Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Presentation By M I Khaleel PK 1st Year M.Phil clinical psychology pkmikhaleel@gmail.com LGBRIMH, TEZPUR Date: 25-07-2014

PERSONALITY TESTS Observe and describe the structure and content of personality – the characteristic ways an individual thinks, feels, behaves, and interacts Clarifies Diagnoses Problematic patterns of behavior Intra and interpersonal dynamics Treatment implications Can be objective or projective

Measuring Personality & Personality tests Objective testing Specific questions or statements to which the person responds by using specific, fixed answers or a rating scale Scores tabulated and compared to reference groups Examples Minnesota Multiphasic Personality Inventory (MMPI; MMPI-2) Millon Multi-Axial Inventory III (MCMI-III) 16 Personality Factors (16PF) NEO Personality Inventory (NEO-PI)

Projective testing Ambiguous or unstructured stimuli to which client is asked to respond freely. Unconscious or conscious needs, motives, interests, dynamics are projected onto ambiguous stimuli revealing internal dynamics or personality More challenging to score and interpret than objective Example Rorschach Inkblot, Thematic Apperception Test (TAT) Projective Drawing Tests Draw-A-Person, Draw-A-House, Draw-A-Tree,Draw-A-Family Sentence completion tests

Minnesota Multiphasic Personality Inventory-2 MMPI-2 Minnesota Multiphasic Personality Inventory-2

INTODUCTION The MMPI was developed in the late 1930’s and first published in 1942 by Starke Hathaway and J. C. McKinley 1100 original items and was cut down to 566 by the time it was first published Designed for routine diagnostic assessments Empirical keying approach 724 Minnesota”normals” Originally 8 clinical scales plus validity scales MF and Si added later

Cont.. Revised version is the MMPI-2 (1989) Authors and consultants of MMPI-2 are James N Butcher , John R Graham Yossef S Ben-Porath, Auke Tellegen and W. Grant Dahlstrom. Revised in 2001-Version being reviewed 84% of the original items are in new version in original or revised form Some test elements revised Added new clinical and validity scales

Cont.. Separate forms for adolescents and adults 567 true/false items Normative sample (MMPI-2) 2600 U.S. residents(1138 male and 1462 female) aged 18-90 (census derived) Yields individual’s clinical profile compared with the normative sample Much of research on interpretation from MMPI applies to MMPI-2 It is the most widely used psychometric test for measuring adult psychopathology in the world. The MMPI-2 is used in mental health, medical and employment settings. ( Drayton, M. 2013) There are more than10000 published papers using the MMPI-2 and this pool is added to by hundreds of papers every year ( Drayton, M. 2013).

Cont.. Publishing by University of Minnesota Press Distributed by Pearson Available in English, Spanish, and Canadian French Paper-and-pencil, audiocassette recording, compact disc recording, box form (with each item on a separate card & client separates cards into true & false categories), and computer

Administrator Qualifications Must be licensed to practice psychology independently OR Have a graduate degree in psychology or a closely-related field and either graduate courses in tests and measurement or completion of a Pearson Assessments-approved workshop or other approved course

Administration procedures Quiet room Good lighting Comfortable chair and table Establish rapport before administration Before administration begins, provide information regarding nature of the test and give complete, clear instructions Completion time = 60 to 90 minutes

Respondent Characteristics 18 years or older At least 6th grade reading level Should be able to read and comprehend test questions for the paper/pencil and computer tests Recommended IQ of 80 or higher(?) Our textbook says that the respondent can be 16 or older and the publisher states 18 or older.

Factors Influencing Performance Faking Social Desirability Item Omission Problems of Interpretation Self Deception Lack of Insight

Content of the MMPI-2 Original 10 clinical/personality scales and original 3 validity scales and added 4 validity measures Additional options: Content scales Content component scales Harris-Lingoes subscales Supplementary scales Critical items

MMPI-II: Validity Scales ?: Cannot Say L: Lie F: Infrequency K: Correction Fb: Back Side Infrequency Fp: Infrequency -Psychopathology S: Superlative Self-Presentation VRIN: Variable Response Inconsistency TRIN: True Response Inconsistency

MMPI-II: Validity Scales (?) Cannot Say F K Fb Fp S VRIN TRIN Not an actual scale Unanswered questions (or both T&F) High Scores Reflect: Carelessness / Psychomotor retardation Avoiding / Not wanting to admit Indecision Lack of information for meaningful response / Difficulty reading Extreme defensiveness Consistent with: Severe depression, obsessional states, extreme intellectualization, paranoia

MMPI-II: Validity Scales Cannot Say (?) F K Fb Fp S VRIN TRIN > 30 Items May be Invalid Determine location of omissions. If most occur after item 370, L,F,K and clinical scales may be interpretable 11 – 29 Items Interpret carefully Some scales may be invalid Determine Omitted Items. Do not interpret a scale with more than 10% of its items omitted 0-10 Items ProbablyValid

(L) Lie Scale Hathaway and McKinley developed To assess that the test taker approached the instrument with a defensive mind set. TRIN scale be examined for possible acquiescent or non acquiescent response styles of prior to interpreting scores on lie scale

MMPI-II: Validity Scales (L) Lie ? L F K Fb Fp S VRIN TRIN Client describing self in an unrealistic positive manner High Scores Reflect: Trying to create favorable impression Defensive, denying, repressing Confused / rigid / moralistic Little insight into their motivations Little awareness of consequences Inflated perception of self-worth Socially conforming / Not original Poor tolerance for stress Low Scores Reflect: Responding frankly to items Able to admit minor faults May be exaggerating negative things Strong, natural, relaxed, independent Communicate ideas well – leadership !!!

