MMPI-2

Dale Pietrzak, Ed.D., LPC-MH, NCC, CCMHC

Counseling & Psychology in Education University of South Dakota

MMPI: General
1st published in 1943 (Stark Hathaway, Ph.D, & J. Chaney McKinley, M.D.) Group administered procedure to reliably diagnose Used Empirical keying approach (new at time)
Graham (2000) MMPI-2: Assessing Personality & Psychopathology (3rd ed) Butcher, Et. Al (1989) MMPI-2: Manual for Admin & Scoring

MMPI: Development
About 1000 potential items were collected Hathaway & McKinley selected 504 believed to be relatively novel from each other Appropriate criterion groups were selected
Minnesota Normals Clinical Subjects 504 items administered to groups

MMPI: Development Cont

Item Analysis (Discrimination Index) used to determine items Selected items were cross validated Later 5 (Mf) and 0 (Si) were added

MMPI Validity Scale Development

3 scales (?, L & F) were originally intended with K added shortly thereafter ? (Cannot Say): Number of omitted and double marked items L (Lie): Unsophisticated attempts to present oneself in an overly favorable light F (Infrequency): Designed to detect deviant test taking behaviors (<10% of normals)

MMPI Validity Scale Development

K (Defensiveness): Meehl & Hathaway (1945) to identify defensiveness
Clinical subjects who scored low for level of pathology were contrasted with normals to select items Later incorporated as a correction factor for basic scales I think my hand is broken!

MMPI Validity Scale Development

F(p): Infrequency-Psychopathology: Try to reduce impact of pathology on F scale. Although officially no cut score set, scores of 100 are seen as cutoff.

Changes Due to Use

10 years saw MMPI could not do intend job of independent classification accurately Too many normals scored high Scales Highly inter-correlated Approach from pure classification to locating empirical correlates of scales and code types Scale names dropped in favor of numbers

Need for Revision of MMPI (MMPI-2)

MMPI was consistently ranked as one of the most used instruments Clinicians (not just testers) found it valuable Several weakness were Identified

MMPI Weaknesses
No revision since 1943 Representativness of standardization sample Non-Normal distributions of scales scores Item content dated, bias, or objectionable Insufficient coverage of pathology (drug use, relationships, suicide, etc.) 1982 U of M Press appoints restandardization committee (Graham, Butcher, Dalstrom)

Revision Process Form AX (Adults)

704 total items
550 original items maintained
82 were rewritten and 15 reworded

About time

154 new items tried

National Solicitation of Sample

Phone Books, etc. Paid $15 individual and $40 couple Emphasis on special populations 2900 subjects tested 2600 retained

Standardization Sample Characteristics

Under represents the below HS educated (little statistical impact) 81% Cauc., 12% Black, 3% Hispanic, 3% Native Am., 1% Asian Am. Age: 18-85 (Mean 41; SD 15) Education: 3 years to 20+ (Mean 15; SD 2) Mostly Married I cant take anymore!

Final MMPI-2 Booklet

567 Items Objectionable Items & Bias removed New Scales Developed Most Supplemental and All Clinical Scales Retained

Ta Da!

Comparability of MMPI & MMPI-2

The results of the 2 tests have proven to be generally comparable The less defined the profile the less reliable the comparison Greene (1991) suggests conversion to MMPI scores with table K-1 from Manual Graham says to use individual scales when not clear code type

Administration & Scoring

Advanced degree in mental health, supervised testing (25) and Psychopathology May the force 1 to 1.5 hours to take be with you! 8th grade reading level Supervised administration (No TV or movies, etc.) 200+ scales, VRIN/TRIN

Distributions and T-Scores

Non-normal distributions Uniform T-Scores (Averaged distribution)
Clinical Scales, Content Scales & MDS use Uniform Supplemental, Harris-Lingoes, Mf and Si use Linear T of 30 = 99%, T of 50 = 45%, T of 65 = 8%, T of 80 = 1%
Im Back!

