MMPI2 Dale Pietrzak Ed D LPCMH NCC CCMHC

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

MMPI: General • 1 st published in 1943 (Stark Hathaway, Ph. D, & J. Chaney Mc. Kinley, M. D. ) • Group administered procedure to reliably diagnose • Used Empirical keying approach (new at time) Graham (2000) MMPI-2: Assessing Personality & Psychopathology (3 rd ed) Butcher, Et. Al (1989) MMPI-2: Manual for Admin & Scoring

MMPI: Development • About 1000 potential items were collected • Hathaway & Mc. Kinley selected 504 believed to be relatively novel from each other • Appropriate criterion groups were selected – “Minnesota Normals” – “Clinical Subjects” – 504 items administered to groups

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

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)

Co n’ t MMPI Validity Scale Development • 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!

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.

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

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

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)

Revision Process Form AX (Adults) • 704 total items – 550 original items maintained About time • 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

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!

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

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

Administration & Scoring • Advanced degree in mental health, supervised testing (25) and Psychopathology May the force • 1 to 1. 5 hours to take be with you! • 8 th grade reading level • Supervised administration • (No TV or movies, etc. ) • 200+ scales, VRIN/TRIN

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!

MALES Scale 1 Week L. 77 F. 78 K. 84 1 Hs. 85 2 D. 75 3 Hy. 72 4 Pd. 81 5 Mf. 82 6 Pa. 67 7 Pt. 89 8 Sc. 87 9 Ma. 83 0 Si. 92 Stability SEM 1. 0 1. 5 1. 9 1. 5 2. 3 2. 0 1. 6 2. 2 2. 4 1. 8 2. 4 FEMALES Scale 1 Week L. 81 F. 69 K. 81 1 Hs. 85 2 D. 77 3 Hy. 76 4 Pd. 79 5 Mf. 73 6 Pa. 58 7 Pt. 88 8 Sc. 80 9 Ma. 68 0 Si. 91 SEM 1. 0 1. 8 1. 9 2. 4 2. 3 2. 2 2. 3 2. 0 2. 5 3. 5 2. 9 Stability of Basic Scales

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

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

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

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

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).

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

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)

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

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

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. .

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

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

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

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.

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

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

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. . .

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!

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

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!

Supplemental Scales Con’t • Mac. Andrew 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

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

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

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?

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

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

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)

Special Populations • No adolescents (MMPI-A: 20 -25% 8 th 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

Evaluation • 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

I survived the MMPI-2!