Comparison of clients' standard, exaggerated, and matching MMPI profiles

A Literature Review of Subtle-Obvious Items on the MMPI

This article chronologically reviews the literature relating to subtle and obvious items of the Minnesota Multiphasic Personality Inventory. Wiener's original development of subtle and obvious subscales, Seeman's support for the concept of subtlety, and Duffs arguments concerning empirical versus face validity are discussed. Later research exploring demand characteristics are then reviewed, such as the paradoxical relationships under differing instruction sets and population issues. The work from Auburn University researchers on the development of a 5-point subtlety scale, the interaction with personality factors, and individual scale research is critiqued.

Validity of the MMPI subtle items

This article presents a review and critique of research on the Minnesota Multiphasic Personality Inventory (MMPI) subtle items in regard to their validity as measures of their scales' characteristics. The main categories of focus are their convergent and discriminative validity, the paradoxical effect, and the issue of whether removing these items would improve MMPI validity. Important problems in the methodologies are noted and discussed in some detail. These methodological concerns and the conflicting results across studies obscure firm conclusions on the validity of the subtle items, although strong support is lacking. However, more evidence is needed before deciding to remove these items from the MMPI; therefore, this article provides recommendations for future research.

MMPI discriminators of deficit vs. non-deficit recent-onset schizophrenia patients

Seventy-four patients with a recent initial onset of schizophrenia were studied during an inpatient hospitalization for a recent onset of schizophrenia as well as during a 12-month period of outpatient treatment as part of a large longitudinal study at UCLA. The Proxy for the Deficit Syndrome (PDS; Kirkpatrick, B., Buchanan, R.W., Carpenter, W.T., 1993. Case identification and stability of the deficit syndrome of schizophrenia. Psychiatry Research 47, 47-56.) was calculated based on psychiatric symptoms rated on the Brief Psychiatric Rating Scale every 2 weeks throughout the 12 months. The Minnesota Multiphasic Personality Inventory (MMPI) was administered to the schizophrenia patients at the index hospitalization. The 168-item version of the MMPI (MMPI-168) was administered at the baseline point of the 12-month period of outpatient treatment, and again 1 year later. Normal comparison subjects were tested with the MMPI or MMPI-168 at comparable time intervals. The UCLA Social Attainment Scale, a measure of the adequacy of social functioning and relatedness, was examined at the outpatient baseline and 12-month points. During the outpatient period, the Deficit Schizophrenia group (i.e. schizophrenia patients with high 12-month average PDS scores) had lower T-scores than the Non-deficit Schizophrenia group on several MMPI-168 scales, especially scales related to affective distress and anxiety. The MMPI-168 scores of normal subjects were generally the lowest of the three groups, but not always significantly lower than those of the Deficit Schizophrenia group. Social functioning at the end of the 12-month period was worst for the patient group with high deficit (PDS) scores. The findings are congruent with the concept of a Deficit Syndrome for which the PDS is the proxy.

Heritability of MMPI Harris-Lingoes and Subtle-Obvious subscales in twins reared apart

A large sample of identical and fraternal twins who had been reared apart was used to examine the genetic and environmental architecture of the MMPI Subtle-Obvious and Harris-Lingoes subscales. Univariate genetic analyses indicated significant heritability for all 28 of the Harris-Lingoes subscales (estimates ranged from.23 to.61), all five Obvious subscales (estimates ranged from.37 to.56) and four of the five Subtle subscales (estimates ranged from.27 to.35). Two randomly constructed scales were analyzed as controls; neither of these scales showed significant heritability. Exploratory correlational findings suggested that three of the Wiener-Harmon Subtle subscales may tap aspects of psychological health, naivete, or repression. Ma-S may come closest to Wiener and Harmon s intent. Although they apparently diverge from their original purpose, it may be too early to abandon the low face valid items of the Subtle subscales.

The effects of description clarity and disorder type on MMPI-2 FAKE-BAD validity indices

Simulation research indicates that the MMPI-2 validity scales easily detect faked-bad profiles that follow vague, but not specific, instructions. The present study compared the fake-bad validity scales (i.e., F, F-Back, F-K, Fake-Bad Scale, critical items, and O-S scales) for differences among one authentic and four simulation (fake-bad) groups. The simulation groups differed according to the type of disorder simulated (neurotic or psychotic) and the clarity of the behavioral descriptions they received (clear or unclear descriptions). Results indicated that the validity scales together could discriminate (a) clear from unclear description profiles; (b) neurotic from psychotic simulation profiles; and (c) authentic from simulated profiles. Actuarial analyses indicated that participants given clear character descriptions were more likely to escape detection than were participants given unclear character descriptions. Future research on incentive and punishment is considered.

