Empirical Correlates of the MMPI–2 Restructured Clinical (RC) Scales in Psychiatric Inpatients

We identified empirical correlates of the MMPI–2 Restructured Clinical (RC) scales in 1,872 male and 498 female psychiatric inpatients drawn from 2 large tertiary care medical centers. We generated clinical criteria from a systematic review of the patients' intake and discharge medical records. We report zero order correlations between RC scales and clinical criteria and relative risk ratios for dichotomous variables. We found the RC scales to be correlated with conceptually relevant criteria such that for each scale, we identified significant increases in the risk for a variety of emotional, cognitive, and behavioral problems among individuals whose T score exceed 64.     

The structure of PTSD among two cohorts of returning soldiers: before, during, and following deployment to Iraq

Evidence suggests either a four-factor emotional numbing or dysphoria model likely reflects the underlying structure of posttraumatic stress disorder (PTSD). Questions remain as to which of these structures best represents PTSD, how the structure changes with time, the applicability of models to returning veterans, and the validity of the symptom clusters. The present study addresses these questions among two longitudinal samples of National Guard soldiers assessed prior to, during, and following a combat deployment to Iraq. Findings support a four-factor intercorrelated dysphoria model of PTSD that remains stable across samples and time points. Differential associations were observed among PTSD symptom clusters over time and between symptom clusters and both depression and combat exposure, supporting important distinctions between symptom clusters.     

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.     

General behavior inventory identification of unipolar and bipolar affective conditions in a nonclinical university population

Validated the General Behavior Inventory (GBI), revised to identify unipolar as well as bipolar affective conditions, in a nonclinical sample (n = 201) against naive, interview-derived diagnoses. For bipolar and unipolar conditions, respectively, the GBI had high positive (.94, .87) and negative (.99, .93) predictive power with the effect of prevalence considered, adequate sensitivity (.78, .76), high specificity (.99, .99), and adequate selection ratios for sampling of affective and nonaffective subjects from nonclinical populations for research purposes. The utility of the GBI in several different research contexts is discussed.     

The Utility of MMPI–2–RF Scale Scores in the Differential Diagnosis of Schizophrenia and Major Depressive Disorder

This study was designed to determine whether scores on selected Minnesota Multiphasic Personality Inventory–2–Restructured Form (MMPI–2–RF) scales could be used to differentiate between individuals diagnosed with schizophrenia (SCZ) and major depressive disorder (MDD). The sample was drawn from 2 psychiatric inpatient hospitals and included data from 199 individuals with SCZ and 808 individuals with MDD. A series of multivariate analyses of variance, analyses of variance, and odds ratios were calculated to determine which MMPI–2–RF scales provide the best differentiation between individuals presenting with these 2 disorders. Results indicated scales assessing internalizing dysfunction, including Emotional/Internalizing Dysfunction (EID), Restructured Clinical Scales Demoralization (RCd), Low Positive Emotions (RC2), Suicidal/Death Ideation (SUI), and Self Doubt (SFD) best discriminated MDD from SCZ. Scales assessing thought dysfunction, incluidng Thought Dysfunction (THD), Restructured Clinical Scales Ideas of Persecution (RC6) and Aberrant Experiences (RC8), and Psychoticism-Revised (PSYC-r) were demonstrated to best identify SCZ. Comparisons of the examined MMPI–2–RF scales to MMPI–2 scales assessing similar constructs suggested scales from the MMPI–2–RF perform similarly to their MMPI–2 counterparts in detecting MDD or SCZ, but might have increased ability to discriminate SCZ from other conditions. Overall, results of this study suggest that scores on the examined MMPI–2–RF scales provide important information about the differential diagnosis of MDD and SCZ to clinicians working in inpatient settings.     

The Minnesota Multiphasic Personality Inventory-2 Restructured Form in National Guard soldiers screening positive for posttraumatic stress disorder and mild traumatic brain injury

The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2 RF) was administered to 251 National Guard soldiers who had recently returned from deployment to Iraq. Soldiers were also administered questionnaires to identify posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). On the basis of responses to the screening instruments, the National Guard soldiers who produced a valid MMPI-2 RF were classified into four groups: 21 soldiers who screened positive for PTSD only, 33 soldiers who screened positive for mTBI only, 9 soldiers who screened positive for both conditions, and 166 soldiers who did not screen positive for either condition. Results showed that the MMPI-2 RF was able to differentiate across the groups with the MMPI-2 RF specific problem scale Anxiety adding incrementally to MMPI-2 Restructured Clinical scales in predicting PTSD. Both MMPI-2 RC1 (Somatic Complaints) and MMPI-2 RF head pain complaints predicted mTBI screen but did not add incrementally to each other. Of note, all of the MMPI-2 RF validity scales associated with overreporting, including Symptom Validity-Revised (FBS-r), were not significantly elevated in the mTBI group. These findings support the use of the MMPI-2 RF in assessing PTSD in non-treatment-seeking veterans. This further suggests that a positive screen for mTBI alone is not associated with significant emotional disturbance.     

Susceptibility of the MMPI-2 clinical, restructured clinical (RC), and content scales to overreporting and underreporting

The authors examined and compared the susceptibility of three Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scale sets (Clinical, Restructured Clinical [RC], and Content) to over- and underreporting using five analog samples. Two samples of 85 and 191 undergraduate students, respectively, took the MMPI-2 under underreporting versus standard instructions. Three samples consisting of 42 undergraduates, 73 psychiatric inpatients, and 84 medical patients took the MMPI-2 under overreporting versus standard instructions. A comparison of the effect sizes across the three sets of scales indicated that Clinical Scale scores are not less susceptible to distortion than the Content or RC Scales. An apparent lesser susceptibility to underreporting for the Clinical Scales was an artifact of the subtle items' effect on these scales.     

