MMPI-2

1. MMPI-2 Dale Pietrzak, Ed.D., LPC-MH, NCC, CCMHC Counseling & Psychology in Education University of South Dakota

2. 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

3. 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

4. MMPI: Development Con’t • Item Analysis (Discrimination Index) used to determine items • Selected items were cross validated • Later 5 (Mf) and 0 (Si) were added

5. 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)

6. MMPI Validity Scale Development Con’t • 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!

7. 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.

8. 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

9. 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

10. 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)

11. Revision Process Form AX (Adults) About time • 704 total items • 550 original items maintained • 82 were rewritten and 15 reworded • 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

12. 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 can’t take anymore!

13. Final MMPI-2 Booklet • 567 Items • Objectionable Items & Bias removed • New Scales Developed • Most Supplemental and All Clinical Scales Retained Ta Da!

14. 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

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

16. 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% I’m Back!

17. Stability Stability of Basic Scales MALES Scale1 WeekSEM L .77 1.0 F .78 1.5 K .84 1.9 1 Hs .85 1.5 2 D .75 2.3 3 Hy .72 2.3 4 Pd .81 2.0 5 Mf .82 2.0 6 Pa .67 1.6 7 Pt .89 2.2 8 Sc .87 2.4 9 Ma .83 1.8 0 Si .92 2.4 FEMALES Scale1 WeekSEM L .81 1.0 F .69 1.8 K .81 1.9 1 Hs .85 1.9 2 D .77 2.4 3 Hy .76 2.3 4 Pd .79 2.2 5 Mf .73 2.3 6 Pa .58 2.0 7 Pt .88 2.5 8 Sc .80 3.5 9 Ma .68 2.5 0 Si .91 2.9

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

19. MMPI-2 Interpretation Process • Determine Profile Validity • Configural (Code types) • Content (Basic, Content, and Supplemental) As easy as 1, 2,3 ... Yah! right...

20. 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

21. Validity scales: General Guidelines Con’t • VRIN > 80 Invalid • TRIN > 80 Invalid I think I would rather be home.

22. 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).

23. 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

24. 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)

25. 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

26. 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

27. Basic Clinical Scales Con’t • 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 ....

28. Basic Clinical Scales Con’t • 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

29. Basic Clinical Scales Con’t • 0: shyness, self-consciousness, social avoidance, alienation Sounds like me after this class.

30. 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

31. 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.

32. Content Scales Con’t • 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

33. Content Scales Con’t • 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

34. Content Scales Con’t • 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...

35. 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!

36. 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

37. Supplemental Scales Con’t • Ego Strength (Es) : • When defensive artificially high • improvement of neurotics but fail cross validation • Seems to be general emotional stability I’ll show you ego strength!

38. Supplemental Scales Con’t • 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

39. Supplemental Scales Con’t • 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

40. Supplemental Scales Con’t • 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

41. Supplemental Scales Con’t • Masculine Gender Role (GM) and Feminine Gender Role (GF) : • Experimental • Quadrant interpretation? • T > 70 indicate stereotypic attitudes So what is the point?

42. Supplemental Scales Con’t • Post-traumatic Stress Disorder Scale (PK): • T > 70 many PTSD symptoms • Post-Traumatic Stress Disorder Scale (PS) • Experimental Fire one!

43. Other Scales • Subtle-Obvious • Harris-Lingoes • Content Component Subscales • Personality Disorder scales • Over 300 other scales Doesn’t he ever stop?!

44. 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)

45. 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

46. 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 inter-correlations & Item overlap Evaluation

47. I survived the MMPI-2!