Development of a three-scale MMPI: the MMPI-TRI

A 60-item short form of the MMPI with very high content validity and items that appear on both the MMPI and MMPI-2 was developed and named the MMPI-TRI. It contains three 20-item scales--the Subjective Distress, Acting-Out, and Psychosis scales. These three scales have excellent internal consistency and sufficient independence from each other. An anxiety and depression group of patients, prison inmate group, and a schizophrenic and other psychotic group had the highest mean scores on Subjective Distress, Acting-Out, and Psychosis, respectively. Correlations with the 13 regular scales of the MMPI and MMPI-2, their content and supplementary scales, and four other psychometric instruments provided very strong evidence for validity. Norms are provided.

MMPI-2 Normative Data for the F-K Index: Implications for Clinical, Neuropsychological, and Forensic Practice

The F-K index has long been used as a validity indicator with the MMPI to help identify subjects who may be over- or underreporting psychological problems. The revision of the MMPI necessitates the collection of new norms and development of cutoff scores for the F-K index due to changes in the test itself as well as changes in the way subjects respond to items since the time of the development of the original test. Continuation of the use of old cutoff scores and clinical lore may lead to erroneous conclusions and decisions in the clinical and forensic arenas in which the index is used. MMPI-2 norms for the F-K index are provided for the standardization sample, and additional data are presented for samples of psychiatric patients, head injured patients, individuals seeking disability benefits, job applicants for police and priest positions, and substance abusers. Implications for use of the tables for interpretation of F-K scores are discussed.

The evaluation of truthfulness in alleged sex offenders' self-reports: 16PF and MMPI validity scales

The evaluation of response bias (i.e., minimization or exaggeration) is central to forensic psychological evaluations. Yet few studies have assessed forensic samples to investigate the ability of psychological tests to detect response bias. We studied the relationship between the Sixteen Personality Factors Questionnaire (16PF) and the Minnesota Multiphasic Personality Inventory (MMPI) validity scales for 65 alleged sex offenders and assessed the effects of different cutoff scores for the 16PF validity scales. Results indicate consistent significant correlations between the validity scales of the 16PF and the MMPI for measures of minimization and exaggeration. use of a priori cutoff scores resulted in the classification of our sample in proportions parallel to those found in previous research for the 16PF Fake-Good scale but not the Fake-Bad scale. Our results indicate that 16PF validity scales are useful, but interpretations must take into account different base rates of response bias between sex offenders and the general population.

Efficacy of MMPI-2 validity scales and MCMI-II modifier scales for detecting spurious PTSD claims: F, F-K, Fake Bad Scale, ego strength, subtle-obvious subscales, DIS, and DEB

This study compared 119 personal injury claimants' scores on MMPI-2 and MCMI-II malingering scales. Data from 55 pseudo-PTSD patients and 64 controls confirm the utility of the scales examined. The following cut-offs were most effective for identifying spurious PTSD: F greater than 62, F-K = greater than -4, Es = greater than 30, FBS = greater than 24 (men), FBS = greater than 26 (women), total obvious minus subtle = greater than 90, DIS = greater than 60, and DEB = greater than 60. Pseudo-PTSD patients were those who (1) claimed to be suffering a psychological injury (2) that was so severe that it was disabling (3) due to an experience that was entirely implausible as a candidate for PTSD criterion A in DSM-III-R and (4) scored T = 65 or higher on both PK and PS, the post-traumatic stress disorder subscales of the MMPI-2.

A Fake Bad Scale on the MMPI-2 for personal injury claimants

This paper presents a scale for using the Minnesota Multiphasic Personality Inventory-2 for the detection of malingerers in personal injury claims. Data are reported for personal injury claimants and for medical outpatients simulating emotional distress caused by motor vehicle accidents, industrial stress, and toxic exposure. Criterion problems are discussed. The answers and scored directions are presented in an appendix to the paper.

A limitation of using the Wiener and Harmon obvious and subtle scales to detect faking on the MMPI

More frequent endorsement of obvious than subtle items on the MMPI has been advocated as a strategy to detect negative response bias. An assumption of this strategy is that faking is correlated differentially with obvious and subtle items, whereas psychopathology is not. In order to evaluate this assumption, MMPI profiles were obtained from the records of 375 psychiatric inpatients. Analysis revealed a strong positive correlation between profile elevation and obvious minus subtle differences. Excluding MMPIs of questionable validity did not weaken this relationship. The high correlation between clinical scale elevation and obvious minus subtle differences in valid profiles complicates the use of this strategy to detect intentional exaggeration of psychopathology.

