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INTER-CULTURAL

COMPENTENCY

ASSESSING HISPANIC

CLERGY USING THE

MMPI-2/16PF

Raphael Romero, Psy.D.Los Angeles County

Department of Mental Health

March 7, 2014

Email: [email protected]

INTER-CULTURAL COMPETENCY WITH

HISPANIC CLERGY - INTRUCTION

Development of the MPPI-2 with Hispanics

Difference in the MMPI-2 with White and Hispanic Norms

Using the MMPI-2 with Hispanic clergy in the United States

Uses of the 16PF-5 – Brief overview

Cultural Consideration

Integration of identity models in psychometric assessments

INTER-CULTURAL COMPETENCY WITH

HISPANIC CLERGY

•Two perspectives to consider in assessment:1. Origination of psychiatry, psychology, assessment…come from a

Eurocentric worldview and culture.

2. Migration to the industrialized nations has led for the need for

describe human experience beyond only a particular group or culture

•Views of Assessment–Culture and human behavior have a relationship between culture and

psychopathology that leads that personality dimensions/structures are

similar across cultures

–Allocentrism indicates that there are certain characteristics particular to

groups and not individuals within Latin American nationalities.–Expression of symptoms will be different

Butcher, J., Cabiya, J., Lucio, E., & Garido, M.. (2007)

INTER-CULTURAL COMPETENCY

WITH HISPANIC CLERGY –MMPI2

•Which MMPI-2 do I use?

•Test Construction• Linguistic Equivalence

• Will the translation have the same meaning?

• Construct Equivalence• Will the personality concepts be applicable across cultures

• Psychometric Equivalence• Get local norms if the cultures are very different

• Psychological Equivalence beyond only a particular group or culture• Is the psychological meaning the same across the cultures, ie., eye contact

•Bias in Assessment1. Lack of culture-specific norms

2. Tests did not originate in the target culture – different values

3. Lack of standardized mechanism – can’t account for acculturation

4. Conducting assessments in a quantitative manner as opposed to the other information,

interview and observation5. Lack of awareness of own ethnic identity

Butcher, J., Cabiya, J., Lucio, E., & Garido, M.,(2007)



•MMPI-2 in Cuba

•50 years with effective use to address mental health problems

•1993 Spanish Translation adaptation: Garcia-Azan’s MMPI-2 Hispania

(Garcia-Peltoniemi & Azan Chaviano, 1993) – use this one

•MMPI-2 in Mexico

• 1992 Adaption at the National Autonomous University of Mexico (UNAM) – G.

M. E. Lucio & Reyes-Lagunes, (1996) – use this one

•Literal translation – bilingual psychologist

•Semantic and cultural adaptation – bilingual translators

•External validity – 90% agreement

•Content readjustment

•Back translation

Butcher, J., Cabiya, J., Lucio, E., & Garido, M., (2007)



•MMPI-2 in Mexico

•Equivalence research (813 men and 1,107 women) compared to U.S. college

normative sample (Butcher, Graham, Dahlstrom, & Bowman, 1990)

•Men and women different except on L (Lie) and 8 (Schizophrenia) as in

U.S. separate norms needed

•Significant statistical differences between Mexican and American male

university students except on 4 (Psychopathic Deviate).

•Largest differences in L, 2 (Depression), 6 (Paranoia)

•Significant differences between Mexican and American female university

students, except on F (Infrequency), 1 (Hypochondriasis), and 3 (Hysteria)

•Largest difference in 5 (Masculinity-Femininity).

