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Abstract
The purpose of this literature review is to examine the validity of the MMPI-2 RF for
three ethnic groups: American Indian, Latino, and Vietnamese. Do the MMPI-2 RF scales
predict equally well for whites as well as other ethnic minority groups or is there inherent
ethnocentric bias based upon a Euro-American worldview? This author will investigate
research regarding the MMPI-2 RF test content, design and profile patterns of various ethnic
groups to determine if there exists a potential difference in interpretation of the control group and
ethnicity. Critical examination of ethnic, sexist or other problematic test content issues will be
Table of Contents
Introduction
The testing instrument under consideration in this author’s Critical Literature Review is
the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2 RF) authored
by Yossef S. Ben-Porath, PhD, and Auke Tellegen, PhD (Ben-Porath, Y. S., & Tellegen, A.,
2008). The test was published by the University of Minnesota Press in 2008. The MMPI and its
subsequent revisions: MMPI-2 and the MMPI-2 RF are structured personality tests that utilize a
criterion-based empirical strategy to gather and analyze test response data. The instrument is
currently being used to assist clinicians in diagnosing personality and mental disorders as well as
The original MMPI was developed by S. R. Hathaway and J. C. McKinley in 1943 and
was considered a landmark assessment tool. It was the next step in refining structured
personality instruments by assuring test validation through empirical research in place of logical-
content assumptions. It employed the use of scales from group responses that had shown
characteristics of known psychopathologies. The test design developed norm studies based upon
The MMPI-2 was developed in 1989 as a revision of the MMPI in an effort to broaden
the representative control group which had been a source of criticism of the original MMPI. The
MMPI-2 RF, the latest revision of the MMPI-2, builds on the strengths of its predecessor but
adds 9 additional validated Restructured Clinical Scales (RC) as well as 41 revised validated
scales. This author chose the MMPI-2 RF because of its widely accepted use by clinical
disorders.
Critical Literature Review 5
The purpose of this literature review is to examine the validity of the MMPI-2 RF for
three ethnic groups: American Indian, Latino and Vietnamese. Do the MMPI-2 RF scales
predict equally well for whites as well as other ethnic minority groups or is there inherent
ethnocentric bias based upon a Euro-American worldview? Test developers and clinicians can
display bias by minimizing group differences and failing to provide adequate validation studies
on the racially and culturally diverse populations they seek to serve. The outcome assessments
In the revision of the MMPI-2, no new norms were collected for the MMPI-2 RF.
American minorities were included in the normative sample of both the MMPI-2 and MMPI-2
RF, but in both cases no separate cultural norms were developed (Capella, 2009). Therefore,
since the MMPI-2 RF normative sample is drawn from the MMPI-2 and no changes regarding
cultural adaptations were developed, both instruments shall be referred to by the author with
respect to the consequences of systemic bias and its influence upon the psychological assessment
process.
As a future clinical psychologist, this author will investigate research regarding the
MMPI-2 RF test content, design and profile patterns of various ethnic groups to determine if
there exists a potential difference in interpretation of the control group and ethnicity. Critical
examination of ethnic or other problematic test content issues will be discussed as they relate to
The authors search strategy will consist of researching scholarly peer-reviewed journals
and publications through the Capella resource library. Specific databases such as
Most studies have compared African Americans and Whites. It has been often reported
that African-American groups have had higher scores on the MMPI-2 scales in comparison with
White groups (Timbrook & Graham, 1994). However, according to Pritchard and Rosenblatt
(1980) when comparing mean differences between African-American and White samples, there
were no MMPI clinical scales on which significant racial differences occurred (as cited in
Timbrook & Graham, 1994). Therefore this author will focus research on other ethnic groups
Article Summaries
Study #1
A study by Velasquez et al. (2000) examined the dynamic linguistic equivalence of two
particular studies: English to Spanish and Spanish to Spanish in Latino populations for the
MMPI-2. Given the increase in a variety of Spanish speaking groups in the US population with
potential mental health issues, linguistics versions of MMPI-2 that are accurate and culturally
sensitive are essential to minimizing the possibility of bias. Linguistic equivalence is one area of
importance when examining the question of racial and cultural bias in the MMPI-2 and MMPI-2
RF to determine its multi-ethnic validity and effectiveness as an assessment tool. The article
substantiates the need for further investigation and research in making the MMPI-2 and MMPI-2
Method
Study 1. The Participants were 57 adult undergraduate students (42 women, 15 men)
from a major university in southern California. To be eligible to participate in this study, the
participants had to produce valid MMPI-2 protocols in both English and Spanish according to the
following criteria: “cannot say” = raw score < 30 and F raw < 20. Participants were administered
Critical Literature Review 7
Hispana, which is considered to be the “official” U.S. Spanish translation. Because of time
limitations the participants were only administered the first 370 items under standard instructions
first and then Spanish translation second, or vice versa. The participants were predominantly
single (87%) and Mexican American or Chicano (80%). The average age of the sample was 24
Study 2. The Participants were 27 adult undergraduate students (17 women, 10 men)
from the same university as mentioned in Study 1. The same eligibility criteria were used for
this study but also included Variable Response Inconsistency Scale (VRIN) > 74 T score.
