An Examination of the Treatment Utility of the MMPI-2-RF: Prediction of Post-Treatment Depressive Symptoms and Increased Understanding of the Therapeutic Alliance in an Inpatient Mood Disorder Treatment

The study examined the ability of Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) substantive scales to predict depressive symptoms in a psychiatric inpatient setting. The indirect effect of patient-rated alliance with their treatment team on these relationships was also investigated. Participants included 678 (52.5% female, 97.1% White) inpatients diagnosed with a mood disorder. MMPI-2-RF scales, Patient Health Questionnaire (PHQ-9) at intake and discharge, and Working Alliance Inventory-Short at discharge were used to test study hypotheses regarding MMPI-2-RF predictive utility and the influence of alliance. Jacobson and Truax's (1991) reliable change index (RCI) was calculated to identify those who did (74% of the sample) and did not (24%) make reliable and clinically significant depressive symptom change, and the predictive utility of MMPI-2-RF scores in distinguishing these groups was examined. MMPI-2-RF scales assessing internalizing and somatic dysfunction accounted for an additional 2% to 8% of the variance in depressive symptoms reported at discharge, above and beyond depressive symptoms reported at intake. Somatic scales were also able to differentiate groups based on clinically significant change on the PHQ-9 (small-sized effect). The relationship between MMPI-2-RF scales and depressive symptoms at discharge was indirect through alliance in 64% of models. Clinical implications are discussed.

Associations among eating disorder symptoms and the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in college students

PURPOSE

To identify associations between eating disorder (ED) attitudes and behaviors and scores on the MMPI-2-RF in college students.

METHODS

The study included 425 undergraduate students (38.5% males and 61.5% females) with a mean age of 19.13 (SD = 1.77). Measures included the MMPI-2-RF and the Eating Disorder Examination Questionnaire. Correlations and relative risk ratios were computed between MMPI-2-RF scores and ED variables.

RESULTS

Scores on several MMPI-2-RF Scales were associated with the presence of subthreshold ED symptoms. Manifestations of emotional/internalizing dysfunction were associated with all ED symptom presentations.

CONCLUSIONS

The results of this study identified narrowly defined personality and psychopathology constructs relevant to, and found across college students experiencing various subthreshold ED symptoms. Considering this additional information in ED screening or treatment planning could reduce the likelihood of subthreshold symptoms worsening and increase the effectiveness of ED interventions with at-risk college student populations.

LEVEL OF EVIDENCE

Level III, evidence obtained from well-designed cohort or case-control analytic studies.

Clinical Utility of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in a Residential Treatment Program for Homeless Individuals

The current study examined the clinical utility of the Restructured Form of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2-RF) in a residential treatment program for homeless individuals. MMPI-2-RF scale scores from 146 participants with valid profiles were correlated with variables obtained at intake and during treatment. The sample was then followed 12 months postdischarge to test preregistered hypotheses regarding MMPI-2-RF predictors of hospital readmissions. The results indicated that a variety of MMPI-2-RF scale scores were correlated with historical and diagnostic variables at intake and with measures of treatment outcome, including behavioral problems and successful outcome. A broad range of MMPI-2-RF scale scores were related to readmissions postdischarge and many of these relationships remained significant when tested in Poisson regression models containing other predictors. However, the postdischarge findings were generally inconsistent with our predictions and were of small effect size. The clinical implications of MMPI-2-RF results for residential treatment programs are discussed.

The Relationship of MMPI-2-RF Scales to Treatment Engagement and Alliance

Clients' personality characteristics can be important correlates of treatment engagement and alliance. The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) is one of the most comprehensive and widely used personality measures in clinical settings and includes measures of symptom validity. A few prior studies using the MMPI-2 and MMPI-2-RF suggest that externalizing characteristics and the validity scales might be associated with treatment engagement, but no studies to date have examined MMPI correlates of treatment alliance. This study examined the relationship of MMPI-2-RF scales to treatment engagement and alliance in 134 individuals seeking outpatient treatment at a psychology department training clinic. It was predicted that validity scales and externalizing scales would be related to treatment engagement (premature termination, no-show rate) and to alliance. Contrary to expectations, MMPI-2-RF validity scales were not related to premature termination but high scores on F-r were related to higher no-show rates and high scores on Symptom Validity (FBS-r) were related to lower alliance. As predicted, higher scores on scales assessing externalizing psychopathology were related to premature termination and higher no-show rate. Exploratory analyses also suggested higher scores on somatic and interpersonal scales were related to lower alliance. Accuracy statistics using clinical cutoffs on MMPI scales are provided.

