MMPI Research Paper

The MMPI-2 contains 567 true–false questions addressing mental health symptoms, beliefs, and attitudes. The items on the MMPI-2 are grouped into scales (clusters of items) that address specific clinical problems such as depression or anxiety. After the inventory is completed, the items are scored or grouped according to the scales that have been developed. An MMPI scale allows the clinician to compare the responses of the client with those of thousands of other people. Initially, the scores are compared to the normative sample, a large representative sample of people from across the USA, in order to determine if the person’s responses are different from people who do not have mental health problems. If the person obtains scores in the extreme ranges, for example on the depression scale, compared with the normative sample then they are likely to be experiencing problems comparable to the clinical samples of depressed clients that have been studied.

1. Evaluating Cooperative Responding

In some situations clients might be motivated to present personality characteristics and problems in ways that are different than they actually are. For example, if people are being tested to determine whether or not they are ‘sane’ enough to stand trial in a criminal court case they might attempt to exaggerate symptoms or problems in order to avoid responsibility. Alternatively, people being evaluated in preemployment psychological evaluation might be inclined to present themselves in an extremely positive way to cover up problems. It is important, in MMPI- 2 profile interpretation, to evaluate the way in which people approach the task of self-revelation. Are they sufficiently cooperative with the testing to produce a valid result?

There are several indices on the MMPI-2 to address honesty and cooperativeness in responding to the items (Baer et al. 1995):

1.1 Cannot Say Score

This index is simply the total number of unanswered items. If the client leaves out many items on the test (e.g., 30 items), the profile may be invalidated. A high score on this index suggests that clients have not cooperated sufficiently to provide a clear picture of their personality functioning.

1.2 The L Scale

The L or Lie scale is a measure of the client’s willingness to acknowledge personal faults or problems. Individuals who score high on this scale are presenting an overly virtuous picture of themselves. They claim virtue and positive characteristics that are not typically found among people in general. The L scale is particularly valuable in situations where the individual has something to gain by not appearing to have problems, such as in personnel screening or in child-custody disputes. In these cases, people might try to put their best foot forward and present themselves as ‘better’ adjusted than they actually are.

1.3 The K Scale

The K scale was developed as a means of evaluating the tendency that some people have to minimize problems. This scale is also used as an index for correcting some clinical scales that have been shown to be affected by defensiveness; that is, it serves as a correction factor to compensate for the tendency of some people to deny problems. Empirically derived percentages of the K scale score are added to five of the clinical scales in order to improve test discrimination.

1.4 The Infrequency Scales

The MMPI-2 contains three measures to assess the tendency of some people to exaggerate their problems or ‘fake’ the test by over-responding to extreme items (the F or Infrequency scale, the Back F or F(B) scale, and the P(p) scale). Each scale performs a somewhat different function in interpretation. The items on these scales are very rare or bizarre symptoms. Individuals who endorse a lot of these items tend to exaggerate symptoms on the MMPI-2, perhaps as a way of trying to convince professionals that they need to have psychological services. Some people who have a need to claim problems in order to influence court decisions will tend to elevate the infrequency scales. The infrequency scales can be elevated for several possible reasons: the profile could be invalid because the client became confused or disoriented or responded in a random manner. High F and F(B) scores are commonly found among clients who are malingering or producing exaggerated responses in order falsely to claim mental illness (Graham et al. 1991).

1.5 TRIN AND VRIN scales

Two scales to assess inconsistent responding have been developed for the MMPI-2. These scales were derived by examination of the individual’s responses to pairs of items that have similar content. A particular response to one of the items in the pair requires that the other item be endorsed in a given way in order to be consistent: for example, a pair of items that contains content that cannot logically be answered in the same direction if the subject is responding consistently to the content.

2. Profile Interpretation

The assessment of clinical problems is approached by examining the client’s responses to the items using several strategies. We will examine three types of scales that comprise the MMPI-2’s problem measures: the traditional clinical scales and profile codes, the MMPI-2 content scales, and the supplemental or specific-problems scales.

