1. ISABELLA ROMERO SUPERVISED BY DR. DANIELLE BURCHETT CALIFORNIA STATE UNIVERSITY, MONTEREY BAY IN COLLABORATION WITH DR. DAVID GLASSMIRE PATTON STATE HOSPITAL Mental Disorder Assessment: Mapping the MMPI-2-RF Substantive Scales onto Internalizing, Externalizing and Thought Dysfunction Dimensions

2. Why Validate Assessments? Tools which inform important processes for mental health practitioners  Give clinical picture  Must be accurate to inform effective treatment plan Diagnostic construct validity http://www.fairfaxmentalhealth.com/wp- content/uploads/2014/08/psychologists-prescribing-medications.jpg http://www.californiapainmedicinecenter.com/wp- content/uploads/2015/05/psychotherapy-los-angeles.jpg

3. Model of Psychopathology Three Factor Model of Psychopathology: The internalizing and externalizing dimensions, have received the most empirical support within general populations (Eaton, et al., 2012, Krueger, 1999) Internalizing Externalizing Thought Dysfunction Schizophrenia Mania Substance Abuse Antisocial Personality Attention- Hyperactivity Depression Anxiety Somatic Disorders (?)

4. MMPI-2-RF Minnesota Multiphasic Personality Inventory-2- Restructured Form (MMPI-2-RF, Ben-Porath & Tellegen, 2008/2011)

5. MMPI-2-RF Technical Manual of the MMPI-2-RF (Tellegen & Ben- Porath, 2008/2011) Low AES & MEC: Aesthetic-Literary Interests & Mechanical Interests

6. MMPI-2-RF

8. Current Study: Research Question Past MMPI-2-RF Research:  Compared mean scores for specific diagnostic groups (eg. Bipolar disorder, v. schizophrenia, Sellbom, et al., 2012) Current Study:  Does the MMPI-2-RF distinguish between forensic inpatients with and without  1. Internalizing Disorders  2. Externalizing Disorders  3. Thought Dysfunction Disorders ?

9. Method Participants  641 forensic inpatients, Males (72.1 %) Mean Age = 40.96 years Total = 1,110 Total = 1,110 Valid = 641 Valid = 641 Internalizing Externalizing Yes (n =320) No (n =321) Yes (n =469) Thought No (n = 172 ) Yes (n = 562) No (n = 69)

10. Hypotheses ScalesInternalizingExternalizing Thought Dysfunction Higher- Order Scales EIDBXDTHD Restructured Clinical Scales RCd, RC1, RC2, RC,7 RC4 & RC9RC6 & RC8 Specific Problems Scales Internalizing, Somatic, Intrapersonal ANP, Externalizing Scales, FML Interest ScalesLow AES & MEC Personality Pathology-5 Scales NEGE-r & INTR-r DISC-r & AGG-r PSYC-r

11. Method: Statistical Analyses M1M1 M2M2 * Independent Samples t-test: Comparing means of independent samples Hedges' g values: Comparing size of difference between two means Small:.20-.49 Medium:.50-.79 Large:.80+ Cohen (1988)

12. Results: Internalizing Diagnosis MMPI-2-RF ScalesYes (n = 320)No (n = 321)g Higher-Order ScalesMSDM EID: Emotional/ Internalizing Dysfunction53.912.649.310.50.39* Restructured Clinical Scales RCd: Demoralization55.711.951.610.70.35* RC1: Somatic Complaints55.711.051.710.60.33* RC2: Low Positive Emotions53.813.850.911.60.22* RC7: Dysfunctional Negative Emotions51.511.247.410.70.37* Somatic Specific Problems Scales MLS: Malaise53.9215.452.810.70.29* GIC: Gastrointestinal Complaints 52.9811.9249.669.410.31* HPC: Head Pan Complaints 51.8810.5250.369.480.15* NUC: Neurological Complaints 59.9112.5755.4512.580.35* COG: Cognitive Complaints 54.7712.9551.5711.490.26* Interest Scales AES: Aesthetic-Literary Interests 50.0810.0449.9711.240.01 MEC: Mechanical Interests 53.8110.7056.0510.68-0.21*