Participants were administered two Spanish versions of the MMPI-2, the Version Hispana by
Minnesota-2 Espanol translated by Lucio and Reyes-Lagunes for use in Mexico. In this study,
the participants were administered all 567 items, which allowed for scoring on the validity,
clinical, content, and supplementary scales. Participants were administered the MMPI-2 under
(90%) and Mexican American or Chicano (85%). The average age of the sample was also 24
years ( SD = 5.96).
Results
The findings from Study 1 supported the author’s expectations and appeared to be similar
to the results obtained by researchers who have evaluated bilinguals with the MMPI-2 in other
parts of the world. The mean reliability coefficient was considered to be moderately high,
Critical Literature Review 8
between any of the scales. The findings confirmed that the Version Hispana, as a generic
version, can be used with Spanish-speaking Latinos in the United States with some degree of
confidence. The findings from Study 2, while indicating no scale score differences, did result in
a lower mean correlation coefficient. This suggested variable performance when Spanish-
speaking participants were administered two different Spanish translations of the MMPI-2.
Unlike Study 1, in which participants were required to respond to an English and Spanish
translation, the participants in Study 2 may have found this task to be less linguistically
It appears from the test results that some of the participants may have struggled with
some of the idioms or sentence structures of the items. This finding indicated that idiomatic
adaptations of an instrument are needed because a particular language has many unique
idiomatic nuances. Given these findings future considerations for Mexican Americans to be
administered a “Mexican” adaptation is warranted. Puerto Ricans (living in the United States)
Conclusion
The findings point toward the need for greater research on bilingualism and the
expression of psychopathology through instruments such as the MMPI-2 and MMPI-2 RF. An
examination of the research literature on Latinos indicates that this area of research has been
largely neglected in favor of studies that typically compare Latinos with other ethnic groups. It
is clear that language remains crucial in the understanding of Latinos' mental health issues. If
psychologists are to use standardized measures such as the MMPI-2 RF, they need to be fully
Critical Literature Review 9
aware of both the strengths and limitations that currently exist. Given the fact that the Spanish
language continues to thrive among Latinos, even after numerous generations in the United
States it is essential that these measures be further evaluated for validity. Also, researchers
should consider the possibility of developing bilingual diagnostic measures in light of many
Latinos' equal use of both English and Spanish. The authors strongly encourage researchers to
Study #2
A study of American Indians by Greene, Robin, Albaugh, Caldwell, & Goldman (2003)
examined the empirical correlates of the MMPI-2 scale scores in two American Indian tribal
groups. The article reflects substantial differences in scales between American Indians and the
MMPI-2 normative group. According to the author these differences do not necessarily reflect a
cultural test bias but behavior and symptoms characteristic of severe mental disorder in
American Indians in part caused by adverse health conditions and social stressors.