MMPI-II: Validity Scales (L) Lie ? L F K Fb Fp S VRIN TRIN T > 80 If TRIN >79F then profile is invalid and un interpretable Consider “Faking Good” & likely invalid Conventional / Conforming Unoriginal / Inflexible Moralistic Repressed / In denial T = 65-79 Faking good or traditional background May be invalid T < 64 Average – responding frankly

MMPI-II: Validity Scales (L) Lie (Demographic Variables) ? L F K Fb Fp S VRIN TRIN Lower scores on L: Better educated & Brighter More sophisticated

MMPI-II: Validity Scales (F) Infrequency ? L F K Fb Fp S VRIN TRIN Designed to indicate or detect deviant / atypical responses High Scores Reflect: Random responses All true or All false responses Faking bad Low Scores Reflect: Free of psychopathology Faking good? Normal responses

MMPI-II: Validity Scales (F) Infrequency ? L F K Fb Fp S VRIN TRIN T > =100 If TRIN or VRIN >79F then profile is invalid and un interpretable ,if both in normal limit Fp should be examined. if Fp also within normal profile reflecting severe psychopathology Disoriented / Confused / Clear Psychotic Behaviors T = 80 – 99 Consider Profile Invalid (All False, lazy, Exaggerating) If valid – consider exaggeration of symptoms T = 55 – 79 Psychotic / Severe Neurotic Highly Deviant Social / Political Beliefs Moody, Restless, Dissatisfied, Unpredictable

MMPI-II: Validity Scales (K) Correction ? L F K Fb Fp S VRIN TRIN Developed for assess an individual level of defensiveness in responding High Scores Reflect: Serious psychological disturbances but are not aware of this Faking good? Low Scores Reflect: Respond to most items “true” Faking bad? Suspicious of others

MMPI-II: Validity Scales (K) Correction ? L F K Fb Fp S VRIN TRIN T >= 65 Consider profile may be invalid “Faking good” / All False If TRIN is within normal limit then shows Clinically defensive / denying /Intolerant / Uninsightful T = 40 – 64 Valid profile, Balanced Self-evaluation / well adjusted Independent / intelligent / Enthusiastic / wide interests T = < 40 If TRIN within limit a low K score may be the result of faking bad All true / “Faking bad” / Exaggeration

MMPI-II: Validity Scales (Fb) Back Side Infrequency ? L F K Fb Fp S VRIN TRIN Designed to Identify a “fake bad” mode of responding for the last 197 items. T >= 110 Consider profile invalid T score of Fb should be compared with T score of F, if difference at lest 30 then it reflects a significant changes in responding in later part and later part can be interpreted. All true, faking bad Psychiatric in patient may be: disoriented, confused, clear psychotic behavior

MMPI-II: Validity Scales (Fp) Infrequency - Psychopathology ? L F K Fb Fp S VRIN TRIN Fp can assist in differentiating elevation on F that are product of genuine psychopathology. T > =100 If TRIN or VRIN above 79 t then Consider profile is invalid. If normal then test taker over reporting psychopathology Random, All true, faking bad T = 70-99 Likely exaggerated, but may be valid If valid, consider it is a cry for help T < 69: Consider profile valid

MMPI-II: Validity Scales (S) Superlative Self-Presenting ? L F K Fb Fp S VRIN TRIN A measure of defensiveness highly correlated with “K”. Developed by Butcher and Han in 1995 In Clinical Settings: T > 70 If TRIN or VRIN above 79 t then Consider profile is invalid Consider profile invalid Faking good – very defensive T < 69: Consider profile being valid

MMPI-II: Validity Scales (VRIN) Variable Response Inconsistency ? L F K Fb Fp S VRIN TRIN Designed to detect inconsistent responding T Score >= 80: profile is invalid and uninterpretive Suggests Random Responding T score 40-64 profile is valid T score 65-79; profile valid however some inconsistent responding, may be occasional loss of concentration

MMPI-II: Validity Scales (TRIN) True Response Infrequency ? L F K Fb Fp S VRIN TRIN Designed to detect indiscriminant responses It made up opposite content pairs T score 80=> profile is invalid 65- 79 T ; profile is valid however some acquiescence

Validity Scales Faking BAD 120 110 100 90 80 70 60 50 40 30 20 L (Lie) F (Infrequency) K (Correction)

Validity Scales Faking GOOD 120 110 100 90 80 70 60 50 40 30 20 L (Lie) F (Infrequency) K (Correction)

Clinical Scales The MMPI-2 clinical scales are essentially the same as for the original MMPI, but few items were deleted because of objectionable content Harris and Lingoes (1955, 1968) grouped items in some of clinical scales into content homogeneous subscales. The subscales should be interpreted only when the T scores are >64 ( will be discussed later) T score >_75 indicates very high level, T score 55-64 indicates high level, T score 55- 64 indicates moderate level, 45-54 T score indicates average and no interpretation and T score <45 indicates low level and no interpretation Total number of clinical scales are 10.

MMPI-II: Clinical Scales Hs (1): Hypochondriasis D (2): Depression Hy (3): Hysteria Pd (4): Psychopathic Deviate Mf (5): Masculinity / Femininity Pa (6): Paranoia Pt (7): Psychasthenia Sc (8): Schizophrenia Ma (9): Hypomania Si (0): Social Introversion

MMPI-II: Clinical Scales Hs (1) Hypochondrisis Pd (4) Mf (5) Pa (6) Pt (7) Sc (8) Ma (9) Si (0) Designed to indicate a variety of personality characteristics consistent with hypochondriasis. Overuse of medical system Elderly individuals tend to score higher on scale 1 with declining health issues.

