1. Interpretation and Reporting
MCMI-III
Interpretation and Reporting

2. Issues Related to Interpretation
Gender
Ethnicity
Age
Code types

3. Scale Elevation Personality Patterns: Clinical Syndromes:
likely to possess traits of the construct
BR clinically significant personality traits
BR Personality disorder
Clinical Syndromes:
likely to possess some symptoms of the syndrome
BR presence of a syndrome
BR prominence of syndrome

4. Level of adjustment How many scales are elevated above 75?
The higher the elevation, the more the dysfunction - in general
Narcissistic, Histrionic, Compulsive Scales can show strengths of pathology
modest levels are healthy
Look at Modifying Indices

5. Formulating diagnoses
Look at elevation
Look at contextual information including clinical impressions
Look at prototypal items

6. Steps in Interpretation
1. Determine profile validity
2. Interpret the Personality Disorder Scales
3. Interpret Clinical Syndrome Scales
4. Review noteworthy responses
5. Provide diagnostic impressions
6. Write a personality description
7. Treatment implications and
recommendations

7. 1. Determine Profile Validity
Scale V (Validity Index)
Items 65, 110, 157
2 or more true responses - invalid profile
1 true response - “questionable validity”
Scale X (Disclosure Index)
If raw score is below 34 - invalid and defensive underreporting
If raw score is above invalid and exaggeration of symptoms
X is only scale on MCMI where er interpret high and low - others only interpreted if above 75

8. 1. Determine Profile Validity
Scale Y - (Desirability Index)
Measure of defensive responding
BR above 75 (not necessarily invalid) indicates presenting self in an overly positive, moral, emotionally stable, gregarious manner - “faking good”
the higher the score, the more the person is concealing
Scale Z (Debasement Index)
Opposite from Desirability Index
BR above 75 - self description is negative, pathological
Above 85 - could be a cry for help
Z - feelings of being angry, crying easility, low self-esteem, possible self-destruction,tense, guilty, depressed
Can have high score on bot Y and Z but not likely

9. 2. Interpret Personality Disorder Scales
Check elevations on Severe Personality
Disorders
Primary focus for diagnosis
Check elevations on Clinical Personality Scales
Clinical Personality Scales serve to color or elaborate on Severe Personality Pattern elevations (unless extremely elevated compared with severe scales)
Guidelines = patterns/traits
85+ = disorder
Moderate on severe<high on personality disorder (85+)
Marginally elevated = 75 to 80 range
75 to 84=syndorme, pattern is present
85 above indicates promience

10. Severe Personality Pathology Scale S (Schizotypal)
Like DSM IV Schizotypal personality disorder
Cognitively dysfunctional
Interpersonally detached, prefers social isolation
Appear self-absorbed and ruminative
Behaviorally eccentric and perceived by others as strange or different
Communication style – tangential, personal irrelevancies and magical associations
Some are detached and emotionally bland others are more suspicious, anxious and apprehensive
Prognosis is poor
May need medication
FREQUENT CODE TYPES: Clinical: PP, SS; Personality: 1, 2A, P
Between schizoid and schizophrenia – can coext
Autistic of cognitively confused, tangential thought
Eccentricity, disorganization and social isolation
Peculiar mannerisms, starneg clothes, bizzare expressions s
Alienated, isolated, fragmented
Drfters
Little distinction between fantasy and reality
Lack interest and energy to initiate social interactioj
1=schizoid, SS= Thought Disorder, PP= Delusional Disorder
Schizoid and schizophrenic may co-exist
1=schizoid
2-Avoidant
P=paranoid
SS= thought disorder
PP= delusional disorder

11. Scale C (Borderline) Unstable moods and behavior
Can be self-destructive, self-mutilation
Marked mood swings, intermittent periods of depression, generalized anxiety and intense emotional attacks on others
Interpersonal difficulties – ambivalence, instability and intensity
React strongly to fears of abandonment
Idealizes and devalues others
Poorly defined sense of self
Feelings of emptiness
Disorganized thoughts - may have psychotic episodes under stress
At risk for depression and suicide
FREQUENT CODE TYPES: Clinical: N,D, B,T; Exaggerations of less dysfunctional personality disorders: 3,4,5,8A, 8B
Mood disorders and substance abuse are frequent
Can be seen as exaggerations of masochistic, passive-aggressive, dependent, hsitrionic, narc
Extremely concerned with maintain emoional supprt from othesr
3= Dependent
4=Histrionic
5=Narcissistic
8A = Passive agrressive
8B: Self Defeating

12. Scale P (Paranoid) Suspiciousness and defensiveness with others
Feelings of superiority
Vigilant to criticism and deceit
Abrasive, touchy, hostile and irritable
Externalizes blame
Describe self as misunderstood, righteous, suspicious, mistreated and defensive
Will attack and humiliate those they feel are trying to control or influence them
May have delusions of grandeur, ideas of reference, intense fears of being persecuted (psychotic delusions may be present)
FREQUENT CODE TYPES: Clinical symptoms: A, PP,SS Personality Scales: 2A, 5, 6B, 8A
Anxiety is the Axis 1 complication 0 or OCD
Tightly organized and coherent personality and cognitive structure that makes them feel emotionally and physically disconnected
2A – avoidant
5=Narc
6B=Sadistic
8A= Passive aggressive