Method
The MMPI-2 was administered over a 5-year period (1990–1995) by trained local tribal
interviewers to a total of 297 Plains and 535 Southwestern tribal members. The two tribes
differed in terms of language, history, social and religious organization, cultural and geographic
location. Approximately 8% of the study participants were excluded from further analyses
because of their inability to meet validity criteria. Final analyses were performed for 239 (92
men, 147 women) Plains and 490 (209 men, 281 women) Southwestern tribal members; this
The Plains tribal members averaged 38.2 years of age (SD = 12.7), whereas the
Southwestern tribal members averaged 36.6 years of age (SD = 13.3). The members of both
tribes generally had a high school education or less (Plains = 71.2%, Southwestern = 67.6%), and
slightly over one-half of them were married (Plains = 51.2%, Southwestern = 53.3%). The
MMPI-2 was administered by trained local tribal interviewers. English is the predominant
language spoken in both tribal communities. Most of the 913 study participants from the two
tribes' total study sample were administered the MMPI-2 individually (87.7%); however, 112
members of the Plains tribe (12.2% of the tribes' total study sample) were administered the
MMPI-2 in 11 group sessions at various rural locations averaging 10 people per session.
All participants were in a family study on alcoholism. The clinical histories of the
participants were not used for selection. In addition, the participants were required to be adults
over 21 years of age and enrolled in, or eligible for, tribal membership (≥1/4th tribal ancestry).
Thus, all participants were recruited as community volunteers and were not referred from
Results
The authors conclude that because the potential correlates fell primarily into the
categories of symptoms of alcohol or drug use, antisocial behaviors, and depressive or negative
effect, there were a number of significant relationships with those MMPI-2 scales related to these
areas. There were a large number of significant correlates reflecting antisocial symptoms.
The absence of any potential correlates that assessed physical symptoms resulted in virtually no
correlates for Scales 1 (Hs), 3 (Hy), and HEA. Similarly there were few potential correlates
Critical Literature Review 11
Scales 5 (Mf), 0 (Si), and SOD. Although some of the correlates of the clinical and content scales
were similar in the American Indian men and women, those correlates assessing generalized
distress and negative effects such as crying, feeling guilty, having low energy, feeling
For example, the construct of crying was correlated with most of the clinical scales in
men and none of these scales in women. The American Indian men reported changes in appetite,
sleep difficulties, loss of interest in things, and lack of energy as significant correlates of most of
the individual content scales, and particularly for the scales ANX, OBS, DEP, WRK, and TRT that
are general markers for negative emotionality and distress on the MMPI-2. The American Indian
women reported being pessimistic, needing reassurance, having low energy, and feeling resentful
or angry as the significant correlates of these same scales. The American Indian men were
unlikely to describe their general distress in terms of being pessimi stic or needing reassurance,
and the American Indian women did not report loss of interest in things, sleep difficulties, or
Conclusion
The authors conclude that clinicians using the MMPI-2 with American Indians should not
quickly dismiss elevations on these scales as reflecting test bias. Rather, these differences appear
to accurately reflect the behaviors and symptoms that American Indian study participants were
experiencing.
Critical Literature Review 12
Study #3
A study by Hall, Bansal & Lopez (1999) reviews the extant research over 31 years of the
comparisons of MMPI/MMPI-2 validity and clinical scale scores of male and female European
Americans and of male and female ethnic minorities. The study concludes that differences
among European Americans, African Americans and Latino Americans are negligible and the
Method
The studies included in the PsycInfo database from 1967–1998 that directly compared
ethnic minority groups with European Americans on the MMPI or MMPI-2 were considered.
Male and female participants' data were analyzed separately because combined analyses may
obscure potential gender differences. Studies in which adolescents were administered the MMPI
Americans versus another male or female ethnic group were required to qualify for inclusion in
these analyses. This resulted in the identification of 25 usable studies of male African Americans
versus European Americans, 12 usable studies of female African Americans, and 13 usable
Results
The studies revealed that male African Americans exhibited higher scores than male
1 scale. Female African Americans exhibited higher scores than female European Americans on
Critical Literature Review 13
8 scales, lower scores on 4 scales, and no difference on one scale across studies. Latino
Americans exhibited higher scores across studies than male European Americans on 3 scales and
Conclusion
The general conclusion of this study was that MMPI/MMPI-2 differences among
European Americans, African Americans, and Latino Americans are minor. The MMPI and
MMPI-2 apparently do not unfairly portray African Americans and Latino Americans as
pathological.