Stability
MALES Scale 1 Week L .77 F .78 K .84 1 Hs .85 2D .75 3 Hy .72 4 Pd .81 5 Mf .82 6 Pa .67 7 Pt .89 8 Sc .87 9 Ma .83 0 Si .92 SEM 1.0 1.5 1.9 1.5 2.3 2.3 2.0 2.0 1.6 2.2 2.4 1.8 2.4 FEMALES Scale 1 Week L .81 F .69 K .81 1 Hs .85 2D .77 3 Hy .76 4 Pd .79 5 Mf .73 6 Pa .58 7 Pt .88 8 Sc .80 9 Ma .68 0 Si .91

Stability of Basic Scales

SEM 1.0 1.8 1.9 1.9 2.4 2.3 2.2 2.3 2.0 2.5 3.5 2.5 2.9

Internal Consistency
Scale L F K 1 Hs 2D 3 Hy 4 Pd 5 Mf 6 Pa 7 Pt 8 Sc 9 Ma 0 Si Males .62 .64 .74 .77 .59 .58 .60 .58 .34 .85 .85 .58 .82 Females .57 .63 .72 .81 Did you .64 see that! .56 .62 .37 .39 .87 .86 .61 .84

MMPI-2 Interpretation Process

Determine Profile Validity Configural (Code types) Content (Basic, Content, and Supplemental)

As easy as 1, 2,3 ...

Yah! right...

Validity scales:
General Guidelines
? 30+ Definitely Invalid; 10+ Great Caution L > 65 probably Invalid F, Fb >100 Likely Invalid (Highly correlated with severity of pathology) K > 70 Invalid (Correlated with ego Strength) F(p)> 100 Invalid

Validity scales:
General Guidelines
VRIN > 80 Invalid TRIN > 80 Invalid
I think I would rather be home.

Deviant Response Sets: General

Random: F >100, Fb >100, F(p)> 100 VRIN >80 All True: F > 100, Fb > 100, TRIN > 80 All False: L > 65, F > 100, Fb > 100, TRIN > 80 Negative Impression: F > 100, F(p) < 100, K Low, VRIN & TRIN Acceptable; Exaggeration: Clinical Judgment Positive Impression: L > 65, K > 65, Low F Defensiveness: K & L 10 points higher than F; either F or K elevated (experimental: S [superlative] greater than 29).

Interpretation Examples
Random
VRIN=98, F=103 and F(p)=99

Fake Good
K=70, L=67 and S=68

Fake Bad
F=110, F(p)=78 often L,K & S are very low

Configural Information: Slant

Level of F and profile elevation Left of Profile elevated neurotic slope Right of Profile Elevated more sever pathology Conversion V (1 & 3 elevated with 2 lower) Psychotic valley (6 & 8 Elevated with 7 lower) Cry for Help (2-7)

Configural Information:
Code Types
Use the highest 2 or 3 scales (NOT including 5 or 0) If over 65 think more pathology, if under think more normal expression of configuration Highest scale determines but all scales within 5 to 7 points are interchangeable Most codes order is not vital

Basic Clinical Scales

1: Hypocondrical complaints 2: subjective depression, psychomotor retardation, physical symptoms, mental dullness & brooding 3: denial of social anxiety, need for affection, general icky feelings, somatic complaints, inhibition of anger

Basic Clinical Scales Cont

4: family discord, authority problems, social imperturbability, social alienation and self-alienation 5: stereotypic gender interests, sexuality 6: persecutory ideas, hypersensitivity, naive trust
I have an idea about what to do to this presenter ....

Basic Clinical Scales Cont

7: anxiety and compulsivity 8: concentration, thought disorders, creativity, social alienation, apathy, depression, lack of emotional control & hallucinations 9: manipulative, distrust, Over activity, imperturbability & ego inflation

Basic Clinical Scales Cont

0: shyness, self-consciousness, social avoidance, alienation
Sounds like me after this class.