MMPI-II: Clinical Scales Hs (1) Hypochondrisis Pd (4) Mf (5) Pa (6) Pt (7) Sc (8) Ma (9) Si (0) T > 75 Extreme somatic concerns Consider somatic delusions T = 65 – 74 Somatic concerns Sleep disturbances / Lack of energy Demanding / Dissatisfied / Complaining T = 45 – 54: Average

MMPI-II: Clinical Scales D (2) Depression Hs (1) D (2) Hy (3) Pd (4) Mf (5) Pa (6) Pt (7) Sc (8) Ma (9) Si (0) An index of discomfort Dissatisfaction with life Scores associated with age: Elderly Individuals score 5-10 points higher Adolescents score 5-10 points lower

MMPI-II: Clinical Scales D (2) Depression Hs (1) D (2) Hy (3) Pd (4) Mf (5) Pa (6) Pt (7) Sc (8) Ma (9) Si (0) T >75 Serious Clinical Depression T = 65 – 74 Moderate depression / worried Dissatisfaction with life / withdrawn Somatic complaints / low self-confidence

MMPI-II: Clinical Scales Hy (3) Hysteria Hs (1) D (2) Hy (3) Pd (4) Mf (5) Pa (6) Pt (7) Sc (8) Ma (9) Si (0) Identify individuals who have developed a psychogenic based sensory or motor disorder: Total number of items 60 Some items reflects physical complaints. Many items involve a denial of problems of life and denail of social anxiety

MMPI-II: Clinical Scales Hy (3) Hysteria Hs (1) D (2) Hy (3) Pd (4) Mf (5) Pa (6) Pt (7) Sc (8) Ma (9) Si (0) Very high T >=75 Consider Conversion disorder Extreme somatic complaints Reaction to stress by developing somatic symptoms High T 65 – 74 Somatic Symptoms / denial Sleep disturbances / Lack of energy Lacks insight on causes of symptoms Moderate T 55-64 Immature / self-centered / demanding

MMPI-II: Clinical Scales Pd (4) Psychopathic Deviate Hs (1) D (2) Hy (3) Pd (4) Mf (5) Pa (6) Pt (7) Sc (8) Ma (9) Si (0) 50 items Some items concern difficulties in school or law. other items reflect a lack of concern about most social and moral standards of conduct, the presence of family problems, absence of life satisfaction A fraction of raw score(.4) of K scale is added to the raw score on scale 4

MMPI-II: Clinical Scales Pd (4) Psychopathic Deviate Hs (1) D (2) Hy (3) Pd (4) Mf (5) Pa (6) Pt (7) Sc (8) Ma (9) Si (0) T >=75: Asocial / antisocial behavior T = 65 – 74 trouble with law, problem with family , poor work history Family problems, Impulsive , poor judgment, impatient , 55-64 superficial relationships, energetic ,extroverted, Immature, self centered

MMPI-II: Clinical Scales Mf (5) Masculinity / Femininity Hs (1) D (2) Hy (3) Pd (4) Mf (5) Pa (6) Pt (7) Sc (8) Ma (9) Si (0) Relates to the degree of traditional gender roles Developed for using men who were upset about their homoerotic feeling and confused about their gender role And measure of gender role divergence in women Scale 5 subsequently was used both male and female

MMPI-II: Clinical Scales Mf (5) Masculinity / Femininity (MALES) Hs (1) D (2) Hy (3) Pd (4) Mf (5) Pa (6) Pt (7) Sc (8) Ma (9) Si (0) T >=65 high Consider serious sexual problems Lacks traditional masculine interests T = 45 – 64: Average No interpretation T < 45: traditional masculine interests Macho

MMPI-II: Clinical Scales Mf (5) Masculinity / Femininity (FEMALES) Hs (1) D (2) Hy (3) Pd (4) Mf (5) Pa (6) Pt (7) Sc (8) Ma (9) Si (0) T >=65 Consider serious sexual problems Rejects traditional feminine role T = 60 – 74 Lacks traditional feminine interests T = 40 – 59: Average No itrepetation T < 40 Very traditional feminine interests But not so much in modern times

MMPI-II: Clinical Scales Pa (6) Paranoia Hs (1) D (2) Hy (3) Pd (4) Mf (5) Pa (6) Pt (7) Sc (8) Ma (9) Si (0) Designed to detect paranoid symptoms Some items measures frankly psychotic behavior other items cover diverse topics as sensitivity cynicism, asocial behavior, etc.. total items 40

MMPI-II: Clinical Scales Pa (6) Paranoia Hs (1) D (2) Hy (3) Pd (4) Mf (5) Pa (6) Pt (7) Sc (8) Ma (9) Si (0) T >=75 Consider Paranoid Psychosis, idea of reference, delusions persecution T = 65 – 74 Extremely sensitive / Suspicious, responsive to opinions of others Emotional labile, argumentative manner T = 45 – 54: Overly sensitive, distrustful. Angry.etc..

MMPI-II: Clinical Scales Pt (7) Psychasthenia Hs (1) D (2) Hy (3) Pd (4) Mf (5) Pa (6) Pt (7) Sc (8) Ma (9) Si (0) Scale was constructed primarily using patients showing obsessive worries, compulsive rituals, or exaggerated fear Total number of items 48 The full value of the K raw score is added to the raw score of scale 7.