Predicting therapist ratings of treatment progress and outcomes with the MMPI-2-RF

OBJECTIVE

We examined the ability of scores on the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) scales to predict treatment progress (compliance and activity in therapy) and outcome at termination (success in therapy, readiness for termination, and functioning at termination).

METHOD

Our sample included 448 (185 males, 263 females) community mental health center outpatients with an average age of 32.2 years (standard deviation = 10.2). We used MMPI-2-RF (self-report) indicators of personality and psychopathology and a composite outcome variable that represents therapist ratings of clients' treatment progress and outcomes.

RESULTS

Scores on several MMPI-2-RF scales were correlated and associated with increased risk for poorer psychotherapy progress and outcomes in a mental health outpatient sample.

CONCLUSIONS

Clinicians can utilize the MMPI-2-RF to identify clients at risk for therapy process challenges and adverse outcomes, suggesting possible problem areas for intervention.

The MMPI-2-Restructured Form (MMPI-2-RF): Assessment of Personality and Psychopathology in the Twenty-First Century

This article describes the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and situates the instrument in contemporary psychopathology and personality literature. The historical evolution of the MMPI instruments is highlighted, including how failure to update the test for several decades resulted in increasing disinterest by basic researchers and how the restructuring efforts beginning in the 2000s promised to realign the instrument with basic research. In this regard, the construct validity associated with MMPI-2-RF scores in the context of contemporary dimensional models of psychopathology is considered. Research supporting the applied utility of the MMPI-2-RF scales in a variety of contexts-including mental health screenings, presurgical evaluations, forensic assessment, and public safety screening-is also reviewed. Critiques of the MMPI-2-RF are described and addressed. Finally, a series of recommendations for future updates of the MMPI-2-RF are described along with a path toward the MMPI-3.

Validity of a Novel Touch Screen Tablet-Based Assessment for Mild Cognitive Impairment and Probable AD in Older Adults

This study aimed to develop a psychometrically valid touch screen tablet-based cognitive test battery to identify early cognitive impairment due to dementia in older adults. The battery includes eight tests with 13 subscores, evaluating visual attention, auditory attention, information processing speed, visual memory, motor control, and visuospatial perception. Among the participants, 43 had been diagnosed with mild cognitive impairment (MCI) and 36 with probable Alzheimer’s disease (AD); 41 had no cognitive impairment. The average time to administer the tablet-based tests was 10 minutes. Significant correlations with the Mini-Mental State Examination were found in 9 out of 13 subscores. Patients with probable AD scored significantly lower than controls in 8 out of 13 subscores, whereas those with MCI scored significantly lower in 4 out of 13 subscores. Confirmatory factor analysis using Promax rotation showed that four factors caused lower subscores in the MCI group compared with the controls: information processing speed, memory, visuospatial perception, and motor control. All four factors significantly discriminated the controls from the MCI and probable AD groups, and in the expected direction. The touch screen tablet-based cognitive test battery is psychometrically valid for evaluating cognition in older adults.

Examination of MMPI-2-RF Substantive Scales as Indicators of Acute Suicidal Affective Disturbance Components

A new suicide-specific diagnostic entity, acute suicidal affective disturbance (ASAD), was recently proposed to fill a void in the nomenclature. Although several studies have examined the reliability, validity, and potential clinical utility of ASAD, no studies have examined personality indicators of ASAD. This study sought to examine the association between personality and psychopathology factors, as assessed by the Minnesota Multiphasic Personality Inventory-2-Revised Form (MMPI-2-RF), and constructs that comprise ASAD in a sample of 554 psychiatric outpatients who completed all measures prior to their intake appointments. A smaller subset of patients (N = 58) also completed a measure designed to assess lifetime ASAD symptoms. Results indicated that ASAD symptoms were associated with traits characterized by emotional turmoil and atypical cognitive processes. Further, suicide-related criteria that comprise ASAD were related to low positive emotionality and hopelessness, whereas the overarousal criteria were associated with somatic symptoms and an inability to tolerate frustration and stress. These findings expand on previous research that examines the convergent and discriminant validity of ASAD and could inform clinical treatment by providing insight into personality traits that might be associated with acute suicide risk.