david m. mccord western carolina university [email protected] find materials at: practical...
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![Page 1: David M. McCord Western Carolina University mccord@wcu.edu Find materials at: Practical Introduction to the MMPI-2-RF](https://reader031.vdocuments.net/reader031/viewer/2022032309/56649d145503460f949e8af3/html5/thumbnails/1.jpg)
David M. McCordWestern Carolina University
Find materials at:http://paws.wcu.edu/mccord
Practical Introduction to the MMPI-2-RF
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Agenda
Overview 9:00-9:15 Background 9:15-9:20 Development 9:20-9:30 Scales 9:30-10:15 Break 10:15-10:30 Administration and Scoring 10:30-
10:45 Interpretation 10:45-11:15 Cases 11:15-12:00
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MMPI-2-RF Overview
Published 2008 Authors Ben-Porath & Tellegen
338 items Subset of MMPI-2 Item Pool Norms based on MMPI-2 normative sample 240+ peer-reviewed publications Used widely in mental health, medical,
forensic and public safety settings
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MMPI-2-RF Overview
Overall Objective: Represent the clinically significant substance of the MMPI-2 item pool with a comprehensive set of psychometrically adequate measures: Improve efficiency Enhance construct validity
Overall Strategy: First restructure the Clinical Scales (resulting
in the Restructured Clinical [RC] Scales) Then augment the RC Scales with needed
additional measures
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MMPI-2-RF Overview
• 51 Scales • 9 Validity Scales• 3 Higher-Order Scales• 9 RC Scales• 23 Specific Problems Scales
• 5 Somatic/Cognitive• 9 Internalizing• 4 Externalizing• 5 Interpersonal
• 2 Interest Scales• 5 PSY-5 Scales
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Background
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Background
Clinical Scales developed by Hathaway and McKinley in late 1930s early 1940s
Intended to function as a differential diagnostic test
Targeted Kraepelinian nosology Published 1943 Didn’t work as intended
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Background
Psychometric Challenges Excessive correlations Item Overlap Heterogeneity
Ad hoc solutions Code Types Subscales Supplementary Scales
Challenges Not addressed with MMPI-2
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Development
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Development
Factor analyses of targeted item sets to: Identify and remove (to the extent
needed and feasible) a common factor - Demoralization
Identify Major Distinctive Core Components
Targeted item sets include: Clinical Scales Content Scales Select Subscales Supplementary Scales Various “experimental” scales
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Development
Correlational analyses augment Seed Scales with items contributing to convergent and discriminant patterns
Scales retained IF show evidence of convergent and discriminant validity
Linked to current models and conceptualizations of personality and psychopathology
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MMPI-2-RF Scales
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MMPI-2-RF: Validity Scales
VRIN-r: Variable Response Inconsistency – Random responding TRIN-r: True Response Inconsistency – Fixed responding F-r: Infrequent Responses – Responses infrequent in the
general populationFp-r: Infrequent Psychopathology Responses – Responses
infrequent in psychiatric populations Fs: Infrequent Somatic Responses – Somatic complaints
infrequent in medical patient populationsFBS-r: Symptom Validity – Somatic and cognitive complaints
associated at high levels with over-reportingRBS: Response Bias Scale - Exaggerated memory complaintsL-r: Uncommon Virtues – Rarely claimed moral attributes or
activitiesK-r: Adjustment Validity – Avowals of good psychological
adjustment associated at high levels with under-reporting
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MMPI-2-RF: Higher-Order Scales
EID – Emotional/Internalizing Dysfunction – Problems associated with mood and affect
THD – Thought Dysfunction – Problems associated with
disordered thinking
BXD – Behavioral/Externalizing Dysfunction – Problems associated with under-controlled behavior
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Identical to MMPI-2 RC Scales
RCd: Demoralization – General unhappiness and
dissatisfaction RC1: Somatic Complaints – Diffuse physical
health complaints
RC2: Low Positive Emotions – Lack of positive
emotional responsiveness RC3: Cynicism – Non-self-referential beliefs
expressing distrust and a generally low opinion of
others RC4: Antisocial Behavior – Rule breaking and
irresponsible behavior
MMPI-2-RF: RC Scales
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RC6: Ideas of Persecution – Self-referential beliefs that
others pose a threat RC7: Dysfunctional Negative Emotions –
Maladaptive anxiety, anger, irritability
RC8: Aberrant Experiences -- Unusual perceptions
or thoughts RC9: Hypomanic Activation – Over-Activation,
aggression, impulsivity, and grandiosity
MMPI-2-RF: RC Scales
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Somatic/Cognitive MLS: Malaise – Overall sense of physical
debilitation, poor health GIC: Gastrointestinal Complaints –
Nausea, recurring upset stomach, and poor
appetite HPC: Head Pain Complaints – Head and
neck pain NUC: Neurological Complaints – Dizziness,
weakness, paralysis, loss of balance, etc. COG: Cognitive Complaints – Memory
problems, difficulties concentrating
MMPI-2-RF: Specific Problems (SP) Scales
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Internalizing (RCd Facets):
SUI: Suicidal/Death Ideation – Direct reports of
suicidal ideation and recent attempts
HLP: Helplessness/Hopelessness – Belief that goals
cannot be reached or problems solved
SFD: Self-Doubt -- Lack of self-confidence, feelings
of uselessness
NFC: Inefficacy – Belief that one is indecisive
and inefficacious
MMPI-2-RF: Specific Problems (SP) Scales
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MMPI-2-RF: Specific Problems (SP) Scales Internalizing (RC7 Facets):
STW: Stress/Worry -- Preoccupation with disappointments, difficulty with time
pressure
AXY: Anxiety – Pervasive anxiety, frights, frequent
nightmares
ANP: Anger Proneness -- Becoming easily angered,
impatient with others
BRF: Behavior-Restricting Fears -- Fears that
significantly inhibit normal behavior
MSF: Multiple Specific Fears -- Fears of blood, fire,
thunder, etc.
