Essentials of MMPI-2 Assessment

David S. Nichols, Alan S. Kaufman

• Publisher: Wiley
• Year: 2011
• Print ISBN: 9780470923238
• eBook ISBN: 9781118037393
• Edition: 2
• Topic: Psychology
• Subtopic: Research & Methodology in Psychology
• Index: Psychology

The Minnesota Multiphasic Personality Inventory, Second Edition is used by a broad range of clinicians to assist with the diagnosis of mental disorders and the selection of appropriate treatment methods. To use it properly, professionals need an authoritative source for use of this test. This thoroughly updated and revised second edition of Essentials of MMPI-2 Assessment provides that resource. In addition to comprehensive updates to the research and literature throughout, the new edition will include information on other versions of the test, including the MMPI-2 RC and the MMPI-2-RF. Clinical and school psychologists are provided with information on administering, interpreting, and scoring this most widely used test for assessing personality.

Chapter One

History and Development

The road that led to the development of the Minnesota Multiphasic Personality Inventory (MMPI) was circuitous, its course passing by several notable psychometric failures and one surprising success in the area of occupational psychology. The achievement of Starke Rosecrans Hathaway, a physiological psychologist, and J. Charnley McKinley, a neuropsychiatrist, rested on 30 years of experience with self-report questionnaires created to discern personality features. The need to evaluate the fitness of military personnel to serve in the Armed Forces during World War I was a major stimulus to the development of personality questionnaires. The best-known example of these was the Woodworth Personal Data Sheet (1920), which incorporated its author’s Psychoneurotic Tendencies, a scale developed three years earlier in an effort to assess the vulnerability of military personnel to shell shock, battle fatigue, or other emotional instability. The test was a qualified success, presumably, in part, because prospective soldiers who feared combat or otherwise considered themselves in need of evaluation were more than willing to acknowledge their attitudes on the test (Hathaway, 1965).

The Psychoneurotic Tendencies scale was adapted as one of the scales of the Bernreuter Personality Inventory (1933), which was to become hugely popular despite telling research failures that appeared almost immediately following its publication. Landis and Katz (1934) found, for example, that its scale for neuroticism was unable to discriminate neurotics from psychotics. Moreover, some of the scale’s items were endorsed by members of a normal sample more frequently than by neurotics. The Achilles’ heel of the Bernreuter lay in the strategy of its construction. The composition of the test items was guided by rational considerations applied to textbooks or case histories on the assumption that neurotics, for example, would respond to the items as expert opinion suggested they should. The work of Landis and Katz (1934) and others showed that neurotics, among others, could be somewhat perverse in this regard.

The Humm-Wadsworth Temperament Scale (1935) was the first personality questionnaire to use the actual responses of psychiatric patients to determine the direction in which items should be scored and their suitability for scale development. It was also the first inventory to attempt to model a specific theory of personality, that of psychiatrist Aaron Rosanoff (1921). The Humm-Wadsworth contained 318 items and provided scores for seven scales: Normal, Hysteroid, Manic, Depressive, Autistic, Paranoid, and Epileptoid. The item assignments for each scale were based on the difference between the item’s frequency of endorsement among a group of patients judged high on the trait and a comparison group of normals. For whatever reason, the test didn’t catch on in clinical settings, but it became popular for use in industry (Goldberg, 1971). The method of contrasted groups was not discovered by Humm and Wadsworth. It had been known since at least the early 1920s and had been used to conspicuous advantage by E.K. Strong in the development of the Strong Vocational Interest Blank (SVIB; 1927). Strong had built his interest inventory by requiring that the items on his scales discriminate between occupational groups (e.g., lawyers) and “men-in-general.”

As Hathaway began to develop the MMPI, he was aware of the criticisms of the Bernreuter and of the rational approach to inventory construction in general. He also knew both of the methods used to develop the SVIB and of the success of this inventory in practice. Finally, Hathaway knew of the Humm-Wadsworth, which figured in his first publication in the field of clinical psychology (1939), and from which he borrowed about one-quarter of his MMPI items.

