minnesota multiphasic personality inventory an overview

MINNESOTA MULTIPHASIC PERSONALITY INVENTORY

AN OVERVIEW

MMPI

• ORIGINAL INSTRUMENT DEVELOPED IN LATE 1930’S

• MOST WIDELY USED AND EXTENSIVELY RESEARCHED OF ALL PSYCHOLOGICAL TESTS

• REVISED IN 1989--MMPI-2

MMPI

• POPULARITY OF THE INSTRUMENT DUE TO 3 ASPECTS OF ITS DEVELOPMENT– MULTIPHASIC NATURE OF THE TEST– FORMAL ASSESSMENT OF TEST TAKING

ATTITUDE– EMPIRICAL BASIS FOR ITEM SELECTION

MMPI CLINICAL SCALE DEVELOPMENT

• AUTHORED BY HATHAWAY AND S McKINLEY AT THE UNIVERSITY OF MINNESOTA HOSPITALS

• SELECTED A POOL OF OVER 1000 ITEMS FROM A VARIETY OF SOURCES, PSYCH TEXTS, INTERVIEWS, AND THEIR OWN CLINICAL EXPERIENCE

MMPI CLINICAL SCALE DEVELOPMENT

• DELETED DUPLICATE ITEMS AND ELIMINATED THOSE NOT USEFUL FOR THEIR PURPOSES LEAVING A POOL OF 504 ITEMS

• THESE ITEMS PRESENTED AS FIRST PERSON DECLARATIVE STATEMENTS TO WHICH SUBJECT RESPONDED EITHER TRUE OR FALSE

MMPI CLINICAL SCALE DEVELOPMENT

• TESTED A GROUP OF “NORMALS” AND COMPARED THEIR RESPONSES WITH THOSE OF CAREFULLY IDENTIFIED GROUPS OF PATIENTS FROM SPECIFIC DIAGNOSTIC CATEGORIES

MMPI CLINICAL SCALE DEVELOPMENT

• ORIGINAL 8 DIAGNOSTIC COMPARISON CATEGORIES WERE

HYPOCHONDRIASIS, DEPRESSION, HYSTERIA, PSYCHOPATHIC DEVIATE, PARANOIA, PSYCHASTHENIA, SCHIZOPHRENIA, AND HYPOMANIA

MMPI CLINICAL SCALE DEVELOPMENT

• THE PROPORTION OF TRUE VS. FALSE RESPONSES GIVEN BY THE PATIENT GROUP WAS COMPARED TO THE PROPORTION OF TRUE VS. FALSE GIVEN BY THE “NORMAL” GROUP

• TESTED FOR SIGNIFICANT DIFFERENCES AT .05 LEVEL

MMPI CLINICAL SCALE DEVELOPMENT

• RETAINED ITEMS THAT WERE SIGNIFICANT AND CROSS-VALIDATED THEM AGAINST 4 ADDITIONAL REFERENCE GROUPS

• TO BE RETAINED AN ITEM HAD TO DISCRIMINATE BETWEEN THE PATIENT GROUP AND PRIMARY NORMAL GROUP & CROSS VALIDATE

MMPI CLINICAL SCALE DEVELOPMENT

• EACH SCALE WAS THEN NORMED BY CALCULATING THE MEAN AND SD IN THE PRIMARY NORM GROUP

• MASCULINITY-FEMININITY SCALE AND SOCIAL INTROVERSION SCALES WERE DEVELOPED LATER AND DIFFERENTLY THAN THE ORIGINAL 8 SCALES

MMPI Mf SCALE DEVELOPMENT

• 55 ITEMS RELATING TO SEXUAL ORIENTATION OR GENDER INTEREST PATTERNS WERE ADDED TO THE POOL

• TEST WAS ADMINISTERED TO AN IDENTIFIED GROUP OF MALE HOMOSEXUALS AND A GROUP OF MALE SOLDIERS

MMPI Mf SCALE DEVELOPMENT

• FEW ITEMS ACTUALLY DISCRIMINATED BETWEEN THE TWO GROUPS SO ITEMS THAT DISCRIMINATED BETWEEN MEN AND WOMEN WERE USED FOR THE Mf SCALE

