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

Exploring Potential Ethnic Bias Among MMPI-3 Scales in Assessing Personality Psychopathology

This study examined statistical bias in the measurement of personality psychopathology in the Latinx population using the Minnesota Multiphasic Personality Inventory-3 (MMPI-3). Data were extracted from two studies that yielded a composite data set of 103 White individuals and 250 Latinx individuals. All participants were administered the MMPI-2-Restructured Form-Extended Battery (MMPI-2-RF-EX) or MMPI-3 and the Personality Inventory for the DSM-5 Short Form (PID-5-SF). First, we conducted correlation analyses between theoretically overlapping scales of the PID-5-SF and the MMPI-3 among White and Latinx individuals. The majority of theoretically associated scales were found to be at least moderately associated in the total sample. In addition, Steiger's z-tests indicated that correlations were similar in magnitude across the White and Latinx ethnic groups. Hierarchical regression subsequently determined the presence of slope and/or intercept bias. Only one analysis (the MMPI-3 Anger Proneness prediction of PID-5-SF Negative Affectivity) indicated statistically significant intercept bias. No evidence of slope bias was found. In other words, these analyses indicated that the vast majority of the relationships between MMPI-3 scales and associated personality psychopathology constructs (as measured by the PID-5-SF) remained consistent across both ethnic groups. Overall, the results supported the appropriate cross-cultural use of the MMPI-3 to assess personality psychopathology.

Psychosis superspectrum II: neurobiology, treatment, and implications

Alternatives to traditional categorical diagnoses have been proposed to improve the validity and utility of psychiatric nosology. This paper continues the companion review of an alternative model, the psychosis superspectrum of the Hierarchical Taxonomy of Psychopathology (HiTOP). The superspectrum model aims to describe psychosis-related psychopathology according to data on distributions and associations among signs and symptoms. The superspectrum includes psychoticism and detachment spectra as well as narrow subdimensions within them. Auxiliary domains of cognitive deficit and functional impairment complete the psychopathology profile. The current paper reviews evidence on this model from neurobiology, treatment response, clinical utility, and measure development. Neurobiology research suggests that psychopathology included in the superspectrum shows similar patterns of neural alterations. Treatment response often mirrors the hierarchy of the superspectrum with some treatments being efficacious for psychoticism, others for detachment, and others for a specific subdimension. Compared to traditional diagnostic systems, the quantitative nosology shows an approximately 2-fold increase in reliability, explanatory power, and prognostic accuracy. Clinicians consistently report that the quantitative nosology has more utility than traditional diagnoses, but studies of patients with frank psychosis are currently lacking. Validated measures are available to implement the superspectrum model in practice. The dimensional conceptualization of psychosis-related psychopathology has implications for research, clinical practice, and public health programs. For example, it encourages use of the cohort study design (rather than case-control), transdiagnostic treatment strategies, and selective prevention based on subclinical symptoms. These approaches are already used in the field, and the superspectrum provides further impetus and guidance for their implementation. Existing knowledge on this model is substantial, but significant gaps remain. We identify outstanding questions and propose testable hypotheses to guide further research. Overall, we predict that the more informative, reliable, and valid characterization of psychopathology offered by the superspectrum model will facilitate progress in research and clinical care.

No relations between executive functions and dimensional models of psychopathology or is time the missing link?

Impaired executive functions (EF) have been found within various mental disorders (e.g., attention deficit hyperactivity disorder, autism spectrum disorder, schizophrenia spectrum disorders) as described in DSM-5. However, although impaired EF has been observed within several categories of mental disorders, empirical research on direct relations between EF and broader dimension of psychopathology is still scarce. Therefore, in the current investigation we examined relations between three EF performance tasks and self-reported dimensions of psychopathology (i.e., the internalizing, externalizing, and thought disorder spectra) in a combined dataset of patients with a broad range of mental disorders (N = 440). Despite previously reported results that indicate impaired EF in several categories of mental disorders, in this study no direct relations were found between EF performance tasks and self-reported broader dimensions of psychopathology. These results indicate that relations between EF and psychopathology could be more complex and non-linear in nature. We evaluate the need for integration of EF and dimensional models of psychopathology and reflect on EF as a possible transdiagnostic factor of psychopathology.

