William P. Wattles, Ph.D. Francis Marion University MMPI-2 William P. Wattles, Ph.D. Francis Marion University

MMPI-2 with Adolescents Should not be used with people less than 18

MMPI-2 with Older Adults Higher scores on: 1, 2, 3, 0 Lower scores on: 4, 9 MMPI-2 generally valid with older adults

Studies with older adults Most studies cross-sectional Cohort factors One longitudinal study found similar results Differences do not suggest pathology but genuine concerns about health. Age-related changes in physical health

Cohort Effects Patterns of disease frequency due to an exposure occurring to a group of people at about the same time in their lives

MMPI-2 with Ethnic Minorities Assessing MMPI-2 and minorities Any difference = bias Assess Validity

Data on African-Americans Slightly higher scores on scales 8 & 9. Not seen when matched for demographics, ses Differences tend to be associated with relevant extratest characteristics.

Explanation for differences Accurate measurement of different personality traits. Social desirability Role conflicts Modesty expectations Language/experience

MMPI-2 with Ethnic Minorities No consistent differences across all populations Moderator variables such as education, income, age, and type of pathology explain most differences.

MMPI-2 with Hispanics Differences between groups relatively small and not statistically or clinically significant. Language and reading obviously an issue.

Medical Patients Large Mayo clinic study suggests that medical problems alone do not result in elevated profiles.

Screening for Substance Abuse Elevated Scale 4 Mac Andrews Scale AAS APS Beware false negatives

MMPI-2 and employment screening Screen for psychopathology Limited to sensitive occupations Air traffic controller Police officer Nuclear power plant operator Predict quality of job performance Negative work attitude scale interesting MMPI-2 Not recommended

MMPI-2 and employment screening Applicants usually defensive. Invalid profile for defensiveness should not be cause to disqualify. Thus, scores above 65 meaningful 60-65 may indicate problems.

Report writing Interpretive strategy Use MMPI-2 to generate hypotheses Not all interpretive data applies to each subject MMPI-2 deal in probabilities Blind interpretation problematic

Report writing Test-taking attitude Missing items may indicate indecisiveness, ambivalence Long test times can mean indecisiveness, confusion Qualitative analysis of behavior Upset Atypical difficulties

Report writing Test-taking attitude Yea-saying (TRIN) L scale naïve, global denial K scale defensive, self-critical

Report Writing Adjustment Level Psychological comfort, overall elevation Scores above 65 suggest discomfort. Welsh’s Anxiety (A) Ego Strength (ES)

Characteristic Functioning Symptoms Major needs Dependency, achievement Perceptions View of others and optimism Reactions to stress Coping style and effectiveness Self-concept

Characteristic Functioning Sexual orientation Emotional control Interpersonal relationships Psychological resources

Dynamics and Etiology Higher order inferences about underlying dynamics and cause

Diagnostic Impressions MMPI-2 can be a tool in settling on a diagnosis if required for insurance etc. Diagnosis can be in the form of a symptom description.

Treatment Implications. A primary goal of assessment is to make treatment recommendations. To treat or not Type of treatment Prognosis Receptiveness to treatment Motivation

Somatic Symptom and Related Disorders Individuals with these disorders primarily present in medical rather than mental health settings. All of these disorders involve a prominent focus on somatic concerns.

Somatic Symptom Disorder Persistent somatic symptoms Preoccupation with physical symptoms.

Somatization is a tendency to experience and communicate psychological distress in the form of somatic symptoms and to seek medical help for them. More commonly expressed, it is the generation of physical symptoms of a psychiatric condition such as anxiety.

Somatization occurs when psychological concerns are converted into physical symptoms. Though they have no underlying physical cause, somatic symptoms, such as pain or nausea, are very real and have not been invented by the person experiencing them.

Fibromyalgia a fibromyalgia diagnosis can be made if a person has had widespread pain for more than three months — with no underlying medical condition that could cause the pain.

Chronic fatigue syndrome Chronic fatigue syndrome (CFS) is a complicated disorder characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue may worsen with physical or mental activity, but doesn't improve with rest.

Irritable bowel syndrome Irritable bowel syndrome (IBS) is one of the most common diagnoses made by gastroenterologists and primary care providers alike, and yet the underlying causes of IBS are poorly understood. In diagnosing irritable bowel syndrome, your symptoms and their severity are only part of the picture. Other causes need to be ruled out.