MMPI Test

Tes Inventory
Overview
• The Minnesota Multiphasic Personality Inventory (MMPI) is a true-
false self-report inventory.
• MMPI was developed by Stark Hathway and J. C. McKinley in 1943.
❑ The original MMPI was revised into two separate versions:
• 1. The MMPI-2 (Butcher, Dalstrom, Graham, Tellegen & Kaemmer,
1989).
• 2. The MMPI-Adolescent also known as MMPI-A (Butcher, Williams,
Graham, Archer, Tellegen, Ben-Porath & Kaemmer, 1992)
• Items- 567 items comprising 10 clinical scales and 7 validity scales.
• Age - 16-84 years and Used as a diagnostic tool to help in the
diagnosis clarification and in assessment of personality.
  10 clinical scales and 3 validity scales
 Empirical scale development with items
selected based on their ability to differentiate
normals, from a target group (another clinical
group with similar symptoms was sometimes
MMPI (Hathaway & also employed)
McKinley, 1943)  Clients should be 18 or older & 6th grade
education
 Generally lower face validity (breaks with
tradition of items that clearly sample the
domain of interest); most relevant for clinical
population
  Item pool derived from psychological and
psychiatric reports, textbooks, previous scales,
etc.
 Criterion group composition
 Minnesota normals – 724 relatives and visitors of
MMPI patients at the U. of M. Hospitals, 265 recent high
school grads, 265 administration workers, and 254
development medical patients
 Clinical groups – 221 patients representing the
major psychiatric categories (excludes those with
multiple diagnoses, or questionable diagnoses)
 Item analysis to identify those items
differentiating the clinical and normal groups
  The items that could differentiate were then
cross validated with new groups of normals and
patients
 Later developed two non-clinical scales
MMPI  M/F – initially to identify male homosexuals was
augmented with broader items
development –  Si – derived from an introversion/extraversion scale
cont. and cross validated by predicting involvement in
college activities in a second sample (all female
college students)
 Validity scales were either derived rationally (L
& K) or from baserates in the normal group (F)
  Not considered a diagnostic inventory (as was originally intended)
 Ineffective at differential diagnosis (based on how it was originally
Utility of the developed)

MMPI  Numerical scale labels was intended to further minimize the

connection with a specific diagnostic label
  Method of determining the criterion group
 The PIGs were not a truly random group
(relatives and friends of those in the hospital –
though largely the medical patients);
convenient
Some
 Criterion and PIGs were largely from the
problems with midwest, in the late 1930s/early 1940s
MMPI  Utility of some of the scales as it matched
diagnostic concerns of that era, dated and
culture-specific item content, and
representativeness of the norm group.
  MMPI was the most widely used personality
test in all pops (though only validated for
inpatient adult samples)
 MMPI validation and norm samples were ones
MMPI vs. of convenience with limited variability on
MMPI-2 (1989) education (M=8 years), coming from a rural
background in the midwest
 Normative data collected in the 1930s
 Clinical cut-off now defined by t-score of 65 vs.
70 on the MMPI
  Advantages of updating the test
 more representative norms (based on projected
census data)
 relevance of the items
 language employed for the items (both temporally
MMPI vs. laden references like “drop the hanky”, and gender
MMPI-2 biases in item content)
 addition of new scales of relevance today
 Uniform T-score transformation now used so that
T-scores reflect percentile ranks that are the same
across all clinical scales
  Disadvantages to all updates
 over 20,000 published studies no longer apply
 MMPI-2 must revalidate all of the scales
MMPI vs.  inability to make comparisons with adolescent scores (MMPI-2 vs.
MMPI-2 MMPI-A)
 Many of the new scales are very short and lack appropriate
psychometric properties
 How often should we redevelop or renorm the scale?
  Norm group = 2,600 community based subjects
MMPI-2  1138 m & 1462 f, aged 18-85 (M=41, SD15.3), education 3 yrs - 20+,
61% married median incomes $25-$35,000, 3% of m and 6% of f
(1989): 567 receiving mental health treatment
items  81% Caucasian, 12% A-A, 3% Hispanic, 3% Native American, 1%
Asian-American
  Assumption that the clinical population will not be able
to answer forthright
 Lie – naive or unsophisticated lying (low SES and
education)
 K – less obvious (high SES and education)
defensiveness is a component of all responding
Validity scales
 F – answering questions in such a way so as to be
different from 90% or more of the population (non-
normative responses); See fake bad/fake good profiles
 F – K Index = can be used to indicate fake bad, with
larger numbers making it more likely (little evidence to
suggest that fake good can be detected); see p. 38
  1. Hs - exaggerated concerns re: physical illness, or tendency to
report symptoms
 2. D - Clinical dep; unhappy & pessimistic about the future
Clinical Scales  3. Hy - conversion reactions (substitute illness for emotions)
 4. Pd - History of delinquency, antisocial behavior (non-
conventional re: moral standards)
  5. Mf - prototypical gender identity (military recruits,
stewardesses, homosexual males students)
 6. Pa - paranoid symptoms (ideas of reference, persecution,
Clinical scales - grandeur)
continued  7. Pt - anxious, obsessive-compulsive, guilt ridden, self-doubts
 8. Sc - thought disorder, perceptual abnormalities (various types of
Schiz.)
  9. Ma - exhibition of mania, elevated mood, excessive activity,
distractibility, (possible manic-depression or BP II)
 10. Si - college students scoring in the extreme range on
Clinical Scales - introversion - extra.
continued
 Costa & McCrae (1990) suggest that the MMPI-2 wont work in the
normal pop. As people don’t respond “passively” to items
  Basic validity comes from L, F, & K
 VRIN (variable response inconsistency)
 47 pairs of items that should be answered similarly or the opposing
New Validity direction. Client gets a point for each inconsistent response.
Indexes  A completely random response set results in T scores of 96 for m and
98 for f (>80 inval.)
 acquiescent responding T = 50
  TRIN (true response inconsistency)
 23 pairs of items that are opposite in content
 either T/T or F/F to assess acquiescent or non-acquiescent
responding
New Validity –  larger raw scores = true responding while smaller raw scores = false
cont. responding
 raw scores should be between 6 and 12 in order to consider the
profile valid