Psychometric Properties of the MMPI-3 in a Sample of Black and White American Undergraduate Students: Examining Group Differences and Convergent/Discriminant Validity with the ASEBA Adult Self-Report

The current study examined MMPI-3 internal and external psychometric properties with a focus on the impact of racialized group membership (Black and White Americans). The second aim was to examine convergent/discriminant MMPI-3 scale associations with a different broadband, hierarchical self-report assessment tool [Adult Self-Report (ASR)]. Consistent with findings on prior MMPI iterations, we expected to observe no clinically meaningful mean differences on MMPI-3 scale T-scores. We hypothesized that validity coefficients between MMPI-3 and ASR scales measuring similar constructs would be stronger (convergent validity) and the inverse for scales measuring disparate constructs (discriminant validity). We also expected coefficient magnitude consistency across racial groups. The final sample was composed of 254 undergraduates (74.4% female; 63.8% White, 36.2% Black). Results suggest 1) MMPI-3 substantive scale mean T-scores are comparable between White and Black American undergraduates; 2) MMPI-3 scales correlate with ASR scale scores in expected ways with regard to internalizing problems, rule breaking and impulsivity, thought problems, and substance use (but not overall externalizing, aggression, attention problems, and intrusiveness); and 3) convergent and discriminant associations between MMPI-3 and ASR scales are consistent across White and Black Americans. This work provides support for MMPI-3 use with racially diverse individuals, considers next steps for understanding MMPI-3 scale score functioning in diverse populations, and provides novel information on MMPI-3 correspondence with the ASR.

Use of Broadband Personality Tests in Bariatric Surgery: A Scoping Review

INTRODUCTION

Studies have reported significant associations between personality scales of broadband psychometric testing to bariatric surgical outcomes; however, the literature falls short in outlining how these instruments can be best utilized to optimize weight loss milestones after surgery. The purpose of this scoping review is to analyze the literature utilizing broadband personality tests in the bariatric surgical population with relation to weight loss outcomes to identify gaps in research and summarize results to guide American Society for Metabolic and Bariatric Surgery practices and future research.

METHODS

Six databases were searched for broadband personality assessments, bariatric surgery, and weight loss outcomes terms. Studies included were peer-reviewed, published in English, and compared psychological assessments and weight loss outcomes.

RESULTS

Five hundred nineteen studies were reviewed, with 20 included in the full-text analysis. Studies used at least one of six defined broadband personality assessments. Elevated scores for depression were associated with lower weight loss with three of the assessments. Anxiety was inconsistently associated with postoperative weight loss, but this may be dependent on follow-up time CONCLUSIONS: Preoperative broadband personality assessments may support identifying behaviors that help patients reach their postoperative weight loss goals. Inconsistencies in the reporting of weight loss outcome measures across the literature make it difficult to draw significant conclusions. The American Society for Metabolic and Bariatric Surgery recommends standardization of outcome reporting, further highlighting a need in research to identify scales that are consistent predictors of weight loss outcomes.

The Meaning and Clinical Implications of Low MMPI-3 Self-Importance Scores

The Minnesota Multiphasic Personality Inventory-3 (MMPI-3) includes two self-concept-oriented scales: Self-Doubt (SFD), a measure of low self-esteem, and Self-Importance (SFI), a measure of beliefs that one has special attributes and abilities. Past research has demonstrated that SFD and SFI measure related but distinct constructs. The present study focused on explicating the meaning and clinical implications of low SFI scores. Using three clinical samples (private practice and community mental health and private practice neuropsychology clinics), we investigated whether the presence of interpretable low SFI scores (< 39 T) in the context of interpretable SFD elevations (≥ 65 T) is associated with distinctive MMPI-3 findings, and whether low SFI scores add clinically meaningful information in predicting relevant extra-test criteria. Consistent meaningful findings were obtained with respect to implications of low SFI scores for assessment of depression- and social engagement-related constructs. Additionally, the full range of SFI scores was meaningfully and negatively correlated with depressive disorder diagnoses and suicidal ideation but yielded very small correlations with suicide attempt and nonmeaningful correlations with diagnoses of Social Anxiety or Avoidant Personality Disorder. Hierarchical logistic regression analyses showed that SFI scores could meaningfully increment other related MMPI-3 scales in predicting diagnosed depressive disorders, albeit with small effect sizes.

Association between personality profiles and symptomatology patterns based on TCI and MMPI-2-RF in a transdiagnostic psychiatric sample: A person-centered approach

BACKGROUND

The temperament and character dimensions of personality appear to be networking structures that interact nonlinearly. Previous studies have attempted to classify temperament and character subtypes using a person-centered approach but have been unable to explore the relationship between the combination of temperament and character and psychopathology patterns in a transdiagnostic sample. The purpose of this study was to examine how symptomatology patterns differ according to individuals' personality profiles, employing a psychobiological model in a transdiagnostic psychiatric sample.

METHODS

Participants were 1881 patients who visited the psychiatry department of a major medical hospital in Seoul, Korea, and completed both the Temperament Character Inventory (TCI) and the Minnesota Multiphasic Personality Inventory-2-Restructed Form (MMPI-2-RF) as part of their psychological evaluation. We performed two separate latent profile analyses using four temperament and four character indicators of the TCI to identify personality profiles and nine restructured clinical scales of the MMPI-2-RF to identify symptom patterns.