13. Yes (n = 320)No (n = 321)g Internalizing SP ScalesMSDM SUI: Suicidal/Death Ideation 53.9215.3949.9810.590.30* HLP: Helplessness 52.5213.6349.3611.270.25* SFD: Self-Doubt 52.9611.5049.469.690.33* NFC: Inefficacy 53.1810.6050.4610.830.25* STW: Stress and Worry 51.1311.1547.709.590.33* AXY: Anxiety 55.5014.1152.1512.880.25* ANP: Anger Proneness 50.5010.1247.138.910.35* BRF: Behavior restricting Fears 55.7513.4752.4311.640.26* MSF: Multiple Specific Fears 51.719.3249.119.200.28* Interpersonal Specific Problems Scales IPP: Interpersonal Problems 48.4310.4348.529.72-0.01 SAV: Social Avoidance 50.6610.8549.3410.940.12 SHY: Shyness 49.369.4247.698.440.19* DSF: Disafiliativeness 54.4612.6653.4012.080.09 Personality Pathology- 5 Scales NEGE-r: Negative Emotionality/Neuroticism-Revised 52.5110.7848.2810.300.40* INTR-r: Introversion-Revised 52.1311.7351.4211.680.06

14. Results: Externalizing Diagnosis MMPI-2-RF ScalesYes (n = 469)No (n = 172)g Higher-Order ScalesMSDM BXD: Behavioral Externalizing Dysfunction 58.6010.6353.7210.390.46* Restructured Clinical Scales RC4: Antisocial Behaviors 62.1311.4356.7010.900.48* RC9: Hypomanic Activation 48.0310.8646.9510.990.10 Internalizing Specific Problems Scale ANP: Anger Proneness 49.199.8347.789.180.15 Externalizing Specific Problems Scales JCP: Juvenile Conduct Problems 61.3413.1155.6012.640.44* SUB; Substance Abuse 57.1110.3550.499.960.65* AGG: Aggression 49.7810.9748.209.950.15* ACT: Activation 47.3612.1746.0311.550.11 Interpersonal Scales FML: Family Problems 51.5912.1050.7212.450.07 Personality Pathology-5 Scales AGGR-r: Aggressiveness-Revised 51.4810.4351.139.480.03 DISC-R: Disconstraint-Revised 57.0710.1552.789.750.43*

15. Results: Thought Dysfunction Diagnosis MMPI-2-RF ScalesYes (n = 572)No (n = 69)g Higher-Order ScalesMSDM THD: Thought Dysfunction 58.0515.1453.9614.090.27* Restructured Clinical Scales RC6: Ideas of Persecution 61.7215.8360.5915.75 0.07 RC8: Aberrant Experiences 55.1912.5752.2611.900.23* Personality Pathology-5 Scales PSYC-r: Psychoticism-Revised 56.2214.9152.9413.650.22*

16. Discussion Key Findings :  Higher-Order (H-O) scales demonstrated strong construct validity  Somatic problems are significantly associated with Internalizing domain  Interestingly, Ideas of Persecution scores were similar across groups; may be result of controlled settings (Morgan, Rozycki, & Wilson, 2004) Strengths:  High base rates of severe mental illness across all three domains Limitations & Future Directions  Overlapping vs. pure diagnostic groups VS.

17. Acknowledgements & References Eaton, N. R., Krueger, R. F., Markon, K. E., Keyes, K. M., Skodol, A. E., Wall, M., Grant, B. F. (2012). The structure and predictive validity of the internalizing disorders. Journal of Abnormal Psychology, 122(1), 86–92. doi: 10.1037/a0029598 Krueger, R. F. (1999). The structure of common mental disorders. Archives of General Psychiatry, 56(10), 921–926. doi: 10.1001/archpsyc.56.10.921 Tellegen, A., & Ben-Porath, Y. S. (2008/2011). MMPI-2-RF (Minnesota Multiphasic Personality Inventory-2 Restructured Form): Technical manual. Minneapolis, MN: University of Minnesota Press. Weinborn, M., Orr, T., Woods, S. P., Conover, E., & Feix, J. (2003). A validation of the Test of Memory Malingering in a forensic psychiatric setting. Journal of Clinical and Experimental Neuropsychology, 25(7), 979- 990. Thanks to the following for making this study possible: University of Minnesota Press, which supported data collection Dr. Glassmire of Patton State Hospital Dr. Danielle Burchett CSUMB Undergraduate Research Opportunities Center (UROC)