MMPI-2 Flashcards
What does the MMPI-2 measure?
The Minnesota Multiphasic Personality Inventory (MMPI) is the most widely used and researched standardized psychometric test of adult personality and psychopathology.[1] Psychologists and other mental health professionals use various versions of the MMPI to develop treatment plans; assist with differential diagnosis; help answer legal questions (forensic psychology); screen job candidates during the personnel selection process; or as part of a therapeutic assessment procedure.
So it’s not explicitly stated in the slides, but I’m assuming it’s facilitating psychiatric diagnosis among a more representative sample. As opposed to the MMPI, the MMPI-2 includes minority groups.
What is empirical keying and how was it used in the MMPI?
Empirical Keying: Empirical determination of items that differentiated between groups
Very innovative approach at the time
Test items selected or developed according to face validity
Focus on validity: Each item had to discriminate between groups successfully
What was the original standardization sample for the MMPI?
724 visitors to University of Minnesota hospital and outpatient clinics: became known as the
“Minnesota Normals”
Confirmed they were not under the care of a physician; ages 16-65
Demographics based upon 1930 census data for Minnesota: Typical examinee was 35 years old, married, lived in small town or rural area, had 8 years of general schooling, worked at skilled or semi-skilled trade (or was married to man at this level)
How reliable is the MMPI-2?
Test re test: Clinical scales .93 (Si) to .56 (Pa)
Describe the MMPI-2’s validity.
Convergent, discriminant and incremental in comparison to other measures of emotional functioning
Describe threats to validity.
Threats to Protocol Validity Non-Content-Based Invalid Responding Non-Responding Random Responding Intentional Unintentional Reading Difficulties Lack of comprehension Confusion Fixed Responding Acquiescence (yea saying) Counter-Acquiescence (nay saying) Content-Based Invalid Responding Over-Reporting “Faking bad” or “Malingering” Intentional Exaggeration vs. Fabrication Unintentional Negative Emotionality/Distress/Help Seeking Under-Reporting “Faking good” or defensiveness Intentional Minimization vs. Denial Unintentional Ego Defenses Social Desirability
What are the advantages of MMPI-2?
Provide information regarding the accuracy of self-report
Specify the type of distortion or impression management
Indicate the extent of distortion
Provide a dimensional perspective
Allow confidence in the clinical inferences made from the MMPI-2
Describe disadvantages of MMPI-2.
Only Caucasians in original MMPI development
MMPI-2 matched 1980 census for inclusion of ethnic minorities, but test could still be biased
Early studies found significant differences between Caucasian and ethnic minority groups
Later studies found small differences when groups were matched for age, education, and other demographics
Need to consider level of acculturation
Graham (2011, 5th edition of text) advises:
T scores 50 - 60 likely reflect issues of acculturation
T scores > 65 likely reflect symptoms and problems consistent with Caucasian group
Here are a few: the hispanic and Asian American population is underrepresented in the sample, sample exceeded estimates for educational level and occupational status (majority of the sample had 2 years of college - which is not the norm in the U.S.).
What is the age range for the MMPI-2?
ages 18 and older
What reading level is necessary to administer the MMPI-2?
6th grade reading level
What is a clinically significant score on the MMPI-2?
Clinical Elevation = 65+
What are the mean T-score and standard deviation and how are they related to MMPI-2 test interpretation?
T scores: Mean = 50 Standard Deviation = 10 Clinical Elevation = 65+ Low Score = < 40 (only interpreted for certain scales, e.g. K, 7, O)
CNS
Cannot Say (?) Non-responding A 567-Item “Scale” >10 omissions concern for validity; check scale Possible Reasons for Elevation: Lack of cooperation & defensiveness Lack of insight Obsessiveness Reading difficulties or confusion Effects on Profile: Deflated scores Depending on the scale location of the omitted items
VRIN
Variable Response Inconsistency Random Responding Designed to detect Random Responding 47 item pairs, 12 can be scored two ways T scores range from 30 to 120 Applications Detection of random responding VRIN ≥ 80 Detection of “hypervigilance” VRIN < 40 Aid in the interpretation of infrequency scales Use VRIN to evaluate random responding
TRIN
True Response Inconsistency Fixed Responding Designed to detect Fixed Responding (Acquiescence or Counter-Acquiescence) 20 item pairs, 3 symmetrical (both ways) Raw score converted to T score which will always be equal to or greater than 50 T score greater than 50 will be followed by a “T” or an “F” Fixed response set indicated if TRIN ≥ 80T OR TRIN ≥ 80F Applications Detection of response sets Interpretation of L, K, and S Use TRIN to evaluate fixed responding
F
Infrequency
Infrequency scales (confounded with distress)
Over-Reporting
Used to identify over-reporting
60 “infrequently endorsed” items among first 370 items in the booklet
Possible reasons for elevation:
Intentional over-reporting
Unintentional over-reporting
Random responding
Fixed responding
Severe psychopathology or severe distress
Use FP to evaluate intentional over-reporting
Fb
Back (Side) Infrequency
Infrequency scales (confounded with distress)
Over-Reporting
Designed to detect changes in responding between first (#s 1-370) and second half of the test
40 infrequently endorsed items appearing in second half of booklet
Possible reasons for elevation:
Intentional Over-reporting
Unintentional Over-reporting
Random Responding
Fixed Responding
Severe Psychopathology or Severe Distress
Fatigue
If T score FB > T score F+30, significant change in responding occurred
Fp
Infrequency Psychopathology
Psychiatric infrequency scale (malingering?)
