1
Q
Purpose
A
Measure of emotional adjustment – and test taking approach/ attitude
2
Q
Began what tradition of approach for test taking?
A
MMPI began tradition of approaching test protocol with a degree of skepticism until individual’s cooperation is assured
3
Q
True/False - MMPI-2 has a theoretical orientation
A
FALSE
4
Q
Developed by…
A
Hathaway and McKinley in 1930s
5
Q
Original goals of MMPI
A
- 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
6
Q
originally developed to…
A
- 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
7
Q
Method of development
A
- 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”
8
Q
Original M-F scale
A
Initial intent to distinguish homosexual from heterosexual males
Too few items
9
Q
Original Si scale
A
(Drake) – to distinguish extroverted females
Later generalized to males and females
10
Q
Infl of attitude toward test taking
A
- 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)
11
Q
Original norms
A
226 male; 315 females
- administtered to 724 pts not under dr care - served as normal reference
12
Q
MMPI-2 norms
A
nationally representative same of normal individuals (1,138 men and 1,462 women).
13
Q
MMPI-2 new scales
A
(SAM)
Superlative Self-Presentation (S)
Addition Proneness (APS)
Marital Adjustment (MDS
14
Q
Common uses of MMPI-2
A
- 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
15
Q
MMPI-2 - WHO
A
18 years old and up
Sixth grade reading level
IQ above 70
16
Q
MMPI2 completion time
A
60-90 minutes
17
Q
MMPI2 number of items
A
567
18
Q
Upon completion, review protocol sheets for..
A
Omitted items
Items marked both T and F
Clean erasures
19
Q
Traditional validity and clinical scales can be obtained from administration of first ___ items
A
370
20
Q
Remaining ___ used for scoring supplementary and content scales
A
197
21
Q
Raw scores
A
Sum of the number of “agreements” between the test responses and the scoring key
22
Q
T scores
A
Statistically derived standard score equivalents for the raw scores for each scale
23
Q
2 types of T scores
A
- Linear T scores used on the validity scales
2. Uniform T scores used for clinical scales and content scales except MF and Si
24
Q
Linear T score
A
linear transformation of raw scores that maintain the underlying distributions of the raw score.
25
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.
26
Mean and SD of MMPI-2
```
M = 50
SD = 10
```
27
T scores interpreted when..
- elevated beyond 1.5 standard deviations above the mean
| - AKA when it is greater than T = 65
28
Validity scales
1. Cannot say (?)
2. Variable response inconsistency (VRIN)
3. True responding inconsistency (TRIN)
4. Lie scale (L)
5. Defensiveness scale (K)
6. Superlative self-presentation (S)
7. Infrequency scale (F)
8. Infrequency back scale (Fb)
9. Psychiatric infrequency scale (Fp)
29
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
30
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
31
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
32
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.
33
Two scales detecting when client endorses positive adjustment and denies his/her problems
1. Defensiveness scale (K)
| 2. Superlative Self Presentation Scale (S)
34
Defensiveness scale (K)
To test defensiveness and to correct for defensiveness by adding points to certain scales.
- 30 items
35
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
36
Exaggerated symptom endorsement
- clients present problems in exaggerated manner
| - clients feel to his/her advantage to appear psychologically disturbed
37
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
38
Infrqeuency-back scale (Fb)
Another measure of exaggerated symptoms, usually elevated with F.
- measures sxs on latter part of the test
39
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.
40
Number of clinical scales
8
41
Standard profile is comprised of
traditional clinical scales
42
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.
43
T = 60-64 (1 SD)...
personality correlatives are considered to apply to the test taker
44
T = or > 65
all of the correlates should be applied to the scale as indicated.
45
profile definition involves...
how elevated the interpreted clinical scales (high point or high point code) are above the next highest scales
46
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
47
Very high profile definition
T=/> 10 pts
48
high profile definition
T=5 – 9 pts
49
Low profile definition
T=/< 4 pts
50
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)
```
51
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
52
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
53
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
54
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
55
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
56
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
57
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
58
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
59
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
60
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
61
Harris and Lingoes scales
Subscales determine the components that serve to elevate the scale in question.