•Confirmed internal consistency, reliability, and discriminant validity

•Differences did not show elevated pathological indexes as in MMPI

Butcher, J., Cabiya, J., Lucio, E., & Garido, M. (2007)



•MMPI-2 in Mexico•General population study (2001) – Norms developed in (see Appendix C)

•Mexican men/women scored higher than American men/women on same

scales

•Greatest difference in CYN (Cynicism), FRS (Fears), and ASP

(Antisocial Personality)

•FRS due to socioeconomic conditions

•ASP due to different things are considered antisocial in each culture

• Other studies results

•Mexican people score higher on L than Americans

•More inclined to project a good image – collective as opposed to

individualistic

•More traditional than American society

•Fear of judgment from disclosure – strong family loyalty and privacy

•Have difficulty understanding the double negative – “Cantinflas”

•Low SES, difficulty with comprehension

Butcher, J., Cabiya, J., Lucio, E., & Garido, M., (2007)



•MMPI-2 has been translated and adapted in other Latin

American Countries

•Puerto Rico

•Argentina

•Chile

•Peru

•Spain – Castilian

•High equivalence of the Castilian and U.S. versions in general

populations

•Endorsement percentages 0.850 for females and 0.871 for males

•Provided transcultural evidence

Butcher, J., Cabiya, J., Lucio, E., & Garido, M. (2007).



•MMPI-2 in the United States with Hispanics

•English version of MMPI-2 use?

•Yes – Bilingual, live, work, and attend school in the U.S.

•Read and comprehend English at a 6th grade level.

•Code switching

•Hispanics that are not bilingual but monolingual Spanish– use the Garcia-

Azan’s MMPI-2 Hispania (Garcia-Peltoniemi & Azan Chaviano, 1993)

translation

•Include Puerto Ricans




•MMPI-2 in the United States with Hispanics

•Recent immigrant – use a translation from one of the countries closest to

the country of origin.

•English and Spanish have booklet and audiotaped formats

•Mexican Version of the MMPI-2 booklet, El Manual Moderno

•Use U.S. norms except when using the Mexican Version or the one for

Spain and Chile that have their own norms.

•There was a normative subset sample of Hispanic individuals

•No current normative sample for Spanish-speaking American

population

•Avoid interpretation of Psychopathology Five – PSY5 Scales and the

Restructured Clinical Scales because they have not been researched or

validated sufficiently with Hispanics or Latin American populations.




•Interpretation guides with Hispanics in the United States

•F and L scale are slightly higher

•Lack of acculturation

•Infrequent responding (F) – immigrant stress

•Scale 5 (Masculinity-Femininity) – variable among the Hispanic groups

– unclear why, traditions, religion, inferiority complex, SES

•Machismo/Marianismo

•High HS (Hypochondrisasis) and HES (Health Concerns) - Somatic

reporting

•Determination if they can read English

•Cannot Say (CNS)

•Variable (VRIN) and True (TRIN)

•Infrequency scales (F, Fb, and Fp)

•True/False percentages – evaluates effort, >30% - invalid




Case SamplePedro is a 21-year-old, single bilingual Hispanic male. Pedro was born in Orange,

California, however. His heritage is from South America. Both of his parents were born

in Bolivia. He had a normal birth and developmental milestones within normal limits.

He described himself as an Evangelical Christian but rejected by his Catholic family.

•Pedro’s MMPI-2 results are valid indicators of his personality functioning.

However, his profile should be interpreted with extreme caution (MMPI-2: L=65)

•Pedro responded to all of the items on the test (MMPI-2: CANNOT SAY=0).

•He responded to similar items consistently (MMPI-2: VRIN=40).

•He did not respond randomly to the test items but was able to discriminate

(MMPI-2: TRIN=50).

•He denied experiencing any significant pathology (MMPI-2: F=42). However, in

the second part of the test, Pedro endorsed items that are relevant to one area of

difficulty (MMPI-2: Fb=55).

•Pedro’s approach to the test was defensive and presented him in a favorable light

(MMPI-2: L=65).



Case Sample

•Pedro presented himself in a very positive manner that seemed unrealistic

(MMPI-2: Ma=74). •He expressed that his idea of right and wrong was better than that of other

people.

•He felt that he was unfairly mistreated by the lack of support from his

mother after he changed his faith and that others that are not of his faith

mistreated him (MMPI-2: Ma4=69).

