content scales. Implications of the results are discussed.     

Creative personality in schizophreniform disorder.

This paper sets forth the contention that a schizophreniform disorder can enhance creativity. Given the usual brief duration of no more than six months, this disorder may enable the resilient ego of a creative person to descend temporarily into the symbolic sea of the unconscious. With such broadening of the person's symbolic experience in the unconscious, in the postpsychotic period the person may be able to forge symbols into novel concepts through a cohesive ego restored to homeostasis.     

Confirmatory factor analysis of the three-factor structure of the schizotypal personality questionnaire and Chapman schizotypy scales

We examined the factor structure of the Schizotypal Personality Questionnaire (SPQ; Raine, 1991), using confirmatory factor analysis in 3 experiments, with an aim to better understand the construct of schizotypy. In Experiment 1 we tested the fit of 2-, 3-, and 4-factor models on SPQ data from a normal sample. The paranoid 4-factor model fit the data best but not adequately. Based on the strong basis for the Raine 3-factor model we attempted to improve the fit of the 3-factor model by making 3 modifications to the Raine model. These modifications produced a well-fitting model. In Experiment 2 the good fit of this modified 2-factor model to SPQ scores was replicated in an independent normal sample. In Experiment 3, the modified 3-factor model was successfully extended to include the 3 Chapman schizotypy scales. Together these 3 experiments indicate that the 3-factor model of the SPQ, albeit with some slight modifications, is a good model for schizotypy structure that is not restricted to 1 measure of schizotypal personality traits.     

Psychodiagnosis of personality structure: psychotic personality organization.

Recent developments in Rorschach psychology, including nomothetic approaches focused on scores, ratios, and indices and idiographic approaches focused on content emerging from psychoanalytic theory, offer the Rorschach clinician a rich and potent interpretive methodology. This article examines the structural diagnosis of personality organization with a focus on psychotic personality structure. Rorschach approaches to the differential diagnosis of psychotic personality organization are presented. The Rorschach is viewed as indispensible in the differential diagnosis of personality organization, especially in the so-called "borderline" cases.     

The structure of traits delineating personality disorder in a Chinese sample

The present study examined the factorial structure of a Chinese language version of the self-report Dimensional Assessment of Personality Pathology Questionnaire in 581 adults. Four factors were extracted (Emotional Dysregulation, Dissocial, Inhibition, and Compulsivity) that are similar to the factors extracted in the scales' normative clinical and general population samples from North America (factor comparability coefficients range from .88 to .96), supporting the idea that this trait structure is invariant across diverse populations. The internal consistency of the scales (Cronbach's alpha) was satisfactory across age and gender groups with the exception of the Intimacy Problems scale. Possible explanations for the poor internal consistency of the Intimacy Problems scale, such as cultural differences in social factors influencing marital and romantic relationships in Chinese populations, as opposed to other populations are discussed.