13. Clinical Personality Patterns
Scale 1(Schizoid)
Little or no interest in others
Detached, impersonal, withdrawn
Peripheral role in family, work, social situations
Lack of depth to feelings
Indifferent to praise or criticism
Communication is vague, distant and unfocused (spacey)
Not disturbed by much, makes decisions easily, self sufficient
FREQUENT CODE TYPES: Clinical symptoms: A, SS; Personality Scales: 2A, 3,7,8A
Avoidants are the most frequent cleitns in therapy
Clinical Anxiety – thoguht disorder
Personality – Avoidant, dependent, Compulsive, passive aggressive

14. Clinical Personality Patterns
Scale 2A: Avoidant
Want to be involved and accepted by others
Vigilant to environment
Sense of unease, disquiet, anxiety and overreaction to minor events
Preoccupied with intrusive, fearful and disruptive thoughts
Perceive themselves as socially inept, inadequate
Feel alone, empty, isolated
Prone to social phobia and frequently depressed
Sensitive to the needs and perspectives of others, compassionate and emotionally responsive
FREQUENT CODE TYPES: Clinical: A, D, H; Personality: 1,3,5, 6A,8A.
Personality – schizoid, dependent, Narc, antisocial, Passive-aggressive

15. Clinical Personality Patterns
Scale 2B: Depressive
Enduring pattern of thoughts, attitudes, behaviors and self-concepts related to depression
Feels worthless, inadequate, guilty, self critical
Forlorn, discouraged, hopeless
Helpless and immobile in solving life’s problems
Angry, resentful, pessimistic in relationships
FREQUENT CODETYPES: Clinical: D, N Personality: 1,2A,8A,8B,C
Depresive personality disorered is distinguished from major affective – early, extended onset and many traits of depression
Dependent- elevation consistent with bulimia – others see them as gullible, wishy washye Describe self as placating, passive, immature and deserted
Pers: avoidant, schizoid, passive aggressive, self defeating, Borderline

16. Clinical Personality Patterns
Scale 3 (Dependent)
Feelings of being incapable and incompetent of functioning independently
Inadequate, insecure, low self-esteem
Submissive and cooperative in relationships
Agreeable, minimizes problems
Well-liked because of compliance, values opinion of others., defuses conflict, warm tender, loyal in friendships
FREQUENT CODETYPES: Clinical: A,D,N; Personality: 1, 2A, 4, 7, 8A, 8B
Anxiety – could include – panic attacks, aocial phobias, agiraphobia – fears of separation

17. Clinical Personality Patterns
Scale 4 (Histrionic)
Dramatic, colorful and emotional
Tolerance for boredom is low
Describe self as active, egocentric, exhibitionistic, flighty, extroverted, flirtatious
Charming and outgoing, attention seeking
Can be loud, demanding and uncontrollable
Strong needs for dependency
Can be warm, emotionally responsive, good sense of humor, adaptable
Good social adjustment, low levels of distress
FREQUENT CODETYPES: Clinical: A, H,B,T; Personality: 3,5,6A,7,8A
Dissociative behaviors, conversion reactions
If histrionic is the only elevated scale =- not a PD but a style of adapting
Constantly seeking new situations Conflicted, painful feelings which they avoid
Narc – frequently feel entitled – workers comp, make good first impression – interpret as a style if milfdly elevated, or if the only elevation
Failures are rationalized, and conflicts are minimized
Deprecates others to make selves look superior

18. Clinical Personality Patterns
Scale 5 (Narcissistic)
Exaggerated sense of self-importance and competence
Hypersensitive to criticism
Conventional rules of behavior do not apply
Arrogant, haughty, snobbish, conceited
Presents as intelligent, sophisticated, outgoing and charming
Lacking in empathy
Potential for substance abuse and depression is high
Subset will be well adjusted without much emotional distress
FREQUENT CODETYPES: Clinical: D,N,B,T ; Personality: 2A,3,4,6A,8A

19. Clinical Personality Patterns
Scale 6A (Antisocial)
Duplicitous, illegal behavior designed to exploit the environment for self gain
Impulsive acting-out
Provocative, violent, vicious, self-centered, dominant
Avoids perceived abuse and victimization through their behavior
Ignores consequences of behavior
Lack of empathy and remorse
Mistrustful, suspicious, guarded with others
Can be gracious, charming and friendly
Alcohol and drug dependence are common
FREQUENT CODETYPES: Clinical: B,T,N,D; Personality: 2A,3,4,5,6B,7,8A
Anti - Interpersonally irresponsible
aggressive - Type A personality

