Readings Flashcards
Nichols Ch. 1 (History & Development)
Minnesota Multi-phasic Personality Inventory (MMPI) - Hathaway and McKinley
Needed to evaluate the fitness of military personnel to serve in the Armed Forces during World War I
Hathaway intended the MMPI to achieve a “sampling of behavior of significance to the psychiatrist,” and this aim determined the range of clinical scales to be developed for the inventory.
550 items
The item format chosen was the first-person declarative sentence, written with simplified wording based on contemporary word-frequency tables.
Responses were limited to True, False, and Cannot Say (?)
Norms for the MMPI-2 (or any other such instrument) can never be assumed to be equally applicable for all examinees
- Consideration of subcultural membership and differences are improtant
The restandardization project culminated in the publication of the MMPI-2 in 1989
The standard validity and clinical scales of the MMPI are unchanged in the MMPI-2 (some items were deleted)
The revised instrument contains 567 items, of which none are repeated (vs. the MMPI’s 566 items, of which 16 were repeated)
Ninety items, 15 with religious content, were dropped from the original MMPI item pool; 107 were new to the MMPI-2.
The Harris-Lingoes sub-scales for six of the eight basic scales were for the most part unchanged for the MMPI-2
The restandardization subjects were actively discouraged from leaving items unmarked, so that their average Cannot Say (?) score was lower than that of the Minnesota Normals, thereby reducing the distorting influence of omitted items on MMPI-2 mean scale scores.
Hathaway had set a fifth-grade reading level as the minimum competency for taking the MMPI; subsequent research on reading skills showed that the difficulty of many of the items was well beyond this level of reading competency. As a result of studies on reading difficulty of items carried out as a part of the MMPI-2 restandardization, the authors set an eighth-grade level of reading proficiency as the new minimum.
One of the problems unanticipated by Hathaway and McKinley in the construction of the MMPI that became evident over the course of ensuing decades of research was the extensive covariation among the clinical scales.
- In order to address this problem, Auke Tellegen began a program of investigation in the 1990s that culminated in a new set of nine Restructured Clinical (RC) Scales
The RC scales have been controversial almost from their original publication and have stimulated several research studies and critical evaluations questioning their basis and the methods used in their development
The most recent MMPI development was the release of an abbreviated and restructured form, the MMPI-2-RF, in 2008. This new form consists of 338 MMPI-2 items divided among 50 scales (a categorical listing of the 229 items not included in the MMPI-2-RF is available in Butcher, 2011). The clinical scales have been abandoned in the RF form and replaced with the RC scales.
Nichols Ch. 2 (Administration)
MMPI-2 for ages 18 and older
MMPI-A for adolescents
Establish rapport and engender motivation
Must obtain informed consent
Provide an overview of assessment
Explain any 3rd party relationships
Introduce the MMPI-2
Assess sensory and motor barriers
Assess reading comprehension
Conduct test session
Perform post-test review
The amount of time required to complete the MMPI-2 is 1 to 2 hours for most people, but some will require much more time and occasionally even multiple sittings.
Nichols Ch. 3 (Scoring)
Objective scoring - one of the strengths
Derived into T-scores
Separate templates must be used for males and females for the hand- scoring of Scale 5 (Masculinity- Femininity [Mf]).
Nichols Ch. 4 (Intro to Interpretation)
The first stage in the interpretive process is assessing the extent to which the obtained set of test scores provides an adequate basis for describing the patient’s characteristic symptoms, attitudes, and behavior pattern.
For example, it is not assumed that a patient with a high score on Scale 1 is a hypochondriac, even though that was how the members of the criterion group for Scale 1 were diagnosed. Rather, it is believed that the external correlates that have been identified in subsequent research to be associated empirically with high scores on Scale 1 will aid in clinically describing high Scale 1 scorers, and that these elements of description will help the clinician make reliable, valid predictions about such patients’ diagnoses, future behaviors, and responses to various kinds of treatment.
Strategy to interpretation:
1. First, it is necessary to evaluate the examinee’s approach to taking the test.
- The second step involves an assessment of the overall level of distress reflected in the test results.
- The third step is the assessment of the overall adequacy of the examinee’s controls, emotional and behavioral.
- In the fourth step, the profile of clinical scales can be examined cursorily for its conformity to four primary patterns.
- The final step seeks to further specify symptoms, complaints, attributes, and behaviors suggested by the test findings.
Nichols Ch. 5 (Assessing Protocol Validity)
The initial and crucial steps in evaluating MMPI-2 results establish the interpretability of the individual’s test protocol.
The scales described in this section enable the interpreter to determine:
(a) when an answer sheet is eligible for scoring
- “Is the test administration complete?”
(b) when scores appear to reflect a cognizant interaction between the examinee and the MMPI-2 items
- “Are the responses to the test items consistent?”
(c) the examinee’s pattern of attitudes toward completing the MMPI-2, the elements, origins, and possible motives of these attitudes, and the potential distortions they may have introduced into test findings
- “Is the examinee’s self-portrayal accurate?”
