Patterns of MMPI-2-Restructured Form (MMPI-2-RF) validity scale scores observed across Veteran Affairs settings.

Abstract

The purpose of this investigation is to provide descriptive information on veteran response styles for a variety of VA referral types using the Minnesota Multiphasic Personality Inventory (MMPI)-2-Restructured Form (MMPI-2-RF), which has well-supported protocol validity scales. The sample included 17,640 veterans who were administered the MMPI-2-RF between when it was introduced to the VA system in 2013 until May 31, 2015 at any VA in the United States. This study examines frequencies of protocol invalidity based on the MMPI-2-RF's validity scales and provides comprehensive descriptive findings on validity scale scores within the VA. Three distinct trends can be seen. First, a majority of the sample did not elevate any of the validity scales beyond their recommended interpretive cut-scores, indicating that scores on the substantive scales would be deemed valid and interpretable in those cases. Second, elevation rates are higher for the overreporting scales in comparison to the underreporting and non-content-based invalid responding scales. Lastly, a majority of those with an elevation on one overreporting validity indicator also had an elevation on at least one other overreporting scale. Implications for practice and the utility of the MMPI-2-RF within the VA are discussed.

Descriptive Profiles of the MMPI-2-Restructured Form (MMPI-2-RF) across a National Sample of Four Veteran Affairs Treatment Settings

“…In general, those excluded from analysis most frequently demonstrate patterns of profile invalidity evidenced by elevations on the over-reporting scores as is consistently observed within the VA (see Ingram et al 2019). Generally, valid participants across the four settings were demographically similar (Table 1).…”

“…Of note, clinically significant elevations were relatively common across settings, which likely reflects the high rate of complex and comorbid mental health needs of veterans, as well as the centrality of trauma-experiences to their difficulties. To some extent, these elevations may also be due to the frequency of compensation and pension evaluations, which may impact response style in spite of invalid responding detection methods (e.g., Ingram et al 2019;Nelson et al 2011;Ray 2017).…”

“…The validity scales consistently discriminate between valid and invalid patterns of responding (Goodwin et al 2013;Nelson et al 2011;Sellbom et al 2012b;Shura et al 2017), offering a means to evaluate the potential for response bias within the VA (Ray 2017). Similarly, the substantive scales are useful in predicting diagnostic presentations and identifying important clinical concerns (Koffel et al 2012;Gottfried et al 2014;Sellbom et al 2012a;Wolf et al 2008). Moreover, the substantive scales have also been shown to predict treatment engagement (Anestis et al 2015;Arbisi et al 2013) and other treatment outcomes (Arbisi et al 2008;Forbey et al 2012).…”

“…Likewise, the demographic characteristics of those samples under-represent or exclude several groups frequently cared for within the VA. For example, the substance use comparison group is comprised of only males and era of service underrepresents Gulf War veterans. Most importantly, the comparison groups reported in the Technical Manual represent a narrow band of VA clinical contexts and variability in response style across service locations is common (Ingram et al 2019).…”

Comparing MMPI-2-Restructured Form Scores by Service Era for Veterans Assessed Within the Veteran Affairs Healthcare System

“…This study included only those patients whose assessments were conducted in PTSD Clinical Team (PCT) settings. We excluded patients who scored above the recommended validity cut-scores on the MMPI-2-RF as such scores indicate invalid responding and bias substantive scale elevations (Ingram et al, 2019b). We excluded individuals whose electronic medical records indicated that they did not serve in Vietnam or Gulf War periods.…”