Developed for 6 of the clinical scales
62
Which 6 clinical scales - Harris/Lingoes
(248-369)
- Depression (2)
- Psychopathic (4)
- Schizophrenia (8)
- Hysteria (3)
- Paranoia (6)
- Hypomania (9)
63
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.
64
T scores for content scales
T > 65 = high
| T > 60 = mild
65
Content scales grouped into
1. Internal symptomatic bx
2. External bx
3. negative self-view
4. General problem areas
66
Internal sypmtomatic bx scales (6)
1. Anxiety (ANX)
2. Fears (FRS)
3. Obsessions (OBS)
4. Depression (DEP)
5. Health Concerns (HEA)
6. Bizarre Mentation (BIZ)
67
External Aggressive tendencies scales (4)
1. Anger (ANG)
2. Cynicism (CYN)
3. Antisocial Practices (ASP)
4. Type A (TPA)
68
Negative self-views scales (1)
1. Low self-esteem (LSE)
69
General Problem Areas:
Social, Family, Work and Treatment
1. Social Discomfort (SOD)
2. Family Problems (FAM)
3. Work Interference (WRK)
4. Negative Treatment Indicators (TRT)
70
Content (with component scales when applicable): ANX
Anxiety
71
Content (with component scales when applicable): FRS
Fears
1. FRS1 = general
2. FRS2 = multiple specific
72
Content (with component scales when applicable): OBS
Obsessiveness
| - OCD
73
Content (with component scales when applicable): DEP
Depression
1. DEP1 = Anhedonia
2. DEP2 = Dysphoria
3. DEP3 = Negative self-esteem
4. DEP4 = S/I
74
Content (with component scales when applicable): HEA
Health concerns
1. HEA1= GI
2. HEA2 = Neuro
3. HEA3 = general
75
Content (with component scales when applicable): BIZ
Bizarre mentation
1. BIZ1 = Psychotic (psychotic)
2. BIZ2 = Schizotypal (Weird)
76
Content (with component scales when applicable): SOD
Social discomfort
1. SOD1 = Introversion
2. SOD2 = Shyness
77
Content (with component scales when applicable): ANG
Anger
1. ANG1 = Explosive
2. ANG2 = irritable
78
Content (with component scales when applicable): ASP
Antisocial practices
1. ASP1 = attitudes
2. ASP2 = Bxs
79
Content (with component scales when applicable): TPA
Type A Personality
1. TPA1 = Impatient
2. TPA2 = Competitive
80
Content (with component scales when applicable): LSE
Low self-esteem
1. LSE1 = self-doubt
2. LSE2 = submissiveness
81
Content (with component scales when applicable): WRK
Work interference
82
Content (with component scales when applicable): TRT
Negative Treatment indicators
1. TRT1 = Low motivation
2. TRT2 = Poor ability to disclose
83
Content (with component scales when applicable): FAM
Family problems
1. FAM1 = Discord
2. FAM2 = Alienation
84
Content (with component scales when applicable): CYN
Cynicism
1. CYN1 = Misanthropic beliefs
2. CYN2 = Interpersonal suspiciousness
85
Supplementary scales
1. Anxiety (A)
2. Repression (R)
3. Ego Strength (Es)
4. Dominance (Do)
5. Social Responsibility (Re)
6. College Maladjustment (Mt)
7. Post-Traumatic Stress Disorder Scale (Pk)
8. Marital Distress Scale (MDS)
9. Hostility (HO)
10. Over-controlled hostility (O-H)
11. MacAndrew Addiction Scale (MAC-R)
12. Addition Potential Scale (APS)
13. Addition Acknowledgement Scale (AAS)
14. Gender role - Male (GM)
15. Gender role - Female (GF)
86
Supplementary: A
Anxiety
87
Supplementary: R
Repression
| - tend to internalize
88
Supplementary: Es
Ego strength
| - responsiveness to tx
89
Supplementary: Do
Dominance
| - assertivenes
90
Supplementary: Re
Social responsibility