2.1 The MMPI-2 Clinical Scales

Hathaway and McKinley developed the original MMPI clinical scales to classify empirically or group patients into problem types. For example, they developed scales to assess hypochondriasis (the Hs scale), depression (the D scale), hysteria (the Hy scale), psychopathic deviation (the Pd scale), paranoid thinking (the Pa scale), psychasthenia (the Pt scale), schizophrenia (the Sc scale), and mania (the Ma scale). In addition, two other scales were included on the basic profile to address problems of sex-role identification (the Mf scale) and social introversion and extraversion (the Si scale). These scales have clearly defined correlates or empirical relationships. If a scale is elevated in the significant range, the individual is considered to possess the attributes measured by the scale.

Some clients have only one of the clinical scales elevated in their profile. In these cases, the profile interpretation is straightforward—the clinician simply examines the published correlates for that scale and incorporates these into the psychological report. However, some clients might have several of the clinical scales elevated in their profile. The full pattern or profile configuration needs to be interpreted. Fortunately, extensive research has been undertaken to evaluate complex profiles or code types. These profile types result from having two or more of the clinical scales elevated in the interpretive range. In these cases, the practitioner refers to published ‘code books’ which provide empirical descriptions for the various patterns that have been studied.

2.2 Content-based Scales

The MMPI-2 contains a number of scales that assesses content themes that the individual endorsed in the item pool. The content scales are homogeneous item clusters that summarize themes and represent direct communications about problems to the practitioner. There are 15 content scales measuring different symptom areas and problems: for example, Antisocial Practices (ASP), Bizarre Mentation (BIZ), and Low Self Esteem (LSE).

2.3 Special-problem or Supplemental Scales

Several supplemental scales have been developed to assess specific problems such as the potential to develop problems of addiction (the MacAndrew Addiction scale or MAC-R and the Addiction Potential scale or APS) and whether or not the individual acknowledges having problems with drugs or alcohol. Another scale, the Marital Distress scale, addressed a client’s attitudes toward their marital relationship. The MMPI-2 supplemental scales provide the practitioner with the means of evaluating specific problems (such as post-traumatic stress disorder) that are not addressed in the clinical or content scales.

3. Applications of the MMPI-2

Contemporary uses of the MMPI-2 include such activities as evaluating clients following their admission to an inpatient psychiatric facility; providing personality information about client’s problems and attitudes in the early stages of psychological treatment to assess treatment amenability; providing personality information for therapists to employ in giving the client feedback in psychotherapy; and providing information that would aid the clinician in arriving at an appropriate clinical diagnosis. The MMPI-2 is also widely used in medical settings to provide psychological adjustment information on patients—for example, in rehabilitation programs as a measure of behavior problems and symptoms following a stroke as part of the neuropsychological evaluation; or in the evaluation of drug treatment effects.

A great deal of contemporary personality assessment research is also aimed at further exploring the MMPI-2 test variables. The two most active research areas involve further exploration into the external validity of the MMPI-2 scales, and the translation and adaptation of the instrument for other languages and cultures. For example, research carried out in the mid-1990s has further explored the validity of the test in diverse settings such as personnel screening (Butcher 1995); forensic assessment (Megargee 1997); and test correlates with outpatients (Graham et al. 2000). Several studies have explored the use of MMPI-2based personality descriptions in providing test feedback to psychotherapy clients. This research has shown that providing psychological test feedback in treatment increases the effectiveness of treatment (Finn 1996, Finn and Tonsager 1992, Newman and Greenway 1997).

The MMPI-2 is also widely used as a cross-cultural research technique to study psychopathology across cultures. The MMPI-2 items and scales have shown remarkable resilience when used in other languages and cultures (Butcher 1996), and computer-based interpretation of the MMPI-2 has been shown to be highly effective in describing clinical patients in other cultures (Butcher et al. 1998).

4. Conclusion

The MMPI-2 is the most widely used and most versatile clinical personality instrument that clinical psychologists have available. It is a self-report personality questionnaire that provides the test user with scores on a number of scales that address important clinical problem areas. In addition the MMPI-2 provides mental health professionals with information that allows them to appraise the client’s willingness and frankness in the appraisal—key information about the client’s response attitudes that allows for a determination of the credibility of the client’s selfreport. Once cooperation in the assessment is assured, the MMPI-2 clinical measures can be effective in delineating the mental health symptoms, personality traits, and special problems that the client is likely to be experiencing.

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