MMPI SI SCALE DEVELOPMENT

• MMPI ITEMS THAT DISCRIMINATED BETWEEN STUDENTS SCORING ABOVE THE 65TH PERCENTILE FROM THOSE SCORING BELOW THE 65TH PERCENTILE ON THE MINNESOTA T-S-E, A TEST OF SOCIAL INTROVERSION-EXTRAVERSION WERE INCLUDED ON SI SCALE

MMPI VALIDITY SCALE DEVELOPMENT

• ? CANNOT SAY SCALE IS NOT ACTUALLY A SCALE BUT SIMPLY THE NUMBER OF TEST ITEMS EITHER OMITTED OR DOUBLE MARKED

• L (LIE) SCALE CONSIST OF 15 ITEMS ORIGINALLY CONSTRUCTED TO DETECT DELIBERATE LYING, USING A RATIONAL SELECTION PROCESS

MMPI VALIDITY SCALE DEVELOPMENT

• F SCALE CONSISTS OF 60 ITEMS ENDORSED ONLY RARELY BY NORMALS

• SCALE DERIVED BY INCLUDING THOSE QUESTIONS FROM THE NORMING SAMPLE THAT WERE RESPONDED TO IN THE SCORED DIRECTION BY < 10% OF NORMALS

MMPI VALIDITY SCALE DEVELOPMENT

• K (CORRECTION SCALE) CONSISTS OF 30 ITEMS TO DETECT MORE SUBTLE ATTEMPTS TO DENY FAULTS OR PRESENT ONESELF FAVORABLY

• DERIVED FROM THOSE QUESTIONS THAT COULD DISCRIMINATE BETWEEN “NORMALS” AND PATIENTS WITH KNOWN PATHOLOGY WHO PRODUCED NORMAL PROFILES

MMPI

• FINAL VERSION OF MMPI CONSISTED OF 566 ITEMS ON 10 CLINICAL SCALES AND FOUR VALIDITY SCALES

MMPI

• VALIDITY SCALES– CANNOT SAY ?– LIE L– FREQUENCY F– CORRECTION K

MMPI

• CLINICAL SCALES– HYPOCHONDRIASIS Hs 1– DEPRESSION D 2– HYSTERIA Hy 3– PSYCHOPATHIC DEVIATE Pd 4– MASCULINITY-FEMININITY Mf 5

MMPI

– PARANOIA Pa 6– PSYCHASTHENIA Pt 7– SCHIZOPHRENIA Sc 8– HYPOMANIA Ma 9– SOCIAL INTROVERSION Si 0

MMPI-2

AN OVERVIEW

MMPI-2

• NORMING SAMPLE PROBLEMATIC

• MINNESOTA “NORMALS”– WHITE– RURAL BACKGROUND– FARMERS/BLUE COLLAR WORKERS– PROTESTANT– SCANDANAVIAN BACKGROUND– 35 YEARS OLD W/ 8TH GRADE EDUC

MMPI-2

• ORIGINAL ITEMS OBSOLETE, POLITICALLY INCORRECT, OR OFFENSIVE

• ELIMINATED AND/OR REWORDED ITEMS; ADDED ITEMS TO INCLUDE AREAS SUCH AS SUBSTANCE ABUSE AND MARITAL RELATIONSHIPS TO GET POOL OF 704 ITEMS

