MMPI Flashcards
Purpose
Measure of emotional adjustment – and test taking approach/ attitude
Began what tradition of approach for test taking?
MMPI began tradition of approaching test protocol with a degree of skepticism until individual’s cooperation is assured
True/False - MMPI-2 has a theoretical orientation
FALSE
Developed by…
Hathaway and McKinley in 1930s
Original goals of MMPI
- Goal of obtaining truthful and accurate information about patient’s own symptoms descriptions
- Self-report measure
- Empirical method of personality assessment
- Ushered in a tradition in clinical assessment of personality
- One of first standard assessment methods
originally developed to…
- assess clinical problems in objective manner
- Wanted patients to describe their problems honestly through self-report
- MMPI offered something different than other instruments of the day and gave it stamina
Method of development
- Selected items for scales by identifying those items that discriminated clinical group from normal group
- Empirical validation
- Included those items that discriminated clinical population from group of “normals”
Original M-F scale
Initial intent to distinguish homosexual from heterosexual males
Too few items
Original Si scale
(Drake) – to distinguish extroverted females
Later generalized to males and females
Infl of attitude toward test taking
- Individuals could alter impression by the way they responded
- Scales developed to evaluate honesty, desire to present favorably or fake symptoms, degree of defensiveness
- Many new scales and subscales added (Harris-Lingoes, Wiggins Content)
Original norms
226 male; 315 females
- administtered to 724 pts not under dr care - served as normal reference
MMPI-2 norms
nationally representative same of normal individuals (1,138 men and 1,462 women).
MMPI-2 new scales
(SAM)
Superlative Self-Presentation (S)
Addition Proneness (APS)
Marital Adjustment (MDS
Common uses of MMPI-2
- Evaluation of patients in mental health settings
- Symptom appraisal to determine need for hospitalization
- Assessment of clients in pretreatment planning
- Evaluation of treatment effects
- Personality appraisal for public safety position, such as police, fire, airline pilot and nuclear power plant personnel
- Psychological research to study group differences in personality
- Longitudinal studies of personality processes and change
- Classification of convicted felons at incarceration
- Evaluations of parents in family custody cases
- Appraisal of personality factors to determine whether a personal injury claimant has mental health problems he/she claims
MMPI-2 - WHO
18 years old and up
Sixth grade reading level
IQ above 70
MMPI2 completion time
60-90 minutes
MMPI2 number of items
567
Upon completion, review protocol sheets for..
Omitted items
Items marked both T and F
Clean erasures
Traditional validity and clinical scales can be obtained from administration of first ___ items
370
Remaining ___ used for scoring supplementary and content scales
197
Raw scores
Sum of the number of “agreements” between the test responses and the scoring key
T scores
Statistically derived standard score equivalents for the raw scores for each scale
2 types of T scores
- Linear T scores used on the validity scales
2. Uniform T scores used for clinical scales and content scales except MF and Si
Linear T score
linear transformation of raw scores that maintain the underlying distributions of the raw score.
uniform T score
modification of the linear T score
- ensures that percentile ranks are equivalent across all scales.
- Example: T=65 would fall approximately at the 92nd percentile across all scales.
Mean and SD of MMPI-2
M = 50 SD = 10
T scores interpreted when..
- elevated beyond 1.5 standard deviations above the mean
- AKA when it is greater than T = 65
Validity scales
- Cannot say (?)
- Variable response inconsistency (VRIN)
- True responding inconsistency (TRIN)
- Lie scale (L)
- Defensiveness scale (K)
- Superlative self-presentation (S)
- Infrequency scale (F)
- Infrequency back scale (Fb)
- Psychiatric infrequency scale (Fp)
Cannot say scale (?)
Omitted items.
- Protocol may be uninterpretable.
- 30-item cut off.
- Computer will interpret exact impact of Cannot Say scores on each scale.
- Some scales may be interpretable.
- Content of omitted items can give clues to motivation that could underlie invalidating conditions
Variable response inconsistency (VRIN)
- total number of items pairs (67) answered inconsistently; measure of inconsistent, random responding.
- Client does not respond to similar items consistently
True responding inconsistency (TRIN)
- made up of pairs of items (23) that are opposite in content;
- another measure of inconsistent, random responding
- TRIN T score (T>80) client endorsed several items inconsistently in true direction
- TRIN F suggests inconsistent response in false direction
Lie scale (L)
- Client present self in overly favorable light & exaggerated virtues
- Fake good—highly virtuous self presentation
- T=65 client presenting noncredible & highly virtuous pattern of responding to avoid disclosing problems.
Two scales detecting when client endorses positive adjustment and denies his/her problems
- Defensiveness scale (K)
2. Superlative Self Presentation Scale (S)
Defensiveness scale (K)
To test defensiveness and to correct for defensiveness by adding points to certain scales.