20. Clinical Personality Patterns
Scale 6B (Aggressive-Sadistic)
Gets pleasure by humiliating and violating others’ rights
Hostile and combative
Dominating, antagonistic, frequent persecutory actions
Competitive, hardheaded, authoritarian and socially intolerant
Can be physically aggressive
Sometimes enter socially approved roles and disguise aggression (example police officer)
Unaffected by pain and punishment
No shame, guilt or sentimentality
Can cope effectively with many challenges – unflinching and daring
FREQUENT CODETYPES: Personality:5, 6A, 7, P
Infrequent elevation
When 7 is elevated – methodcial and disciplined expressionof aggression

21. Clinical Personality Patterns
Scale 7 (Compulsive)
Coincides with DSM IV Obsessive-compulsive personality disorder
Conformity, discipline, self-restraint and formality
Adheres strictly to social norms
Conscientious, well prepared, righteous and meticulous
Fears social disapproval, deny hostility
Disciplined, self-restraint, high demands on themselves
Overt passivity and public compliance
Loyalty, prudence, consistency, predictability.
Approaches problems with maturity and competence
High achievers – rarely report psychiatric distress
FREQUENT CODETYPES: Clinical: A,D ; Personality: 1,2A, 2B, 4,5, 6A
Comp – relflect more a person’ adaptive stlye, Hard workers – no leisure, Strong sense of duty
Usually not accompanied by elevations on other scales – a well developed population – less overlap
Depression of the agitated nature
Minimize risk by becoming perfoectionsitci, distant and aloof in relations
Negativistic individuals
Acti on resentments in impulsive and erratic ways
“raw deal” in life
Externalize blame – little insightinto behaior

22. Clinical Personality Patterns
Scale 8A (Passive- Aggressive- Negativistic)
Approximates DSM III-R Passive-Aggressive personality disorder
Indirect expression of negative emotion
Passive compliance combined with resentment and opposition
Guilty and conflicted over their feelings of resentment
Moody, complaining and intermittently hostile
Chronic unhappiness – pessimism, disillusionment and cynicism
Moody and unpredictable
At best can be agreeable and friendly – flexible, emotionally responsive and sensitive
FREQUENT CODETYPES: Clinical: D,A, H; Personality: 1, 2A, 3, 4, 5, 6A, 6B
Frequently feel rejected – likley to experience depression

23. Clinical Personality Patterns
Scale 8B (Self-Defeating-Masochistic)
Like DSM III-R self defeating –masochistic personality disorder
Place themselves in the victim role
Relate to others in an obsequious and self-sacrificing manner
Feel they deserve to be shamed and humbled
Inferior, nonindulgent, unassuming and self-effacing
Unempathic and distrustful in relationships
Anxious, apprehensive, mournful, anguished and tormented
They are involved and connected with people
Can have good insight into problems- level of distress high enough to be motivated for treatment
FREQUENT CODETYPES: Clinical: D, A, H; Personality: 2A, 2B, 3, C
Can encourage others to take advantage of them
Focus on deficits
Self deefating – risk of depression, anxiety – paradoc in therapy – make them happier – but they don’t want to be happy

24. 3. Interpret Clinical Syndrome Scales
Interpret Severe Clinical Syndrome Scales
Often several complementary scales will be elevated together
Interpret Basic Clinical Syndrome Scales
Guidelines:
BR between 60 to 74 are suggestive but not sufficiently indicative of pathology
BR = clinical syndrome
BR 85+ = presence of pathological symptom

25. 4. Review noteworthy responses
Similar to Critical Items of MMPI
Organized around topics of
Health Preoccupation
Interpersonal Alienation
Emotional Dyscontrol
Self-Destructive Potential
Childhood Abuse
Eating Disorders
Rationally categorized – can be used to orgaize the clinical interview – inserted selectuively into a report

26. 5. Provide Diagnostic Impressions (if any)
Axis I: Clinical Disorders
Axis II: Personality Disorders

27. 6. Personality Description
Write a personality description based on previous steps.
Attempt to understand meaning of clinical syndrome for client’s personality functioning

28. 7. Treatment Implications and Recommendations
Give priority to the Clinical Syndrome Scales
Treatment suggestions for personality patterns are listed in Groth-Marnat

29. Mid-term
20 multiple choice/fill-in-the-blank questions (worth 2 points each – 40 pts.)
Choose 3 out of five short essay (worth 5 points each -15 pts)
1 MMPI-2 Profile Interpretation worth 35 points (open book)

30. Multiple Choice/Short Essay
REVIEW:
Lectures 1/15-2/12
Groth-Marnat
Chapters 1, 2, 3, 7, 8
Graham
Chapters 3, 4, 5, 12

31. For Profile Interpretation/ Write-up
Bring and have thorough knowledge of Graham: Chapters 3, 4, 5 and 10
Bring Groth-Marnat –Know how to use Chapter 7