Study #4
A study by Pace, Robbins, Choney, Hill, Lacey & Blair (2006) examined the normative
validity of the MMPI-2 for American Indians from a contextualized and holistic framework.
This study is an in-depth look at the issue of cultural bias of the MMPI-2 by comparing the
across 13 validity and clinical scales. The results appear significantly different than Green et al.
(2003) above.
Method
Woodland Oklahoma (EWO) and 87 Southwest Plains Oklahoma (SWPO) American Indians
were anonymously surveyed through pencil and paper inventories and questionnaires. The
average age of the male and female participants was 36.1 in the SWOP tribe and 35.4 in the
EWO tribe. Participants completed a standard demographic form, a brief mental health history
Critical Literature Review 14
screening form, the Life Perspective Scales and the MMPI-2. The LPS is a 41-item theoretically
driven acculturation instrument that measures level of traditionals among American Indians.
Each item has a Likert scale format with anchors of 1 = Never and 5 = Most of the Time.
Results
For the SWPO tribe, scales L, F, 1, 4, 6, 8, and 9 were all significant elevated 5T points
above the mean of 50, while scales 5 and 7 reached statistical significance (.004) and almost
reached the 5T criteria in elevation above the mean of 50. For the EWO tribe, scales F, 1, 6, 8,
and 9 were significant and elevated 5T above the mean of 50, while scales 4, 5, and 7 reached
statistical significance (.004) and almost reached the 5T criteria in elevation above the mean of
50. Thus for both the EWO and SWPO tribes, a total of 8 of the 13 basic validity and clinical
scales of the MMPI-2 were at or near 5T points above the standard mean of 50 for the normative
sample. The only difference between the results for these two tribal samples is that the SWPO
elevated the L scale more than 5T above the mean of 50 while the EWO tribe did not. Both tribes
had slightly non significantly lower than average K scores and both were near the normative
mean of 50 on scales 2, 3, and 0. Lower educational levels resulted in higher scores on L in the
EWO sample, but not the SWPO sample. Acculturation status did not affect scores for the
SWPO sample. However, lower acculturation resulted in higher scores on F and 8 for the EWO
sample, which may support the hypothesis that acculturation stress may be more acute for less
Conclusion
The authors conclude that other studies such as Greene et al. (2003) are correct in
assuming elevated American Indian norms reflect something about the distress and challenges
Critical Literature Review 15
faced by American Indian people. In addition, the authors argue that these results must also be
understood in light of the historical oppression and racism enacted against American Indians
along with the ensuing disadvantages created by forced assimilation, poverty, unemployment,
inadequate health care, and broken social structures. The authors conclude that the very
assumptions that are presupposed in the MMPI-2 (and mainstream psychology) may in some
Study #5
A study by Butcher, Cheung & Kim (2003) examined the use of the MMPI-2 in other
countries throughout Asia. Linguistic and sociocultural dynamic equivalence is compared to the
normative group of the Euro-American context in which the MMPI-2 testing instrument was
developed. The article offers research on the instruments current usage in Asian countries and
the difficulties encountered in equivalency, validity and cultural bias. This article reflects
specifically on the challenges of producing a cross cultural test adaptation for effective use in
other cultures.
Conclusions
Several factors have made the MMPI-2 adaptable for international applications. The
revised MMPI-2 item pool is more culturally appropriate and more standardized today than they
were in the past. There are fewer idiosyncratic versions of the MMPI-2 in existence and
available MMPI-2 translations have been more carefully adapted than earlier test translations.
instruments and the application of equivalent and comparable procedures make it possible for
Critical Literature Review 16
symptoms.