MMPI-2

• EXPERIMENTAL FORM WAS ADMINISTERED TO NEW STANDARDIZATION SAMPLE

• NEW SAMPLE– AGE 18-90– WIDE GEOGRAPHIC AREA– GENERALLY COMPARES WELL WITH US

CENSUS DATA

MMPI-2

• FINAL VERSION CONSISTS OF 567 ITEMS

• ORIGINAL 4 VALIDITY SCALES AND 10 CLINICAL SCALES (ALL IN FIRST 370 ITEMS) IN ADDITION TO NEW VALIDITY SCALES

• RESULTS ARE EXPRESSED AS UNIFORM T SCORES

MMPI-2

• ADMINISTRATION– RECOMMENDED FOR USE WITH

PERSONS 18 YEARS OLD OR OLDER– NEED AT LEAST 8 YEARS OF

EDUCATION– MOST ITEMS WRITTEN 6TH-8TH GRADE

READING LEVEL– NORMAL TESTING TIME 60-90 MINUTES

MMPI-2

• SUBECTS SHOULD BE INFORMED WHY THE TEST IS BEING ADMINISTERED

• SHOULD BE GIVEN FEEDBACK RE/ RESULTS

• AVOID PROVIDING DIRECT HELP• EMPHASIZE THAT THEY SHOULD

RESPOND IN WAY THAT REFLECTS THEIR CURRENT THOUGHTS, FEELINGS, BEHAVIORS, AND EXPERIENCES

MMPI-2

• SCORING– HAND SCORING INVOLVES USE OF

SEMI-TRANSPARENT TEMPLATES PLACED OVER THE ANSWER SHEET

– EXAMINE ANSWER SHEET FOR DOUBLE MARKED OR OMITTED ITEMS & CIRCLE

– SEPARATE ANSWER SHEETS BY SEX– COUNT # OF RESPONSES IN BOXES

MMPI-2

– THIS BECOMES THE RAW SCORE FOR THAT SCALE WHICH IS ENTERED IN APPROPRIATE SPACE ON PROFILE SHEET

– PROFILE SHEETS ARE TWO SIDED-M/F– PLOT VALIDITY SCALE SCORES BY

MARKING AT THE ELEVATION THAT REFLECTS THE RAW SCORE. CONNECT VALIDITY SCALES WITH A LINE

MMPI-2

– BEFORE PLOTTING CLINICAL SCALES ADD APPROPRIATE “K CORRECTION” TO SCALES 1,4,7,8, AND 9.

– MARK THE ELEVATION OF THE 10 CLINICAL SCALES ON PROFILE SHEET.

– CONNECT WITH A LINE– RECORD THE UNIFORM T SCORE FOR

EACH SCALE (ON FAR LEFT AND RIGHT COLUMN OF PROFILE SHEET)

MMPI-2 INTERPRETATION

• FIRST, DETERMINE THE VALIDITY OF THE PROFILE ( TEST TAKING ATTITUDE OF THE SUBJECT)

• EXAMINE BASIC SCALES FOR CLINICAL MEANING

• T>65 IS ELEVATED

• T<40 LOW

MMPI-2-CANNOT SAY SCALE

• NOT A SCALE BUT THE # OF ITEMS DOUBLE MARKED OR OMITTED

• > 30 ITEMS INVALIDATES PROFILE

• HIGH SCORE– READING PROBLEM

– CARELESSNESS

– OCD/INDECISIVENESS

– QUESTIONS DO NOT APPLY/LACK INFO

MMPI-2 LIE (L) SCALE

• ORIGINALLY CONSTRUCTED TO DETECT A DELIBERATE AND UNSOPHISTICATED ATTEMPT TO PRESENT ONESELF IN A POSITIVE LIGHT

• 15 ITEMS

• HIGH SCORE INDICATES DENIAL AS A PROMINENT DEFENSE MECHANISM

MMPI-2 LIE (L) SCALE

• HIGH SCORES– CLERGY– LIMITED SOCIAL AWARENESS– SOCIOPATHS– LIMITED INSIGHT, DENIAL, POOR

TOLERANCE FOR STRESS– PRESENTING SELF IN

UNREALISTICALLY POSITIVE LIGHT

MMPI-2 LIE (L) SCALE

• LOW SCORES– BETTER EDUCATED, BRIGHTER, MORE

SOPHISTICATED PERSONS TEND TO SCORE LOWER

– SCORES <45 SUGGEST THAT SUBJECT RESPONDED FRANKLY TO ITEMS AND WAS COMFORTABLE ENOUGH TO ADMIT TO MINOR FAULTS AND SHORTCOMINGS

MMPI-2 INFREQUENCY (F) SCALE

• ELEVATIONS ON F > 65– SCORING ERRORS– POOR READING ABILITY– FAKING BAD (T>95)– EXAGGERATING SYMPTOMS– EXPRESSION OF DEFIANCE, HOSTILITY,