It might be supposed that the method of contrasted groups appealed only to Hathaway’s scientific scruples, but this is far from the case. Hathaway was a tinkerer, an inventor, and a builder of gadgetry and apparatus. He was by temperament a thoroughgoing pragmatist with a deep distrust of theory and an abiding belief in practical experience. The method of contrasted groups provided Hathaway with a practical means of avoiding theory and sidestepping rational or intuitive guidance in the selection of the items for the MMPI clinical scales. Hathaway did not pretend to know how different kinds of patients would respond to his items. The method of contrasted groups allowed him a satisfactory way of finding out: It allowed him to ask them.

There was another advantage to this method that was not wasted on Hathaway. He knew that the previous rationally developed inventories had failed at least in part because their developers’ attention had wandered from the central question of validity. By relying on the method of contrasted groups, Hathaway required items to surmount a validity hurdle from the outset: Each item had to demonstrate construct relevant variance by concretely discriminating between groups. This was no guarantee that the item would survive subsequent challenges to its validity. For example, it could fail on cross-validation to discriminate the same group of criterion cases from a different group of normal controls; or a similar but separately constituted group of criterion cases from the same group of normal controls; or in comparisons in which both the criterion cases and normal controls involved previously untested subjects. The advantage of the method was that the items exposed to such subsequent challenges had achieved at least some initial, concrete, discriminative advantage, a claim no rationally derived item could make.

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. From an initial pool of more than 1,000 items drawn from psychiatric textbooks, guides for the mental status examination, and previously published tests, Hathaway and McKinley winnowed the pool to 504 items divided into 26 content areas. These included items related to general medical and neurological symptoms, political and social attitudes, affective and cognitive symptoms, and fears and obsessions; items implicating family, educational, and occupational experience; and a set of items to reveal an overly virtuous self-presentation on the inventory. An additional 55 items thought to be related to masculinity-femininity were later added, and 9 items were subsequently deleted to achieve the final pool of 550 items.

The item format chosen was the first-person declarative sentence, written with simplified wording based on contemporary word-frequency tables. Brevity, clarity, and simplicity were occasionally given precedence over grammatical precision. Common English slang and idioms were used, but esoteric or specialized language was avoided. Responses were limited to True, False, and Cannot Say (?).

The group of normals selected to contrast with the pathological criterion groups were 724 University of Minnesota hospital and outpatient clinic visitors between the ages of 16 and 65 (hereafter referred to as the “Minnesota Normals”). Each affirmed that he or she was not currently under a physician’s care for the treatment of any illness. The demographics of this group of normals corresponded well to 1930 census values for Minnesota regarding age, sex, and marital status (Colligan, Osborne, Swenson, & Offord, 1983). “In 1940, such a Minnesota normal adult was about 35 years old, was married, lived in a small town or rural area, had eight years of general schooling, and worked at a skilled or semi-skilled trade (or was married to a man with such an occupational level),” (Dahlstrom, Welsh, and Dahlstrom, 1972, p. 8).

First published in 1942, the MMPI included scales for Hypochondriasis (Hs), Depression (D), Hysteria (Hy), Psychopathic Deviate (Pd), Masculinity-Femininity (Mf), Paranoia (Pa), Psychasthenia (Pt), and Schizophrenia (Sc), and was an immediate success. By the end of April 1943, 230 copies had been sold for use in clinics, correctional facilities, corporations, and universities, generating enough revenue to more than cover the costs of initial publication. The Psychological Corporation, which had turned down the test when it was first submitted, became its licensed distributor in 1943, by which time the ninth and last of the clinical scales, Hypomania (Ma), was ready to be included in the revised Manual (Hathaway & McKinley, 1943) and test materials. A manual supplement introducing a booklet form of the test as an alternative to the original box form was published in 1946. This supplement also introduced the K scale—which thereafter took its place next to F on the standard profile form—as well as the practice of adding fractions of K to suppress some of the scale score variances related to response style. The MMPI arrived in its final form in the 1951 Manual with the addition of the Social Introversion scale (Si), the last of the standard clinical scales.