Significant limitations on using the MMPI-2 in Asian countries were also noted by the
authors. Although many translators developed separate in-country norms for the test translation
in the country of intended use, some of the existing versions do not have separate norms and
need to rely upon the U.S. norms as a standard of comparison. Some, such as the Philippines and
Thailand do not have separate in-country norms because use of the English language versions
has been established as an effective tradition. In some countries, such as Korea, where separate
norms appear to be needed, a normative study has not yet been completed. The authors advocate
the need for norms to be established in various Asian countries so broad-based research can
Study #6
In a study by Dong & Church (2003), the authors had two goals: 1) to investigate the
Multiphasic Personality Inventory-2 (MMPI–2, Tran, 1996) and 2) to determine whether the
MMPI–2 can be a useful tool in the psychological assessment of Vietnamese refugees, many of
whom exhibit psychological symptoms associated with experienced traumas. The authors state
that between 1975 and 1982, about 1.4 million Southeast Asian refugees fled their homelands
after the fall of Saigon. Today, Southeast Asians comprise the largest refugee group in the
United States, and Vietnamese account for 65% of this group (American Council for
Nationalities Service, 1985; Mattson, 1993 as cited in Dong & Church, 2003).
Method
Critical Literature Review 17
The initial sample consisted of 143 adult Vietnamese refugees. All of the participants
were born in Vietnam and migrated to the United States. 73 were men and 70 were women.
Mean age was 41.2 years (SD = 14.3). Of the 73 men, 23 were veterans of the Vietnamese army.
Participants arrived in the United States during the following time periods: 1975–1979, n = 30,
21%; 1980–1989, n = 57, 40%; 1990–1999, n = 56, 39%. Ages on arrival in the United States
were as follows: 4–9 years old, 7%; 10–19 years old, 24%; 20–29 years old, 32%; 31–39 years
old, 12%; 40–49 years old, 12%; 50–59 years old, 10%; and 60 or older, 3%. Most participants
(n = 121, 85%) were currently employed, with 21% unskilled, 52% skilled, 26% professional,
and 1% not reporting their occupation. About 30% of the sample were college graduates or had
attended some 4-year college. Participants were recruited at four community colleges, two
universities, Silicon Valley Technical School, and the Vietnamese Refugee Resettlement
Program, all in California. Another 50% had attended or completed community college or
technical school. The remainder had attended or graduated from high school. Three validity
scales (L, F, and K) and the 10 basic clinical scales were scored from the first 370 items of the
MMPI–2. Only these 370 items were administered because of time constraints. The remaining
197 items are scored for various supplemental, content, and research scales.
Results
Scales F and 8 findings and tendencies to report somatic complaints. In addition, both men and
women showed moderate elevations (i.e., T scores around 60 or higher) on Scales L, 2, and 7. If
taken at face value, the authors suggest that this represents naive defensiveness or limited insight
(L), moderate dissatisfaction or adjustment difficulties (F), somatic complaints (Scale 1),
depression (Scale 2), anxiety (Scale 7), and social alienation (Scale 8) in the sample as a whole.
Critical Literature Review 18
The authors suggest that since the sample consists of refugees, most of whom have had some
exposure to traumatic experiences, these mean elevations may be regarded as typical rather than
Conclusion
Thus, we believe that the instrument has the potential to be a useful tool in the psychological
assessment of Vietnamese refugees, if not Vietnamese people more generally. Researchers who
investigate the cross-cultural equivalence and validity of different language versions of the
MMPI–2 generally examine mean profiles based on U.S. norms (Butcher, 1996 as cited in Dong
& Church, 2003). Elevated scores do not necessarily imply that the instrument lacks
equivalence in the new cultural group, but large mean T-score differences might raise concerns
about nonequivalence. In the present Vietnamese sample, moderate elevations (i.e., T scores
around 60 or higher) were observed on a number of scales. The authors believe that these
moderate elevations reflect valid assessments of symptom patterns rather than an invalid cultural
measurement. Yet the authors still suggest that until additional studies are conducted with the
Vietnamese MMPI–2, clinical practitioners should remain cautious in their use of the MMPI-2.
