Minnesota Multiphasic Personality Inventory (MMPI) – Adolescent

 

Minnesota Multiphasic Personality Inventory (MMPI) – Adolescent

 

 

Final Paper

 

 

 

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Abstract

            This paper discusses the details importantly to take note of regarding the Minnesota Multiphasic Personality Inventory-Adolescent or MMPI-A. This describes the historical background of the test in order to provide useful background or support of the discussion. It also includes the general description of the test, which would be highly useful in the progression of the discussion. Psychometric qualities of the test were also provided, which includes the standardization, validity, and reliability of the test. Its varied uses were also given importance, such as its use in the clinical or medical, legal or forensic, and psychological uses. A critique of the test was done through determining and analyzing the strengths and weaknesses of the test, by stating its psychometric qualities, and by discussing the relevant ethical and legal issues involved in its use. Part of the paper is to specify its use in the practical setting, which indicates its purposes, benefits, challenges, and use of the results of the test. At the end of the paper, a conclusion was done, which places emphasis on the summary of what was discussed in the paper and the personal thoughts of the author.  

 

 

 

 

 

 

Table of Contents

 

Title Page                                                                                                                    1

Abstract                                                                                                                      2

Table of Contents                                                                                                       3

Introduction                                                                                                                4

Description of the Test and Its History                                                                      4

Psychometric Qualities of the Test                                                                             6

Uses of the Test                                                                                                          8

Critique of the Test                                                                                                     10

Description of the Use of the Test in Own Setting                                                    13

Conclusion                                                                                                                  14

References                                                                                                                  16

 

 

 

Introduction

            The drastic changes happening in the society today significantly affect the welfare, personality, perceptions, and even the future of adolescents, thus, affecting the future of the entire society as well. Such changes lead to more serious problems that result to emotional, physical, and psychological damages in individuals that consequently yield to other social problems, such as increased rates and cases of juvenile delinquency, crimes involving adolescents, abortion, single-parenthood, and diseases caused by sexual aggression, such as AIDS and sexually-transmitted illnesses. With these problems at hand, the field of psychology would be able to help the society, particularly the adolescents in terms of introducing psychological tests, which would assist adolescents in measuring their personality, such as the MMPI-A or the Minnesota Multiphasic Personality Inventory-Adolescent. The different details about the test, including its qualities and uses are discussed in the paper, including its critique and application. At the end of the paper, a conclusion is provided in order to highlight the important points discussed in the paper.

 

Description of the Test and Its History (Important Evolutionary Milestone)

            It has been reported by Archer (2005) that the work on the Minnesota Multiphasic Personality Inventory or the MMPI was begun by Stark R. Hathaway, a psychologist, and J.C. McKinley, a neuropsychologist, in 1937. The authors of the test were motivated to come up a “personality inventory” based primarily on noticing that a large proportion of clients for medical treatment manifested psychoneurotic complaints. As such, Hathaway and McKinley sought to develop an instrument that would be useful in determining and describing clients in a manner that was more effective and appropriate than using psychiatric interview techniques, which are traditionally used for psychological evaluations of medical clients. During the continuous development and administration of the test, its application is extended to adolescent populations for both clinical and research purposes. Although the administration of MMPI was intended for individuals who were 16 years of age and older, Dahlstrom et al (1972) noted that it can be also used effectively with “bright children as young as 12”, thus, the delineation of age 12 as its lower limit in terms of MMPI administration was probably related to the estimate that a sixth-grade reading level was a prerequisite for understanding the MMPI item pool (p. 24).

            The year 1941 marks the first research application of the MMPI with adolescents, which is two years before the formal application of MMPI in 1943. Dora Capwell, in 1945 indicated that the test has an ability to accurately discriminate between groups of delinquent and non-delinquent adolescent girls based on Pd scale elevation. The validity of the test was also proven by Hathaway and Monachesi, who collected the largest MMPI data set ever obtained on adolescents, in a longitudinal study of the relationship between MMPI findings and delinquent behaviors. In the end, the study done by Hathaway and Monachesi proved to be very valuable in a number of ways, namely, by (1) establishing that the MMPI can usefully predict at least one broad area of important behavior exhibited by adolescents, which is delinquency; (2) providing a body of crucial information concerning differences in item endorsement for male vs. female adolescents and for adolescents vs. adults; (3) providing a major component of the traditionally used adolescent norms, which is later developed by Marks and Briggs; and (4) providing an extraordinarily rich source of data for follow-up investigations of the original Hathaway and Monachesi subjects, across topics from the prediction of juvenile delinquency to the personality precursors of schizophrenia (Archer, 2005, pp. 30-32). Thus, with such findings, at present, the Minnesota Multiphasic Personality Inventory is now the most frequently used objective personality instrument employed with adolescents (Janus et al., 1998, p. 321). It is now the most frequently used self-report measure to determine adolescents who are in need of psychological intervention and used to identify such adolescents from those displaying the normal spectrum of emotional and behavioral liability (as cited in Hand et al., 2007, p. 80). With this, it is often employed in court cases in order to provide personality information on defendants or litigants in which psychological adjustment factors are relevant to the resolution of the case. Its administration is fairly easy, thus, providing an objective measure of personality. Being a well-researched and highly-reliable instrument, the test is often used in custody evaluations, as it provides clear and valid descriptions of the problems, symptoms, and characteristics of individuals in broadly accepted clinical language. In addition, the profiles are manageable to explain in court and appear to be relatively simple for people to comprehend (Karp and Karp, 2008).  