MMPI-II: Clinical Scales Pt (7) Psychasthenia Hs (1) D (2) Hy (3) Pd (4) Mf (5) Pa (6) Pt (7) Sc (8) Ma (9) Si (0) T >=75 very high Extreme fear, anxiety, tension Disturbing thoughts, fear of losing ones mind obsessive compulsive symptoms Unable to concentrate T = 65 – 74 high Moderate anxiety, depression, insomnia, guilt T = 40 – 59: moderate Lacks self-confidence, anxious, tense, uncomfortable

MMPI-II: Clinical Scales Sc (8) Schizophrenia Hs (1) D (2) Hy (3) Pd (4) Mf (5) Pa (6) Pt (7) Sc (8) Ma (9) Si (0) Designed to find out Schizophrenia Identifies individuals with disturbances of thinking, mood, behavior The full value of the raw score on K scale is added to the raw score on scale 8

MMPI-II: Clinical Scales Sc (8) Schizophrenia Hs (1) D (2) Hy (3) Pd (4) Mf (5) Pa (6) Pt (7) Sc (8) Ma (9) Si (0) T >75 very high Consider schizophrenia diagnosis(confused , disorganized thinking, hallucinations, delusions poor judgment, etc..) T = 65 – 74 high unusual beliefs, social withdrawal, excessive fantasy, generalized fear and anxiety T = 45 – 64: moderate limited interest in other people, insecurity, etc..

MMPI-II: Clinical Scales Ma (9) Hypomania Hs (1) D (2) Hy (3) Pd (4) Mf (5) Pa (6) Pt (7) Sc (8) Ma (9) Si (0) Designed to identify individuals experiencing hypomanic symptoms (manic episodes) Total items 46 Some items deals the features of hypomanic disturbance some deals family relations, moral values and attitude, and physical or body concern A fraction of raw score (.2) of K scale is added to the raw score of scale 9.

MMPI-II: Clinical Scales Ma (9) Hypomania Hs (1) D (2) Hy (3) Pd (4) Mf (5) Pa (6) Pt (7) Sc (8) Ma (9) Si (0) T >=75 Consider bipolar disorder / manic type T = 65 – 74 Excessive energy / lacks direction / bossy Conceptual disorganization / talks too much Unrealistic self-appraisal / impulsive / low tolerance T = 55 – 64 Active / energetic / extroverted Creative / rebellious T = 45 – 54: Average

MMPI-II: Clinical Scales Si (0) Social Introversion Hs (1) D (2) Hy (3) Pd (4) Mf (5) Pa (6) Pt (7) Sc (8) Ma (9) Si (0) This scale was developed by L.E.Drake in 1946 Not typically included in a clinical assessment The items are of two general types. One group deals with social participation, the other deals with general neurotic maladjustment and self depression Hostetler, Ben-porah, Butcher and Graham developed a set of sub scale for scale 0 (si1,si2,si3) in 1989. (will be discussed later)

MMPI-II: Clinical Scales Si (0) Social Introversion Hs (1) D (2) Hy (3) Pd (4) Mf (5) Pa (6) Pt (7) Sc (8) Ma (9) Si (0) T >=75: Extreme withdrawal T = 65 – 74 Introverted, Emotionally over controlled, passive T =55-64 shy, timid, depressed, guilty dependable, low self-confidence Below 45 Extroverted, sociable T = 45 – 54: Average

MMPI-II Scales Scale Name No of Items ?: Cannot Say -- L: Lie 15 F: Infrequency 60 K: Correction 30 Hs (1): Hypochondriasis 32 D (2): Depression 57 Hy (3): Hysteria 60 Pd (4): Psychopathic Deviate 50 Mf (5): Masculinity / Femininity 56 Pa (6): Paranoia 40 Pt (7): Psychasthenia 48 Sc (8): Schizophrenia 78 Ma (9): Hypomania 46 Si (0): Social Introversion 69

CODE TYPES importance in mmpi-2 Coding is based on the code of scale Most elevated scales code will be considered for coding of patient Scale 5 and 0 traditionally have not been considered in determining code type. there are two types of codes , 2 point codes and three point codes The 2 or 3 highest points i.e., a 1-2 code = scale 1 is the highest & scale 2 is the second highest Combinations of scale elevations are of even more

MMPI-II: 2 & 3 Point Codes 123/213/231 132/312 138 139 247/274/472 278/728 468/486/648/684/846/864 478/487/748/784/847/874 687/867 12/21 13/31 14/41 18/81 19/91 23/32 24/42 26/62 27/72 28/82 29/92 34/43 36/63 38/83 46/64 47/74 48/84 49/94 68/86 69/96 78/87 89/98

MMPI-II: 2 & 3 Point Codes There are 90 possible 2 Point Code combinations There are 720 possible 3 Point Code combinations Your book does not list all possible combinations for 3 Point Codes For class purposes – if your book does not list a 2 or 3 point code use individual scales For 3 point codes not listed – use a 2 point & an individual scale

MMPI-II: Two-Point Code Types 12/21 13/31 14/41 18/81 19/91 23/32 24/42 26/62 27/72 28/82 29/92 34/43 36/63 38/83 46/64 47/74 48/84 49/94 68/86 69/96 78/87 89/98 12/21 (Hypochondriasis & Depression): Somatic discomfort / Depression 13/31 (Hypochondriasis & Hysteria): Somatic complaints without major psychiatric complaints interfering with functioning More prevalent in women & elderly 14/41 (Hypochondriasis & Psychopathic Deviate): Severe somatic symptoms / extroverted Pessimistic & grouchy & Alcohol use More prevalent in men 18/81 (Hypochondriasis & Schizophrenia): Hostility / Aggression but unable to express it Socially inadequate & lack trust

MMPI-II: Two-Point Code Types 12/21 13/31 14/41 18/81 19/91 23/32 24/42 26/62 27/72 28/82 29/92 34/43 36/63 38/83 46/64 47/74 48/84 49/94 68/86 69/96 78/87 89/98 19/91 (Hypochondriasis & Hypomania): Great deal of distress / anxious, somatic complaints Aggressive / belligerent / great ambition Frustrated by low achievements 23/32 (Depression & Hysteria): Passive & Dependent Depressed but without severe anxiety Difficulty expressing emotions 24/42 (Depression & Psychopathic Deviate): Trouble with family or law Angry, resentful, critical, impulsive Drug & alcohol use & Suicide !!!! 26/62 (Depression & Paranoia): Paranoia & hostility & resentfulness Lack energy, hopeless & some suicide!

