How (not) to evaluate the comparability of MMPI and MMPI-2 profile configurations: a reply to Humphrey and Dahlstrom

Humphrey and Dahlstrom (1995) presented a study on the comparability of MMPI/MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) profiles in which they concluded that "the bases for clinical interpretation derived from the MMPI and MMPI-2 profiles were sufficiently at variance to require different conclusions" [sic] (p. 2). In this brief critique, we identify procedural and data-analytical deficiencies that invalidate Humphrey and Dahlstrom's argument. Their blanket recommendation based on this argument, namely, that clinicians routinely plot both MMPI and MMPI-2 profiles, is unwarranted.     

Mapping the MMPI-2 Restructured Clinical scales onto normal personality traits: evidence of construct validity

The MMPI-2 Restructured Clinical (RC; Tellegen et al., 2003) scales were developed to remove common factor variance that saturates the clinical scales and create a more distinct set of measures, yielding a new set of scales with improved convergent and discriminant validity. In this study, we examined the relation between RC scale scores and scores on the Multidimensional Personality Questionnaire (MPQ; Tellegen, in press), a measure of normal personality, using a sample of 811 college students. The results indicate strong convergence between the RC scales and expected MPQ higher order factors and primary scales. The RC scales also demonstrated expected improved convergent and discriminant validity over the clinical scales.     

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.     

Dialectical Behavior Therapy: Does It Bring About Improvements in Affect Regulation in Individuals with Eating Disorders?

The current investigation sought to determine whether a standard outpatient dose of dialectical behavior therapy (DBT) skills training (2 h per week) coupled with standard CBT treatment would be sufficient to produce changes in affect regulation over the course of day hospitalization treatment. In an uncontrolled pre-post treatment design, 65 women diagnosed with anorexia nervosa or bulimia nervosa were assessed at the beginning of treatment and at the end of treatment on affect regulation. Findings indicated that participants demonstrated a significant improvement in their ability to regulate affect, suggesting that weekly DBT treatment may play an important role in producing changes in affect regulation. Secondary analyses on eating disorder outcomes revealed a significant increase in weight gain as well as a significant reduction in restriction, bingeing, purging and eating disordered cognitions. Findings are discussed in the context of clinical and treatment implications for those with severe eating disorders.     

External Validity of the New Devereux Adolescent Behavior Rating Scales

The discriminant and concurrent validity of the five new scales for the Devereux Adolescent Behavior Rating Scale (DAB) was explored using a heterogeneous sample of psychiatric and substance abuse patients. Consistent with predictions, the substance abuse patients scored higher on the Acting Out Behaviors (AOB) and Heterosexual Interests (HI) scales, and psychiatric patients scored higher on the Psychotic Behaviors scale. Gender differences also were found, including boys being rated higher on Acting Out Behaviors, and girls higher on Heterosexual Interests. The new DAB scales demonstrated sufficient concurrent validity using a thorough record review and a parent rating scale (the Child Behavior Checklist [CBCL]). The Neurotic/Dependent Behaviors scale (NDB) showed a consistent relationship with substance abuse and several other measures of more externalizing behaviors, in addition to the predicted relationships with anxious, tense, and dependent behaviors. The Withdrawn/Timid Behaviors scale (WTB) proved to be a purer measure of internalizing behaviors in both sexes.     

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.     

Associations Between Symptom Validity Test Failure and Scores on the MMPI–2–RF Validity and Substantive Scales

Existing measures of approval motivation attempt to assess this dimension of personality indirectly through evaluation of socially desirable response tendencies. The Martin-Larsen Approval Motivation (MLAM) Scale takes a more direct approach by focusing on individual differences in need for social approval. Since the original version of the MLAM scale is subject to acquiescence response bias, fully balanced and partially balanced scales were created to minimize this response style. Results indicated that the revised measures arc equivalent to the original version and that balancing affects the magnitude but not the pattern of correlates with other scales. Comparisons with the Marlowe-Crowne Social Desirability (MCSD) Scale revealed a divergent pattern of correlates with several measures of personality suggesting a basic difference between the MLAM and MCSD in their conceptualization of approval motivation.     

Predictive validity of the MMPI-2 Restructured Clinical (RC) Scales in a batterers' intervention program

We examined the convergent and discriminant validity of the MMPI-2 Restructured Clinical (RC) scales in predicting relevant historical variables, treatment success, and recidivism in offenders enrolled in a batterers' intervention program. We used a sample studied previously by Petroskey, Ben-Porath, and Erez (2002), which included an ethnically diverse group of 483 men enrolled in a psychoeducational batterer's intervention program. We coded various historical variables (e.g., criminal history, substance abuse problems, mental health treatment, anger problems, and amount of partner violence), treatment dismissal, and recidivism up to 1 year posttreatment. Correlational analyses with the historical variables provided evidence of convergent and discriminant validity of the RC scales in this forensic sample. Regression analyses showed that these scales added to the historical variables in predicting treatment failure and recidivism. Relative risk analyses indicated the extent to which individuals entering treatment with elevated scores on RC4 and RC9 were at increased risk for these negative outcomes.     

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.