 

Psychometric Qualities of the Test (Standardization, Reliability and Validity)

            Standardization of the Test. It has been indicated that the MMPI was re-standardized in 1992 specifically for use with adolescents, in part to resolve normative confusion and to modify its original form for more appropriate use with adolescent respondents. The development of the MMPI-A involved the collection of normative data for 805 boys and 815 girls between the ages of 14 and 18, inclusive. Its final form included the original 13 basic validity and clinical scales with significant basic scale changes largely restricted to scales F, Mf, and Si. Although endorsement frequencies for the MMPI-A items were examined, comparisons between normative and clinical samples were not used as criteria in retaining or modifying the basic scales. It also included the development of 15 content scales, where eleven overlap with similar measures developed for MMPI-2, whereas 4 scales were uniquely developed for the MMPI-A (Archer et al., 2001, p. 421).  

            Reliability. Groth-Marnat (2003) reports that reliability studies indicate that MMPI-A had moderate levels of temporal stability and internal consistency, due to fluctuations in some scales. For example, Scale 2 (Depression) is particularly likely to be lowered after successful treatment; Scale 7 (Psychasthenia) would be likely to change according to an individual’s external situation. Thus, in this sense, test-retest reliability may actually be an inappropriate method of evaluating these scales for certain populations. In addition, this defense of the tests’ reliability is somewhat undermined by the observation that test-retest reliability is actually slightly more stable for psychiatric populations than for normals. Whereas the media range for psychiatric clients is about .80, media reliabilities for normals are about .70. Split-half reliabilities are likewise moderate, having an extremely wide range from .05 to .96 with median correlations in the .70s (as cited in Groth-Marnat, 2003, p. 221).

            Validity. It has been indicated that findings from studies of the MMPI-2 and MMPI-A have mostly been consistent with studies done of the original MMPI. Investigations and studies have suggested that an incremental, though modest, contribution to the accuracy of clinical prediction when the MMPI is compared or combined with other sources of clinical information. Moreover, evidence for the convergent validity of the MMPI, MMPI-2, and MMPI-A is generally recognized to be better than that for its discriminant validity. The method of contrasted groups, in which the item responses of a pathological criterion group are contrasted with those of a diverse group of psychiatrically healthy individuals, used for the development of the basic clinical scales has been the subject of criticism on both theoretical and psychometric grounds. Thus, in this regard, this method of scale construction increased sensitivity but allowed considerable item overlap, giving rise to enhanced correlations among the clinical scales and reduction of specificity and compromising discriminant validity. As a result, the test tends to perform better in discriminating between major psychiatric conditions than it does within them (American Psychiatric Assocation, 2000, p.91).

 

Uses of the Test

            Primarily, the basic use of MMPI-A is in clinical settings. One clinical application of its use has been emphasized in the study done to address concerns about the mixing of different developmental ages, use of inadequate comparison groups, and the lack of reliance on reliable and valid measures of psychological, behavioral, and psychosocial problems used in previous studies of sexually abused children and adolescents. Through the administration of the test, the study has found out that a number of significant differences between reportedly sexually abused and non-sexually abused on the MMPI-A scales are reported, and a significantly larger proportion of sexually abused participants were diagnosed with post-traumatic stress disorder had numerous difficulties. Based on the tests, sexually abused adolescents had significantly higher elevations on scales that reflect thoughts of self-harm, depression, feelings of worthlessness, withdrawal from others and frequent running away. In addition, adolescents with such elevations tend to see their future as hopeless, feel that no one understands them, and consequently, respond minimally to treatment (Forbey et al., 2000, pp.9-10). Thus, clinicians must be able to take note of such factors in order to provide better diagnosis and treatment for such adolescents.

            Another use of the MMPI-A is for research purposes. It has been emphasized that the test manual for MMPI-A not only provides extensive data based on its normative sample but also provides psychometric data derived from a clinical sample of 420 boys and 293 girls between the ages of 14 and 18, inclusive. It also provided the mean MMPI-A profiles for 1,032 girls and 730 boys in psychiatric treatment who had completed the original MMPI, with the protocols rescored on MMPI-A norms. Through the test, a variety of studies have already been studied in relation to profile characteristics of adolescents in residential or inpatient psychiatric facilities, eating disorder programs, and in several inpatient and outpatient treatment programs for juvenile offenders (Forbey et al., 2000, p.3). Thus, in this regard, it can be understood that the test significantly provides additional information and knowledge regarding the different issue at hand.