MMPI-II: Two-Point Code Types 12/21 13/31 14/41 18/81 19/91 23/32 24/42 26/62 27/72 28/82 29/92 34/43 36/63 38/83 46/64 47/74 48/84 49/94 68/86 69/96 78/87 89/98 27/72 (Depression & Psychasthena): Worry / high strung / anticipate problems Clinical depression with high expectations 28/82 (Depression & Schizophrenia): Anxious & Agitated & Dissociated Poor concentration, sleep, memory Basically dependent & ineffective If both are highly elevated = serious psychopathology 29/92 (Depression & Hypomania): Self centered / narcissistic Tense & anxious w/ somatic complaints Bi-polar & periods of fatigue 34/43 (Hysteria & Psychopathic Deviate): ANGER & HOSTILITY!!! Suicide & Acting Out!

MMPI-II: Two-Point Code Types 12/21 13/31 14/41 18/81 19/91 23/32 24/42 26/62 27/72 28/82 29/92 34/43 36/63 38/83 46/64 47/74 48/84 49/94 68/86 69/96 78/87 89/98 36/63 (Hysteria & Paranoia): Deep hostility with family Minor anxiety / somatic problems Defiant / uncooperative / narcissistic 38/83 (Hysteria & Schizophrenia): Great psychological turmoil & anxiety & fear Depression / hopelessness are common Problems decision making / Apathetic & pessimistic Obsessive ruminations & delusions / hallucinations 46/64 (Psychopathic Deviate & Paranoia): Immature / Narcissistic / Self-indulgent Rationalize & blame others / no responsibility Passive – aggressive personality / schizophrenia

MMPI-II: Two-Point Code Types 12/21 13/31 14/41 18/81 19/91 23/32 24/42 26/62 27/72 28/82 29/92 34/43 36/63 38/83 46/64 47/74 48/84 49/94 68/86 69/96 78/87 89/98 47/74 (Psychopathic Deviate & Psychasthena): Swing from serious insensitivity to others – how they effect others Acting out (drinking / sexual promiscuity) followed by guilt Need constant reassurance & support 48/84 (Psychopathic Deviate & Schizophrenia): Do not fit in their environment Resent authority / deep feelings of insecurity Erratic & unpredictable / impulse problems Possible bizarre symptomatology 49/94 (Psychopathic Deviate & Hypomania): Disregard for social standards / values Narcissistic / selfish / self-indulgent Irritable / low tolerance Energetic / restless / ambitious / superficial

MMPI-II: Two-Point Code Types 12/21 13/31 14/41 18/81 19/91 23/32 24/42 26/62 27/72 28/82 29/92 34/43 36/63 38/83 46/64 47/74 48/84 49/94 68/86 69/96 78/87 89/98 68/86 (Paranoia & Schizophrenia): Intense inferiority / insecurity Distrust others / avoid deep relationships Blunted affect / rapid speech / incoherent 69/96 (Paranoia & Hypomania): Dependent / need for affection Appear tearful / trembling 78/87 (Psychasthenia & Schizophrenia): Great deal of turmoil / easily discuss their pain Depressed & pessimistic / confused / panic Schizophrenia / Depression / OCD / personality disorders 89/98 (Schizophrenia & Hypomania): Self-centered / infantile / demanding Labile!!! / Fear emotional involvement Bizarre speech & thinking

MMPI-II: Three-Point Code Types 123/213/231 132/312 138 139 247/274/472 278/728 468/486/648/684/846/864 478/487/748/784/847/874 687/867 MMPI-II: Three-Point Code Types 123/213/231 (Hypochondriasis & Depression & Hysteria): Somatoform disorder / anxiety disorder / depressive disorder Life is a strain / keep people at a distance Fatigued / low energy & sex drive 132/312 (Hypochondriasis & Depression & Hysteria): 1 & 3 are significantly higher than 2 the “conversion valley” Conversion symptoms – somatoform pain disorder Denial & repression / Approval is important / seek med. TX often 138 (Hypochondriasis & Hysteria & Schizophrenia): Schizophrenia (paranoid type) or paranoid personality disorder Bizarre somatic symptoms – delusional in nature Depression / suicide / thought disorder / alcohol / agitated

MMPI-II: Three-Point Code Types 123/213/231 132/312 138 139 247/274/472 278/728 468/486/648/684/846/864 478/487/748/784/847/874 687/867 MMPI-II: Three-Point Code Types 139 (Hypochondriasis & Hysteria & Hypomania): Somatoform disorder / organic brain syndrome Frequent outbursts of temper / irritation 247/274/472 (Depression & Psychopathic Deviate & Psychasthenia): Passive-aggressive personality disorder / alcohol & drugs Family problems / depressed & pessimistic / OCD Overreact to stress / hostile / fear of failing 278/728 (Depression & Psychopathic Deviate & Schizophrenia): Schizoid life styles / great life turmoil Tense / nervous / fearful / sad / pessimistic / despondent Variety of diagnoses – consult other subscales for diagnosis

MMPI-II: Three-Point Code Types 123/213/231 132/312 138 139 247/274/472 278/728 468/486/648/684/846/864 478/487/748/784/847/874 687/867 MMPI-II: Three-Point Code Types 468/486/648/684/846/864 (Psychopathic Deviate & Paranoia & Schizophrenia): Anxious / Depressed / Agitated / Critical History of physical abuse / suicide / family problems Psychiatric hospitalizations 478/487/748/784/847/874 (Psychopathic Deviate & Psychasthenia & Schizophrenia): Psychotic symptoms – delusions / hallucinations / poor reality Depression / suicide / anxiety / agitation 687/867 (Paranoia & Schizophrenia & Psychasthenia): 6 & 8 much more elevated than 7 – the “psychotic valley” Serious psychopathology – schizophrenia (paranoid type) Hallucinations / delusions / blunted affect / aggressive when drinking

Content Scales Wiggings developed this scale in 1966 He suggested that how an individual chooses to present himself or herself when responding to the mmpi items, whatever the reasoning or motivation, provide useful information that might argument what can be learned from scores on the clinical scales. The descriptors are based on the scale content and empirical. They apply of content scale score if greater than than 64.

