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Personality Tests . Observe and describe the structure and content of personality – the characteristic ways an individual thinks, feels, behaves, and interacts Clarifies Diagnoses Problematic patterns of behavior Intra and interpersonal dynamics Treatment implications
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Personality Tests • Observe and describe the structure and content of personality – the characteristic ways an individual thinks, feels, behaves, and interacts • Clarifies • Diagnoses • Problematic patterns of behavior • Intra and interpersonal dynamics • Treatment implications • Can be objective or projective
Measuring Personality & Psychological Functioning • Objective testing • Specific questions or statements to which the person responds by using specific, fixed answers or a rating scale • Scores tabulated and compared to reference groups • Projective testing • Ambiguous or unstructured stimuli to which client is asked to respond freely. • Unconscious or conscious needs, motives, interests, dynamics are projected onto ambiguous stimuli revealing internal dynamics or personality • More challenging to score and interpret than objective
Objective Tests • Minnesota Multiphasic Personality Inventory (MMPI; MMPI-2) • Millon Multi-Axial Inventory III (MCMI-III) • 16 Personality Factors (16PF) • NEO Personality Inventory (NEO-PI)
Minnesota Multiphasic Personality Inventory- 2 Introduction and Overview
History • First published in 1943 by Hathaway and McKinley • Designed for routine diagnostic assessments • Empirical keying approach • 504 statements • 724 Minnesota”normals” and 221 psychiatric patients • Originally 8 clinical scales plus validity scales • MF and Si added later (items increased to 566)
History (cont.) • Revised version is the MMPI-2 (1989) • inadequate original standardization sample • concerns about item content • objectionable items • not broad enough to assess certain characteristics like suicide and drug abuse • Separate forms for adolescents and adults • 567 true/false items • Normative sample (MMPI-2) • 2600 U.S. residents aged 18-90 (census derived) • Test retest ranges from .58-.92
History MMPI-2 • Yields individual’s clinical profile compared with the normative sample • Much of research on interpretation from MMPI applies to MMPI-2 • Most frequently used personality test in the US for adults and adolescents
MMPI-2/MMPI-A • Original 10 clinical/personality scales and original 3 validity scales and added 4 validity measures • Additional options: • Content scales • Harris-Lingoes subscales • Supplementary scales • Critical items
Validity Scales • ? Scale (Cannot say) • number of items left unanswered • If 30 or more items are left unanswered the protocol is invalid • F scale (Infrequency) • 66 items • atypical or deviant response style • endorsed by less than 10% of the population • accompanied by high scores on clinical scales • general indicator of pathology or “faking bad.”
F scale (cont.) • No exact cutoff for suspecting an invalid profile • T scores of 70 - 90 are common among prison, inpatient populations • Extreme elevations indicate invalid profile • 100 or higher • More liberal cutoff for adolescents on MMPI-A
Validity Scales (cont.) • Lie (L) Scale • 15 items • extent to which client is “faking good” or describing self in an overly positive manner • Uneducated, lower SES will score higher • Average number of endorsed items is 3 • T Scores of 65 or above are suspect and indicate profile should not be interpreted • High scores may lead to lower scores on clinical scales
Validity Scales (cont) • K scale(30 items) • More subtle and sophisticated index of “faking good” or “faking bad” • T scores above 65 or 70 are higher than expected • Higher scores indicative of ego defensiveness and guardedness • Persons from lower SES and educational backgrounds score somewhat lower on K • Persons of higher intelligence and psychological sophistication may score high on K and low on L • K scores are inversely related to Scales 8,7 and 0 • K correction is added to five of the clinical scales
Validity scales (cont.) • Variable Response Inconsistency Scale (VRIN) • An additional validity indicator developed for MMPI-2 • Measures tendency to respond inconsistently to MMPI-2 items • 47 pairs of items with similar or opposite content • In general, raw score greater than 13 (T>80) indicates inconsistent responding • Useful when examined along with F scale • True Response Inconsistency Scale (TRIN) • To identify an all true (acquiescence) or all false (non acquiescence) response style • 20 pairs of items that are opposite in content • Raw scores range from 0 to 23 • Higher TRIN (T> 80 in true direction) tendency to give true responses indiscriminately • lower TRIN (T > 80 in false direction) tendency to give false responses indiscriminately
Clinical Scales • Scale 1. Hypochondriasis (Hs) • personality characteristics consistent with a diagnosis of hypochondriasis • high concern with illness and disease • complain about a variety of physical problems and attempt to manipulate/ control others with complaints • egocentric, immature, pessimistic, sour, whiny and passive aggressive • critical of others • express hostility inwardly
Scale 2: Depression (D) • Items related to brooding, physical slowness, subjective feelings of depression, mental apathy, physical malfunctioning • High scorers (T>70) report feelings of depression, sadness, feeling blue, unhappiness, dysphoria, hopelessness about future • Display behaviors like lack of energy, anhedonia, crying, psychomotor retardation • Tend to be self critical, withdrawn, aloof • Patients seeking inpatient care often have Scale 2 as highest point