Whenever Cannot Say (?) is greater than five responses,
(a) examine the content of the omitted items,
(b) note where in the sequence of items they are occurring (e.g., first half versus second half),
(c) note the percentage of items for which responses were provided on each scale, and
(d) review omitted items with the examinee at the time test feedback is given.
Variable Response Consistency Scale (VRIN)
VRIN is composed of 67 pairs of items (97 total items; 49 unique pairs) selected on the basis of their statistical associations and semantic similarities.
True Response Consistency Scale (TRIN)
TRIN is composed of 23 pairs of items (40 total items; 20 unique pairs), 14 of which are scorable when both response alternatives are endorsed True, and 9 of which are scorable when both response alternatives are endorsed False. Like the
VRIN item pairs, the TRIN item pairs were selected on the basis of their statistical associations and semantic similarities.
The |F – FB| Index
The F and F Back (FB ) scales are both composed of infrequently endorsed items. Because the items of the F scale occur mostly among the first 300 test items and those of FB occur mostly among the 267 remaining items, the absolute difference between the raw scores on these scales provides a rough measure of the consistency of performance on the front and back portions of the test and tends to confirm indications of inconsistency from other scales, such as VRIN and TRIN.
The F (Infrequency) Scale
Elevations on F can indicate deviance or unconventionality.
The items of the F scale were selected on the basis of their endorsement by 10% or fewer of the original Minnesota Normals (not the restandardization sample).
Elevations on F may occur for the following reasons: (a) severe psychopathology, especially of psychotic type; (b) problems in completing the inventory, such as difficulties in reading comprehension, confusion caused by active psychotic disruption, or a random or careless pattern of responding to the test items; (c) the exaggeration of psychopathology out of a sense of fear/panic/distress, or as a cry for help; or (d) malingering.
The F Back (FB) Scale
The FB scale consists of 40 items that members of the MMPI-2 restandardization sample endorsed at a frequency of 15% or less. This scale was intended to serve the same function for items falling on the last half of the test as that served by the F scale for items on the first half. Almost half of the FB items occur among the final 100 items on the test, and all occur after item number 280.
The FP (Infrequency Psychopathology) Scale
FP was developed and cross-validated within a sample of psychiatric inpatients, and again with the MMPI-2 restandardization sample.
The L (Lie) Scale
The L scale items do not implicate lying as such; they merely deny minor and widespread failings of character and observance that carry little or no social opprobrium because such flaws are so widespread in Anglo-American culture that to deny such failings may be considered naive if not obtuse.
The K Scale
The K scale was the last of the original validity scales to be constructed and functions primarily as one of the self-deception scales, although it is also susceptible to impression management. It was developed to fill the need for a scale to reduce the number of false negatives occurring when the patient produces a profile within normal limits (WNL) although hospitalized and manifesting significant psychopathology.
The S (Superlative Self-Presentation) Scale
Primarily a self-deception scale but one that, like K, is somewhat influenced by impression management, S was developed to assess “the presentation of self in a superlative manner”
Nichols Ch. 6 (The Standard Clinical Scales)
Nichols Ch. 7 (Content and Content Component, PSY-5, RC, and Supplementary Scales)
Nichols Ch. 8 (Profile Patterns and Codetypes)
One simplifying strategy, the “well-defined” codetype is to require that the highest scale (or second highest, etc.) exceed the next highest by a minimum of 5 T-scores to be included in the codetype.
An alternative strategy, the A-B-C-D Paradigm proposed by Caldwell (1998), recommends arranging the five most elevated basic scales by pairs or triads according to a scheme in which the highest scale is assigned to position A, the second to position B, the third to position C, the fourth to position D, and the fifth to position E.
Nichols Ch. 9 (Strengths and Weaknesses of the MMPI-2)
Although the MMPI/MMPI-2 grew out of the need for better psychodiagnostic methods for use with psychiatric inpatients, the accumulation of more than a half century of experience and research has tended to support the use of the MMPI-2 in a much wider range of populations than was originally envisioned.
Always refer to the subscales, content scales, and supplementary scales to assess the likelihood that the clinical scale correlates will be descriptive of the patient’s personality and behavior.
Nichols Ch. 10 (Clinical Applications of the MMPI-2)
This chapter identifies six clinical applications of the MMPI-2:
1. Assessment of self-presentation
2. Assessment of the severity and chronicity of disturbance
3. Assessment of clinical syndromes
4. Assessment of symptomatic status
5. Assessment of personality and social functioning
6. Assessment of personality change and suitability for psychotherapy
Nichols Ch. 11 (Illustrative Case Report)
Outline for Sample MMPI-2 Report
I. Protocol validity
A. Response omissions
B. Response consistency
C. Response accuracy
D. Test-taking attitude
II. General description of profile
A. Profile code
B. Characteristics in terms of MMPI-2 factor structure
III. Symptoms, problems, and complaints
A. Major interpretive implications (summary)
B. Mood
C. Cognition
D. Interpersonal relations
E. Other problems or issues
IV. Diagnostic considerations
V. Treatment considerations
