1. More Diagnostic Testing: The MMPI, the MCMI, and MMSE
PSY 614
Fall 2007
Instructor: Emily E. Bullock, Ph.D.

2. DSM-IV-TR Diagnosis Axis I-Clinical Disorders
Axis II-Personality Disorders; Mental Retardation
Axis II-General Medical Conditions
Axis IV-Psychosocial & Environmental Problems
Axis V-Global Assessment of Functioning Scale (GAF)

3. The MMPI-2
The Minnesota Multiphasic Personality Inventory-2
Standardized questionnaire that elicits a wide range of self-descriptions scored to give a quantitative measurement of an individual’s level of emotional adjustment and attitude toward test taking
Most widely used clinical inventory and has over 10,000 published research references
Original development of MMPI-1939 at the Univ. of Minnesota by Hathaway and McKinley
MMPI revised to create MMPI-2 in 1989

4. The MMPI-2 The Basics 567 questions
13 Standard Scales (10 of which are clinical/personality scales)
Other Scales: Content, Harris-Lingoes subscales, critical items, supplementary scales
Requires about 90 minutes to complete
MMPI-2: for individuals 18 and over; 8th grade reading level
MMPI-A: for adolescents 14-18

5. The MMPI Psychometric Properties
Reliability: Complex due to # of scales and different populations sampled
Temporal stability and Internal Consistency:
Split Half: (.70 median)
Test-Retest:
Validity
Normative Group: 1,138 males & 1,462 females from 7 states

6. MMPI-2 Scaling and Scoring
Type of scaling used: original pool of questions developed theoretically; final question pool determined empirically
Scoring
Mean=50; Standard Deviation=10
Clinical significance = T score of 65 (92nd percentile)
Interpretation norm referenced
Code types used in interpretation-good psychometric qualities

7. MMPI-2 Limitations and Group Issues
Provides more reliable information for “abnormal” rather than “normal” individuals
Misleading labels for scales
Higher reading level and psychological sophistication necessary
No consistent patterns have been found across different populations for African Americans, Native Americans, Hispanics, and Asian Americans
Card version for those with concentration issues
Audio version for issues of blindness, illiteracy, or aphasia

8. MMPI-2 The 3 Main/Original Validity Scales
L (Lie) scale: attempt to which a person is attempting to describe himself or herself in an unrealistically positive manner
F (Infrequency) scale: extent to which person answers in an atypical and deviant manner
K (Correction) scale: detects persons describing themselves in overly positive terms; more subtle and effective than L scale

9. MMPI-2 Other Important Validity Scales
The Cannot Say (?) scale: determined by the number items left unanswered; 30 or more items unanswered=invalid
VRIN (Variable Response Inconsistency Scale): detects inconsistent responding
TRIN (True Response Inconsistency Scale): detects indiscriminant responding

10. MMPI-2 Clinical Scales Scale 1 (Hs, Hypochondriasis)
Scale 2 (D, Depression)
Scale 3 (Hy, Hysteria)
Scale 4 (Pd, Psychopathic Deviate)
Scale 5 (Mf, Masculinity-Femininity)

11. MMPI-2 Clinical Scales Scale 6: (Pa, Paranoia)
Scale 7: (Pt, Psychasthenia)
Scale 8: (Sc, Schizophrenia)
Scale 9: (Ma, Hypomania)
Scale 0: (Si, Social Introversion)

12. MMPI-2 Interpretation Determine validity of the profile first
Note scores above T65
Interpret highest elevations first, moderate interpretations on only slightly elevated scales

13. The MCMI-III The Millon Clinical Multiaxial Inventory-III
Commonly called the Millon or MCMI
Standardized, self-report questionnaire that assesses a wide range of information related to a client’s personality, emotional adjustment, and attitude toward test taking. It uniquely focuses on personality disorders.
Based on Millon’s theory of personality and the DSM-IV
Originally developed in 1977; This revision 1994/1997

14. MCMI-III The Basics 175 items 28 scales 20-30 minutes to complete
For 18 yrs and older
Only appropriate for those seeking or receiving more than a moderate level of mental health treatment
8th grade reading level

15. MCMI-III Psychometric Properties
Overall, well constructed psychometric instrument
Reliability
Internal Consistency: Most Scales above .80
Test Retest: 5-14 day interval; Median .91
Validity
Correlated with other measures from .59 to .70
Normative Sample
1,079 Clinical patients who had come from a diversity of backgrounds and treatment settings

16. MCMI-III Scaling and Scoring
Initial item pool theoretically developed (Millon’s theory of personality and DSM-IV criteria) and utilized empirical methods to determine final item pool and scale structures
Scores are reported in Base Rates (BR)
BR > 85-characteristics definitely present
BR > 75-some features present
BR pf 35-,median score of nonpsychiatric groups
BR of 60-median for psychiatric populations

17. MCMI-III Limitations and Group Issues
Scale overlap and some mixed results with diagnostic accuracy when compared to clinician’s interview and MMPI
Criteria for scales vary on whether more related to Millon’s theory or DSM criteria
State and Trait issue
Frequent revisions make it difficult for research to catch up
Overdiagnoses and Overpathologizes despite the group involved

18. MCMI-III Scales 5 categories of scales Modifying Indices
Clinical Personality Patterns
Severe Personality Pathology
Clinical Syndromes
Severe Syndromes

19. MCMI-III Modifying Indices
Disclosure
Debasement
Desirability
Validity

20. MCMI-III Severe Personality Pathology Scales
Schizotypal
Borderline
Paranoid

21. MCMI-III: Clinical Personality Pattern Scales
Schizoid
Avoidant
Depressive
Dependent
Histrionic
Narcissistic
Antisocial
Aggressive
Compulsive
Passive Aggressive
Self-Defeating

22. MCMI-III Severe Syndrome Scales
Thought Disorder
Major Depression
Delusional Disorder

23. MCMI-III Clinical Syndrome Scales
Anxiety
Somatoform
Bipolar: Manic
Dysthymia
Alcohol Dependence
Drug Dependence
PTSD

24. MCMI-III Steps of Interpretation
1. Check validity through the Modifying Indices
2. Interpret the Personality Scales first
3. Interpret Clinical Syndrome Scales
4. Review noteworthy items

25. MMSE Mini-Mental Status Examination
Used to assess cognitive mental status as an initial evaluation tool or evaluation of treatment
assesses orientation, attention, immediate and short-term recall, language, and the ability to follow simple verbal and written commands

26. MMSE Domains on the Folstein version Orientation to time Naming
Orientation to Place
Immediate Recall
Attention
Delayed Recall
Naming
Repetition
3 Stage Command
Reading
Copying
Writing