MCMI-IIIMCMI-III

Interpretation and Interpretation and ReportingReporting

Issues Related to InterpretationIssues Related to Interpretation

GenderGender EthnicityEthnicity AgeAge Code typesCode types

Scale ElevationScale Elevation Personality Patterns:Personality Patterns:

– 70 - 74 - likely to possess 70 - 74 - likely to possess traits of the constructtraits of the construct– BR 75-84 - clinically BR 75-84 - clinically significant personalitysignificant personality traitstraits– BR 85 + - Personality BR 85 + - Personality disorderdisorder

Clinical Syndromes:Clinical Syndromes:– 60 - 74 - likely to possess 60 - 74 - likely to possess some symptomssome symptoms of the of the

syndromesyndrome– BR 75-84 - BR 75-84 - presence presence of a syndromeof a syndrome– BR 85+ - BR 85+ - prominence prominence of syndromeof syndrome

Level of adjustmentLevel of adjustment

How many scales are elevated above How many scales are elevated above 75?75?

The higher the elevation, the more The higher the elevation, the more the dysfunction - in generalthe dysfunction - in general– Narcissistic, Histrionic, Compulsive Narcissistic, Histrionic, Compulsive

Scales can show strengths of pathologyScales can show strengths of pathologymodest levels are healthy modest levels are healthy

Look at Modifying IndicesLook at Modifying Indices

Formulating diagnosesFormulating diagnoses

Look at elevationLook at elevation Look at contextual information Look at contextual information

including clinical impressionsincluding clinical impressions Look at prototypal itemsLook at prototypal items

Steps in InterpretationSteps in Interpretation

1. Determine profile validity1. Determine profile validity

2. Interpret the Personality Disorder Scales2. Interpret the Personality Disorder Scales

3. Interpret Clinical Syndrome Scales3. Interpret Clinical Syndrome Scales

4. Review noteworthy responses4. Review noteworthy responses

5. Provide diagnostic impressions5. Provide diagnostic impressions

6. Write a personality description6. Write a personality description

7. 7. Treatment implications and Treatment implications and

recommendationsrecommendations

1. Determine Profile Validity1. Determine Profile Validity Scale V (Validity Index)Scale V (Validity Index)

– Items 65, 110, 157Items 65, 110, 157– 2 or more true responses - invalid profile2 or more true responses - invalid profile– 1 true response - “questionable validity”1 true response - “questionable validity”

Scale X (Disclosure Index)Scale X (Disclosure Index)– If raw score is below 34 - invalid and If raw score is below 34 - invalid and

defensive underreportingdefensive underreporting– If raw score is above 178 - invalid and If raw score is above 178 - invalid and

exaggeration of symptomsexaggeration of symptoms

1. Determine Profile Validity1. Determine Profile Validity Scale Y - (Desirability Index)Scale Y - (Desirability Index)

– Measure of defensive respondingMeasure of defensive responding– BR above 75 (not necessarily invalid) indicates BR above 75 (not necessarily invalid) indicates

presenting self in an overly positive, moral, emotionally presenting self in an overly positive, moral, emotionally stable, gregarious manner - “faking good”stable, gregarious manner - “faking good”

– the higher the score, the more the person is concealingthe higher the score, the more the person is concealing

Scale Z (Debasement Index)Scale Z (Debasement Index)– Opposite from Desirability IndexOpposite from Desirability Index– BR above 75 - self description is negative, BR above 75 - self description is negative,

pathologicalpathological– Above 85 - could be a cry for helpAbove 85 - could be a cry for help

2. Interpret Personality Disorder Scales2. Interpret Personality Disorder Scales

1.1. Check elevations on Severe Personality Check elevations on Severe Personality DisordersDisorders

– Primary focus for diagnosisPrimary focus for diagnosis

2.2. Check elevations on Clinical Personality ScalesCheck elevations on Clinical Personality Scales— Clinical Personality Scales serve to color or elaborate Clinical Personality Scales serve to color or elaborate

on Severe Personality Pattern elevations (unless on Severe Personality Pattern elevations (unless extremely elevated compared with severe scales)extremely elevated compared with severe scales)

3.3. Guidelines 75-84 = patterns/traitsGuidelines 75-84 = patterns/traits 85+ = disorder 85+ = disorder

Severe Personality PathologySevere Personality PathologyScale S (Schizotypal)Scale S (Schizotypal)