The detection of malingering in neuropsychological assessment

Although malingering, or the manipulation of data by the patient, is a problem commonly faced by neuropsychologists, there has been little systematic investigation of this problem. This paper reviews the literature on the detection of malingering in assessment instruments commonly used by clinical neuropsychologists. Criticism of previous research is discussed, and suggestions are made both for future research and for clinical practice.

MMPI profiles of malingerers diagnosed in pretrial forensic evaluations

The MMPI has several indices associated with exaggeration of symptomatology, but they have seldom been researched with actual malingering subjects. Based upon interview behavior during pretrial forensic evaluations, samples of malingering (n = 18), psychotic (n = 17), and nonpsychotic (n = 36) criminal defendants were assembled for the present study. Both the malingerers and the psychotics either were untestable or produced incomplete or random MMPIs in about 50% of the cases. Comparisons of remaining profiles revealed significant differences between malingerers and other groups on several MMPI scales and F-K index. Discriminant analysis accurately classified malingerers and psychotics on the basis of MMPI variables. The MMPI may have considerable utility to detect malingering when subjects cooperate with testing.

The utility of MMPI subtle, obvious scales for detecting fake good and fake bad response sets

The MMPI was administered twice to 40 graduate students to determine the utility of the Weiner subtle and obvious scales (D, HY, PD, PA, MA) for estimating how fake good and fake bad response sets might influence full scale scores. The first time, the MMPI was administered under standard conditions. Subjects then were divided randomly into two groups: fake good (complete MMPI for job application) and fake bad (qualify for psychotherapy). There were significant multivariate test effects (standard vs. response set) for the raw scores of all five obvious, subtle, and full scales. However, when raw scores were converted to T scores to ascertain practical significance, the obvious scales appeared to provide the most useful information to enhance the interpretation of full scale scores in normal populations.

MMPI F-K index among hospitalized Vietnam veterans

The F-K index of the MMPI has been used as a marker of symptom overreporting. One population for which previous research has shown this pattern is Vietnam in-country veterans with PTSD. This study assessed the F-K index on 515 inpatients: 329 Vietnam in-country and 186 Vietnam-era patients. Normative data on psychiatric inpatients were presented. Also, a special MMPI subscale (MMPI-PTSD), a measure to identify PTSD among these veterans, was used. Results showed that all Vietnam veterans, especially in-country veterans, overreport symptoms to a high degree. The overall mean for in-country vets was 7.3. Also, when the special MMPI-PTSD subscale was used, a vast majority of in-country veterans who were in the PTSD range had high F-K index scores. Dissimulation as a symptom of PTSD was discussed.

Assessing dissimulation and denial on the MMPI in a sample of maximum security, male inmates

Comparisons were made between three groups of maximum security inmates thought to possess varying degrees of motivation to either exaggerate or suppress psychiatric symptomatology in their Minnesota Multiphasic Personality Inventory (MMPI) self-report. A group of individuals requesting single-cell placement (the group hypothesized to be motivated to exaggerate symptomatology) were found to score significantly higher on Scale F, the F-K Index, and a number of special MMPI scales (i.e., D-O, Hy-O, Pd-O, Pa-O, Ma-O, Dissimulation Scale, total number of Obvious Items, O:S Ratio) and significantly lower on scales K, Hy-S, Ma-S, and the total number of Subtle items relative to inmates undergoing parole evaluations (denial condition) or entering group therapy (neutral condition). Differences between the parole and group therapy conditions were relatively small, with only D-O, Hy-O, and the Dissimulation Scale producing statistically significant results. These findings tend to support use of the MMPI in assessing a respondent's test-taking attitude, particularly in cases where the subject is attempting to exaggerate psychiatric symptomatology.

A psychometric study of stereotypes: assessment of malingering in a criminal forensic group

This research investigates the validity of the stereotype of insanity defendants as malingerers by analyzing the proportions of insanity defendants who exaggerate psychopathology at the pre- and postacquittal stages of the legal process and by assessing the severity of psychopathology among preacquittal defendants. We administered the Minnesota Multiphasic Personality Inventory (MMPI) to 49 insanity defendants evaluated for fitness to stand trial and/or sanity at the time of the alleged crime and to 52 subjects previously found not guilty by reason of insanity. Results indicated: (a) Contrary to the stereotype, a minority (14% to 41%) of insanity defendants clearly malingered, whereas 22% to 39% showed evidence of minimizing psychopathology. (b) Eighty-one percent of these subjects had MMPI profiles suggestive of psychosis, but relatively few showed evidence of primarily antisocial behavior. Thus, the malingering stereotype may be application to only a minority of insanity defendants and is specifically inapplicable to a substantial proportion who minimized psychopathology or showed evidence of psychosis consistent with the claim of insanity.