RESULTS

Five personality classes emerged: "vulnerable-maladaptive," "stable-adaptive," "average," "inhibited-neurotic," and "impulsive-irrational." Moreover, six symptom classes emerged: "non-distressed," "depressed," "emotionally-distressed," "average," "dysfunctional thoughts," and "confused." The personality profiles comprising a combination of rigid temperament and immature character were related to patterns of more severe subjective pain and symptoms. However, profiles with less rigid temperament and less immature character exhibited more diverse symptom patterns.

CONCLUSIONS

This study examined the relationship between personality profiles and symptomatology patterns, suggesting that understanding patients' personality profiles may be helpful in predicting symptom manifestation and establishing treatment plans.

Demoralization: Where it stands-and where we can take it: A bibliometric analysis

Objectives

The purpose is to analyze existing studies related to the field of demoralization through bibliometrics.

Methodology

Relevant literature on demoralization was searched from PubMed, Web of Science, the Cochrane Library, and CINAHL Complete. Bibliometric analysis was performed using GraphPad Prisma 8.2.1, VOSviewer 1.6.18 and R software. Research publication trends, author-country collaboration, research hotspots and future trends were explored by generating network relationship maps.

Results

A total of 1,035 publications related to the field of demoralization were identified. The earliest relevant studies have been published since 1974, and the studies have grown faster since 2000. Psyche-oncology and Psychother Psychosom had the highest number of publications (n = 25). The United States, Italy and Australia have made outstanding contributions to the field and there was an active collaboration among leading scholars. Major research hotspots include the multiple ways of assessing demoralization, the specificity of various demographics and psychological disorders in different disease contexts, and the association and distinction of diverse clinical psychological abnormalities. The impact of COVID-19 on demoralization and subsequent interventions and psychological care may become a future research direction.

Conclusion

There has been a significant increase in research in the field of demoralization after 2000. The United States provided the most publications. There is overall active collaboration between authors, countries, and institutions. In future research, more attention will be paid to the effects of COVID-19 on demoralization and intervention care for this psychology.

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.

Detecting feigned ADHD in college students using the Minnesota multiphasic personality inventory-2-restructured form (MMPI-2-RF)

Objective: To investigate the utility of the validity scales of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) for detecting feigned Attention-Deficit Hyperreactivity Disorder (ADHD), we utilized a simulation design. Method: We examined group differences across the Restructured Clinical (RC) and validity scales as well as the classification ability of the validity scales across three cut scores. Analyses were conducted across five simulation groups (N = 177) and a standard instruction group (N = 32). Results: Across most of the RC and validity scales, those feigning ADHD produced significantly higher scores than the standard instruction group, but generally no significant differences between the feigning groups were demonstrated. The most promising scales for detecting feigned ADHD were F-r, Fp-r, and Fs at cut scores in the 70 T to 80 T range, respectively. Conclusions: Results support the use of the MMPI-2-RF in ADHD evaluations with scores on F-r, Fs, and Fp-r being particularly useful in detecting feigned ADHD in college students. However, there was no evidence to support the feigning of distinct ADHD symptoms presentations.

Somatoform's placement and validity in the hierarchical taxonomy of psychopathology (HiTOP)

Limitations of a polythetic-categorical classification system has sparked ongoing quantitative efforts to establish a valid and reliable method for diagnosing mental illness. Dimensional methods of classification, such as the Hierarchical Taxonomy of Psychopathology (HiTOP), have been found to ameliorate the limitations of a categorical approach - despite the provisional placement of a Somatoform spectrum. The current investigation sought to elucidate the placement of the Somatoform spectrum within the HiTOP model, and to further corroborate discriminant and convergent validity of the Somatoform spectrum. Using a sample of patients seeking chronic low-back pain treatment (n = 200), superior model fit suggested Somatoform fits better as a separate spectrum from Internalizing and placing Somatoform as a subfactor of Internalizing did not improve model fit. Discriminant and convergent validity with an external criteria demonstrated distinctiveness of the Somatoform spectrum from the Internalizing spectrum in the HiTOP model.

The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and Patient-Reported Outcomes Measurement Information System-29 (PROMIS-29) Comparison Study: Assessing for PROMIS-29 Depression and Anxiety Psychopathologic Cutoff Values Amongst Patients Undergoing Elective Complex Spine Procedures

OBJECTIVE

The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and the Patient-Reported Outcomes Measurement Information System-29 (PROMIS-29) are used to assess patient psychology, pain, and quality of life. As psychological factors, such as depression and anxiety, are associated with poor perioperative outcomes, we aim to translate MMPI-2-RF values to PROMIS-29 scores and establish cutoff values for PROMIS-29 anxiety and depression domains that might warrant attention preoperatively.