Over-Reporting
Designed to detect intentional and unintentional over-reporting in individuals with psychopathology
27 items endorsed infrequently by a variety of clinical samples including psychiatric inpatients
Possible reasons for elevation:
Intentional over-reporting
Random responding
Fixed responding
FP > 70 and < 100 reflects degree of exaggeration of symptoms
If FP ≥ 100 AND VRIN < 70 AND TRIN < 70, intentional over-reporting is indicated
If F is elevated AND FP < 70, the elevated score on F likely reflects severe pathology, distress, or unintentional over-reporting
L
Lie Claiming excessive virtue Under-Reporting Designed to detect intentional under-reporting 15 obvious items All keyed “false” Possible reasons for elevation: Intentional under-reporting Lack of insight Very traditional values and beliefs Indiscriminant “false” responding
K
Correction
Defensiveness, reservations
Under-Reporting
Designed to detect unintentional under-reporting
30 “subtle” items
Defensive person less likely to recognize purpose of items and to avoid detection
All but one keyed “false”
Possible reasons for elevation:
Defensiveness, denying symptoms, problems, and negative characteristics more than the average person
Psychological well-being, ego strength, psychological resources
Effects of education
Minimal with MMPI-2
Recent research has not supported routine use of K-corrected clinical scale scores
Caution in settings where defensiveness is common (e.g., employment screening, child custody evaluations)
K-corrected scores may overpathologize test takers
Nonclinical applications:
Generate both K-corrected and non-K-corrected scores
Use non-K-corrected scale scores when the K-scale scores are significantly above or below average
S
Superlative Self-Presentation
Under-Reporting
Developed by Butcher and Han (1995) to identify under-reporting
Tendency to present as highly virtuous, responsible and free of psychological problems
Common in personnel screening, child custody
Contains subscales to assist in identifying specific areas of defensiveness:
Belief in human goodness
Serenity
Contentment with life
Patience and denial of irritability and anger
Denial of moral flaws
Patience and denial of irritability and anger
Denial of moral flaws
Non-defensive with significant psychopathology
If F is elevated AND FP < 70, the elevated score on F likely reflects severe pathology, distress, or unintentional over-reporting
Random Responding
Random responding: F, FB and FP usually greater than 100, K & S near 50 and L 60-70.
Faking Bad Profile
Faking Bad: F and FB have T scores greater than 100 while L and K are low.
Cry for Help Profile
Inverted V or Cry for Help: L and K lower than F. Check for secondary gain and be alert for malingering. Can be indicative of true distress.
Faking Good Profile
L and K T scores > 65 higher than F which has a T score in the 40-50 range suggests guardedness and defensiveness. V shaped or check mark shaped
What is K correction, when is it used and on what clinical scales?