Critical Literature Review 19
Evaluation of the test administration procedures varied with each of the following
studies:
In Study #1, Velasquez et al. (2000), participants were administered the MMPI-2 in
is considered to be the “official” U.S. Spanish translation. Because of time limitations the
participants were only administered the first 370 items under standard instructions at an interval
of 6 weeks. Some participants were administered the English-language MMPI-2 first and then
Spanish translation second, or vice versa. In Study #2, Greene, Robin, Albaugh, Caldwell, &
Goldman (2003), The MMPI-2 was administered over a 5-year period (1990–1995) by trained
local tribal interviewers to a total of 297 Plains and 535 Southwestern tribal members.
In Study #3, the study included the PsycInfo database from 1967–1998 that directly
compared ethnic minority groups with European Americans on the MMPI or MMPI-2 were
considered. In Study #4, Pace, Robbins, Choney, Hill, Lacey & Blair (2006), one hundred and
and 87 Southwest Plains Oklahoma (SWPO) American Indians were anonymously surveyed
In Study #5, Butcher, Cheung & Kim (2003), the authors reviewed the standardized
normative data of the MMPI-2 in several Asian countries to survey their validity for each
cultural setting. In Study #6, Dong & Church (2003), administered the MMPI-2 to a sample
consisted of 143 adult Vietnamese refugees. All of the participants were born in Vietnam and
Critical Literature Review 20
migrated to the United States. 73 were men and 70 were women. Mean age was 41.2 years (SD
= 14.3).
In several of the above test administrations some underlying circumstances regarding the
control group must be noted. Among the American Indian studies the MMPI-2 was administered
immediately and over a five year period. In the comparison study of ethnic groups to European
Americans a longitudinal study comprising 31 years was conducted. In the Vietnamese study
test administrations were conducted in several hours and in the Latino study over a 6 week
period.
It is important to note that modifications because of time constraints were made for the
MMPI-2 in the Latino study (Study #1) (Velasquez et al., 2000) and the Vietnamese (Dong &
Church, 2003) research study and the complete MMPI-2 assessment was not administered. The
Standard text indicates that modifications involving some aspect of a test that was originally
developed for use with a target population have the potential to affect the psychometric qualities
of the test (AERA, APA, & NCME, 1999). Any test modifications adopted should be
appropriate for the individual test taker, while maintaining all feasible standardized features
It appears that the test modifications were not administered because of inherent linguistic
limitations or disabilities but because of time constraints. A question arises as to the validity of
such a practice in light of the standards referenced above. Construct underrepresentation simply
means that the test lacks important constructs that can accurately measure the content (Kaplan,
R. M., & Saccuzzo, D. P., 2009). In a cross cultural study of this importance and magnitude, test
Critical Literature Review 21
modifications because of time constraints seems unwarranted and may have had a bearing on the
An effort was made by the researchers in the Latino study (Velasquez et al., 2000) to
However, it must be noted that bilingual examinees present special challenges to test usage. An
individual who knows two languages may not test well in either one (AERA, APA, & NCME,
1999). Proficiencies in written and spoken languages can often differ as well.
The findings in Study #1 control group from the Latino study indicated that the mean
However, the findings from Study 2, while indicating no scale score differences, did result in a
lower mean correlation coefficient. This suggests variable performance when Spanish-speaking
participants were administered two different Spanish translations of the MMPI-2. Unlike Study
1 in which participants were required to respond to an English and Spanish translation, the
participants in Study 2 may have found this task to be less linguistically challenging because
details have been mentioned regarding the Latino study groups. As a result, researchers
determined there may have been idiomatic differences that accounted for test score variances
(Velasquez et al., 2000). This author takes note that in each of the above ethnic studies trained
In each of the above ethnic studies the psychometric properties of normative sampling
and errors of measurement appear to be sound. However, the issue of validity or bias may have a
Critical Literature Review 22
bearing on the reliability of test administrations. Only the Latino study mentions psychometric
properties of test-retest correlation coefficients. The lack of psychometric property data in other
studies raises questions of the usefulness of the findings. It appears from the recommendations
of cautious use of the MMPI-2 by the researchers of the Latino, Vietnamese and American
The Vietnamese (Dong & Church 2003), and American Indian studies (Pace, Robbins,
Choney, Hill, Lacey & Blair 2006) appeared to render moderately high scale elevations for the
MMPI-2. For the Vietnamese study, mean T scores for the low-trauma group were below 59 for
most scales, whereas Scales F, 1, and 8, but not 3, were moderately elevated (59–64). In
addition, Scale 2 was moderately elevated (T = 61). Overall, the low-trauma group reported mild
dissatisfaction (F) and depression (Scale 2), some somatic complaints (Scale 1), and perhaps
mild social alienation (Scale 8). In contrast, the high-trauma group exhibited moderate
elevations (T = 59–66) on all of the expected scales (Scales F, 1, 2, 7, and 8), with the exception
In both American Indian study (Pace, Robbins, Choney, Hill, Lacey & Blair 2006;
Greene, Robin, Albaugh, Caldwell, & Goldman (2003), There were a large number of significant
correlates reflecting antisocial symptoms with Scales 4 (Pd), 9 (Hypomania [Ma]), ANG, and
ASP. There were even a larger number of significant correlates reflecting generalized distress
and negative affect with Scales 7 (Pt), 8 (Sc), ANX, OBS, DEP, LSE, WRK, TRT, and A.
