The MMPI-2 Restructured Clinical Scales in the assessment of posttraumatic stress disorder and comorbid disorders.

Abstract

This study examined the psychometric properties of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Restructured Clinical Scales (RCSs) in individuals with posttraumatic stress disorder (PTSD) receiving clinical services at Veterans Affairs medical centers. Study 1 included 1,098 men who completed the MMPI-2 and were assessed for a range of psychological disorders via structured clinical interview. Study 2 included 136 women who completed the MMPI-2 and were interviewed with the Clinician Administered Scale for PTSD. The utility of the RCSs was compared to that of the Clinical Scales (CSs) and the Keane PTSD (PK) scale. The RCSs demonstrated good psychometric properties along with patterns of associations with other measures of psychopathology that corresponded to current theory regarding the structure of comorbidity. A notable advantage of the RCSs compared to the MMPI-2 CSs was their enhanced construct validity and clinical utility in the assessment of comorbid internalizing and externalizing psychopathology. The PK scale demonstrated incremental validity in the prediction of PTSD beyond that of the RCSs or CSs. KeywordsMinnesota Multiphasic Personality Inventory-2; Restructured Clinical Scales; posttraumatic stress disorder; internalizing; externalizingThe Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) is one of the most widely used assessment instruments in mental health and, as such, is often used in the assessment of posttraumatic stress disorder (PTSD). Its extensive array of scales, established norms for a range of populations, and unparalleled breadth of research provides a solid foundation from which to evaluate the profiles of individuals with PTSD for clinical description, case conceptualization, and treatment planning purposes. Despite clear strengths, there are psychometric limitations to its main scales, the Clinical Scales (CSs). Within-scale item content is heterogeneous and some scales tap multiple constructs, complicating the interpretation of scale elevations and limiting construct validity (Tellegen et al., 2003). There is considerable item overlap among the CSs, which contributes to artificially inflated intercorrelations (Helmes & Reddon, 1993;Tellegen et al., 2003). This makes it difficult to determine if elevations on multiple scales are indicative of substantive patterns of symptom covariation or simply due to common items. Recently, the MMPI-2 Restructured Clinical Scales (RCSs) were developed to address these issues and to increase the independence of each scale and provide purer, more valid indicators of pathology (Tellegen et al., 2003). This article describes two studies that examined the psychometric properties and diagnostic utility of the RCSs for the assessment of PTSD and comorbid disorders in men Correspondence concerning this article should be addressed to Mark W. Miller, National Center for PTSD (116B-2), VA Boston Healthcare System, 150 South Huntington Avenue, Boston, MA 02130. E-mail: mark.m...

Internalizing and externalizing personality styles and psychopathology in OEF–OIF veterans

“…The low pathology group overall showed the least amount of elevation. These findings regarding both the PSY-5 and RC scales are consistent with previous research on these personality types, showing similar elevations and levels on each domain (see Miller et al, 2004;Wolf et al, 2008).…”

Investigating the MMPI–2 Trauma Profile in Treatment-Seeking Peacekeepers

“…Scale PK showed marked correlations with avoidance and arousal symptoms and correlated moderately with intrusive symptomatology. These findings correspond to results reported by Wolf et al (2008).…”

Psychometric properties of the Schedule for Nonadaptive and Adaptive Personality in a PTSD sample.

“…With respect to SNAP trait and temperament scale associations with PTSD, this study demonstrated that negative temperament shares the most variance with overall PTSD severity, following prior work with other measures of personality (e.g., Clark, Watson, & Mineka, 1994; Clark & Watson, 1991; Miller, 2003; Wolf et al, 2008). The finding that this scale evidenced associations with all four PTSD symptom clusters highlights the contribution of non-specific distress to the disorder, a phenomenon which is not unique to the SNAP and replicates prior work showing associations between NEM and PTSD symptoms broadly (Marshall, Schell, & Miles, 2010; Wolf et al, 2008).…”

“…With respect to SNAP trait and temperament scale associations with PTSD, this study demonstrated that negative temperament shares the most variance with overall PTSD severity, following prior work with other measures of personality (e.g., Clark, Watson, & Mineka, 1994; Clark & Watson, 1991; Miller, 2003; Wolf et al, 2008). The finding that this scale evidenced associations with all four PTSD symptom clusters highlights the contribution of non-specific distress to the disorder, a phenomenon which is not unique to the SNAP and replicates prior work showing associations between NEM and PTSD symptoms broadly (Marshall, Schell, & Miles, 2010; Wolf et al, 2008). Although there is a conceptual appeal to attempts to remove NEM-related variance from the PTSD criteria so that only disorder-specific variance is retained (Simms, Watson, & Doebbeling, 2002; Watson, 2005, 2009), these results, in concert with prior work (e.g., Marshall et al, 2010), raise questions about whether this distinction is possible or clinically useful.…”