MMPI-II: Content Scales ANX: Anxiety FRS: Fears OBS: Obsessiveness DEP: Depression HEA: Health Concerns BIZ: Bizarre Mentation ANG: Anger CYN: Cynicism ASP: Antisocial Practices TPA: Type A Behavior LSE: Low Self-Esteem SOD: Social Discomfort FAM: Family Problems WRK: Work Interference TRT: Negative Treatment Indicators

MMPI-II: Content Scales ANX (Anxiety) FRS (Fears) OBS DEP HEA BIZ ANG CYN ASP TPA LSE SOD FAM WRK TRT Anxious / Nervous Poor concentration Uneasy decision making OCD symptoms May have suicidal ideation Hopeless / Overwhelmed Insecure / low self-confidence Fearful Uneasy Phobias Multiple fears Not very competitive

MMPI-II: Content Scales OBS (Obsessiveness) DEP (Depression) ANX FRS OBS DEP HEA BIZ ANG CYN ASP TPA LSE SOD FAM WRK TRT Difficulty decision making Rigid / not like change Worry / ruminate Low self-confidence OCD symptoms Hopeless Low interest in things Depressed / blue Fatigued / lethargic Pessimistic Cry Past suicide attempts Health concerns Relationship problems Life is a strain

MMPI-II: Content Scales HEA (Health Concerns) BIZ (Bizarre Mentation) ANX FRS OBS DEP HEA BIZ ANG CYN ASP TPA LSE SOD FAM WRK TRT Deny good physical health Preoccupied with physical health Lethargic Poor coping skills Depressive symptoms Somatic symptoms in times of stress Psychotic thoughts Unusual thought content Feeling in unreality Paranoia? “People reading my Mind” History of suicide attempts Past sexual abuse? Poor achievement

MMPI-II: Content Scales ANG (Anger) CYN (Cynicism) ANX FRS OBS DEP HEA BIZ ANG CYN ASP TPA LSE SOD FAM WRK TRT Angry / Hostile Irritable, impatient Aggressive / Impulsive Swearing / smashing things Loss of control Feelings of unfair TX Physically abused? Dishonest, uncaring Suspicious Untrusting Not friendly / helpful Low achievement Paranoia? Physical abuse?

MMPI-II: Content Scales ASP (Antisocial Practices) TPA (Type A) ANX FRS OBS DEP HEA BIZ ANG CYN ASP TPA LSE SOD FAM WRK TRT Trouble w/ & disregard for law or school Enjoy criminals Resent authority Manipulative / Cold hearted Self-centered Dishonest / Antisocial Aggressive / angry / Impulsive Work oriented Fast paced Never enough time Impatient Hostile / irritable Overbearing Hold grudges Paranoia?

MMPI-II: Content Scales LSE (Low Self-Esteem) SOD (Social Discomfort) ANX FRS OBS DEP HEA BIZ ANG CYN ASP TPA LSE SOD FAM WRK TRT Poor self-concepts Anticipate failure Feeling inept See others as superior Passive in relationships Worries / fears Uncomfortable with compliments Shy / introverted Limited interests Feeling awkward Preoccupied with health Overly sensitive Emotionally withdrawn Depressive Disorder?

MMPI-II: Content Scales FAM (Family Problems) WRK (Work Interference) ANX FRS OBS DEP HEA BIZ ANG CYN ASP TPA LSE SOD FAM WRK TRT Problems w/ family Family lacks love Rejects family Angry toward family Raw deal from life Physically abused? Depressed Depressive disorder? Poor work performance Questioning own career Others disapproved of their career Insecure / failures Low achievement Lethargic / sad Suicidal ideation

MMPI-II: Content Scales TRT (Negative Treatment Indicators) ANX FRS OBS DEP HEA BIZ ANG CYN ASP TPA LSE SOD FAM WRK TRT Do not like clinicians Terminate TX early No one can understand Do not want to disclose Experience intense emotional distress Do not like change Low energy / insecure Suicidal ideation Poor judgment

Content Component Scales The Content Scales are further broken down & described in the Content Component Scales. There are a total of 27 Content Component Scales that Correspond with the Content Scales. ANX, OBS, & WRK do not have any Component Scales Developed by Ben porah and Sher-wood in 1993 Interpreted only the score more than 64 and parent content scale T score 60 or greater.