Refinement of the MMPI-2 F(p) scale is not necessary: a response to Gass and Luis

Gass and Luis (2001) reported that four MMPI-2 Lie scale items contained on the F(p) scale do not measure symptom exaggeration but measure defensiveness. They hold that elimination of the four Lie scale items improves the utility of the F(p) scale in the identification of exaggeration in VA samples. To directly address the assertion that removal of the L scale items from the F(p) scale enhances the predictive validity of F(p), data derived from a previously published study where 74 psychiatric inpatients were asked to retake the MMPI-2 and either feign psychopathology or respond in an honest manner were reanalyzed. The intact F(p) scale demonstrated a stronger correlation with group membership, increased incremental validity, and superior classification rates compared with the F(p) scale without the 4 Lie scale items. Consequently, the F(p) refinement recommended by Gass and Luis is unnecessary.     

Introduction to the Special Section: Linking the MMPI–2–RF to Contemporary Models of Psychopathology

This special section considers 9 independent articles that seek to link the Minnesota Multiphasic Personality Inventory–2–Restructured Form (MMPI–2–RF; Ben-Porath &; Tellegen, 2008/2011 Ben-Porath, Y. S., &; Tellegen, A. (2011). MMPI–2–RF (Minnesota Multiphasic Personality Inventory–2 Restructured Form) manual. Minneapolis: University of Minnesota Press. (Original work published 2008) [Google Scholar]) to contemporary models of psychopathology. Sellbom (this issue Sellbom, M. (this issue). Mapping the MMPI–2–RF Specific Problems scales onto extant psychopathology structures. Journal of Personality Assessment. doi:10.1080/00223891.2016.1206909[Taylor &; Francis Online] , [Google Scholar]) maps the Specific Problems scales onto hierarchical psychopathology structures, whereas Romero, Toorabally, Burchett, Tarescavage, and Glassmire (this issue Romero, I. E., Toorabally, N., Burchett, D., Tarescavage, A. M., &; Glassmire, D. M. (this issue). Mapping the MMPI–2–RF Substantive scales onto internalizing, externalizing, and thought dysfunction dimensions in a forensic inpatient setting. Journal of Personality Assessment. doi:10.1080/00223891.2016.1223681[Taylor &; Francis Online] , [Google Scholar]) and Shkalim, Almagor, and Ben-Porath (this issue Shkalim, E., Almagor, M., &; Ben-Porath, Y. S. (this issue). Examining current conceptualizations of psychopathology with the MMPI–2/MMPI–2–RF Restructured Clinical scales: Preliminary findings from a cross-cultural study. Journal of Personality Assessment. doi:10.1080/00223891.2016.1189429[Taylor &; Francis Online] , [Google Scholar]) show evidence of linking the instruments' scales to diagnostic representations of common higher order psychopathology constructs. McCord, Achee, Cannon, Harrop, and Poynter (this issue McCord, D. M., Achee, M. C., Cannon, E. M., Harrop, T. M., &; Poynter, W. D. (this issue). Using the research domain criteria framework to explore associations between MMPI–2–RF constructs and physiological variables assessed by eye-tracker technology. Journal of Personality Assessment. doi:10.1080/00223891.2016.1228067[Taylor &; Francis Online] , [Google Scholar]) link the MMPI–2–RF scales to psychophysiological constructs inspired by the National Institute of Mental Health (NIMH) Research Domain Criteria. Sellbom and Smith (this issue Sellbom, M. (this issue). Mapping the MMPI–2–RF Specific Problems scales onto extant psychopathology structures. Journal of Personality Assessment. doi:10.1080/00223891.2016.1206909[Taylor &; Francis Online] , [Google Scholar]) find support for MMPI–2–RF scale hypotheses in covering personality psychopathology in general, whereas Klein Haneveld, Kamphuis, Smid, and Forbey (this issue Klein Haneveld, E., Kamphuis, J.H., Smid, W., &; Forbey, J. D. (this issue). Using MMPI–2–RF correlates to elucidate the PCL–R and its four facets in a sample of male forensic psychiatric patients. Journal of Personality Assessment. doi:10.1080/00223891.2016.1228655[Taylor &; Francis Online] , [Google Scholar]) and Kutchen et al. (this issue Kutchen, T. J., Wygant, D. B., Tylicki, J. L., Dieter, A. M., Veltri, C. O., &; Sellbom, M. (this issue). Construct validity of the MMPI–2–RF Triarchic Psychopathy scales in correctional and collegiate samples. Journal of Personality Assessment. doi:10.1080/00223891.2016.1238829[Taylor &; Francis Online] , [Google Scholar]) demonstrate the utility of the MMPI–2–RF in capturing contemporary conceptualizations of the psychopathic personality. Finally, Franz, Harrop, and McCord (this issue Franz, A. O., Harrop, T. M., &; McCord, D. M. (this issue). Examining the construct validity of the MMPI–2–RF Interpersonal Functioning scales using the Computerized Adaptive Test of Personality Disorder as a comparative framework. Journal of Personality Assessment. doi:10.1080/00223891.2016.1222394[Taylor &; Francis Online] , [Google Scholar]) and Rogers et al. (this issue Rogers, M. L., Anestis, J. C., Harrop, T. M., Schneider, M., Bender, T. W., Ringer, F. B., &; Joiner, T. E. (this issue). Examination of MMPI–2–RF Substantive scales as indicators of acute suicidal affective disturbance components. Journal of Personality Assessment. doi:10.1080/00223891.2016.1222393[Taylor &; Francis Online] , [Google Scholar]) mapped the MMPI–2–RF scales onto more specific transdiagnostic constructs reflecting interpersonal functioning and suicide behavior proneness, respectively.