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MMPI-2-RF: Specific Problems (SP) Scales
Externalizing:RC4 Facets JCP: Juvenile Conduct Problems –
Difficulties at school and at home, stealing
SUB: Substance Abuse – Current and past misuse of alcohol and drugs
RC9 Facets AGG: Aggression – Physically aggressive,
violent behavior
ACT: Activation – Heightened excitation and energy level
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MMPI-2-RF: Specific Problems (SP) Scales
Interpersonal: FML: Family Problems – Conflictual
family relationships IPP: Interpersonal Passivity – Being
unassertive and submissive SAV: Social Avoidance – Avoiding or not
enjoying social events SHY: Shyness – Bashful, prone to feel
inhibited and anxious around others
DSF: Disaffiliativeness – Disliking people and being around them
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AES: Aesthetic-Literary Interests – Literature, music, the theater
MEC: Mechanical-Physical Interests – Fixing and building things, the outdoors, sports
MMPI-2-RF: Interest Scales
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MMPI-2-RF: PSY-5 Scales
Revised versions of dimensional model of personality pathology developed by Allan Harkness and John McNulty: AGGR-r: Aggressiveness-Revised – Instrumental,
goal-directed aggression PSYC-r: Psychoticism-Revised – Disconnection
from reality DISC-r: Disconstraint-Revised – Under-controlled
behavior NEGE-r: Negative Emotionality/Neuroticism-
Revised – Anxiety, insecurity, worry, and fear INTR-r: Introversion/Low Positive
Emotionality-Revised – Social disengagement and anhedonia
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Administering and Scoring the MMPI-2-RF
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Administering and Scoring the MMPI-2-RF
Standard Procedures delineated in Manual for Administration, Scoring, and Interpretation
Administration: Before Testing
Consider age Inquire about prior testing experience Assess Testability
Cognitive wherewithal Vision Reading Level: Grade 4.5 (Flesch Kincaid) 6 (Lexile)
Use Standard Administration Modalities Booklet and answer sheet Computer
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Administering and Scoring the MMPI-2-RF
Scoring: Normative Sample:
MMPI-2 Normative Sample Collected in 1980s Non-gendered norms (1,138 men, 1,138
women) Norms appear to be holding up well
(Technical Manual Appendix C)
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Administering and Scoring the MMPI-2-RF
Scoring: Normative Sample:
MMPI-2 Normative Sample Collected in 1980s Non-gendered norms (1,138 men, 1,138
women) Norms appear to be holding up well
(Technical Manual Appendix C) Uniform T scores
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Administering and Scoring the MMPI-2-RF
Scoring: Normative Sample:
MMPI-2 Normative Sample Collected in 1980s Non-gendered norms (1,138 men, 1,138
women) Norms appear to be holding up well
(Technical Manual Appendix C) Uniform T scores
Comparison Groups Technical Manual Appendix D
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MMPI-2-RF: Standard Comparison Groups MMPI-2-RF Normative (Men & Women) Outpatient, Community Mental Health Center (Men & Women) Outpatient, Independent Practice (Men & Women) Psychiatric Inpatient, Community Hospital (Men & Women) Psychiatric Inpatient, VA Hospital (Men) Substance Abuse Treatment, VA (Men) Bariatric Surgery Candidate (Men & Women) Spine Surgery/Spinal Cord Stimulator Candidates (Men & Women) Chronic Pain (Men & Women) College Counseling Clinic (Men & Women) College Student (Men & Women) Forensic, Disability Claimant (Men & Women) Forensic, Independent Neuropsychological Examination (Men &
Women) Forensic, Pre-trial Criminal (Men & Women) Forensic, Child Custody (Men & Women) Forensic, Parental Fitness Evaluees (Men & Women) Prison Inmate (Men & Women) Personnel Screening, Law Enforcement (Men, Women &
Combined) Personnel Screening, Corrections Officer (Men, Women &
Combined) Personnel Screening, Clergy Candidates (Men, Women, &
Combined)
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Administering and Scoring the MMPI-2-RF
Scoring: Normative Sample:
MMPI-2 Normative Sample Collected in 1980s Non-gendered norms (1,138 men, 1,138
women) Norms appear to be holding up well
(Technical Manual Appendix C) Uniform T scores
Comparison Groups Technical Manual Appendix D Embedded in scoring software
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Administering and Scoring the MMPI-2-RF
Scoring: Normative Sample:
MMPI-2 Normative Sample Collected in 1980s Non-gendered norms (1,138 men, 1,138 women) Norms appear to be holding up well (Technical
Manual Appendix C) Uniform T scores
Comparison Groups Technical Manual Appendix D Embedded in scoring software Updated Periodically
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Administering and Scoring the MMPI-2-RF
Scoring: Standard Scoring Modalities:
Hand scoring Computer (Q Local or Q Global)