            The next use of MMPI in adolescents is having knowledge regarding their personality and measuring their type of personality, which would be very helpful in assessing and understanding themselves. Once an adolescent or his/her parents or guardians are able to have adequate knowledge regarding their personality, then they would able to come up with strategies that would contribute to behavior modification, most especially when the behavior of the adolescent creates nuisance or havoc to the family, community or society. In relation to this are the forensic or legal uses of the MMPI-A. There are a variety of referral questions that the MMPI-A can be useful for answering, as the clinical constructs assessed by this instrument are often relevant to forensic issues or to individuals being treated in forensic settings. Some of the uses include competency to stand trial and insanity evaluations, personal injury and disability assessments, and assessment of general mental functioning for purposes of placement and treatment planning (Archer, 2006, p.70).

 

Critique of the Test (Strengths and Weaknesses, Psychometric Qualities and Issues)

            Strengths and Weaknesses. Primarily, its strength is its ability to provide a comprehensive clinical description for adolescents (Reynolds and Kamphaus, 2003, p.384). The test is helpful in assessing and evaluating the personality and associated behaviors of the adolescents, thus, making it easier to understand them. It also evaluates a wide range of symptoms and areas of functioning (Reynolds and Kamphaus, 2003, p.384), which can be used in clinical, psychological, and legal settings. In addition, clinicians using MMPI-A recognize the value of the updated normative sample, which is nationally representative, and includes minority populations (Reynolds and Kamphaus, 2003, p.384). In this sense, the sample does not exclude other representatives of the population, making the test more reliable and valid. The use of the test indicated ease of administration and psychometric soundness. This is because many of the newer scales, particularly the content scales have excellent internal consistency. Another major strength of the test is its ability to check for response biases and its ability to evaluate profile validity. This is because the test includes validity scales, which were also strengths of the MMPI, such as F, L, and K. In addition to such validity scales are the VRIN and TRIN scales, which show promise for determining inconsistent responding or a tendency for acquiescent or non-acquiescent responding. Lastly, the MMPI-A’s research base is supported by decades of MMPI investigations (Reynolds and Kamphaus, 2003, p.384), thus, making the descriptors and correlates of the test highly supported by studies and facts derived from researches.

            However, despite such strengths are a number of weaknesses of the MMPI-A, which include its foundation. This is because most of the basic clinical scales were retained with minimal modification, thus, several of such scales show low internal consistency, specifically when evaluated by today’s standards. In addition, many items are found on more than one scale, thus, contributing to higher correlations among scales. This can lead to uncertainty and confusion in the process of interpretation. Another weakness is that a significant number of items on both the basic and content scales do not demonstrate differential rates of endorsement between clinical and normative groups (Reynolds and Kamphaus, 2003, p.384).

            Psychometric Qualities. The Minnesota Multiphasic Personality Inventory had a long history of use in the assessment of adolescents in various settings, including inpatient and outpatient psychiatric programs, substance abuse programs, and juvenile justice facilities. Similar to the parent and sister instruments of the MMPI-A, the individual scales of the MMPI-A often show appreciable intercorrelation. Factor analyses of the basic clinical and validity scales suggest that four factors account for the majority of the observed variance in scales scores. Furthermore, the large number of individual scales and subscales available on the MMPI-A serves to make the interpretation process quite complex for many clinicians, particularly given the varying degree of overlap between the scales (Archer et al., 2002, pp.1-2).

            Specific Ethical and Legal Issues. It has been indicated that psychologists using the MMPI-A must adhere to ethical guidelines governing both psychological assessment and professional practice with minors. The “Ethical Principles of Psychologists and Code of Conduct” notes that users of psychological assessment devices must have appropriate training and expertise. The manual of the MMPI-A indicates that competent use of the MMPI-A requires knowledge of psychopathology and diagnosis, adolescent development and personality, and psychometric principles and concepts, as well as mastery of the MMPI-A’s content and structure. Although technicians may administer and score the MMPI-A, they must be thoroughly trained and closely supervised by qualified psychologists. The ethics code of the American Psychological Association also requires discussion with adolescents and their parents or guardians of the limits of confidentiality, the purpose of the assessment, how assessment results will be used, and the extent to which feedback will be provided and to whom. These issues become especially complex in forensic settings, where assessment may be ordered by the court (Hersen, 2004, p.219). In relation to its use in forensics, ethical and legal issue involves evaluating adolescents in civil cases rests on its ability to provide an overview of the plaintiff’s psychological or emotional functioning in reference to well-established adolescent norms (Archer, 2006, p.70).