METHODS

Seventy adult patients scheduled for an elective spinal surgery between July 2018 and February 2020 who completed both the MMPI-2-RF and PROMIS-29 preoperatively at a single institution were reviewed.

RESULTS

Patients with MMPI-2-RF scores of 65 or greater (the cutoff for psychopathology) in the emotional/internalizing dysfunction scale (4.29%) had an average PROMIS-29 depression score of 14.33, which is significantly higher than the control group's (<65 score) 8.49 score (P = 0.04). Similarly, those demonstrating psychopathology on the demoralization (4.29%) and helplessness/hopelessness (4.29%) scales had average PROMIS-29 depression scores significantly higher than the control group's averages (15.33 vs. 8.45, P = 0.02 and 14.33 vs. 8.49, P = 0.04, respectively). Patients with an MMPI-2-RF score of 65 or greater on the emotional/internalizing dysfunction (4.29%), stress/worry (10.00%), and anxiety (7.14%) scales had average PROMIS-29 anxiety domain scores of 15, 15, and 15, respectively, which were significantly greater than that of the control group's scores (8.94, P = 0.04; 8.75, P = 0.004; and 8.55, P < 0.001, respectively).

CONCLUSIONS

PROMIS-29 scores of 15 or greater on the depression and anxiety domains may have psychopathologies that warrant addressing, given their increased likelihood of having poor outcomes.

Trainee therapist personality and the rating of cognitive behavioural and dynamic interpersonal therapy processes

Therapist factors are generally thought to be important predictors of the capacity to understand and respond to clinical material. The current study aims to identify which features of personality and clinical symptomatology predict a trainee therapist's rating of cognitive behavioural (CB) and psychodynamic interpersonal (PI) processes in video recordings of these therapies. Eighty psychology trainees completed the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and watched two video recordings of therapy sessions showing prototypical examples of CB and PI psychotherapy, rating the processes they could identify using the Comparative Psychotherapy Process Scale (CPPS). Trainees accurately differentiated CB from PI process while viewing the CB session but rated the CB video higher in PI processes than the PI video itself. Bayesian regression models showed that the most consistent MMPI-2-RF scale that predicted variance in ratings was hypomanic activation (RC9) predicting higher ratings of all psychotherapy processes in both conditions, while clinical scale factors such as Aggressiveness-Revised (AGGR-r) and personality scale factors of Psychoticism-Revised (PSYC-r) and Negative Emotionality/Neuroticism-Revised (NEGE-r) showed some notable but less consistent predictions. The variances in psychotherapy process ratings accounted for by MMPI-2-RF scales ranged from 15% to 51%. The study suggests that some clinical symptoms and personality factors do influence the rating of psychotherapy processes by psychology trainees, but further studies would be required to substantiate such findings. These findings have relevance to therapist training and selection for clinical training and therapist mental health.

Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): III. Emotional dysfunction superspectrum

The Hierarchical Taxonomy of Psychopathology (HiTOP) is a quantitative nosological system that addresses shortcomings of traditional mental disorder diagnoses, including arbitrary boundaries between psychopathology and normality, frequent disorder co-occurrence, substantial heterogeneity within disorders, and diagnostic unreliability over time and across clinicians. This paper reviews evidence on the validity and utility of the internalizing and somatoform spectra of HiTOP, which together provide support for an emotional dysfunction superspectrum. These spectra are composed of homogeneous symptom and maladaptive trait dimensions currently subsumed within multiple diagnostic classes, including depressive, anxiety, trauma-related, eating, bipolar, and somatic symptom disorders, as well as sexual dysfunction and aspects of personality disorders. Dimensions falling within the emotional dysfunction superspectrum are broadly linked to individual differences in negative affect/neuroticism. Extensive evidence establishes that dimensions falling within the superspectrum share genetic diatheses, environmental risk factors, cognitive and affective difficulties, neural substrates and biomarkers, childhood temperamental antecedents, and treatment response. The structure of these validators mirrors the quantitative structure of the superspectrum, with some correlates more specific to internalizing or somatoform conditions, and others common to both, thereby underlining the hierarchical structure of the domain. Compared to traditional diagnoses, the internalizing and somatoform spectra demonstrated substantially improved utility: greater reliability, larger explanatory and predictive power, and greater clinical applicability. Validated measures are currently available to implement the HiTOP system in practice, which can make diagnostic classification more useful, both in research and in the clinic.

