Minnesota Multiphasic Personality Inventory
The Minnesota Multiphasic Personality Inventory, known as the MMPI, and its revised second edition (MMPI-2) are psychological assessment instruments completed by the person being evaluated, and scored and interpreted by the examiner. The clinician evaluates the test taker's personal characteristics by comparing the test taker's answers to those given by various psychiatric and nonpsychiatric comparison groups. By analyzing the test taker's patterns of response to the test items, the examiner is able to draw some tentative conclusions about the client's level of adaptation, behavioral characteristics, and personality traits. The MMPI-2 is preferred to the older MMPI because of its larger and more representative community comparison group (also referred to as the "normative" group). The original version of the MMPI is no longer available from the publisher, although some institutions continue to use old copies of it.
The results of the MMPI-2 allow the test administrator to make inferences about the client's typical behaviors and way of thinking. The test outcomes help the examiner to determine the test taker's severity of impairment, outlook on life, approaches to problem solving, typical mood states, likely diagnoses, and potential problems in treatment. The MMPI-2 is used in a wide range of settings for a variety of procedures. The inventory is often used as part of inpatient psychiatric assessments, differential diagnosis , and outpatient evaluations. In addition, the instrument is often used by expert witnesses in forensic settings as part of an evaluation of a defendant's mental health, particularly in criminal cases. The MMPI has also been used to evaluate candidates for employment in some fields, and in educational counseling.
Although the MMPI-2 may be administered by trained clerical staff or by computer, for best results the examiner should meet the test taker before giving the test in order to establish the context and reassure the client. Most importantly, the test responses should be interpreted only by a qualified mental health professional with postgraduate education in psychological assessment and specialized training in the use of the MMPI-2. While computer-generated narrative reports are available and can be a useful tool, they should be evaluated (and edited if needed) by the on-site professional to individualize the reported results. Computer scoring and hypothesis generation is complex, and only reputable software programs should be used.
Although the MMPI-2 may yield extensive information about the client, it is not a replacement for a clinical interview. The clinical interview helps the test administrator to develop conclusions that best apply to the client from the many hypotheses generated from test results. Furthermore, important aspects of the client's behaviors may emerge in an interview that were not reflected in the test results. For similar reasons, the test results should not be interpreted until the clinician has obtained a biopsychosocial history from the client.
The MMPI-2 should be administered as part of a battery, or group, of tests rather than as an isolated assessment measure. A comprehensive assessment of a person will typically include the Rorschach technique , the Thematic Apperception Test (TAT) or the Sentence Completion Test, and the Wechsler Adult Intelligence Scale , Revised (WAIS-R) or similar test of cognitive functioning as well as the MMPI-2.
The MMPI-2 is composed of 567 true/false items. It can be administered using a printed test booklet and an answer sheet filled in by hand, or by responding to the items on a computer. For the person with limited reading skills or the visually impaired respondent, the MMPI-2 items are available on audiotape. Although the MMPI-2 is frequently referred to as a test, it is not an academic test with "right" and "wrong" answers. Personality inventories like the MMPI-2 are intended to discover what the respondent is like as a person. A number of areas are "tapped into" by the MMPI-2 to answer such questions as: "Who is this person and how would he or she typically feel, think and behave? What psychological problems and issues are relevant to this person?" Associations between patterns of answers to test items and particular traits or behaviors have been discovered through personality research conducted with the MMPI-2. The inventory items are not arranged into topics or areas on the test. The areas of personality that are measured are interspersed in a somewhat random fashion throughout the MMPI-2 booklet. Some examples of true-or-false statements similar to those on the MMPI-2 are: "I wake up with a headache almost every day"; "I certainly feel worthless sometimes"; "I have had peculiar and disturbing experiences that most other people have not had"; "I would like to do the work of a choir director."
The MMPI-2 is intended for use with adults over age 18; a similar test, the MMPI-A, is designed for use with adolescents. The publisher produces the MMPI-2 in English and Spanish versions. The test has also been translated into Dutch-Flemish, two French dialects (France and Canada), German, Hebrew, Hmong, Italian, and three Spanish dialects (for Spain, Mexico or United States).