Content Component Scales Scores FRS 1 (Generalized Fearfulness): Report a general pattern of fearfulness and timidity Generally nervous FRS 2 (Multiple Fears): Many specific fearful stimuli such as animals, heights, etc. Many specific phobias

Content Component Scales Scores DEP 1 (Lack of Drive): Unable to get going and get things done Lack of interest in things DEP 2 (Dysphoria): Depressed, sad, blue & difficulty overcoming depressed feelings DEP 3 (Self-Depreciation): Negative self-concept & Feels useless, helpless, guilty, or worthless DEP 4 (Suicidal Ideation): Current or recent suicidal ideation & gestures

Content Component Scales Scores HEA 1 (Gastrointestinal Symptoms): Reports many gastrointestinal problems HEA 2 (neurological symptoms): Reports many neurological problems HEA 3 (general health concerns): Preoccupied with physical health concerns Believe they are experiencing poor health

Content Component Scales Scores BIZ 1 (Psychotic Symptomatology): A number of frankly psychotic symptoms Hallucinations & delusions BIZ 2 (schizotypal characteristics): Strange and peculiar experiences Ideas of reference & paranoid ideation

Content Component Scales Scores ANG 1 (Explosive Behavior): Explosive behaviors such as hitting and smashing things Frequent temper tantrums ANG 2 (Irritability): Irritable and grouchy Complain a great deal Impatient & easily annoyed

Content Component Scales Scores CYN 1 (Misanthropic Beliefs): Believes others are selfish and interested only in their own welfare Are unwilling to rely on others for help & support or to help others CYN 2 (Interpersonal Suspiciousness): Believe others are not to be trusted Report paranoid ideation

Content Component Scales Scores ASP 1 (Antisocial Attitudes): Antisocial beliefs and attitudes Little respect for the law or authority ASP 2 (Antisocial Behavior): Report engaging in antisocial behaviors May have been in trouble with law & or engage in substance abuse

Content Component Scales Scores TPA 1 (Impatience): Impatient with others especially at work Easily annoyed Do not like to be interrupted TPA 2 (Competitive Drive): Very competitive Driven to succeed at all costs May be viewed by others as hostile

Content Component Scales Scores LSE 1 (Self-Doubt): Poor self-concepts Believe others do not like them Are viewed by others as putting selves down LSE 2 (Submissiveness): Give to others Are readily downed in an argument Passive in relationships Turn to others for help in decision making

Content Component Scales Scores SOD 1 (Introversion): Dislike being around others Kept others at a distance SOD 2 (Shyness): Uncomfortable in interpersonal relationships Find it difficult to interact with new people

Content Component Scales Scores FAM 1 (Family Discord): Experiences significant family conflict and strife Get into frequent arguments with family members FAM 2 (Family Alienation): Feeling alienated from family Do not perceive family as source of support Do not have strong emotional ties with family members

Content Component Scales Scores TRT 1 (Low Motivation): Feel unmotivated or unable to change May be viewed as having given up on solving problems Lack self-confidence TRT 2 (Inability to Disclose): Feel unable to open up to others Are uncomfortable discussing personal matters Believes others cannot understand

Supplementary Scales The supplementary scales are intended to add the interpretation of validity and clinical scale The T score 65 or greater should be considered high and below 40 should be considered low

MMPI-II: Supplementary Scales A: Anxiety (T>64) Anxious and uncomfortable Depressed and have somatic complaints R: Repression (T>64) Introverted, internalizing individuals who have adopted careful and cautious life-styles

MMPI-II: Supplementary Scales Es: Ego Strength (T>64) Appear to be fairly well put together emotionally. In non-clinical populations: not likely to have serious emotional problems. LOW SCORES – more severe problems that are less likely to be situational in nature Es: Ego Strength (T = 40-64) No interpretation Es: Ego Strength (T <40) Poor overall insight Poor prognosis for treatment Limited psychological resources for dealing with problems

MMPI-II: Supplementary Scales MAC-R: MacAndrew Alcoholism-Revised (Raw>28) Socially extroverted, exhibitionistic, self-confident and assertive Aggressive, may have problems in school or law Competitive, risk taking, experience blackouts May be more likely to have made previous suicide attempts MAC-R: MacAndrew Alcoholism-Revised (Raw = 24-27) May suggest substance abuse problems MAC-R: MacAndrew Alcoholism-Revised (Raw < 24) Substance abuse problems less likely

MMPI-II: Supplementary Scales AAS: Addiction Acknowledgement Scale (T>60) May have diagnoses of substance abuse or dependence Have histories of acting out behaviors May have suicide attempts APS: Addiction Potential Scale (T>60) The precursor to the symptoms found on AAS Possible substance abuse problems Antisocial behavior?

MMPI-II: Supplementary Scales MDS: Marital Distress Scale (T>64) Experiencing depression and may have suicidal ideation Anger, sadness, have few friends Ho: Hostility (T>64) High levels of anger, not friendly, increased risk of serious health problems Cynical, suspicious, hostile O-H: Overcontrolled – Hostility (T>64) Tend not to express anger, have strong needs to excel, describe supportive family backgrounds Trustful, dependent on others

MMPI-II: Supplementary Scales Do: Dominance (T>64) Appear poised and self assured, secure and self-confident Resourceful, efficient, realistic achievement oriented Feel adequate to handle problems Re: Social Responsibility (T>64) Have incorporated societal and cultural values and are committed to behaving in a manner consistent with those values – they place high value on honesty and justice. Mt: College Maladjustment (T>64) Suggest general maladjustment and pessimism Procrastinates & anxious

MMPI-II: Supplementary Scales GM: Masculine Gender Role & GF: Feminine Gender Role The higher the score the more traditional gender roles are displayed The higher the score the more positive (confident, free from worries) Also, the higher the score the more likely there is a drug or alcohol issue PK: Post Traumatic Stress Disorder Are reporting intense emotional distress, enxiety and sleep disturbances May be having unwanted or disturbing thoughts

MMPI-II: The Personality Psychopathology Five (PSY-5 Scales) Developed from theories of personality disorders and “normal” personality The PSY-5 constructs cover 5 broad personality domains that are relevant to clinical planning, communication, and intervention.