Do not routinely use K-corrected scores
Always consider impact of correction-do not overpathologize test takers
Calculate both and compare and contrast
For clinical populations, use K- corrected scores
For Normals use, non corrected
Consider and discuss in interpretation
Used on 1,4,7,8,9
1
Hs - Hypochondriasis
32 Items (lost 1 item from MMPI)
Preoccupation with the body and fear of illness and disease
Homogeneous and unidimensional
Denial of good health
Admission of a variety of somatic symptoms
Medical Patients
Average T=60
T > 80 - Extreme somatic concern
- Consider somatic delusions
T = 60-80 - Somatic concerns - Sleep disturbance
- Lacks energy - Demanding - Dissatisfied - Complaining, whiny
T = 40-59 - Average
2
D - Depression
57 items (lost 3 items from MMPI)
Poor morale, lack of hope in the future, and general dissatisfaction with life
Denial of happiness, psychomotor retardation, withdrawal, and lack of interest
Denial of hostile impulses
Difficulty with concentration and memory
General dissatisfaction and discomfort with life circumstances
T > 70 - Serious clinical depression
T = 60-70 - Moderate depression
- Dissatisfaction with life situation - Worried - Somatic complaints - Withdrawn - Lacks self-confidence
T = 40-59 - Average
T < 40 - Low score; no interpretation
3
Hy - Hysteria
60 items (none lost from MMPI)
Developed to identify individuals who were having hysterical reactions to stress, e.g., psychogenic symptoms and loss of function
Two clusters of items
Denial of physical health and report of variety of physical complaints
Denial of psychological or emotional problems
Medical Patients
T > 80 - Consider conversion reaction
T = 60-80 - Somatic symptoms
- Sleep disturbance - Lacks insight concerning causes of symptoms - Denial - Immature, self-centered - Demanding - Suggestible - Affiliative
T = 40-59 - Average
T < 40 - Low score; no interpretation
4
Pd - Psychopathic Deviate
50 items (none lost from MMPI)
Developed to identify psychopathic personality type
Amoral, asocial individuals
Criterion group were not prisoners
Engaged in delinquent acts
Lying, stealing, sexual promiscuity, excessive drinking
Absence of satisfaction with life
Family problems, difficulty with authority
Delinquency, sexual problems
Scale assesses both social maladjustment and social confidence and poise
Graham: indicates rebelliousness
T > 75 - Asocial/antisocial behavior
T = 60-75 - Rebellious, non-conforming
- Family problems - Impulsive
- Angry, irritable - Extroverted
uncooperative (Women) - Creative
- Dissatisfied - Energetic
- Superficial Relationships
T = 40-59 - Average
T < 40 - Low score; no interpretation
5
Mf - Masculinity-Femininity
56 items (lost 4 from MMPI)
52 items keyed in same direction for both men and women
4 items dealing with sexual material keyed in opposite direction
T score is reversed for men and women
Scale was initially developed to identify homosexuals
Few items actually worked
Added items that differentiated men and women
Few items related to sexual topics
Most items associated with
Work and recreational interests
Worries, fears, and excessive sensitivity
Family relationships
Measures interests and is not related to symptoms or problems in inpatient, outpatient, or normal groups
MEN
T > 75 - May report sexual concerns, problems
T = 60-75 - Lacks traditional masculine interests
T = 40-59 - Average
T < 40 - Very traditional masculine interests
WOMEN
T > 75 - May report sexual concerns, problems
T = 60-75 - Lacks traditional feminine interests
T = 40-59 - Average
T < 40 - Very traditional feminine interests
(but not exclusively)
6
Pa - Paranoia 40 items (none lost from MMPI) Developed to identify patients with paranoid symptoms Ideas of reference Feelings of persecution Suspiciousness Excessive sensitivity Rigid opinions and attitudes T > 70 - Consider paranoid psychosis
T = 60-70 - Paranoid style - Guarded
- Extremely sensitive - Suspicious
- Angry, resentful - Withdrawn
T = 45-59 - Average
T < 45 - Low score; no interpretation
7
Pt - Psychasthenia 48 items (none lost from MMPI) Excessive doubt, compulsions, obsessions, unreasonable fears Item content reflects Uncontrollable or obsessive thoughts Feelings of fear and/or anxiety Self-doubt General distress and unhappiness T > 75 - Extreme fear, anxiety, tension - Intruding thoughts - Unable to concentrate
T = 60-75 - Moderate anxiety -Depression
- Bad dreams - Lacks self-confidence
- Guilt - Perfectionistic
- Indecisive - Feels unaccepted
T = 40-59 - Average
T < 40 - Low score; no interpretation
8
Sc - Schizophrenia 78 items (none lost from MMPI) Disturbance of thinking, mood, and behavior Misinterpretation of consensual reality Delusions and hallucinations Item content heterogeneous Frankly psychotic behavior and symptoms Social alienation and estrangement Poor family relations Worries and fears Dissatisfaction Concentration difficulties T > 75 - Distress and confusion - Acute psychological turmoil - Consider psychotic disorder diagnosis
T = 60-75 - Schizoid life-style - Fearful
- Confused - Aloof, uninvolved
- Excessive fantasy -Daydreaming
T = 40-59 - Average
T < 40 - Low score; no interpretation
9
Ma - Hypomania 46 items (none lost from MMPI) Elevated mood; accelerated speech and motor activity; irritability; flight of ideas; and brief periods of dysphoria Item content High activity level Excitability Irritability Grandiosity Family relationships T > 80 - Consider Bipolar Disorder, manic type
T = 70-80 - Excessive energy - Bossy
- Conceptual disorganization - Impulsive
- Unrealistic self-appraisal - Talks too much
- Low frustration tolerance
- Lacks direction
T = 60-69 - Active - Energetic
- Extraverted - Creative
- Rebellious
T = 40-59 - Average