From the 1940s to the 1980s, the original MMPI was the most widely used and most intensely researched psychological assessment instrument in the United States and worldwide. The test was originally developed in 1943 using a process called empirical keying, which was an innovation. Most assessment tools prior to the MMPI used questions or tasks that were merely assumed by the test designer to realistically assess the behaviors under question. The empirical keying process was radically different. To develop empirical keying, the creators of the original MMPI wrote a wide range of true-or-false statements, many of which did not directly target typical psychiatric topics. Research was then conducted with groups of psychiatric inpatients, hospital visitors, college students and medical inpatients, who took the MMPI in order to determine which test items reliably differentiated the psychiatric patients from the others. The test developers also evaluated the items that reliably distinguished groups of patients with a particular diagnosis from the remaining pool of psychiatric patient respondents; these items were grouped into subsets referred to as clinical scales.
An additional innovation in the original MMPI was the presence of validity scales embedded in the test questions. These sets of items, scattered randomly throughout the MMPI-2, allow the examiner to assess whether the respondent answered questions in an open and honest manner, or tried to exaggerate or conceal information. One means of checking for distortions in responding to the instrument is asking whether the test taker refused to admit to some less-than-ideal actions that most people probably engage in and will admit to doing. An example of this type of question would be (true or false) "If I could sneak into the county fair or an amusement park without paying, I would." Another type of validity check that assesses honesty in responses is whether the client admits to participating in far more unusual behaviors and actions than were admitted to by both the psychiatric comparison group and the general community sample. The validity scales also identify whether the test taker responded inconsistently or randomly.
The MMPI-2, which has demonstrated continuity and comparability with its predecessor, was published in1989. The revised version was based on a much larger and more racially and culturally diverse normative community comparison group than the original version. Also, more in-depth and stringent research on the qualities and behaviors associated with different patterns of scores allows improved accuracy in predicting test-respondents' traits and behaviors from their test results.
The true/false items are organized after scoring into validity, clinical, and content scales. The inventory may be scored manually or by computer. After scoring, the configuration of the test taker's scale scores is marked on a profile form that contrasts each client's responses to results obtained by the representative community comparison group. The clinician is able to compare a respondent's choices to those of a large normative comparison group as well as to the results derived from earlier MMPI and MMPI-2 studies. The clinician forms inferences about the client by analyzing his or her response patterns on the validity, clinical and content scales, using published guidebooks to the MMPI-2. These texts are based on results obtained from over 10,000 MMPI/MMPI-2 research studies.
In addition to the standard validity, clinical, and content scales, numerous additional scales for the MMPI have been created for special purposes over the years by researchers. These special supplementary scale scores are often incorporated into the examiner's interpretation of the test results. Commonly used supplementary scales include the MacAndrews Revised Alcoholism Scale, the Addiction Potential Scale, and the Anxiety Scale. The clinician may also choose to obtain computerized reporting, which yields behavioral hypotheses about the respondent, using scoring and interpretation algorithms applied to a commercial database.
Butcher, J. N., W. G. Dahlstrom, J. R. Graham, A. Tellegen, and B. Kaemmer. MMPI-2: Manual for Administration, Scoring and Interpretation. Revised. Minneapolis: University of Minnesota Press, 1989.
Butcher, J. N. and C. L. Williams. Essentials of MMPI-2 and MMPI-A Interpretation. Revised. Minneapolis: University of Minnesota Press, 1999.
Graham, John R. MMPI-2: Assessing Personality and Psychopathology. 3rd edition, revised. New York: Oxford University Press, 2000.
Graham, John R., Yossef S. Ben-Porath, and John L. McNulty. MMPI-2: Correlates for Outpatient Community Mental Health Settings. Minneapolis: University of Minnesota Press, 1999.
McNulty, J. L., J. R. Graham, and Y. Ben-Porath. "An empirical examination of the correlates of well-defined and not defined MMPI-2 codetypes." Journal of Personality Assessment 71 (1998): 393-410.
Deborah Rosch Eifert, Ph.D.