Content Scales: General

More stable and consistent than clinical scales Graham see these scales as more meaningful than the clinical scales in many ways (T greater than 65) Good validity for the scales Content is obvious and so can be manipulated

Content Scales
Anx General Anxiety FRS Specific fears OBS Compulsive, problems with decisions, rigidity, ruminate DEP Down, fatigued, pessimistic HEA Feel unhealthy, health preoccupation
I think the rust is out.

Content Scales Cont

BIZ psychotic thinking, hallucinations, paranoia ANG anger, hostility, grouchy, easily frustrated CYN sees others as selfish & self-centered, guarded, hostile, resent mild demands ASP legal/school trouble, believe breaking law is acceptable, resent authority, anger

Content Scales Cont

TPA: hard-driven, work-oriented, sees more to be done, impatient, irritable, critical, hold grudges LSE poor self-concept, expect to fail, quit, hypersensitive, passive, poor at making decisions SOD: shy, rather be alone

Content Scales Cont

FAM: family discord, resent or angry at family WRK: poor work attitudes and behaviors TRT: negative attitudes towards mental health treatment & doctors, give up easily
I hate them...

Supplemental Scales: General

Each tends to have been developed independently using various methods Generally use linear T-scores (MDS uses uniform) Generally good reliability and validity
I surrender!

Supplemental Scales
Anxiety (A) and Repression (R)
Developed using factor analysis. These are the 2 strongest factors. A- thinking & thought processes, negative emotional tone, pessimism & lack of energy R-health, emotionality, violence, activity, reactivity, dominance, adequacy Quadrant interpretation

Supplemental Scales Cont

Ego Strength (Es) :
When defensive artificially high improvement of neurotics but fail cross validation Seems to be general emotional stability

Ill show you ego strength!

Supplemental Scales Cont

MacAndrew Alcoholism Scale (MAC-R):
28+ substance abuse problems (24-27 suggestive), 24 or less not likely

Addiction Acknowledgment Scale (AAS):

T > 60 openly acknowledge substance abuse problems

Supplemental Scales Cont

Addiction Potential Scale (APS):
T > 60 possible substance abuse

Marital Distress Scale (MDS):

T > 60 indicate possible marital discord

Overcontrolled-Hostility (O-H):
Theory of overcontrol and hostility (prison) T > 70 intrapunative, repress, self-depreciative

Supplemental Scales Cont

Dominance (Do):
T > 70 tend to be confident in self to dominant

Social Responsibility (Re):

T > 70 willing to accept personal responsibility, ethical, even rule bound

College Maladjustment (Mt):

T > 70 pessimistic, procrastinate, ineffectual

Supplemental Scales Cont

Masculine Gender Role (GM) and Feminine Gender Role (GF) :
Experimental Quadrant interpretation? T > 70 indicate stereotypic attitudes

So what is the point?

Supplemental Scales Cont

Post-traumatic Stress Disorder Scale (PK):
T > 70 many PTSD symptoms

Post-Traumatic Stress Disorder Scale (PS)

Experimental
Fire one!

Other Scales
Subtle-Obvious Harris-Lingoes Content Component Subscales Personality Disorder scales Over 300 other scales

Doesnt he ever stop?!

Critical Item Lists

Suicide:
75(F), 303(T), 506(T), 520(T), & 524(T)

Assault:
27(T), 37(T), 85(T), 134(T), 213(T), & 389(T)

Special Populations
No adolescents (MMPI-A: 20-25% 8th grading reading level) Historically the MMPI has had certain scales which score differently for minorities
Bias Vs Environmental responses (Sue & Sue)

Little statistical evidence there are consistent differences with the MMPI-2 Not to be used to screen for organic disorders

Evaluation
Good standardization sample Great research on validity Major test used in area Little bias Recent revision Reliability Form length could provide more information No data on normal personality Scale intercorrelations & Item overlap

I survived the MMPI-2!