NEGATIVITY– T 70-95 MOST SIGNIFICANT PATHOLOGY

MMPI-2 INFREQUENCY (F) SCALE

• LOW SCORES– ABSENCE OF BIZARRE OR UNUSUAL

THINKING– MAY BE ATTEMPT TO FAKE GOOD

MMPI-2 CORRECTION (K) SCALE

• ITEMS DETECT MORE SUBTLE OR SOPHISTICATED ATTEMPTS TO DENY FAULTS AND PRESENT ONESELF FAVORABLY

• HIGH SCORES NOT CORRELATED WITH SPECIFIC BEHAVIORS BUT INSTEAD REFLECT A RELUCTANCE TO ADMIT TO PSYCHOPATHOLOGY

MMPI-2 CORRECTION (K) SCALE

• HIGH SCORES >65 INDICATIVE OF PERSONS WHO ARE VERY GUARDED AND DEFENSIVE AND SHOW MARKED RESISTENCE TO PSYCHOLOGICAL PROBING AND ASSESSMENT

• MINIMIZE AND OVERLOOK FAULTS IN SELF AND FAMILIES

MMPI-2 CORRECTION (K) SCALE

• K SCALE SCORES INFLUENCED BY SETTING, SOCIOECONOMIC STATUS, AND EDUCATION LEVEL. HIGHER SCORES OCCUR NORMALLY IN– WELL EDUCATED PERSONS– HIGH SOCIOECONOMIC STATUS

• LOW SCORES MAY BE FAKE BAD OR DETERIORATED DEFENSES

MMPI-2 NEW VALIDITY SCALES

• BACK F (Fb) SCALE– designed to identify a “fake-bad” mode of

responding for last 197 items• TRUE RESPONSE INCONSISTENCY SCALE

(TRIN)– designed to detect yeasaying/naysaying

• VARIABLE RESPONSE INCONSISTENCY SCALE (VRIN)– designed to detect inconsistent responding

INTERPRETATION OF VALIDITY

• K > 65 MAY SUGGEST A DEFENSIVE PROFILE

• FAKE BAD (OVERREPORTING PSYCHOPATHOLOGY)– T SCORE > 95 ON F (T SCORES > 85 ON

6,7,AND 8) WITH L AND K < 45

INTERPRETATION OF VALIDITY

• FAKING GOOD (UNDERREPORTING PSYCHOPATHOLOGY)– K > 65 AND MOST CLINICAL SCALES

AND F < 45

• F-K INDEX– RAW F SCORE - RAW K SCORE– +11OR MORE SUGGESTS FAKING BAD– -11 OR LESS SUGGEST FAKING GOOD

SCALE 1-HYPOCHONDRIASIS

• DESIGNED TO INDICATE A VARIETY OF PERSONALITY CHARACTERISTICS CONSISTENT WITH BUT NOT NECESSARILY DIAGNOSTIC OF HYPOCHONDRIASIS

SCALE 1-HYPOCHONDRIASIS

• HIGH SCORES SUGGESTIVE OF– HIGH CONCERN WITH ILLNESS OR

DISEASE– SOMATIZATION AS DEFENSE

MECHANISM– SOUR, WHINY, COMPLAINING

ATTITUDE; HOSTILITY/CYNICISM EXPRESSED INDIRECTLY

SCALE 1-HYPOCHONDRIASIS

• LOW SCORES SUGGESTIVE OF– CHEERFUL, OPTIMISTIC ATTITUDE– NON ENDORSEMENT OF SOMATIC

COMPLAINTS

SCALE 2-DEPRESSION

• DESIGNED TO MEASURE SYMPTOMATIC DEPRESSION, AN ATTITUDE CHARACTERIZED BY POOR MORALE, LACK OF HOPE FOR THE FUTURE, AND A GENERAL DISSATISFACTION WITH LIFE

SCALE 2-DEPRESSION

• ITEMS DEAL WITH VARIOUS ASPECTS OF DEPRESSION- DENIAL OF HAPPINESS & PERSONAL WORTH, PSYCHOMOTOR RETARDATION, LACK OF INTEREST, SOCIAL WITHDRAWAL, PHYSICAL COMPLAINTS, & EXCESSIVE WORRY