Non-human contributions to personality neuroscience – from fish through primates. An introduction to the special issue

The most fundamental emotional systems that show trait control are evolutionarily old and extensively conserved. Psychology in general has benefited from non-human neuroscience and from the analytical simplicity of behaviour in those with simpler nervous systems. It has been argued that integration between personality, psychopathology, and neuroscience is particularly promising if we are to understand the neurobiology of human experience. Here, we provide some general arguments for a non-human approach being at least as productive in relation to personality, psychopathology, and their interface. Some early personality theories were directly linked to psychopathology (e.g., Eysenck, Panksepp, and Cloninger). They shared a common interest in brain systems that naturally led to the use of non-human data; behavioural, neural, and pharmacological. In Eysenck’s case, this also led to the selective breeding, at the Maudsley Institute, of emotionally reactive and non-reactive strains of rat as models of trait neuroticism or trait emotionality. Dimensional personality research and categorical approaches to clinical disorder then drifted apart from each other, from neuropsychology, and from non-human data. Recently, the conceptualizations of both healthy personality and psychopathology have moved towards a common hierarchical trait perspective. Indeed, the proposed two sets of trait dimensions appear similar and may even be eventually the same. We provide, here, an introduction to this special issue of Personality Neuroscience, where the authors provide overviews of detailed areas where non-human data inform human personality and its psychopathology or provide explicit models for translation to human neuroscience. Once all the papers in the issue have appeared, we will also provide a concluding summary of them.

The structure of dimensions of psychopathology in normative and clinical samples: Applying causal discovery to MMPI-2-RF scales to investigate clustering of psychopathology spectra and p-factors

We applied a Bayesian Constraint-based Causal Discovery method (BCCD) to examine the hierarchical structure of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) Restructured Clinical (RC) scales. Two different general psychopathology super spectra (p-factor) scales were extracted from (1) all RC scales and (2) all RC scales except the RCd (Demoralization) scale. These p-factor scales were included in separate models to investigate the structure of dimensions of psychopathology in a normative (n = 3,242) and clinical (n = 2,466) sample, as well as the combined normative/clinical sample (N = 5,708), by applying the BCCD algorithm to obtain a data-driven reconstruction of the internal hierarchical structure of the MMPI-2-RF. Research on the underlying structure of the MMPI-2-RF has clinical relevance as well as conceptual relevance in the context of the HiTOP model. Results demonstrated that the syndromes measured with the RC-scales-in presence of a p-factor-cluster into six spectra: internalizing, disinhibited-externalizing, antagonistic-externalizing, thought disorder, detachment, and somatoform. These results may support a super spectrum construct, as it was necessary for obtaining a bottom-up reconstruction of this six-spectrum structure. We found support for superiority of a broad super spectrum with additional variance over and above demoralization, as it resulted in the clearest structure (i.e., clustering of the RC scales). Furthermore, our results indicate independent support for the bifactor structure model of psychopathology.

Using the MMPI-3 in Legal Settings

In this paper, we review the historical evolution of the MMPI instruments, consider the empirical foundations for its use in Forensic Mental Health Assessments (FMHAs) with particular emphasis on the applicability of MMPI-2-RF research to these evaluations, and identify ways in which the inventory can be effectively but also inappropriately used in these assessments. We also review appellate court decisions related to forensic uses of the MMPI and discuss implications for cross-examination on MMPI-3-based testimony, emphasizing the need for forensic practitioners to be familiar with the empirical research available to guide MMPI-3 use in FHMAs. We identify areas needing further research, including the utility of the test in assessments of persons of color, investigations of the applicability of MMPI-3 results in various specific forensic assessments and rehabilitative applications, and further research on implications of the new English and Spanish-language norms. Potential contributions of studies using the updated MMPI-3 scales in descriptive research on forensic populations are also discussed. We conclude that when used properly to assess for evidence of invalid responding that may affect FMHAs, or psychological functioning relevant to answering psycho-legal referral questions, the MMPI-3 rests on solid empirical foundations that can withstand the scrutiny inherent in forensic evaluations.

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.

Physiological Predictors of Mental Disorders Among Police Officers in Indonesia

Police officers may be at a higher risk of suffering from mental disorders (MDs) compared with other occupations. This study aimed to examine the physiological predictors of MDs among police officers in Indonesia. The mental health status of each participant was examined using a standardized Minnesota Multiphasic Personality Inventory (MMPI) tool and underwent several laboratory examinations including hematology, urine, serology, and electrocardiogram tests. A logistic regression was performed to calculate the odds ratio. Of the 4590 participants, 2.14% were diagnosed with MDs. The study found 19 physiological variables are potential predictors of MDs. In multivariate analysis adjusted for body mass index, sex, and age, the concentration of ketones, protein, and specific gravity in urine and the amount of lymphocyte in the blood are among important predictors of MDs. This suggests that carefully examining the results of urinalysis and hematology tests can help us detect early cases of MDs among police officers.

Pre-deployment personality traits predict prescription opioid receipt over 2-year post-deployment period in a longitudinal cohort of deployed National Guard soldiers

BACKGROUND

While military service members are at risk forpain conditions, receipt of prescribed opioids is associated with a range of serious adverse outcomes. The goal of this study is to examine the association between pre-deployment personality traits and receipt of prescription opioids after return from deployment.