MMPI-II: The Personality Psychopathology Five (PSY-5 Scales) AGGR (Aggressiveness) (T >= 64) Enjoy intimidating others and may use aggression as a tool to accomplish their goals Dominant in relationships PSYC (Psychoticism) (T >= 64) This assesses the disconnection from reality DISC (Disconstraint) (T >= 64) Tend to be more risk taking, impulsive, and less traditional Slight tendency to prefer romantic partners who have the same features

MMPI-II: The Personality Psychopathology Five (PSY-5 Scales) NEGE (Negative Emotionality Neuroticism) (T >= 64) DX with depression or dysthymia at intake Low functioning with few friends – focus on their flaws INTR (Introversion / Low Positive emotionality) (T >= 64) Increased rates of depression and low achievement expectations Low score less than 40 T shows extroverted and high positive emotional pattern

MMPI-II: Harris-Lingoes Subscales The Harris – Lingoes Subscales are meant to give a better understanding of basic clinical scales. Developed by Harris – Lingoes The Harris Lingoes Subscales provides information concerning the kinds of items that were endorsed in the scored direction in obtaining a particular score on a clinical (basic) scale. It is only used to understand high elevations. The subscales should be interpreted only when T score grater than 64 and also parent scale T score greater than 64 Harris & Lingoes did not develop subscales for 5 & 0. This was done in accordance to research that does not consider scales 5 and 0 as true clinical scales.

MMPI-II: Harris-Lingoes Subscales D 1: Subjective Depression Feeling unhappy, blue, or depressed Lack self confidence D 2: Psychomotor Retardation Feeling immobilized / withdrawn Avoid other people D 3: Physical Malfunctioning Preoccupied with their own physical functioning Do not have good health D 4: Mental Dullness Lack of energy to cope with the problems of life Feel inferior to others D 5: Brooding Brood, ruminate, cry much of the time Easily hurt by criticism

MMPI-II: Harris-Lingoes Subscales Hy 1: Denial of Social Anxiety A T greater than 65 is not possible – Not helpful in understanding high scores Hy 2: Need for Affection Have strong needs for attention & affection from others and fear that those needs will not be met if they are more honest about their feelings & attitudes Have optimistic and trusting attitudes toward other people Hy 3: Lassitude – Malaise Feeling uncomfortable and are not in good health Feel weak, fatigued Hy 4: Somatic Complaints Have many somatic complaints Experience pain in the hear or chest Express little or no hostility toward other people Hy 5: Inhibition of Aggression Do not experience hostile and aggressive impulses Are not interested in reading about crime or violence

MMPI-II: Harris-Lingoes Subscales Pd 1: Familial Discord See their home and family life as quite unpleasant Have felt like leaving their home situations Pd 2: Authority Problems Resent societal and parental standards and customs Have been in trouble in school or with the law Pd 3: Social Imperturbability A T greater than 65 is not possible – Not helpful in understanding high scores Pd 4: Social Alienation Feels alienated, isolated, etc. Feels that other people do not understand them Pd 5: Self Alienation Feeling uncomfortable and unhappy Have problems concentrating Find it hard to settle down May use alcohol excessively.

MMPI-II: Harris-Lingoes Subscales Pa 1: Persecutory Ideas View the world as a threatening place Feel that they are getting a raw deal from life Are suspicious and untrusting of other people Pa 2: Poignancy Are more high strung and more sensitive than other people Feel more intensely than others Pa 3: Naivete Have very optimistic attitudes about other people Are tursting and see others as honest, unselfish, generous, and altruistic

MMPI-II: Harris-Lingoes Subscales Sc 1: Social Alienation Getting a raw deal from life Others have it in for me or are against me Sc 2: Emotional Alienation Experience feelings of depression and despair and may wish that they are dead Apathetic and frightened or have sadistic &/or masochistic needs Sc 3: Lack of Ego Mastery (Cognitive) Feeling that they might be losing their minds Have strange thought processes and feelings of unreality or have problems with concentration & memory

MMPI-II: Harris-Lingoes Subscales Sc 4: Lack of Ego Mastery (Conative) Feel that life is a strain and that they experience depression and despair Have difficulty in coping with everyday problems and worry excessively Sc 5: Lack of Ego Mastery (Defective Inhibition) Tend to be restless, hyperactive, and irritable Have periods of laughing and crying that they cannot control Sc 6: Bizarre Sensory Experiences Experience feelings that their bodies are changing in strange and unusual ways Experience skin sensitivity, feeling hot or cold, voice changes, muscle twitching, clumsiness, problems in balance, ringing or buzzing in the ears, paralysis, and weakness

MMPI-II: Harris-Lingoes Subscales Ma 1: Amorality Perceive others as selfish, dishonest, and opportunistic because of these perceptions feel justified in behaving in similar ways Derive vicarious satisfaction from the manipulative exploits of others Ma 2: Psychomotor Retardation Experience acceleration of speech, thought processes, and motor activity Feel tense and restless or excited or elated without cause Ma 3: Imperturbability Do not experience social anxiety Feel comfortable around others Have no problem in talking with other Ma 4: Ego Inflation Are important persons Have been treated unfairly Are resentful when others make demands of them

MMPI-II: Other Subscales Ben-Porath, Hostetler, Butcher, & Graham Subscales Si 1: Shyness / Self-Consciousness Si 2: Social Avoidance Si 3: Self / Other Alienation

MMPI-II: Other Subscales Si 1: Shyness / Self-Consciousness High Scores: feeling shy, anxious, uncomfortable, easily embarrassed Low Scores: extroverted, initiate social contact with other people Si 2: Social Avoidance High Scores: do not enjoy being involved with groups or crowds or people Low Scores: enjoy being involved with groups or crowds Si 3: Self / Other Alienation High Scores: low self-esteem, lack interest in activities, feel unable to effect changes in their life, insecure Low Scores: have high self-esteem, appear to be interested in activities

Critical Item Analysis Suicide 75 False, 303 True, 506 True, 520 True, 524 True Assault 27 True, 37 True, 85 True, 134 True, 213 True, 389 True

Thank you…. All the best…