Rapid Reference 1.1

Summary of MMPI-2 Standard Validity and Clinical Scales

Validity Scales

L Lie. Assesses naive attempts to place oneself in a morally and culturally favorable light by denying moral imperfections.

F Infrequency. Assesses the tendency to claim highly unusual attitudes and behaviors as a function of severe psychopathology; a subject’s seeking to place himself or herself in an unfavorable light; or a subject’s difficulties completing the inventory (e.g., reading problems or random or careless responding).

K Correction. Assesses the tendency to control and limit the disclosure of distress, discomfort, and problems relating to others. Fractions of K are added as a correction to Scales 1, 4, 7, 8, and 9 to discourage false-negative/false-positive scores on these scales.

Clinical Scales

1. Hypochondriasis (Hs). Measures the tendency to manifest physical symptoms as an expression of emotional discomfort, to be preoccupied with one’s health, and to reject nonmedical (i.e., psychological) explanations for such symptoms.

2. Depression (D). Measures aspects of symptomatic depression: dysphoria, distress, pessimism, low morale, inhibition, intropunitiveness, physical discomfort and vegetative symptoms, problems in thinking, and social vulnerability.

3. Hysteria (Hy). Measures the tendency to develop physical symptoms under stress, to experience pain, and to deny social friction or discord with others.

4. Psychopathic Deviate (Pd). Measures alienation, social disinhibition, and the tendency to come into conflict with family, authorities, and others through rebellion, exploitation, misconduct, poorly developed conscience, and the lack of internalized moral standards.

5. Masculinity-Femininity (Mf). Measures broad patterns of interests, activities, attitudes, and sentiments that tend to follow gender stereotypes.

6. Paranoia (Pa). Measures personal/moral rigidity, interpersonal sensitivity, resentment, and ideas of being misunderstood, mistreated, persecuted, or controlled by others, and the tendency to construe the actions, intentions, and motives of others as unfair, degrading, or hostile.

7. Psychasthenia (Pt). Measures the tendency to express stresses through tension, anxiety, apprehensiveness, worry, phobias, obsessions, rumination, compulsions, and fears of losing control, with willful and inflexible efforts to control such symptoms.

8. Schizophrenia (Sc). Measures severe alienation, self-contempt, apathy, cognitive disruption, inertia, feelings of unreality, alien impulses, and motor and sensory impairment.

9. Hypomania (Ma). Measures a rapid and energetic personal tempo, hyperarousal, hyperactivity, stimulation-seeking, euphoria, imperviousness, undercontrol, and rebellious impulses (high scores), versus lethargy, slowness, submissiveness, vulnerability, scrupulousness and, occasionally depression (low scores).

10. Social Introversion (Si). Measures introversion, shyness, social anxiety, social timidity and awkwardness, and social avoidance (high scores), versus extroversion, outgoingness, social comfort and skill, social intrepidity, and social stimulation-seeking (low scores).

The success of the MMPI was measured not only by its sales and distribution but also by the amount of research interest it attracted. By the mid-1950s, the MMPI literature had accumulated 700 references, and by 1965, this number had expanded to more than 2,000. In the next decade the latte...

Table of contents

• Cover
• Series
• Title Page
• Copyright
• Dedication
• Series Preface
• Acknowledgments
• Chapter One: History and Development
• Chapter Two: Administration
• Chapter Three: Scoring
• Chapter Four: Introduction to Interpretation
• Chapter Five: Assessing Protocol Validity
• Chapter Six: The Standard Clinical Scales
• Chapter Seven: The Content and Content Component, Personality Psychopathology–5 (PSY-5), Restructured Clinical (RC), and Supplementary Scales
• Chapter Eight: Profile Patterns and Codetypes
• Chapter Nine: Strengths and Weaknesses of the MMPI-2
• Chapter Ten: Clinical Applications of the MMPI-2
• Chapter Eleven: Illustrative Case Report
• References
• Annotated Bibliography
• About the Author
• Index