METHOD

Data were drawn from the Readiness and Resilience in National Guard Soldiers (RINGS) cohort study, an ongoing study of post-deployment health. Participants (N = 522) completed baseline assessments one month prior to deploying to Iraq (2006-2007). At baseline, we assessed personality traits using abbreviated versions of the Personality Psychopathology Five scales from the Minnesota Multiphasic Personality Inventory-2. Follow-up assessments were conducted three months, one year, and two years post-deployment. The primary outcome was total amount of prescribed opioids dispensed from Department of Veterans Affairs outpatient pharmacies in the two-year period following soldiers' return from deployment. Unadjusted and adjusted negative binomial regression models examined the relationships of pre-deployment personality traits, demographics (age, gender, and rank), baseline trauma symptoms, deployment related risk factors (difficult living/working environment, deployment injury, combat exposure), and post-deployment trauma symptoms with post-deployment opioid prescribing.

RESULTS

Disconstraint, negative emotionality, and introversion/low positive emotionality were associated with receipt of more prescribed opioids over the two years after return from deployment. Personality traits measured at baseline remained statistically significantly after adjusting for all eight baseline and deployment risk factors of interest.

CONCLUSIONS

Understanding how pre-deployment personality traits contribute to post-deployment prescription opioid use could inform efforts to improve veterans' health.

HiTOP Assessment of the Somatoform Spectrum and Eating Disorders

We report on Phase 1 efforts of the Hierarchical Taxonomy of Psychopathology (HiTOP) measurement subgroup tasked with developing provisional scales for the somatoform spectrum and eating disorders. In Study 1, items were written to assess five somatoform spectrum constructs (bodily distress symptoms, conversion symptoms, health anxiety, disease conviction, and somatic preoccupation). Scale development analyses were conducted on 550 university students. The conversion symptom items were too infrequently endorsed and were set aside for Phase 2. Analyses of the other items yielded four scales corresponding closely to their hypothesized structure. In Study 2, we delineated 15 specific feeding and eating disorder constructs. A sample of 400 university students were administered candidate items and several eating disorder questionnaires for criterion validity. Analyses yielded six scales capturing previously described constructs, tapping content related to body image and weight concerns, restricting and purging, cognitive restraint, binging, excessive exercise, and muscle building. Two scales representing additional constructs deemed to be of high clinical import-negative attitude towards obesity and avoidant/restrictive food intake disorder-were retained for Phase 2, for a total of eight scales. Overall, we concluded that Phase 1 had been successful at generating a comprehensive set of provisional scales for inclusion in Phase 2.

Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): II. Externalizing superspectrum

The Hierarchical Taxonomy of Psychopathology (HiTOP) is an empirical effort to address limitations of traditional mental disorder diagnoses. These include arbitrary boundaries between disorder and normality, disorder co-occurrence in the modal case, heterogeneity of presentation within dis-orders, and instability of diagnosis within patients. This paper reviews the evidence on the validity and utility of the disinhibited externalizing and antagonistic externalizing spectra of HiTOP, which together constitute a broad externalizing superspectrum. These spectra are composed of elements subsumed within a variety of mental disorders described in recent DSM nosologies, including most notably substance use disorders and "Cluster B" personality disorders. The externalizing superspectrum ranges from normative levels of impulse control and self-assertion, to maladaptive disinhibition and antagonism, to extensive polysubstance involvement and personality psychopathology. A rich literature supports the validity of the externalizing superspectrum, and the disinhibited and antagonistic spectra. This evidence encompasses common genetic influences, environmental risk factors, childhood antecedents, cognitive abnormalities, neural alterations, and treatment response. The structure of these validators mirrors the structure of the phenotypic externalizing superspectrum, with some correlates more specific to disinhibited or antagonistic spectra, and others relevant to the entire externalizing superspectrum, underlining the hierarchical structure of the domain. Compared with traditional diagnostic categories, the externalizing superspectrum conceptualization shows improved utility, reliability, explanatory capacity, and clinical applicability. The externalizing superspectrum is one aspect of the general approach to psychopathology offered by HiTOP and can make diagnostic classification more useful in both research and the clinic.

