Development and Validation of Personality Disorder Spectra Scales for the MMPI–2–RF

An Exploratory Study of MMPI-2-RF Personality and Psychopathology Profiles of Adults with Autism Spectrum Disorder without Intellectual Disability

OBJECTIVE

More empirical research is needed to disentangle the phenotypes of autism spectrum disorder (ASD) and cluster C personality symptomatology (CCPD), as both show similarities in their clinical presentation. We explored personality and psychopathology dimensions as conceptualized in contemporary dimensional taxonomies (i.e., hierarchical taxonomy of psychopathology; HiTOP) in adults with ASD without intellectual disability operationalized by the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF).

METHOD

Applying secondary analytic processes using clinical data, we cross-examined the MMPI-2-RF profiles of adults with ASD (n = 28) compared to adults with Cluster C personality disorders (CCPD; n = 28) and a control group (n = 28) by conducting nonparametric tests and assessing effect sizes.

RESULTS

The profiles of the ASD and CCPD groups evidenced to be similar, and both average clinical profiles diverged from the average control group profiles by elevated levels of demoralization, internalizing, and somatization symptomatology. There were small differences between the average profiles of adults with ASD and adults with CCPD. Additional research using dimensional measures of psychopathology could elucidate the dimensional phenotypes of ASD and CCPD.

CONCLUSIONS

Based on the results in this study, the MMPI-2-RF may not meaningfully discriminate between the two clinical presentations, with the exception of various externalizing scales.

Contributions of Multimethod Personality Assessment in Indirect Evaluation

Indirect assessment is a useful tool in forensic evaluation, especially in cases of threat assessment. To this end, we illustrated the ability to conceptualize a complicated case (i.e., Theodore John Kaczynski) using an indirect approach, with a particular emphasis upon dimensional frameworks of personality. Raters who were unrelated to Mr. Kaczynski's case and with expertise in relevant domains were asked to study information available in the public domain about Mr. Kaczynski and provide ratings using several assessment instruments. Our aim was not to provide a professional clinical opinion, but rather engage in scholarly discourse about the utility of instruments. Mr. Kaczynski was rated to demonstrate characteristics associated with lone actor terrorists. He showed an elevation on a measure of psychosis, and raters conceptualized trauma as an important aspect of his functioning. He demonstrated impairments in detachment and psychoticism (Criterion B of the AMPD) and interpersonal functioning (Criterion A of the AMPD). Clinical conceptualizations for Mr. Kaczynski emphasized schizotypal and paranoid personality disorders. This analysis of an infamous case about which considerable data are publicly available demonstrates the ease with which indirect and multimethod assessment can be applied and integrated in forensic assessment, using modern conceptualizations of personality pathology.

Criterion A of the DSM-5 Alternative Model for Personality Disorders in MMPI-2/RF Personality Disorder Scales

The Minnesota Multiphasic Personality Inventory (MMPI) instruments are frequently used to assess personality and psychopathology. Recent publications of personality disorder (PD) spectra scales for dimensionalized PD syndromes with MMPI instruments may advance PD assessment. To this end, we examined MMPI-Second Edition (2) and MMPI-2-Restructured Form (-RF) PD Spectra scales within the lens of a contemporary dimensional model of PDs, the alternative model for personality disorders (AMPD). The core dimension of PD, Criterion A of the AMPD or level of personality functioning (LPF), was characterized quantitatively within the PD Spectra scales. By sequentially factor analyzing the scales of the Severity Indices of Personality Problems (SIPP-118) to a common general factor of PD, an index of LPF external to the MMPI item pool was established. This LPF dimension was strongly represented across most PD Spectra scales. LPF variances within the PD Spectra scales were deconstructed using measures of general demoralization (RCdemoralization) and maladaptive personality traits indexed by the Personality Psychopathology-5 (PSY-5). Nuanced LPF and PD Spectra scale relationships were discerned. Dimensionalized Antisocial PD, Borderline PD, Dependent PD, and Paranoid PD showed meaningful association with LPF after demoralization, and maladaptive trait variances were removed. The examination of the MMPI-3 item pool reveals that the existing PD Spectra scale item sets are largely carried forward in the new edition of the MMPI. This suggests PD Spectra scale correlates, including LPF relationships, may be discernable in the newest edition of the MMPI, pending future study.

Assessing DSM-5 Section II Personality Disorders Using the MMPI-2-RF in an Iranian Community Sample

The aim of the current study was to examine the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008) scales in assessing Diagnostic and Statistical Manual of Mental Disorders-Fifth edition (DSM-5) Section II Personality Disorder (PD) symptoms. For this purpose, we first tested the cross-cultural factorial and criterion validity of MMPI-2-RF scales. We used a sample of 536 (327 women and 209 men) community individuals in Tehran, Iran. DSM-5 Section II PD criterion counts were assessed using the Structured Clinical Interview for DSM-5-Screening Personality Questionnaire. Exploratory structural equation modelling analyses revealed that the models reported by Ben-Porath and Tellegen generally fitted the data well. Criterion validity of the MMPI-2-RF scales as well as MMPI-2-RF PDs spectra scales were analyzed with respect to their correlations with DSM-5 Section II PDs, indicating results generally consistent with expectations. Results based on Poisson or Negative binomial regression models indicated that a set of MMPI-2-RF scale hypotheses were supported, with several exceptions that are discussed in detail. These findings have implications for applicability of the MMPI-2-RF across Iranian population.

Further Examining the Construct Validity of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) Personality Disorder Spectra Scales

The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) Personality Disorder (PD) Spectra scales reflect a recent effort to dimensionally measure Diagnostic and Statistical Manual of Mental Disorders-5-based personality disorders. Initial studies generally support the sound psychometric properties of most scales, although the need to continue cross-validating and expanding the known empirical correlates of these scales remains. The goal of the current investigation was to replicate and extend previous research on MMPI-2-RF PD Spectra scale scores and further examine their construct validity. Using a sample of 765 undergraduate students (69.3% female; M_age = 19.95; 73.3% White), zero-order correlations between scores on MMPI-2-RF PD Spectra scales and measures of personality and psychopathology variables were calculated. Median convergent and discriminant correlations were compared using Fisher's r-to-z tests. Results indicated that hypothesized convergent associations were meaningfully stronger in magnitude than hypothesized discriminant ones, with exceptions to scales measuring Obsessive-Compulsive, Narcissistic, and Paranoid PDs. Findings generally supported the construct validity of MMPI-2-RF PD Spectra scale scores. Implications for clinical practice and research, methodological limitations, and suggestions for future research are discussed.

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.