- 30 items
Superlative self presentation (S)
- Improves on K as measure of defensiveness.
- Assess tendency to claim positive attributes and endorse few minor faults or problems.
- 50 items.
- belief in human goodness
- serenity
- contentment with life
- patience and denial of irritability and anger
denial of moral flaws
Exaggerated symptom endorsement
- clients present problems in exaggerated manner
- clients feel to his/her advantage to appear psychologically disturbed
Faking or infrequency scale (F)
- Faking or infrequency scale detects exaggerated responding.
- People who attempt to present more disturbed psychological adjustment.
- Faking bad.
- Falsely claiming mental health symptoms.
- within the first 370 items
Infrqeuency-back scale (Fb)
Another measure of exaggerated symptoms, usually elevated with F.
- measures sxs on latter part of the test
Psychiatric infrequency scale (Fp)
- Detects possible malingering of psych symptoms in mental health context.
- Provides an indication of extreme endorsement of symptoms as compared with clients with severe disturbances.
Number of clinical scales
8
Standard profile is comprised of
traditional clinical scales
Guidelines for interpreting clinical scales
- Clinical scales = groups of items that discriminate criterion group from normal group
- cite the scale number rather than the name
- Scale elevations are interpreted in terms of T-score distance from the mean of the normative sample (T=50).
- The higher a scale score, the more like the criterion group the client is assumed to be.
T = 60-64 (1 SD)…
personality correlatives are considered to apply to the test taker
T = or > 65
all of the correlates should be applied to the scale as indicated.
profile definition involves…
how elevated the interpreted clinical scales (high point or high point code) are above the next highest scales
Typically, low scores on a clinical scale ____ be interpreted.
Any exceptions?
- CANNOT
- Some exceptions–Mf and Si are dimensional personality measures that have meaning as low and high point
- Some of clinical scales (Ma) have meaningful correlates reported
Very high profile definition
T=/> 10 pts
high profile definition
T=5 – 9 pts
Low profile definition
T=/< 4 pts
Basic clinical scales (10)
Scale 1 (Hypochondriasis) Scale 2 (Depression) Scale 3 (Hysteria) Scale 4 (Psychopathic Deviate) Scale 5 (Masculinity-Femininity) Scale 6 (Paranoia) Scale 7 (Psychasthenia) Scale 8 (Schizophrenia) Scale 9 (Mania) Scale 0 (Social Introversion)
Scale 1 (Hs)
- HYPOCHONDRIASIS
- Provides an assessment of somatic problems
- Somatoform disorders – psychological disorder manifested through physical symptoms
- Hypochondriacal complaints – clients tend to develop psychologically based physical complaints
- Clients with high score on Hs tend to report excessive bodily concern in their initial symptom description
- Psychogenic pain disorder
Scale 2 (D)
- DEPRESSION
- Developed to assess depressed mood or clinical depression
- High scorers report feeling depressed and unhappy, pessimistic about the future
- Self deprecating and feel guilty
- Tend to be nonaggressive, shy, and lacking in self confidence
- Social withdrawal in not uncommon
Indecisive and have difficulty making decisions - Usually receptive to therapy
Scale 3 (Hy)
- HYSTERIA (histrionic)
- tendency to report vague physical symptoms and present with somatic symptoms in context of personality features:
- Inability to deal effectively with life stressors
- Usually report little anxiety, tension or depression
- Viewed as psychologically immature, childish, self-centered, narcissistic and ego centric
- Expect a great deal of attention and affection from others
- Difficult to engage in therapy as result of excessive denial and tendency to see themselves in overly positive light
- High Hy clients may respond best to direct advice or suggestions rather than insight oriented therapy
Scale 4 (Pd)
- PSYCHOPATHIC DEVIATE (ASPD)
- rebellious actions towards authority figures
- stormy relationships with family - acting out behaviors without considering the consequences of their actions
- Tend to blame other people for their problems
- Often have history of underachievement in school, poor work history, marital or relationship problems
- Often have legal problems
Scale 5 (Mf)
- MASCULINITY/FEMININITY
- No a psychopathology measure;
- does not assess clinical problems
- Addresses issues related to gender role
- Interest scale that appraises traditional male and female roles
- Scale developed for men and scoring of scale is reversed for women
- Assesses individual’s attitude toward interpersonal relationships
Scale 6 (Pa)
- PARANOIA
- Measures suspicion and mistrust
- Along with personality features of interpersonal hypersensitivity
- Clients with high elevations (T>80) typically show psychotic behavior, disturbed thinking, etc.