Like DSM IV Schizotypal personality disorderLike DSM IV Schizotypal personality disorder Cognitively dysfunctional Cognitively dysfunctional Interpersonally detached, prefers social isolationInterpersonally detached, prefers social isolation Appear self-absorbed and ruminativeAppear self-absorbed and ruminative Behaviorally eccentric and perceived by others as Behaviorally eccentric and perceived by others as

strange or differentstrange or different Communication style – tangential, personal Communication style – tangential, personal

irrelevancies and magical associationsirrelevancies and magical associations Some are detached and emotionally bland others are Some are detached and emotionally bland others are

more suspicious, anxious and apprehensivemore suspicious, anxious and apprehensive Prognosis is poorPrognosis is poor May need medicationMay need medication

FREQUENT CODE TYPES: Clinical: PP, SS; FREQUENT CODE TYPES: Clinical: PP, SS; Personality: 1, 2A, PPersonality: 1, 2A, P

Scale C (Borderline)Scale C (Borderline) Unstable moods and behaviorUnstable moods and behavior Can be self-destructive, self-mutilationCan be self-destructive, self-mutilation Marked mood swings, intermittent periods of depression, Marked mood swings, intermittent periods of depression,

generalized anxiety and intense emotional attacks on generalized anxiety and intense emotional attacks on othersothers

Interpersonal difficulties – ambivalence, instability and Interpersonal difficulties – ambivalence, instability and intensityintensity

React strongly to fears of abandonmentReact strongly to fears of abandonment Idealizes and devalues othersIdealizes and devalues others Poorly defined sense of selfPoorly defined sense of self Feelings of emptiness Feelings of emptiness Disorganized thoughts - may have psychotic episodes Disorganized thoughts - may have psychotic episodes

under stressunder stress At risk for depression and suicideAt risk for depression and suicide

FREQUENT CODE TYPES: Clinical: N,D, B,T; FREQUENT CODE TYPES: Clinical: N,D, B,T; Exaggerations of less dysfunctional personality Exaggerations of less dysfunctional personality disorders: 3,4,5,8A, 8Bdisorders: 3,4,5,8A, 8B

Scale P (Paranoid)Scale P (Paranoid) Suspiciousness and defensiveness with othersSuspiciousness and defensiveness with others Feelings of superiorityFeelings of superiority Vigilant to criticism and deceitVigilant to criticism and deceit Abrasive, touchy, hostile and irritableAbrasive, touchy, hostile and irritable Externalizes blameExternalizes blame Describe self as misunderstood, righteous, suspicious, Describe self as misunderstood, righteous, suspicious,

mistreated and defensivemistreated and defensive Will attack and humiliate those they feel are trying to control Will attack and humiliate those they feel are trying to control

or influence themor influence them May have delusions of grandeur, ideas of reference, intense May have delusions of grandeur, ideas of reference, intense

fears of being persecuted (psychotic delusions may be fears of being persecuted (psychotic delusions may be present)present)

FREQUENT CODE TYPES: Clinical symptoms: A, PP,SS FREQUENT CODE TYPES: Clinical symptoms: A, PP,SS Personality Scales: 2A, 5, 6B, 8APersonality Scales: 2A, 5, 6B, 8A

Clinical Personality PatternsClinical Personality Patterns Scale 1(Schizoid)Scale 1(Schizoid)

– Little or no interest in othersLittle or no interest in others– Detached, impersonal, withdrawnDetached, impersonal, withdrawn– Peripheral role in family, work, social situationsPeripheral role in family, work, social situations– Lack of depth to feelingsLack of depth to feelings– Indifferent to praise or criticismIndifferent to praise or criticism– Communication is vague, distant and unfocused Communication is vague, distant and unfocused

(spacey)(spacey)– Not disturbed by much, makes decisions easily, self Not disturbed by much, makes decisions easily, self

sufficientsufficient

– FREQUENT CODE TYPES: Clinical symptoms: A, SS; FREQUENT CODE TYPES: Clinical symptoms: A, SS; Personality Scales: 2A, 3,7,8APersonality Scales: 2A, 3,7,8A

Clinical Personality PatternsClinical Personality Patterns Scale 2A: AvoidantScale 2A: Avoidant

– Want to be involved and accepted by othersWant to be involved and accepted by others– Vigilant to environmentVigilant to environment– Sense of unease, disquiet, anxiety and overreaction to Sense of unease, disquiet, anxiety and overreaction to

minor eventsminor events– Preoccupied with intrusive, fearful and disruptive Preoccupied with intrusive, fearful and disruptive

thoughtsthoughts– Perceive themselves as socially inept, inadequatePerceive themselves as socially inept, inadequate– Feel alone, empty, isolatedFeel alone, empty, isolated– Prone to social phobia and frequently depressedProne to social phobia and frequently depressed– Sensitive to the needs and perspectives of others, Sensitive to the needs and perspectives of others,

compassionate and emotionally responsivecompassionate and emotionally responsive

– FREQUENT CODE TYPES: Clinical: A, D, H; FREQUENT CODE TYPES: Clinical: A, D, H; Personality: 1,3,5, 6A,8A.Personality: 1,3,5, 6A,8A.