The detection of malingering in criminal forensic groups: MMPI validity scales

Despite the value of the MMPI to the forensic assessment of malingering (exaggeration) of psychopathology, few studies have assessed the accuracy of the MMPI validity scales in criminal forensic populations. We administered the MMPI to 35 insanity defendants undergoing evaluation for fitness to stand trial and/or sanity at the time of the crime, who stood to benefit from being assessed as psychologically disturbed, and 39 subjects previously found not guilty by reason of insanity (NGRI), who did not stand to gain from such an assessment, Insanity defendants showed significantly more malingering than NGRI subjects, p less than .05. Racial differences did not affect the data. These findings support the efficacy of MMPI validity scales in assessing malingering within criminal forensic groups, and support the generalizability of the scales across race.

Performance of psychiatric inpatients and intellectually deficient individuals on a task that assesses the validity of memory complaints

A brief psychological screening test, devised by Rey (1964), was developed to assess the validity of memory complaints. Although Rey hypothesized that malingerers would be mislead to perform poorly while even individuals with severe concentration problems could succeed, a review of the literature did not reveal any empirical reports that examined the actual performance of nonmalingering though disturbed patients. Therefore, Rey's test was administered to samples of acutely disturbed psychiatric patients (N = 50) and intellectually deficient individuals (N = 16). The results confirmed the criterion proposed by Lezak (1983) and suggested that malingering should be considered among individuals who deny remembering at least 9 of the 15 times of the Rey test.

MMPI item subtlety research: current issues and directions

This article examines the methodology from recent item subtlety research with the Minnesota Multiphasic Personality Inventory (MMPI). The Christian, Burkhart, and Gynther (1978) ratings, used in this research, define item subtlety as the perceived degree of psychopathology associated with individual items rather than specifying subtlety in relation to qualities characteristic of individual scales. Consequently, the ratings often violate commonsense notions of subtlety, and the results of research with the ratings are difficult to interpret. Studies with the ratings also contain procedural defects which limit generality. It is recommended that future investigators give greater consideration to the operational definition of item subtlety, to the intended applications of the MMPI, and to item properties other than simple correlations with criteria that can enhance the predictive and discriminative powers of MMPI scales.

The validity of MMPI subtle and obvious items in psychiatric patients

This study was designed to assess the validity of four clinical scales with and without subtle items; and the relative validity of obvious and subtle items. Criteria were questionnaire, mental status, diagnostic, and drug treatment measures; subjects were 73 psychiatric inpatients. Across criteria, the results indicated that the validity of the full scales was not improved by the removal of subtle items; and with the exception of the PD scale, subtle items generally were found to be of similar convergent validity and possibly superior discriminant validity. These findings have implications for psychometric theory and test construction strategies.

Item subtletly and faking on the MMPI: a paradoxical relationship

The X-zero distinction has been used as the operational definition of MMPI item subtlety in previous research. A consistent finding has been that the X items, which are obvious in terms of pathological content, can be faked whereas the more subtle zero items cannot be faked. The present study examined the relationship between instructional sets and endorsement patterns, using a more refined, comprehensive measure of item subtlety. Sixty (30 male, 30 female) subjects completed two MMPI protocols, one under a standard instructional set and the other under either a fake-good or fake-bad response set. Order of administration and sex were counterbalanced. In general, the findings for the sublte-obvious dimension paralleled the previous findings with the X-zero distinction. Endorsement of obvious items was a direct function of instructional set, whereas endorsement of sublte items was inversely related to instructional set. Because subtle items did not appear to measure the constructs for which they had been originally intended, other uses for subtle items were discussed.

An external criterion study of the MMPI validity indices

Two hundred and twenty-eight veterans who requested either inpatient or outpatient treatment at a VA Hospital were administered an MMPI and a structured mental status examination (the CAPPS) to determine whether MMPI validity indicators would be useful in the prediction of dissimulation during a structured interview. Statistically significant relationships were found between both F and F-K and ratings of "fake bad" interview behavior. However, the authors point out that the rather small correlations discovered are of little practical utility in the prediction of dissimulation during structured interviews, especially when consideration is given to the amount of time and effort expended to administer and score the MMPI.