Elevated scores do not necessarily imply that the instrument lacks equivalence in the
cultural group, but large mean T-score differences might raise concerns about nonequivalence. In
the present Vietnamese and American Indian samples, moderate elevations (i.e., T scores around
Critical Literature Review 23
60 or higher) were observed on a number of scales. Although the test results must be considered
in light of the traumatic background of the sample group, the results may indicate that the
normative assumptions that are presupposed by mainstream psychology regarding the MMPI-2
may in some cases render it inadequate or even harmful when applied to ethnic groups that are
free of psychopathological disorders. Efforts to validate the MMPI-2 with the above ethnic
groups must go beyond normative and traditional validation studies to address the issues
Conclusion
have far reaching implications. One of the most important implications of ethnic differences
would be the need for culture-specific models of psychopathology, assessment, and treatment.
Cultural differences often persist across ethnic groups even among those who are highly
acculturated. One distinct difference for example in which ethnic groups in the United States
orientation and therefore require different assessments to accurately diagnose and provide
treatment solutions in clinical psychology. However, if assessment tools do not have well-
established psychometric properties they are not useful in clinical samples. Moreover, few
scales have been designed to measure ethnic identity across multiple ethnic groups (Hall, Bansal
The MMPI-2 and the MMPI-2 RF are the most widely used personality instrument and its
applicability and limitations with ethnic minority populations need to be more fully investigated.
The above studies of American Indian, Latino, and Vietnamese testing results indicate that
Critical Literature Review 24
linguistic and validity equivalence evidence seems to be lacking. In order to reduce bias one
must examine if the following areas exist: language that may contain different meanings for
religious language or references that are characteristic of particular groups, a particular bias for a
specific geographical region and the implication of a particular socioeconomic status (Kaplan, R.
It appears that the further research in Latino, American Indian, and Asian cultural
populations is necessary for the MMPI-2 RF to have fundamentally sound construct equivalence
for these and other ethnic populations. Two of the above studies indicated that the MMPI-2 and
MMPI-2 RF differences among European Americans, African Americans, and Latino Americans
are minor. The MMPI and MMPI-2 apparently do not unfairly portray African Americans and
Latino Americans as pathological or present any construct validity issues (Hall, Bansal & Lopez
1999). However, as already noted other studies in this literature review indicated caution in the
use of MMPI-2 RF with American Indians, Latinos and Vietnamese ethnic groups.
except when used by mental health workers who are familiar with acculturation issues and
understand as in the case of American Indians, the unique medical history, their tribal
If identifiable groups differ in their average levels of measured versus unmeasured job
relevant characteristics then fairness is a concern at the group and individual level (AERA, APA,
& NCME, 1999). According to the Standards text, when test outcomes affect the life chances or
Critical Literature Review 25
educational opportunities of test takers and mean differences are found to exist along subgroups
an investigation should be undertaken (AERA, APA, & NCME, 1999). From the results of this
review it appears caution should be used as well in the use of the MMPI-2 in determining job
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