Clinical Personality PatternsClinical Personality Patterns Scale 2B: DepressiveScale 2B: Depressive

– Enduring pattern of thoughtsEnduring pattern of thoughts, , attitudes, attitudes, behaviors and self-concepts related to behaviors and self-concepts related to depressiondepression

– Feels worthless, inadequate, guilty, self criticalFeels worthless, inadequate, guilty, self critical– Forlorn, discouraged, hopelessForlorn, discouraged, hopeless– Helpless and immobile in solving life’s Helpless and immobile in solving life’s

problemsproblems– Angry, resentful, pessimistic in relationshipsAngry, resentful, pessimistic in relationships

– FREQUENT CODETYPES: Clinical: D, N FREQUENT CODETYPES: Clinical: D, N Personality: 1,2A,8A,8B,CPersonality: 1,2A,8A,8B,C

Clinical Personality PatternsClinical Personality Patterns Scale 3 (DependentScale 3 (Dependent))

– Feelings of being incapable and incompetent of Feelings of being incapable and incompetent of functioning independentlyfunctioning independently

– Inadequate, insecure, low self-esteemInadequate, insecure, low self-esteem– Submissive and cooperative in relationshipsSubmissive and cooperative in relationships– Agreeable, minimizes problemsAgreeable, minimizes problems– Well-liked because of compliance, values opinion of Well-liked because of compliance, values opinion of

others., defuses conflict, warm tender, loyal in others., defuses conflict, warm tender, loyal in friendshipsfriendships

– FREQUENT CODETYPES: Clinical: A,D,N; FREQUENT CODETYPES: Clinical: A,D,N; Personality: 1, 2A, 4, 7, 8A, 8BPersonality: 1, 2A, 4, 7, 8A, 8B

Clinical Personality PatternsClinical Personality Patterns Scale 4 (Histrionic)Scale 4 (Histrionic) Dramatic, colorful and emotionalDramatic, colorful and emotional Tolerance for boredom is lowTolerance for boredom is low Describe self as active, egocentric, Describe self as active, egocentric,

exhibitionistic, flighty, extroverted, flirtatiousexhibitionistic, flighty, extroverted, flirtatious Charming and outgoing, attention seekingCharming and outgoing, attention seeking Can be loud, demanding and uncontrollableCan be loud, demanding and uncontrollable Strong needs for dependencyStrong needs for dependency Can be warm, emotionally responsive, good Can be warm, emotionally responsive, good

sense of humor, adaptablesense of humor, adaptable Good social adjustment, low levels of distressGood social adjustment, low levels of distress

FREQUENT CODETYPES: Clinical: A, H,B,T; FREQUENT CODETYPES: Clinical: A, H,B,T; Personality: 3,5,6A,7,8A Personality: 3,5,6A,7,8A

Clinical Personality PatternsClinical Personality Patterns Scale 5 (Narcissistic)Scale 5 (Narcissistic) Exaggerated sense of self-importance and competenceExaggerated sense of self-importance and competence Hypersensitive to criticismHypersensitive to criticism Conventional rules of behavior do not applyConventional rules of behavior do not apply Arrogant, haughty, snobbish, conceitedArrogant, haughty, snobbish, conceited Presents as intelligent, sophisticated, outgoing and Presents as intelligent, sophisticated, outgoing and

charmingcharming Lacking in empathyLacking in empathy Potential for substance abuse and depression is high Potential for substance abuse and depression is high Subset will be well adjusted without much emotional Subset will be well adjusted without much emotional

distressdistress

FREQUENT CODETYPES: Clinical: D,N,B,T ; FREQUENT CODETYPES: Clinical: D,N,B,T ; Personality: 2A,3,4,6A,8APersonality: 2A,3,4,6A,8A