 

Description of the Use of the Test in Own Setting

            Purpose. In the hospital setting, the purpose of the MMPI-A is to provide appropriate diagnosis and treatment to clients, particularly to the adolescents concerned with by the test. It also allows understanding of the issues and problems experienced or faced by the adolescents in the family, community, and society. Another objective or purpose of the use of MMPI-A is to provide relevant solutions for the problems of the adolescents, thus, helping them avoid or prevent severity of their psychological, emotional, and social problems.

            Benefits/Usefulness. One of the benefits of using the MMPI-A is to obtain more knowledge about the practice, thus, enabling medical practitioners to have develop more skills in the area. Another benefit is exposure to different cases, thus, having more references for future applications. The use of the test also provides more accurate and more relevant procedures for better diagnosis and treatment. Lastly, better medical practice can be developed through using the test.

            Challenges. The lack of cooperation and communication among the staff and the clients is one challenge. The lack of knowledge in the administration and the use of the results of the test are also considered. The lack of priority in using the test and the lack of recognition of its importance and implications are also challenges.

            How Results would be Used. Results would be used for additional researches. They can also be used for better treatment of the adolescents. The results can be used to provide better analysis of the problems of the adolescents in the community, thus, giving them useful and relevant options as solutions.

 

Conclusion

            Based on the discussion, it can be deduced that the use of MMPI-A is relevant and significant in the field of psychology, particularly in relation to clinical, legal, and psychological applications. The different details regarding the test were provided, including the major descriptions, validity, reliability, standardization, strengths and weaknesses, and its practical applications in the medical field. In addition, the historical background was specified in the beginning of the discussion in order to provide a background of the test. The different uses of the test were also identified, thus, emphasizing its practicality and applicability in different fields.

            In terms of its future applications, I believe that due to the rich sources and researches to support it, more and more applications can be thought of and proven in relation to the use of MMPI-A. In addition, the many uses and benefits of using the test serve to be the basis for its continued use in the clinical, legal, and psychological field. In the future, it can be perceived that more fields would be using the MMPI-A, such as education, sociology, politics, and economy. Furthermore, future applications of the test may also involve its further modification, which would help its users in terms of better application and results. Thus, it can be suggested that in addressing its limitations or weaknesses, the use of the test would be far more relevant and applicable in the present situation of the community and society, particularly in helping the society address the problems that concern the welfare of the adolescents.    

 

References

American Psychiatric Association. (2000). Task Force for the Handbook of Psychiatric Measures. Handbook of Psychiatric Measures, 1st ed. USA: American Psychiatric Association.

Archer, R.P. (2006). Forensic Uses of Clinical Assessment Instruments. New Jersey: Lawrence Erlbaum Associates, Inc.

Archer, R.P. (2005). MMPI-A: Assessing Adolescent Psychopathology, 3rd ed. Mahwah, New Jersey: Lawrence Erlbaum Associates, Inc.

Archer, R.P., Bolinskey, P.K, Morton, T.L. and Farris, K.L. (2002). A Factor Structure for the MMPI-A: Replication with Male Delinquents. Assessment, 9(4): 319-326.

Archer, R.P., Handel, R.W. and Lynch, K.D. (2001). The Effectiveness of MMPI-A Items in Discriminating Between Normative and Clinical Samples. Journal of Personality Assessment, 77(3): 420-435.

Forbey, J.D., Ben-Porath, Y.S. and Davis, D.L. (2000). A Comparison of Sexually Abused and Non-Sexually Abused Adolescents in a Clinical Treatment Facility using the MMPI-A. Child Abuse & Neglect, 24(4), 557-568.

Groth-Marnat, G. (2003). Handbook of Psychological Assessment, 4th ed. New Jersey: John Wiley & Sons, Inc.

Hand, C.G., Archer, R.P., Handel, R.W. and Forbey, J.D. (2007). The Classification Accuracy of the Minnesota Multiphasic Personality Inventory-Adolescent: Effects of Modifying the Normative Sample. Assessment, 14(1): 80-85

Hersen, M. (2004). Comprehensive Handbook of Psychological Assessment. New Jersey: John Wiley & Sons, Inc.

Janus, M.D., de Groot, C. and Toepfer, S.M. (1998). The MMPI-A and 13-Year-Old Inpatients: How Young is Too Young?. Assessment, 5(4): 321-332.

Karp, C.L. and Karp, L. (2008). General Information on the MMPI. Retrieved May 15, 2008, from http://www.deltabravo.net/custody/mmpi-info.php.

Reynolds, C.R. and Kamphaus, R.W. (2003). Handbook of Psychological and Educational Assessment of Children: Personality, Behavior, and Context, 2nd ed. New York: The Guilford Press.

 

 

 

 

 

         

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