Assessing Physical Pain Perception and Psychological Distress Tolerance through the MMPI-2-RF: A Comparison of Multimethod Measures

While transdiagnostic factors are important domains in clinical assessment and treatment, there is little research to link such constructs to widely accepted and utilized broadband assessments such as the Minnesota Multiphasic Personality Inventory, 2nd edition - Restructured Form (MMPI-2-RF). A handful of studies suggest the ability of the MMPI-2-RF scales to capture variance in transdiagnostic constructs; however, this literature relies solely on self-report criterion measures, despite evidence that self-report and behaviorally-indexed correlates of psychopathology may measure varied aspects of the intended construct and can often yield differing results. The current study investigated MMPI-2-RF scales' ability to assess two widely examined transdiagnostic constructs, distress tolerance and pain perception, across both self-report and behavioral indicators. The sample included 115 undergraduate students who completed a valid MMPI-2-RF and multimethod measures of pain perception and distress tolerance. The results aligned with prior research in areas of internalizing symptoms, psychopathy, and suicide risk factors in self-report, but not behaviorally-based, assessment. Implications of this inconsistency, the association between clinical assessment and transdiagnostic constructs, and the heterogeneity of the distress tolerance and pain perception constructs are discussed.

Validity of the Somatic Complaints Scales of the MMPI-2-RF in an Outpatient Chronic Pain Clinic

Chronic pain has become a significant medical issue. The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) is a broadband psychological test that has been validated for use across various medical settings and can aid in the assessment and treatment planning of chronic pain. In the current investigation, it was hypothesized that the somatic complaints scales of the MMPI-2-RF would demonstrate good convergent validity from a structured psychodiagnostic interview and other measures of pain and somatization, and lack gender bias. Patients (n = 200) who produced valid MMPI-2-RFs in an outpatient chronic pain clinic were included in the study. Patients were also administered the Modified Somatic Perception Questionnaire (MSPQ), Pain Disability Index (PDI), and the Structured Clinical Interview for DSM-IV-TR (SCID). Zero-order and partial correlations (controlling for gender) were calculated between MMPI-2-RF scale scores and other criteria. Stepdown hierarchical regression analyses were used to detect bias. By and large, higher scale scores on the somatic/cognitive scales of the MMPI-2-RF were modestly or substantially correlated with MSPQ scores, PDI scores, and SCID Somatization symptom count, even after controlling for gender. Regression analyses suggested that the MMPI-2-RF scale scores were not biased as a function of gender. These findings support the validity of specific MMPI-2-RF scales to help identify somatization and psychosocial functioning among patients with chronic pain. Identification of somatization early within the course of treatment of chronic pain may help focus treatment targets, including referrals for psychological interventions such as cognitive behavior therapy for chronic pain.

Assessing ICD-11 personality trait domain qualifiers with the MMPI-2-RF

OBJECTIVE

The current study examined the utility of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in assessing ICD-11 personality psychopathology trait domain qualifiers.

METHOD

Using a community sample (N = 217) weighted for externalizing dysfunction, this study evaluated the convergence between ICD-11 trait domains as measured by the personality inventory for DSM-5 (PID-5) with hypothesized MMPI-2-RF scales. Particular emphasis was placed on evaluating the convergence between the ICD-11 trait domain qualifiers and the MMPI-2-RF personality psychopathology-5 (PSY-5) scales, as the latter are meant to represent broadband domains of personality pathology.

RESULTS

Correlation and regression analyses demonstrated expected associations between ICD-11 domains and conceptually expected MMPI-2-RF scales, with some minor exceptions. Notably, the Anankastia domain showed associations with scales assessing negative affect, but did not show expected negative associations with scales related to disinhibition.

CONCLUSIONS

The findings generally supported the use of the MMPI-2-RF in assessing individual expressions of personality dysfunction from the ICD-11 trait domain qualifier perspective.

Construct validity of Minnesota Multiphasic Personality Inventory-2-Restructured Form scale scores in correctional settings

Limited research has examined the link between Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) scales and contemporary personality and psychopathology models within correctional settings. This study focused on establishing construct validity of the MMPI-2-RF in offender samples from a broad personality framework. Two samples of incarcerated men and women completed a battery of broadband personality measures and narrowband measures that capture conceptually related constructs. To examine how MMPI-2-RF scale scores and criterion measures converged in a conjoint latent structure, we conducted a series of exploratory structural equation modelling analyses, which revealed factors similar to those of extant hierarchical personality models. At the broadband level, four factors (Positive Activation, Negative Affectivity, Inhibition and Agreeableness) were observed, whereas narrowband criteria yielded five factors (Behavioural Approach System, Disinhibition/Externalizing, Danger/Thrill Seeking, Self-Assurance/Boldness, and Unemotionality/Coldheartedness). MMPI-2-RF scale scores converged with the personality/psychopathology models in a theoretically expected manner. Limitations and directions for future research are discussed. © 2020 John Wiley & Sons, Ltd.

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.