Clinical Personality PatternsClinical Personality Patterns Scale 6A (AntisocialScale 6A (Antisocial)) Duplicitous, illegal behavior designed to exploit the Duplicitous, illegal behavior designed to exploit the

environment for self gainenvironment for self gain Impulsive acting-outImpulsive acting-out Provocative, violent, vicious, self-centered, dominantProvocative, violent, vicious, self-centered, dominant Avoids perceived abuse and victimization through their Avoids perceived abuse and victimization through their

behaviorbehavior Ignores consequences of behaviorIgnores consequences of behavior Lack of empathy and remorseLack of empathy and remorse Mistrustful, suspicious, guarded with othersMistrustful, suspicious, guarded with others Can be gracious, charming and friendlyCan be gracious, charming and friendly Alcohol and drug dependence are commonAlcohol and drug dependence are common

FREQUENT CODETYPES: Clinical: B,T,N,D; FREQUENT CODETYPES: Clinical: B,T,N,D; Personality: 2A,3,4,5,6B,7,8A Personality: 2A,3,4,5,6B,7,8A

Clinical Personality PatternsClinical Personality Patterns Scale 6B (Aggressive-Sadistic)Scale 6B (Aggressive-Sadistic)

– Gets pleasure by humiliating and violating others’ rightsGets pleasure by humiliating and violating others’ rights– Hostile and combativeHostile and combative– Dominating, antagonistic, frequent persecutory actionsDominating, antagonistic, frequent persecutory actions– Competitive, hardheaded, authoritarian and socially Competitive, hardheaded, authoritarian and socially

intolerantintolerant– Can be physically aggressiveCan be physically aggressive– Sometimes enter socially approved roles and disguise Sometimes enter socially approved roles and disguise

aggression (example police officer)aggression (example police officer)– Unaffected by pain and punishmentUnaffected by pain and punishment– No shame, guilt or sentimentalityNo shame, guilt or sentimentality– Can cope effectively with many challenges – Can cope effectively with many challenges –

unflinching and daringunflinching and daring

– FREQUENT CODETYPES: Personality:5, 6A, 7, P FREQUENT CODETYPES: Personality:5, 6A, 7, P

Clinical Personality PatternsClinical Personality Patterns Scale 7 (Compulsive)Scale 7 (Compulsive)

– Coincides with DSM IV Obsessive-compulsive personality Coincides with DSM IV Obsessive-compulsive personality disorderdisorder

– Conformity, discipline, self-restraint and formalityConformity, discipline, self-restraint and formality– Adheres strictly to social normsAdheres strictly to social norms– Conscientious, well prepared, righteous and meticulousConscientious, well prepared, righteous and meticulous– Fears social disapproval, deny hostilityFears social disapproval, deny hostility– Disciplined, self-restraint, high demands on themselvesDisciplined, self-restraint, high demands on themselves– Overt passivity and public complianceOvert passivity and public compliance– Loyalty, prudence, consistency, predictability. Loyalty, prudence, consistency, predictability. – Approaches problems with maturity and competenceApproaches problems with maturity and competence– High achievers – rarely report psychiatric distressHigh achievers – rarely report psychiatric distress

– FREQUENT CODETYPES: Clinical: A,D ; Personality: FREQUENT CODETYPES: Clinical: A,D ; Personality: 1,2A, 2B, 4,5, 6A1,2A, 2B, 4,5, 6A

Clinical Personality PatternsClinical Personality Patterns Scale 8A (Passive- Aggressive- NegativisticScale 8A (Passive- Aggressive- Negativistic))

– Approximates DSM III-R Passive-Aggressive personality Approximates DSM III-R Passive-Aggressive personality disorderdisorder

– Indirect expression of negative emotionIndirect expression of negative emotion– Passive compliance combined with resentment and Passive compliance combined with resentment and

oppositionopposition– Guilty and conflicted over their feelings of resentmentGuilty and conflicted over their feelings of resentment– Moody, complaining and intermittently hostileMoody, complaining and intermittently hostile– Chronic unhappiness – pessimism, disillusionment and Chronic unhappiness – pessimism, disillusionment and

cynicismcynicism– Moody and unpredictableMoody and unpredictable– At best can be agreeable and friendly – flexible, At best can be agreeable and friendly – flexible,

emotionally responsive and sensitiveemotionally responsive and sensitive

– FREQUENT CODETYPES: Clinical: D,A, H; FREQUENT CODETYPES: Clinical: D,A, H; Personality: 1, 2A, 3, 4, 5, 6A, 6B Personality: 1, 2A, 3, 4, 5, 6A, 6B