Score Report (Described in User’s Guide for Report)
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Administering and Scoring the MMPI-2-RF
Scoring: Standard Scoring Modalities:
Hand scoring Computer
Score Report (Q Local or Q Global) Comparison Groups (Standard and Custom)
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Custom Comparison Groups
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Custom Comparison Groups
Provide the same information as standard comparison groups
Can be created for men, women, or combined gender
Require 200 valid MMPI-2-RF OR MMPI-2 cases stored on Q Local or Q Global
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Administering and Scoring the MMPI-2-RF
Scoring: Standard Scoring Modalities:
Hand scoring Computer
Score Report Comparison Groups (Standard and Custom)
Interpretive Report
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Interpreting the MMPI-2-RF
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Threats to Protocol Validity
Threats to Protocol Validity Non-Content-Based Invalid
responding Non-responding Random responding Fixed responding
Content-Based Invalid Responding Over-reporting Under-Reporting
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MMPI-2-RF Validity Scales
Content Non-Responsiveness CNS VRIN-r (Invalid if > 80) TRIN-r (Invalid if > 80)
Over-Reporting F-r (Invalid if = 120) Fp-r (Invalid if > 100) Fs FBS-r RBS
Under-Reporting L-r K-r
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MMPI-2-RF Interpretation
Substantive Scale Interpretation Begin with Higher-Order Scales
If only one is elevated, use it as starting point then interpret all RC, Specific Problems, PSY-5 scales in that area
When interpreting RC Scales: proceed in order of elevation incorporate relevant SP Scales and PSY-5
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MMPI-2-RF Interpretation
Substantive Scale Interpretation Begin with Higher-Order Scales
If only one is elevated, use it as starting point then interpret all RC, Specific Problems, PSY-5 scales in that area
When interpreting RC Scales: proceed in order of elevation incorporate relevant SP Scales and PSY-5
If more than one H-O Scale is elevated, use highest as starting point, then proceed to next highest
If no H-O Scale is elevated, proceed to RC Scales and interpret by domain, in order of elevation, incorporating relevant SP and PSY-5 scales
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MMPI-2-RF Interpretation
Substantive Scale Interpretation Once all H-O and RC Scales are
covered: Interpret any remaining elevated SP
Scales Interpret Interpersonal and Interest scales If relevant, add diagnostic and treatment
considerations along the way
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Cases
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Ms. G
35 year old single woman Self-referred to community mental health
center Recent job loss owing to obsessive-
compulsive behavior Preoccupied with worry that apartment
will catch fire or be burglarized Repeated checking that stove pilot light
on, appliances turned off, apartment door locked
Increasing intensity of checking behavior leads to frequent tardiness, reduced productivity, and termination
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Ms. G
No prior involvement with mental health system
Family of origin intact with no reported abuse
Long-term romantic relationship ended at time that her symptoms became more severe
First time living on own At intake, reported feeling anxious,
depressed, embarrassed, and guilty over job loss
Diagnosed provisionally with OCD
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Mr. P
49 year old, single male Long-standing Dx of Schizophrenia,
Paranoid type Diagnosed late teens; resides with parents
throughout adult life Father passed away when Mr. P was in his
20s Mother now in 70s Received case management services in
community Periodic employment as unskilled laborer
under auspices of CMHC
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Mr. P
Several weeks prior to hospitalization Mr. P became embroiled in conflict with co-worker
Employment suspended as a consequence of physical altercation
Discontinued medication and decompensated into acute psychotic episode marked by belief that job loss is the result of gov’t conspiracy to take away his disability benefits as well
Mother informed case worker that Mr. P was threatening retaliation against co-worker
Although no history of violent behavior, psychiatrist determined significant risk
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Mr. E
28 year old, never married, male Arrested after assaulting stranger in
a bar Arresting officer noted mumbling
incoherently, religiously preoccupied Taken to crisis united; observed to
be intoxicated, but possibly also psychotic
Admitted to psychiatric community hospital inpatient unit
Tested after three days
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