 Fb - back infrequency items for latter part

  List scale # codes in order of their T-score elevations (from highest
to lowest)
 usually only interpret 4 scale codes and order does not matter
Coding the  Welsh coding system involves adding symbols to numerical scale
Profile codes
 e.g., L F K 1 2 3 4 5 6 7 8 9 0
 T 57 75 43 69 88 75 94 52 81 75 79 59 65
 Welsh: 4268371095 FLK
  ** 100-109, * 90-99, “80-89, ‘70-79, +65-69, -60-64,
/50-59, .:40-49, #30-39
 Some coding forms use ! to denote scores of 110-119
and !! for 120 or greater
Codes (listed
 Underline identical T-scores (and list in ascending
to the right)order) as well as those within one point of each other
 e.g., 4*26”837’10+95/ F’L/K.:
 Code Types 2,3 and 4 point codes: 5 point diff
between lowest code T and T of highest scale not in
the code.
  Integrate the MMPI-2 data with the client
information (vs. laundry list). Note: profile
valid.
 e.g., profile 3-2/2-3 should revolve around the
discussion of depression and the manifestation of
MMPI-2 symptoms (physical symptoms tend to be
practice case: substituted)
M.S.  How does this relate to M.S.?
 Recent loss, seeing her physician, isolation
 What does the 8 (or 2-3-8) tell you?
 How might psychotic symptoms relate to M.S.?
 Confusion from malnutrition, confusion as a result of
depression, her age re: dementia? All are possible
  Include discussion of (or section on) prognosis,
recommendations, and diagnosis
 Axis I: 296.24, Major depression, single episode,
with psychotic features
M.S. -  AXIS II: No diagnosis (or deferred)
continued  AXIS III: Malnutrition, dehydration, poor hygiene &
personal care
 AXIS IV: Death of spouse (Severity: extreme (acute
event)
 AXIS V: GAF: Current, 24; highest past year, 52
  MMPI was originally developed using
Caucasian groups of patients
 Although some research has shown mean score
differences between majority and minority
MMPI-2 with groups, this is less relevant to the issue of
other pops. whether there is differential predictive validity
(few studies on this)
 Hall, Bansal, & Lopez, 2000, have conducted a
meta-analysis of 30 years research on minority
groups and the MMPI (both versions)
  AA – first note that cultural identification moderates all
findings (cf. acculturation)
 Inconsistent findings re: mean differences, with F, 8, &
9 sometimes higher by approximately 5 T-score points
Hall et al.,  Many matched grouped studies of patients have found
no differences, though Ns were small (meaning what?)
2000 -  Generally no differences in predictive validity that
summary achieve statistical or clinical significance and any
differences can be attributed to SES and age
 MMPI-2 has representative norms
 Minimal information on the supplemental scales and
even less for the content scales
  Hispanics likewise show few differences from
Caucasians
 Possible differences for scales 3 and 0, with Hispanics
scoring higher on 3 and lower on 0, but these effects
were small with minimal clinical or statistical sig.
Hall et al.,  Much stronger effect for acculturation in this ethnic
2000 – sum group
 Few studies on Native Americans, but they show this
cont pop. to score slightly higher on most scales
 Few studies for Asian Americans, and they show slight
elevations for scales F, 2, & 8.
 Generally valid to use for these pops given appropriate
acculturation and understanding of the language
  Given its original construction, there should be no
problems using the MMPI in medical settings
 Medical problems do not necessarily result in higher scores
(i.e., more distress)
 In substance abuse settings, no profile emerged to
detect substance abuse, but scale 4 was a good
Other predictor (see also the supplemental scales)