• STATE MEASURE--SITUATIONAL

SCALE 2-DEPRESSION

• HIGH SCORES SUGGESTIVE OF– DEPRESSED– WORRY– PESSIMISM– INDECISION, DOUBT– HOPELESSNESS, SUICIDAL IDEATION

SCALE 2-DEPRESSION

• LOW SCORES SUGGESTIVE OF – LACK OF DEPRESSION, WORRY,

PESSIMISM– TENDENCY TO FEEL COMFORTABLE

WITH LIFE– CHEERFULNESS, BUOYANCY, OPTIMISM

SCALE 3-HYSTERIA

• ITEMS TAP TWO BROAD AREAS: SPECIFIC SOMATIC COMPLAINTS AND DENIAL OF PSYCHOLGICAL OR EMOTIONAL PROBLEMS AND OF DISCOMFORT IN SOCIAL SITUATIONS

SCALE 3-HYSTERIA

• HIGH SCORES SUGGESTIVE OF – IMMATURITY, EGOCENTRICITY,

DEMANDING– HISTRIONIC CHARACTERISTICS AND

REPRESSIVE DEFENSIVES– VANITY, LACKING IN INSIGHT– SHALLOW INTERPERSONAL

RELATIONSHIPS

SCALE 3-HYSTERIA

• LOW SCORES SUGGESTIVE OF– CONSTRICTED, CONFORMING, OVERLY

CONVENTIONAL SUSPICIOUS INDIVIDUAL

– REALISTIC, LOGICAL, LEVEL HEADED– NOT PRONE TO IMPULSIVE DECISIONS

SCALE 4-PSYCHOPATHIC DEVIATE

• ITEMS REFLECT A PRIMARY DIMENSION RANGING FROM CONSTRICTED SOCIAL CONFORMITY TO ANTISOCIAL ACTING-OUT IMPULSES

SCALE 4-PSYCHOPATHIC DEVIATE

• HIGH SCORES SUGGESTIVE OF – GENERAL MALADJUSTMENT– ANGRY DISIDENTIFICATION WITH

CONVENTION AND NORMS– IMPULSE CONTROL PROBLEMS– DISREGARD FOR RIGHTS OF OTHERS– UNWILLING TO ACCEPT

RESPONSIBILITY FOR BEHAVIORS

SCALE 4-PSYCHOPATHIC DEVIATE

• LOW SCORES SUGGESTIVE OF – OVERLY CONVENTIONAL,

CONFORMING, & MORALISTIC– AVOID COMPETITIVE SITUATIONS– STRONG GUILT OVER MINOR

INFRACTIONS

SCALE 5 MASCULINITY-FEMININITY (Mf)

• 56 ITEMS MEASURE THE EXTENT TO WHICH SUBJECT ENDORSES OR IDENTIFIES WITH CULTURALLY STEREOTYPIC MASCULINE OR FEMININE INTEREST PATTERNS, VOCATIONAL CHOICES, ASTHETIC INTERESTS AND AN ACTIVITY-PASSIVITY DIMENSION

SCALE 5 MASCULINITY-FEMININITY (Mf)

• A HIGH SCORE FOR EITHER SEX IS INDICATIVE OF DEVIATION

SCALE 5 MASCULINITY-FEMININITY (Mf)

• MALES WITH HIGH SCORES TEND TO BE RATHER PASSIVE, DEPENDENT, AMBITIOUS, SENSITIVE, AND INTERESTED IN CULTURAL AND AESTHETIC PURSUITS

• MALES WITH LOW SCORES TEND TO BE STEREOTYPICALLY MASCULINE AND PLACE GREAT EMPHASIS ON TRADITIONALLY MASCULINE BEHAVIORS

SCALE 5 MASCULINITY-FEMININITY (Mf)

• FEMALES WITH HIGH SCORES HAVE REJECTED TRADITIONAL FEMININE ROLE. DESCRIBED AS ACTIVE, AGGRESSIVE, ASSERTIVE, COMPETITIVE, UNINHIBITED, AND DOMINEERING

• FEMALES WITH LOW SCORES ARE PASSIVE, SUBMISSIVE YIELDING AND DEMURE

SCALE 6-PARANOIA (Pa)

• 40 ITEMS MEASURES IDEATION RANGING FROM OBVIOUSLY PSYCHOTIC TO SUSPICIOUSNESS AND SELF-RIGHTEOUSNESS.