| - moralistic
91
Supplementary: Mt
College maladjustment
| - general psychological maladjustment
92
Supplementary: Pk
PTSD
- extreme emotional distress
- not nec dx PTSD
93
Supplementary: MDS
Marital dissatisfaction scale
94
Supplementary: Ho
hostility
95
Supplementary: O-H
Over-controlled hosility
96
Supplementary: MAC-R
McAndrew Alcoholism Revised Scale
- life-style, risk taking
- interpret RAW score only
97
Supplementary: AAS
Addiction Acknowledgement Scale
| - openness to discuss D/A problems
98
Supplementary: APS
Addition Potential Scale
99
Supplementary: GM
Gender role - Masculine
100
Supplementary: GF
Gender role Feminine
101
Psy-5 scales
major domains of personality individual differences
1. AGGR
2. PSYC
3. DISC
4. NEGE
5. INTR
102
Psy-5: AGGR
Aggressiveness
| - offensive and instrumental aggression
103
Psy-5: PSYC
Psychoticism
| - disconnection from reality
104
Psy-5: DISC
Disconstraint
| - risk taking, impulsive, acting out
105
Psy-5: NEGE
Negative Emotions
| - Neg affect
106
Psy-5: INTR
Introversion/Low positive emotionality
| - anxious, depressed, somatic sxs
107
Neurotic triad
- Scale 1 (Hs)
- Scale 2 (D)
- Scale 3 (Hy)
108
Distress scales
- Scale 2 (D)
| - Scale 7 (Pt)
109
Unusual thoughts and depression
- Scale 2 (D)
| - Scale 8 (Sc)
110
Somatic and Depression
- Scale 2 (D)
| - SCale 1 (Hs)
111
Conversion V
- Elevated Scales 1 and 3
| - scale 2 10+ points lower
112
Inhibition scales
- Scale 0 (Si)
- Scale 2 (D)
- Scale 7 (Pt)
113
Suppression scales
- 5 (Mf)
| - 0 (Si)
114
Acting out (Impulsivity)
- 4 (Pd)
- 9 (Ma)
releaser/excitatory scales
115
Internal coping style
- 4 (Pd), 6 (Pa), 9 (Ma) < 2 (D), 7 (Pt), 0 (Si)
116
External coping style
- 4 (Pd), 6 (Pa), 9 (Ma) > 2 (D), 7 (Pt), 0 (Si)
117
Overcontrol (repression)
Rigid, overcontrol of impulses
- 3 (Hy)
- O-H
118
Anger (loss of control)
ANG (content)
119
Depression
- 2 (D)
| - Low 9 (Ma)
120
Mania
- 9 (Ma)
| - Low 2 (D)
121
Psychosis
- 8 (Sc)
- Bizarre mentation
- especially if 8 > 7
122
Confusion/disorientation
elevated T on:
- F
- 8 (Sc)
- 7 (Pt)
- Also if 8 clinical scales avg > 70
123
Suspicion/mistrust
- 6 (Pa)
| - especially if highest
124
Introversion
0 (Si)
125
Obsessiveness
- 7 (Pt) especially if highest
| - OBS
126
Cynicism
- CYN (content)
127
D/A problems
- 4 (Pd)
- 2 (D)
- 7 (Pt)
- MAC-R
- APS
- AAS
128
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
129
Code type
made up of highest elevated scale based on their rank order and profile elevation
- Provides shorthand to “type” of client
130
profile spike
single clinical scale is elevated
131
2 point code type
two clinical scales are elevated in clinical range (T>65)
132
T/F 4 code type is common
FALSE - very rare
133
Interpretation - Formulation depends on 3 aspects
1. Acceptability of scores determined by validity indicators
2. Elevation of scores against standards – T-score norms
3. Relative configuration of these within the individual profile
134
Interpretation sequence
Before = background info, hx
1. Validity scales
2. Clinical scales
3. Content
4. Content component
5. Supplementary
6. PSY-5
7. Critical items
135
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
136
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
assessment 2
flashcards
Decks in class (3)
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