- Usually viewed as angry and resentful
- High elevations on Pa tend to have poor prognosis for therapy because they do not discuss their own problems openly
Scale 7 (Pt)
- PSYCHASTHENIA
- Weakness of one’s mental control over thoughts and actions
- Best viewed as measure of anxiety and general maladjustment
- High scorers are usually anxious, tense, and uncomfortable
- Introspective, ruminative, obsessive, and compulsive at times
Scale 8 (Sc)
- SZ
- Relative complexity in interpreting this scale
- Not everyone obtaining some elevation on this scale is schizophrenic
- Some elevation may be associated with people who are antisocial or countercultural
- Can also be alienate and disorganized in approach to life
Scale 9 (Ma)
- MANIA
- Measures manic or hypomanic behavior
Ma assesses lower levels of manic behavior - T > 80 individual shows disruptive behavior: overactive/scattered behavior and accelerated speech
- 65 < T =/> 70: interpret carefully, some normals obtain score in this range: overactive, energetic, talkative
- T< 35 low scores may reflect problems as well; may have low energy, low activity level and lack interest in life
Scale 0 (Si)
- SOCIAL INTROVERSION
- Assesses introversion-extroversion
- Dimensional personality measure and can be interpreted throughout the range of scores
- Introversion at high range
- Extroversion at low range
- High scorers (T>65) report being extremely shy and socially introverted
Harris and Lingoes scales
Subscales determine the components that serve to elevate the scale in question.
Developed for 6 of the clinical scales
Which 6 clinical scales - Harris/Lingoes
(248-369)
- Depression (2)
- Psychopathic (4)
- Schizophrenia (8)
- Hysteria (3)
- Paranoia (6)
- Hypomania (9)
Content scales
- 15 content clusters developed using the MMPI-2 items.
- Scales are a measure of the extent to which the person has endorsed the characteristics and problems summarized by the content scale.
- The higher the K elevation, the more likely the client has failed to endorse problem areas on the content scales.
T scores for content scales
T > 65 = high
T > 60 = mild
Content scales grouped into
- Internal symptomatic bx
- External bx
- negative self-view
- General problem areas
Internal sypmtomatic bx scales (6)
- Anxiety (ANX)
- Fears (FRS)
- Obsessions (OBS)
- Depression (DEP)
- Health Concerns (HEA)
- Bizarre Mentation (BIZ)
External Aggressive tendencies scales (4)
- Anger (ANG)
- Cynicism (CYN)
- Antisocial Practices (ASP)
- Type A (TPA)
Negative self-views scales (1)
- Low self-esteem (LSE)
General Problem Areas:
Social, Family, Work and Treatment
- Social Discomfort (SOD)
- Family Problems (FAM)
- Work Interference (WRK)
- Negative Treatment Indicators (TRT)
Content (with component scales when applicable): ANX
Anxiety
Content (with component scales when applicable): FRS
Fears
- FRS1 = general
- FRS2 = multiple specific
Content (with component scales when applicable): OBS
Obsessiveness
- OCD
Content (with component scales when applicable): DEP
Depression
- DEP1 = Anhedonia
- DEP2 = Dysphoria
- DEP3 = Negative self-esteem
- DEP4 = S/I
Content (with component scales when applicable): HEA
Health concerns
- HEA1= GI
- HEA2 = Neuro
- HEA3 = general
Content (with component scales when applicable): BIZ
Bizarre mentation
- BIZ1 = Psychotic (psychotic)
- BIZ2 = Schizotypal (Weird)
Content (with component scales when applicable): SOD
Social discomfort
- SOD1 = Introversion
- SOD2 = Shyness
Content (with component scales when applicable): ANG
Anger
- ANG1 = Explosive
- ANG2 = irritable
Content (with component scales when applicable): ASP
Antisocial practices
- ASP1 = attitudes
- ASP2 = Bxs
Content (with component scales when applicable): TPA
Type A Personality
- TPA1 = Impatient
- TPA2 = Competitive
Content (with component scales when applicable): LSE
Low self-esteem
- LSE1 = self-doubt
- LSE2 = submissiveness
Content (with component scales when applicable): WRK
Work interference
Content (with component scales when applicable): TRT
Negative Treatment indicators
- TRT1 = Low motivation
- TRT2 = Poor ability to disclose
Content (with component scales when applicable): FAM
Family problems
- FAM1 = Discord
- FAM2 = Alienation
Content (with component scales when applicable): CYN
Cynicism
- CYN1 = Misanthropic beliefs