Scale 3 : Hysteria (Hy) • To identify patients who have hysterical reactions to stress • Person who often feels overwhelmed and avoids responsibility by developing physical symptoms • Physical symptoms worsen with increased stress • May report headaches, stomach discomfort, chest pains, weakness with no organic cause • Have symptoms that appear and dissappear suddenly • Do not report experiencing emotional turmoil and have an exaggerated degree of optimism • Higher scores = exaggeration of denial, somatization, dissociation, immaturity, naïvete, low levels of insight
Scale 4: Psychopathic Deviate (Pd) • Measure of rebelliousness • Difficulty incorporating values and standards of society, problems with authority • May engage in asocial or antisocial acts • Stormy interpersonal and family relationships • Underachievers • Poor planning and judgement • Relationships are shallow and superficial • Immature and childish, narcissistic, selfish, egocentric • Extraverted and outgoing • Can be hostile and aggressive - sarcasm, cynicism, lack of trust
Scale 5: Masculinity-Femininity (Mf) • Originally developed to identify homosexual invert males • 56 items on MMPI-2 covering a range of topics • A non-clinical scale • Scale 5 elevations may be associated with positive functioning • High scores for men - lack of stereotypic masculine interests, aesthetic and artistic interests, participate in child-rearing, housekeeping activities • High scores for women are uncommon and usually indicative of rejection of traditional female role, interest in sports, hobbies, activities that are stereotypically more masculine than feminine • Low scores for men/women - presenting self as traditionally masculine or feminine in hobbies, roles, interests
Scale 6: Paranoia(Pa) • Designed to identify patients judges to have paranoid symptoms like ideas of reference, feelings of persecution, grandiose self-concepts, suspiciousness, excessive sensitivity • T scores above 70 and 6 is highest scale - person may exhibit frankly psychotic behavior • Moderate elevations (60 - 70): paranoid orientation, excessively sensitive, overly responsive to opinions of others, feel mistreated, blame others for difficulties • May also be suspicious and guarded, exhibit hostility, resentment, argumentativeness • Utilize projection as defense mechanism • Prognosis for therapy is poor
Scale 7 : Psychasthenia (Pt) • Similar to obsessive-compulsive disorder • Thinking characterized by excessive doubts, compulsions, obsessions and unreasonable fears • High scorers are extremely anxious, tense and agitated, may have physical complaints • May have physical complaints and complaints of fatigue, exhaustion, insomnia and bad dreams • Rigid and moralistic • High scores will lack self confidence, are plagued by self doubts, can be perfectionistic, conscientious, neat, orderly, and meticulous • Often report feeling sad and unhappy • Tend to be shy and do not interact well socially • May be motivated for treatment due to inner turmoil
Scale 8: Schizophrenia (Sc) • Possibility of a thought disorder (T=75-90) • Confusion, disorganization, disorientation, unusual thoughts, attitudes, • Delusions, hallucinations may be present • Often have histories of inpatient/outpatient psychiatric treatment • Schizoid lifestyle • Shy aloof and uninvolved with few friends • Unable to express hostility- withdraw into daydreams, fantasies • Plagued by self doubt, feel insecure, incompetent, dissatisfied • Stubborn, moody, opinionated but can also be generous, peaceful, sentimental • Can be immature and impulsive • Prognosis for therapy is poor
Scale 9: Hypomania (Ma) • Designed to identify individuals experiencing hypomanic or elevated mood, accelerated speech and motor activity, irritability, flight of ideas and brief periods of depression • A measure of psychological and physical energy • Extreme elevation (T > 80) suggestive of a manic episode • Outgoing, sociable, gregarious • Friendly, pleasant, enthusiastic, self-confident • May feel upset, tense, nervous, anxious, dissatisfied with life • Poor prognosis in therapy
Scale 0: Social Introversion (Si) • Nonclinical scale • Introversion-extraversion continuum • High scorers are socially introverted, insecure and uncomfortable in social situations • Shy, reserved, timid • Prefer to be alone and have few friends • Described by others as cold and distant, hard to get to know • Passive, submissive, compliant in relationships • Worry, anxious, feel irritable, may experience periods of depression • Low scorers – are sociable and extraverted, outgoing, gregarious, friendly and talkative • Strong need to be around others • Viewed as expressive and verbally fluent • Active and energetic
ANX: Anxiety FRS: Fears OBS: Obsessiveness DEP: Depression HEA: Health Concerns BIZ: Bizarre Mentation ANG: Anger CYN: Cynicism ASP: Antisocial Practices TPA: Type A Behavior LSE: Low Self-Esteem SOD: Social Discomfort FAM: Family Problems WRK: Work Interference TRT: Negative Treatment Indicators MMPI-II: Content Scales
Projective Tests • Rorschach Inkblot • Thematic Apperception Test (TAT) • Projective Drawing Tests • Draw-A-Person • Draw-A-House • Draw-A-Tree • Draw-A-Family • Sentence completion tests
Clinical Judgment • Ultimately, clinician uses • Judgment • Impressions • Experience • Data • Examines all the pieces of the puzzle • Theoretical framework • Prior experience • Clinical training • Intuitions • Managed care insurance companies • Highly specific assessment tool • Objectify target symptoms