Using the MMPI-2-RF to Assess Risk of Nonsuicidal Self-Injury among College Students

Nonsuicidal self-injury (NSSI), the deliberate destruction of one's own body tissue without suicidal intent, is a prevalent problem linked to adverse outcomes. Many assessment tools designed to assess for NSSI risk are limited by their behavioral focus, which does not cover the numerous affective, cognitive, and interpersonal correlates. The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) is a widely used inventory of personality and psychopathology that assesses a range of empirical correlates of NSSI risk. The purpose of this study was to investigate the utility of the MMPI-2-RF for assessing these NSSI-related constructs. On the basis of a review of the literature and item content, we pre-identified MMPI-2-RF measures of constructs associated with NSSI risk. Correlations between scores on these scales and the number of methods of NSSI identified several meaningful results, including some small but consistent gender differences in these associations. Zero-inflated negative binomial regression analyses indicated that scores on some expected MMPI-2-RF scales independently predicted NSSI variability. Relative risk ratio analyses demonstrated the potential clinical utility of MMPI-2-RF scale scores for assessing risk of engagement in NSSI. These findings indicate that the MMPI-2-RF may be a useful tool for assessing risk for NSSI among college students.

Evaluating the Measurement Invariance of MMPI-2-RF Restructured Clinical Scale 4 (Antisocial Behavior) between American and Korean Clinical Samples: Exploring Cultural and Translation Issues Affecting Item Responding

Establishing the cross-cultural measurement invariance of psychometric scales is considered an essential step before scale means are compared across cultures. Although the MMPI instruments have been extensively researched, few studies have examined the measurement equivalence of MMPI scales in cross-cultural research. This study examined the measurement invariance of MMPI-2-RF Restructured Clinical Scale 4 (RC4; Antisocial Behavior) using multi-group confirmatory factor analysis with American and Korean clinical samples by (a) comparing a rationally-derived four-factor model (School Problems, Substance Abuse, Family Problems, and Violation of Social Norms) with a one-factor model, and (b) examining the measurement invariance of the RC4 four-factor model. After adjusting for age and gender, partial scalar invariance was achieved, and six non-invariant items were identified, most of which centered around substance abuse. Results support the generalizability of the four factors across cultures; however, special attention is needed when using substance abuse items with Korean clinical populations. Plausible sources of item non-invariance were explored in the context of translation challenges and observed patterns of relationship with external measures.

Expression of ESR1 and ESR2 oestrogen receptor encoding gene and personality traits - preliminary study

INTRODUCTION

The main objective of the study is to examine the hypothesis claiming a correlation between personality traits measured with the use of the Minnesota Multiphasic Personality Inventory (MMPI-2) personality questionnaire and the expression of the ERα (ESR1) and ERβ (ESR2) encoding gene in patients suffering from depression.

MATERIAL AND METHODS

The experiment was carried out on a group of 44 individuals with depression. The Polish variant of the MMPI-2 was applied with the aim of assessing personality traits. Furthermore, the authors evaluated the expression of the genes encoding the oestrogen receptors (ERα and ERβ) at the mRNA level and protein level in the studied population.

RESULTS

No significant differences in the expression of ERα and ERβ encoding genes were found and confirmed in the patients with the first episode of depression and those suffering from subsequent episodes of the disease. No differences were found between women and men, either. In women a positive relationship was found between the scale of psychopathy (p = 0.04), paranoia (p = 0.01), and mania (p = 0.03) and expression for the ERα encoding gene at the mRNA level. A negative relationship was found between the mania scale and ERβ encoding gene expression at mRNA (p = 0.03) and protein (p = 0.04) levels. In males a positive relationship between anxiety as a personality trait and expression of the ERβ receptor encoding gene at mRNA level (p = 0.03) and protein level (p = 0.03) was found.

CONCLUSIONS

Personality traits may be linked with the expression of genes encoding oestrogen receptors (ERα and ERβ) among patients with depressive disorders.

The Multidimensional Behavioral Health Screen 1.0: A Translational Tool for Primary Medical Care

The Multidimensional Behavioral Health Screen (MBHS) is a brief, 27-item questionnaire designed for screening every patient in primary medical care settings. It measures nine psychopathology constructs that represent the major distinctive core dimensions of the types of behavioral health symptoms most commonly encountered in primary care (anxiety-related, depressive, and attention/cognitive symptoms). The underlying design of the MBHS is based on the major paradigm shift that has occurred in the field of theoretical psychopathology, replacing categorical syndromes, or "disorders," with hierarchical-dimensional constructs. Existing screening tests such as the PHQ-9 and GAD-7 are based explicitly on the categorical paradigm and thus suffer from the same (numerous) shortcomings as the categorical model itself. The dimensional paradigm supports enhanced measurement precision with very short scales. The goals of the MBHS are threefold: (1) to provide accurate, treatment-relevant behavioral health information to the medical provider; (2) to provide clear referral cut-points; (3) to contribute nine psychometrically sound behavioral health variables to the "healthcare big data cloud" to support future scholarship of discovery. Presented here are the basic psychometric properties of the MBHS, including reliability, convergent and discriminant validity, and classification accuracy, as well as implementation considerations.