The MMPI and clinical diagnosis: a comparison of classification system outcomes with discharge diagnoses

This study examined the agreement or congruence rate between clinical-discharge diagnoses rendered by a psychiatrist, and admission and discharge MMPI-derived diagnoses from four diagnostic classification systems that have been developed for the MMPI. The four classification systems included a simple high-point code based on the most elevated clinical scale in the profile, the Henrichs revision of the Meehl-Dahlstrom rules, the Goldberg equations, and a system developed by Lachar. Subjects consisted of 150 patients selected from a larger pool of patients who had completed a 9-week adult residential treatment program. Overall, this study yielded modest hit rates between 26% and 34% for MMPI-derived diagnoses and psychiatric diagnoses across the various classification systems. In addition, stability of MMPI-based diagnoses from admission to discharge assessments ranged from 48% to 51% depending on the classification system employed. Findings are discussed in terms of their implications for the use of the MMPI in patient diagnosis. It is recommended that the MMPI be used in conjunction with other sources of clinical and test information in deriving clinical diagnoses.     

A comparison of alternative theoretical approaches to smoking cessation and relapse

Two theoretical approaches to smoking cessation were compared. Participants were randomly assigned either to (a) a traditional treatment program that used contingency contracting and that emphasized the necessity for absolute abstinence (AA) or to (b) a relapse-prevention (RP) treatment that focused on gradual acquisition of nonsmoking skills. It was hypothesized that participants in the RP treatment would be less successful initially but would have better maintenance skills and thus would relapse less during a 1-year follow-up period. Each program was evaluated in two formats: group-based treatment and self-help materials. Results indicated comparable 1-year abstinence rates for all treatments, although more participants dropped out of the self-help formats. Participants in the RP intervention were more likely to lapse sooner after quitting and were more likely to quit again during the 1-year maintenance period. Exploratory analyses of successful participants suggested that women were more successful in the RP program and that men had greater success with the AA approach.     

Aggregate item response analysis

A stochastic postulate is given for the multiple-item, successive-intervals scaling of populations. The logistic equivalent of this postulate provides an aggregate item response model in which a unidimensional submodel may be nested. This reduction provides a subtractive conjoint measurement of several items and stimuli on the same latent scale. Generalized-least-squares methods are used to estimate and test the multiple-item model, and its unidimensional reduction, on aggregate survey responses. The entire procedure is illustrated with an analysis of semantic-differential attitude data. This analysis exhibits an item selection procedure that is applicable to various social constructs.The authors dedicate this paper to the memory and contributions of Clyde Coombs.The programming and data analyses for the present paper were carried out by José Ventura of the Department of Industrial and Systems Engineering, and Jerry Meiten of the Department of Statistics, University of Florida.The study was also supported by the College of Business Administration, University of Florida, and the Faculty of Social Sciences, Hebrew University of Jerusalem.