•Pedro indicated that he was not a person that trusted others and seemed

concerned that other people were not honest about their lifestyles (MMPI-2:

CYN=68, RC6=65).

•Pedro appeared to be a person that was very focused with details and

perfection. Such as, he expressed that he was a very organized person and

that if, there was something that was not organized then, he would organize

it because it would bother him (MMPI-2: AGGR=69, Ho=66).



Case Sample•Pedro’s internal conflict seemed to surface in his interactions with others.

•He did not trust people and thought that they were selfish and uncaring but his faith

required that he serve others (MMPI-2: Ma4=69, CYN2=66, Ho=66).

•This was evident in his inability to form any intimate relationships during his growing

years and love his love above their rejection of him.

•There appeared to be a strong resentment toward his mother for not standing up for

him when he felt persecuted by his family (MMPI-2: Ho=66).

•His strong devotion to his faith has led him to have higher expectations from others

even when they are in authority over him (MMPI-2: Ma=74, CYN=68).

•For instance, Pedro stated that he did not want to be like his father but wanted his

father to accept his faith. Also, he refused to attend the church connected to the

Christian school he attended because it was not like the church he had grown up in.

•He also expressed a strong sense of confidence in his leadership with directing his

younger siblings toward his faith. He said that as the older brother they would do

whatever he did.



Case Sample•Pedro felt very committed to his faith and it appeared that it was a

large source of his emotional stability. However, his internal conflict

demonstrated that it is possible that Pedro felt apprehension because

he had to honor his parents and do what was right but he could

express his feelings toward his parents.

•It seemed that he withheld a lot of aggression and has done so

through most of his life (MMPI-2: Ho=66). For instance,

•Pedro reported that when someone upset him, he would not

confront the individual but waited until he became frustrated.

•Overall, it appeared that Pedro felt better than others because of his

near death events and his faith.


WITH HISPANIC CLERGY –16PF

Sixteen Personality Factors Questionnaire (16PF-5)

• Translated into 35 languages

• Can be taken in several languages on their website.

• Developed mostly in a homogenous group - Caucasians

• No norms for Hispanics in the United States

• Many concerns with inter-cultural competency because of its

development

• Global Scales• Extraversion (A+, F+, H+, N–, Q2–) • Anxiety (Goldberg’s Emotional Stability reflected) (C–, L+, O+,

Q4+) • Tough-Mindedness (Goldberg’s Openness reflected) (A–, I–, M–,

Q1) • Independence (Goldberg’s Agreeableness reflected) (E+, H+, L+,

Q1+)• Self-Control (Goldberg’s Conscientiousness) (G+, F–, M–, Q3+)



Sixteen Personality Factors Questionnaire (16PF-5)

Whitworth, R and Perry, S. (1990).

• Administered the 16PF to three separate groups: White Americans tested in English, Hispanics tested in English and Hispanics tested in Spanish.

• Greatest differences among Anglos who took it in English and Hispanics who took it in Spanish

• Second difference among the Hispanics tested in English and Hispanics tested in Spanish.

• Smallest difference among White Americans and Hispanics tested in English

• Gender Elevations

• Male scored high on scales M and QI

• Females scored high on scales I, L, and O



Scale Num. of Items Anglo-E Mex-A-E Mex-A-Sp

Faking Good +

Faking Bad +

A Warmth 11

B Reasoning 15 +

C Emotional Stability 10

E Dominance 10 +

F Liveliness 10

G Rule-Consciousness 11

H Social Boldness 10 +



Scale Num. of Items Anglo-E Mex-A-E Mex-A-Sp

I Sensitivity 11 +

L Vigilance 10 +

M Abstractedness 11 +

N Privateness 10 +

O Apprehension 10 +

Q1 Openness to Change 14

Q2 Self-Reliance 10 +

Q3 Perfectionism 10

Q4 Tension 10 +

IM Impression 12

Management

Whitworth, R and Perry, S. (1990).

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