Using the MMPI-A to Identify Students with Emotional Disturbance Ellen C. Miller, Ed.D. New Mexico Association of School Psychologists October 28, 2017

K-W-L: What We Know IDEA Criteria for Identification as Emotionally Disturbed An inability to learn which cannot be explained by intellectual, sensory, or health factors An inability to build or maintain satisfactory interpersonal relationships with peers and teachers Inappropriate types of behavior or feelings under normal circumstances A general pervasive mood of unhappiness or depression A tendency to develop physical symptoms or fears associated with personal or school problems

K-W-L: What We Know Estimated prevalence—2% of public school enrollment Some estimates as high as 5% of enrollment Less than 1% receive special education services under IDEA Reasons? Evaluation methods give only clues to underlying emotional issues Diagnostic criteria not based on current research; have not changed since IDEA became law as PL 94-142 in 1975

K-W-L: What We Know Current methods/instruments used to identify students with ED Results from individual intelligence & achievement tests Interviews with teachers & parents Behavioral observations Behavior checklists completed by parents & teachers Projective techniques Draw-A-Person Student interviews

K-W-L: What I Want to Learn What can MMPI-A bring to the process? Objective measure Instrument with solid history in diagnosing psychopathology Sound statistical development Based on 30+ years of research using MMPI with adolescents and 20+ years of research as MMPI-A Can MMPI-A identify students with ED?

K-W-L: What I Want to Learn Eight Scales Chosen for Study Related to poor academic achievement in information from standardization sample for MMPI-A Hypochondriasis (Hs) Schizophrenia (Sc) Hysteria (Hy) Adolescent-health concerns (A-hea) Adolescent-low self esteem (A-lse) Adolescent-low aspirations (A-las) Adolescent-school problems (A-sch) Immaturity (IMM)

K-W-L: What I Want to Learn Three comparison groups Normal sample—students in general education classes, not identified with ED 38 students—11 male, 27 female ED sample—students attending general education campuses identified as ED 36 students—23 male, 13 female Clinical sample—adolescents in residential treatment centers or mental hospitals receiving psychological treatment 37 adolescents—21 male, 16 female

K-W-L: What I Learned Raw scores from each scale of MMPI-A are converted to uniform T-scores that “represent composite or average linear T-scores and serve to promote percentile equivalence” (Robert Archer, 2005, MMPI-A: Assessing Adolescent Psychopathology, p. 123) T-scores use for comparison among scales and among participants; similar to percentiles T-scores charted on profile sheets

K-W-L: What I Learned Results Mean and standard deviation values of three groups including emotional disturbance group (ED), normal group (NG), and clinical inpatient group (CI), and eight scales including Hypochondriasis (Hs), Hysteria (Hy), Schizophrenia (Sc), Adolescent-health concerns (A-hea), Adolescent-low self-esteem (A-lse), Adolescent-low aspirations (A-las), Adolescent-school problems (A-sch), and Immaturity (IMM) .   ED NG CI Measures M SD Hs 54.71 11.01 50.61 13.65 54.81 13.71 Hy 50.00 10.05 51.55 9.72 55.65 11.07 Sc 59.57 12.08 49.08 11.16 60.49 18.27 A-hea 53.77 11.64 51.18 13.47 55.16 13.10 A-lse 55.63 12.10 49.26 10.79 58.41 16.13 A-las 51.57 9.49 49.13 12.55 52.27 12.50 A-sch 56.40 11.77 52.37 12.68 59.46 14.40 IMM 56.57 10.75 48.76 10.68 55.51 14.37

K-W-L: What I Learned Results The r², p values, and effect sizes d of scales. Measures r² p d Hs 3.57 .278 .15 Hy 1.34 .058 .23 Sc 1.03 .001 .35 A-hea .18 .396 .13 A-lse .49 .011 .29 A-las .01 .475 .12 A-sch .58 .065 .22 IMM 1.58 .012 .28   Note. Effect size were interpreted according to Cohen’s conventions (Cohen, 1988): small effect, d = .2, medium, d = .5, and large, d = .8 .

K-W-L: What I Learned Results Percentage of accurate classification for selected eight scales of MMPI-A   Classification ED CI Measure Sensitivity Specificity Hs 45.7% 71.1% 51.4% Hy 34.3% 84.2% 45.9% 68.4% Sc 57.1% 73.7% 54.1% A-hea 62.2% 43.2% 65.8% A-lse 48.6% 56.8% A-las 37.1% 78.9% 40.5% A-sch IMM 62.9% 71.7% Note. Emotional disturbance group (ED), n = 35; Normal group, n = 38; Clinic inpatient group (CI), n = 37

K-W-L: What I Learned Conclusions Scores from the 8 selected scales discriminated among the 3 groups with moderate significance Scores from 8 scales predicted group membership, with Sc scale being best predictor, followed by IMM and A-lse Study supports authors of MMPI-A by demonstrating that students who score in predicted range on selected scales do experience academic/educational difficulty

Discussion/Comments MMPI-A can be used to assist in identifying students with ED Adds objective documentation to information obtained from interviews, observation, intelligence & achievement testing, and behavior checklists Can provide information that clarifies ‘gray areas’ in legal definition (i.e. “satisfactory” interpersonal relationships, “inappropriate” types of behaviors or feelings, “tendency” to develop physical symptoms or fears associated with persons or school problems)

Discussion/Comments Further uses of MMPI-A Some scales appear to have ‘face validity’ for specific symptoms of ED (i.e. Depression and Adolescent-depression) but are not indicators of school difficulties; How well do these scales discriminate students with ED? Discriminating between ED and social maladjustment Codetype 4-9 (Psychopathic Deviate and Hypomania) from MMPI-2 considered markers of Antisocial Personality Disorder in adults Is similar MMPI-A codetype indicative of Conduct Disorder or Oppositional Defiant Disorder

Questions?

Ellen C. Miller, Ed.D. ellen.miller@rrps.net