• CONTENT OF ITEMS IS OBVIOUS MAKING IT EASIER TO FAKE THAN MOST

SCALE 6-PARANOIA (Pa)

• HIGH SCORES IN RANGE OF T>60-70 INDICATES HYPERSENSITIVITY TO CRITICISM, BASIC MISTRUST, TENDENCY TO HARBOR GRUDGES, ANGER, HOSTILITY, E.G. PARANOID TENDENCES AND /OR PARANOID PERSONALITY DISORDER

SCALE 6-PARANOIA (Pa)

• HIGH SCORES BEYOND 75 THE POSSIBILITY OF PSYCHOSIS BECOMES MORE LIKELY

• LOW SCORES <35 SUGGEST 1) SELF CENTERED, STUBBORN, UNAWARE; 2) COLD AND CALLOUS PRESENTATION; 3) OVERTLY PARANOID, DELUSIONAL, DEFENSIVE, AND EVASIVE

SCALE 7 PSYCHASTHENIA (Pt)

• 48 ITEMS REFLECTING CHRONIC ANXIETY, GENERAL DISSATISFACTION WITH LIFE, INDECISIVENESS, DIFFICULTY WITH CONCENTRATION, SELF DOUBT, RUMINATION AND AGITATED CONCERN ABOUT SELF AND THE OBSESSIONAL ASPECTS OF OCD

SCALE 7 PSYCHASTHENIA (Pt)

• GOOD INDEX OF PSYCHOLOGICAL TURMOIL AND DISCOMFORT

• HIGH SCORES ARE DESCRIBED AS RIGID, METICULOUS, MORALISTIC AND DISSATISFIED WITH THEIR PRESENT LIFE SITUATION. ANXIETY IS PRONOUNCED. GENERALIZED PHYSICAL COMPLAINTS ARE COMMON

SCALE 8 SCHIZOPHRENIA (Sc)

• 78 ITEMS TAP DIMENSIONS OF SCHIZOID MENTATION, FEELINGS OF BEING DIFFERENT, ISOLATED, BIZARRE THOUGHT PROCESSES, POOR FAMILY RELATIONSHIPS, SEXUAL IDENTITY CONCERNS, TENDENCY TO WITHDRAW INTO WISH FULFILLING FANTASY

SCALE 8 SCHIZOPHRENIA (Sc)

• HIGH SCORES INDICATIVE OF THOUGHT DISTURBANCES , LOOSE ASSOCIATIONS, POOR JUDGEMENT, MISINTERPRETATION OF REALITY

• OTHER NON-PSYCHOTIC HIGH SCORERERS TEND TO FEEL LONELY ALIENATED, ISOLATED, MISUNDERSTOOD, NOT PART OF SOCIAL GROUP

SCALE 8 SCHIZOPHRENIA (Sc)

• LOW SCORES TEND TO BE INTERESTED IN PEOPLE AND PRACTICAL MATTERS TO THE EXCLUSION OF THEORETICAL AND PHILOSOPHICAL CONCERNS, CONCRETE THINKERS, COMPLIANT, SUBMISSIVE, OVERLY ACCEPTING OF AUTHORITY

SCALE 9 HYPOMANIA (Ma)

• 46 ITEMS THAT ARE A DIRECT MEASURE OF ENERGY LEVEL

• T SCORES >85 SUGGESTIVE OF MANIC DISORDER.

• T SCORES IN RANGE OF 70-85 ARE RESTLESS, ENTHUSIASTIC, IMPATIENT, ENERGETIC, GREGARIOUS, EXAGGERATED SENSE OF SELF WORTH AND IMPORTANCE

SCALE 9 HYPOMANIA (Ma)

• LOW SCORES <40 ARE LISTLESS, LETHARGIC, LOW IN DRIVE, DIFFICULT TO MOTIVATE, LACK INTEREST, INITIATIVE AND INVOLVEMENT; SHOW CHRONIC FATIGUE AND EVEN PHYSICAL EXHAUSTION

SCALE 0-SOCIAL INTROVERSION (Si)

• 69 ITEMS ASSESSING INTROVERSION-EXTROVERSION DIMENSION WITH HIGH SCORES INDICATIVE OF INTROVERSION

• HIGH SCORES INTROVERTED, SHY, SOCIALLY INEPT WITH TENDENCY TO WITHDRAW

• LOW SCORES ADEPT IN SOCIAL SITUATIONS, GREGARIOUS, EXTROVERTED