- CYN2 = Interpersonal suspiciousness
Supplementary scales
- Anxiety (A)
- Repression (R)
- Ego Strength (Es)
- Dominance (Do)
- Social Responsibility (Re)
- College Maladjustment (Mt)
- Post-Traumatic Stress Disorder Scale (Pk)
- Marital Distress Scale (MDS)
- Hostility (HO)
- Over-controlled hostility (O-H)
- MacAndrew Addiction Scale (MAC-R)
- Addition Potential Scale (APS)
- Addition Acknowledgement Scale (AAS)
- Gender role - Male (GM)
- Gender role - Female (GF)
Supplementary: A
Anxiety
Supplementary: R
Repression
- tend to internalize
Supplementary: Es
Ego strength
- responsiveness to tx
Supplementary: Do
Dominance
- assertivenes
Supplementary: Re
Social responsibility
- moralistic
Supplementary: Mt
College maladjustment
- general psychological maladjustment
Supplementary: Pk
PTSD
- extreme emotional distress
- not nec dx PTSD
Supplementary: MDS
Marital dissatisfaction scale
Supplementary: Ho
hostility
Supplementary: O-H
Over-controlled hosility
Supplementary: MAC-R
McAndrew Alcoholism Revised Scale
- life-style, risk taking
- interpret RAW score only
Supplementary: AAS
Addiction Acknowledgement Scale
- openness to discuss D/A problems
Supplementary: APS
Addition Potential Scale
Supplementary: GM
Gender role - Masculine
Supplementary: GF
Gender role Feminine
Psy-5 scales
major domains of personality individual differences
- AGGR
- PSYC
- DISC
- NEGE
- INTR
Psy-5: AGGR
Aggressiveness
- offensive and instrumental aggression
Psy-5: PSYC
Psychoticism
- disconnection from reality
Psy-5: DISC
Disconstraint
- risk taking, impulsive, acting out
Psy-5: NEGE
Negative Emotions
- Neg affect
Psy-5: INTR
Introversion/Low positive emotionality
- anxious, depressed, somatic sxs
Neurotic triad
- Scale 1 (Hs)
- Scale 2 (D)
- Scale 3 (Hy)
Distress scales
- Scale 2 (D)
- Scale 7 (Pt)
Unusual thoughts and depression
- Scale 2 (D)
- Scale 8 (Sc)
Somatic and Depression
- Scale 2 (D)
- SCale 1 (Hs)
Conversion V
- Elevated Scales 1 and 3
- scale 2 10+ points lower
Inhibition scales
- Scale 0 (Si)
- Scale 2 (D)
- Scale 7 (Pt)
Suppression scales
- 5 (Mf)
- 0 (Si)
Acting out (Impulsivity)
- 4 (Pd)
- 9 (Ma)
releaser/excitatory scales
Internal coping style
- 4 (Pd), 6 (Pa), 9 (Ma) < 2 (D), 7 (Pt), 0 (Si)
External coping style
- 4 (Pd), 6 (Pa), 9 (Ma) > 2 (D), 7 (Pt), 0 (Si)
Overcontrol (repression)
Rigid, overcontrol of impulses
- 3 (Hy)
- O-H
Anger (loss of control)
ANG (content)
Depression
- 2 (D)
- Low 9 (Ma)
Mania
- 9 (Ma)
- Low 2 (D)
Psychosis
- 8 (Sc)
- Bizarre mentation
- especially if 8 > 7
Confusion/disorientation
elevated T on:
- F
- 8 (Sc)
- 7 (Pt)
- Also if 8 clinical scales avg > 70
Suspicion/mistrust
- 6 (Pa)
- especially if highest
Introversion
0 (Si)
Obsessiveness
- 7 (Pt) especially if highest
- OBS
Cynicism
- CYN (content)
D/A problems
- 4 (Pd)
- 2 (D)
- 7 (Pt)
- MAC-R
- APS
- AAS
Quality and style of interpersonal relationships
- 0 (Si) = shyness
- SOD = social discomfort
- 1 (Hs) = critical, complaining
- 4 (Pd) = good first impression but superficial
- 6 (Pa) = moralistic, guarded
- 8 (Sc) = isolated, feels misunderstood
- MDS = Marital distress
- Do = Dominance, assertiveness
Code type
made up of highest elevated scale based on their rank order and profile elevation
- Provides shorthand to “type” of client
profile spike
single clinical scale is elevated
2 point code type
two clinical scales are elevated in clinical range (T>65)
T/F 4 code type is common
FALSE - very rare
Interpretation - Formulation depends on 3 aspects
- Acceptability of scores determined by validity indicators
- Elevation of scores against standards – T-score norms
- Relative configuration of these within the individual profile
Interpretation sequence
Before = background info, hx
- Validity scales
- Clinical scales
- Content
- Content component
- Supplementary
- PSY-5
- Critical items
MMPI-RF
Restructured form
- Most recent re-standardization (2008)
- 338 items – no new items
- Norms based on MMPI-2
- Can be used more efficiently for medical and forensic cases.
- When/wherever MMPI-2 is used
- Less time for completion
MMPI-RF scales
51 scales -
- 9 Validity
- 3 Higher Order (H-O)
- 9 Restructured Clinical Scales
- 23 Specific Problems Scales
- 5 Somatic- Cognitive
- 9 Internalizing
- 4 Externalizing
- 5 Interpersonal
- 2 Interest Scales
- 5 PSY-5 Scales