Clinical Personality PatternsClinical Personality Patterns Scale 8B (Self-Defeating-Masochistic)Scale 8B (Self-Defeating-Masochistic)

– Like DSM III-R self defeating –masochistic personality disorderLike DSM III-R self defeating –masochistic personality disorder– Place themselves in the victim rolePlace themselves in the victim role– Relate to others in an obsequious and self-sacrificing mannerRelate to others in an obsequious and self-sacrificing manner– Feel they deserve to be shamed and humbledFeel they deserve to be shamed and humbled– Inferior, nonindulgent, unassuming and self-effacingInferior, nonindulgent, unassuming and self-effacing– Unempathic and distrustful in relationshipsUnempathic and distrustful in relationships– Anxious, apprehensive, mournful, anguished and tormentedAnxious, apprehensive, mournful, anguished and tormented– They are involved and connected with peopleThey are involved and connected with people– Can have good insight into problems- level of distress high Can have good insight into problems- level of distress high

enough to be motivated for treatmentenough to be motivated for treatment

– FREQUENT CODETYPES: Clinical: D, A, H; Personality: FREQUENT CODETYPES: Clinical: D, A, H; Personality: 2A, 2B, 3, C 2A, 2B, 3, C

3. Interpret Clinical Syndrome Scales3. Interpret Clinical Syndrome Scales

1.1. Interpret Severe Clinical Syndrome Interpret Severe Clinical Syndrome ScalesScales

– Often several complementary scales will be Often several complementary scales will be elevated togetherelevated together

2.2. Interpret Basic Clinical Syndrome ScalesInterpret Basic Clinical Syndrome Scales

3.3. Guidelines:Guidelines:• BR between 60 to 74 are suggestive but not BR between 60 to 74 are suggestive but not

sufficiently indicative of pathologysufficiently indicative of pathology• BR 75-84 = clinical syndromeBR 75-84 = clinical syndrome• BR 85+ = presence of pathological symptomBR 85+ = presence of pathological symptom

4. Review noteworthy responses4. Review noteworthy responses

Similar to Critical Items of MMPISimilar to Critical Items of MMPI Organized around topics of Organized around topics of

– Health PreoccupationHealth Preoccupation– Interpersonal AlienationInterpersonal Alienation– Emotional DyscontrolEmotional Dyscontrol– Self-Destructive PotentialSelf-Destructive Potential– Childhood AbuseChildhood Abuse– Eating DisordersEating Disorders

5. Provide Diagnostic Impressions 5. Provide Diagnostic Impressions (if any)(if any)

Axis I: Clinical DisordersAxis I: Clinical Disorders Axis II: Personality Disorders Axis II: Personality Disorders

6. Personality Description6. Personality Description

Write a personality description based Write a personality description based on previous steps.on previous steps.

Attempt to understand meaning of Attempt to understand meaning of clinical syndrome for client’s clinical syndrome for client’s personality functioningpersonality functioning

7. Treatment Implications and 7. Treatment Implications and RecommendationsRecommendations

Give priority to the Clinical Syndrome Give priority to the Clinical Syndrome ScalesScales

Treatment suggestions for Treatment suggestions for personality patterns are listed in personality patterns are listed in Groth-MarnatGroth-Marnat

Mid-termMid-term

20 multiple choice/fill-in-the-blank 20 multiple choice/fill-in-the-blank questions (worth 2 points each – 40 questions (worth 2 points each – 40 pts.)pts.)

Choose 3 out of five short essay Choose 3 out of five short essay (worth 5 points each -15 pts)(worth 5 points each -15 pts)

1 MMPI-2 Profile Interpretation worth 1 MMPI-2 Profile Interpretation worth 35 points (open book)35 points (open book)

Multiple Choice/Short EssayMultiple Choice/Short Essay

REVIEW:REVIEW: Lectures 1/15-2/12Lectures 1/15-2/12 Groth-MarnatGroth-Marnat

– Chapters 1, 2, 3, 7, 8Chapters 1, 2, 3, 7, 8 GrahamGraham

– Chapters 3, 4, 5, 12Chapters 3, 4, 5, 12

For Profile Interpretation/ Write-upFor Profile Interpretation/ Write-up

Bring and have thorough knowledge Bring and have thorough knowledge of Graham: Chapters 3, 4, 5 and 10of Graham: Chapters 3, 4, 5 and 10

Bring Groth-Marnat –Know how to Bring Groth-Marnat –Know how to use Chapter 7use Chapter 7