 We will discuss forensic applications later in the
populations semester (see chapter 13)
 MMPI-2 can be used in non-clinical settings to screen
for psychopathology, but there are some concerns.
 False positives are more common
 Has not been validated to predict success in other settings
(e.g., jobs) which is true of most personality tests (predict
interest)
  Do we need a different inventory for adolescents?
Why? Scales of concern?
 M/F for adolescents may be less defined
 Theoretically Pd is thought to be elevated, but actually it
tends to be lower
 Personality is less stable overall so we need different norms
to better interpret scores and relevant items for this age
group
MMPI-A (1992)  Valid for those aged 14-18 (for 18 y.o., the decision is
based on life circumstances; e.g. at home? working?)
 Important to score on both adult and adolescent norms as
there can be substantial differences (T-score shifts of 15
points)
 478 items (some new some from the original inventory)
 written & auditory forms both in English and Spanish
  Includes all of the clinical, & some new supplemental & content
scales. So we use basically the same scales but different
descriptors (i.e., a high score on Hs will not mean exactly the same
thing for the MMPI-A; e.g., Pd equates more with acting out)
 Biggest change was with the F scale since it is a norm defined
scale (we need new norms)
MMPI-A  Norms: 805 boys & 815 girls aged 14-18 solicited randomly from
schools in 7 states. Represents the U.S. for SES and ethnicity
(again minimal diffs for ethnicity)
 Change from MMPI which had separate norms for different
adolescent age groups (now only one)
 F scale now has 2 parts: F1 = 1st part of test, F2 = 2nd part (F=total)
  New Supplemental scales:
 Alcohol/drug problem proneness (PRO) – empirically
derived to assess the likelihood of alcohol or other drug
problems. Items differentiate adolescents in tx from
those having other psychological problems
MMPI-A: New  Alcohol/drug problem acknowledgement (ACK) – face
valid items that reflect the admission of problems
scales  Immaturity (IMM) – reporting behaviors, attitudes, and
perceptions that reflect immaturity (e.g., poor impulse
control, judgment, and self-awareness). Items predict
academic problems and cognitive limitations.
 Check for diagnoses such as oppositional-defiant,
conduct disorder, and in adulthood ASPD
  For the most part, the psychometric properties of the MMPI-A are
sound. The reliability values are lower than the MMPI-2 values, but
still within acceptable limits.
 Why might there be less temporal stability in the MMPI-A?

 General interpretative data from the MMPI-2 can be generalized

MMPI-A to the MMPI-A, but this data should be considered in light of the
Psychometrics client’s position in life (i.e., consider how the scores relate to
school life, problems with parents, need for independence, etc.)
 Note: no K-correction for clinical scales even though a
defensiveness score is calculated. So what are the clinical scale
implications for a high K?
Overview
• The Minnesota Multiphasic Personality Inventory (MMPI) is a true-
false self-report inventory.
• MMPI was developed by Stark Hathway and J. C. McKinley in 1943.
❑ The original MMPI was revised into two separate versions:
• 1. The MMPI-2 (Butcher, Dalstrom, Graham, Tellegen & Kaemmer,
1989).
• 2. The MMPI-Adolescent also known as MMPI-A (Butcher, Williams,
Graham, Archer, Tellegen, Ben-Porath & Kaemmer, 1992)
• Items- 567 items comprising 10 clinical scales and 7 validity scales.
• Age - 16-84 years and Used as a diagnostic tool to help in the
diagnosis clarification and in assessment of personality.