1
Overview
MCMI-III
Administration
Interpretation
Case Examples
By whom
THANK YOU!!!
-Psychologists
-Counselors
-Psychiatrists
-Administrative Assistants
Who
- Adults seeking mental health tx
-Admin in Spanish or English
-Audio recordings available
-8th grade reading level required
-Normative sample is highly diverse
Clinical Profile
Group Project
Clinical Profile
MCMI-III
Your Turn!
By Kelsey & Engin
Where
Hand scoring
Unscorable/Invalid Tests
Interpreting Validity Scales
-Taken anywhere
-Should not be sent home with client
-Comfortable-Free of distraction/excessive fatigue
Scale Y:
- Assesses social desirability
example: "I am always looking to make new friends and meet new people"
- Scale Y with a BR of 75 or over is considered uninterpretable
Scale Z
- Debasement index (reflects tendencies that are opposite of those reflected by scale Y)
example: "Things that are going well today won't last very long"
- Scale Z with a BR of 75 or above is considered uninterpretable.
1. Examine answer sheet carefully and draw line through omitted or double
marked items
2. Check client 18 yr old and other validity
checks
3. Raw scores calculated
4. Convert into base rate (BR) scores
5. Make final adjustments based on validity
scales
-Younger than 18
-Missing demographics
-12 or more items missing
-Raw score on invalidity scale (V) is <1
-Raw score on inconsistency scale (W) is <9
-Raw score on scale X (disclosure) is less than 34 or greater than 178
-None of the BR score on clinical pattern scales are <59
*Although some experts say that scores of more than 75 on these scales are uninterpretable, others say they may be a cry for help and should be interpreted- what do you think?
Scoring
How
Can be scored by computer or by hand
Computer:
-Pearson software
-Don’t get interpretative report without comp
-Interpretative report, profile report, corrections
report
Instructions come with test packet
1. Asked to take a few min to read directions carefully and fill in
demographic info
2. Encouraged to weigh the advantages and disadvantages of taking
assessment with client
3. Once finished, check if answered all of questions
MCMI-III Scales
Components of the MCMI-III
Configural Interpretation of Personality Scales
Clinical Syndrome Scale
A Anxiety
H Somatoform
N Bipolar
D Dysthymia
B Alcohol Dependence
T Drug Dependence
R PTSD
Clinical Syndrome Scales
- 7 scales
- Identify major Axis 1 disorders
- Distortions of an individual's basic personality patterns
Personality Style Scales
1 Schizoid
2A Avoidant
2B Depressive
3 Dependent
4 Histrionic
5 Narcissistic
6A Antisocial
6B Sadistic
7 Compulsive
8A Negativistic
8B Masochistic
Personality Style Scales
- 11 scales
- Identify pervasive personality characteristics that impair psychological functioning
- 8 correspond to the DSM
- Other three scales (2B-Depressive, 6B-Sadistic/Agressive, and 8B-Masochistic/Self-defeating)
-Concerned with achieving an adequate interpretation of client personality
-Configural Domain Synthesis
-If two scales are equal, talk about them both equally or pool from one
more or less to the exclusion to the other
- Also use Clinical Interview/Behavior Impressions to make a decision
Severe Clinical Syndrome Scales
- 3 scales
- Most serious Axis 1 disorders
Severe Clinical Syndrome
SS Thought Disorder
PP Delusional Disorder
CC Major Depressive Disorder
Severe Personality Scales
S Schizotypal
C Borderline
P Paranoid
Sever Personality Scales
-3 scales
- Identify a higher degree of pathology
- Underlie the 11 personality scales
Interpreting Validity Scales
Interpretation Steps
Severity and Functionality of Pathological Personalities
Random response indicators (V and W)
Scale V
3 items where a true response is highly implausible if the test taker is responding to the true content
"I flew across the Atlantic 30 times last year"
Scale W
- Organized into corresponding pairs
example: "Lately, my strength seems to be draining out of me, even in the morning" and "I feel weak and tired much of the time"
"Lately, I have to think things over and over again for no good reason."and"I often get lost in my thoughts and forget what's going on around me"
Other Validity Scales
Scale X:
-Disclosure (problematic response behavior)
-Calculated by the degree of positive or negative deviation from the adjusted composite raw score for scales 1-8B.
- When the raw score for Scale X is below 34 or above 178, it is considered uninterpretable.
1. Assess Validity Scales
2. Assess Severe Personality Styles
3. Assess Personality Styles
4. Assess Severe Clinical Syndromes
5. Assess Clinical Syndromes
-As a general rule the greater number of scales elevated above 75 greater amount of personality pathology
-Three features to locate patient on continuum:
1. Tenuous stability under stress
2. Inflexibility
3. Tendency to foster vicious cycles
Facet Scales
Severe Personality Pathology Scales
Histrionic, Narcissistic, Compulsive Scales
Interpretation
Notable Response Patterns
-Easier to interpret because scales represent extreme dysfunctional variants of the clinical
personality scales
-Same elevations on clinical scales but different on severe scales creates different personality
profile
Each of 14 primary personality scales has 3 facet scales
-In order for facet scales to be interpretable each of personality scales score must be a BR of 65 or higher
-Facet scores should be at least 75 to be interpreted
-Most elevated scores->most relevant personality
When there is overlap in domain scores
-What are the relative elevations of overlapping facets?
-Which of two primary personality scales has the higher score elevation and how outstanding is that elevation?
-What information can be obtained from other measures including clinical impressions?
Final Step
-Look at how different facets interaction (sim. to configural interpretation)
-Can be adaptive
-Hard to measure
-High and low levels are maladaptive but modest levels are helpful
-Absence of pathology tends to elevate these three scales
-First level of interpretation is concerned only with making diagnoses.
-Looks only at which scales are elevated (Which scores are higher than the cutoff BR of 75 and 85?)
- 75 means that the person exhibits behaviors consistent with a personality style, while 85 is high enough for the person to have a diagnosis.
* This kind of interpretation is consistent with the medical model,
and can be very problematic.
"Clinicians who use the MCMI-III should do so
with goal of achieving an understanding
of the person as an integrated entity, not
as an aggrgation of diagnoses."
-Low BR on X and Y, and high score on Z= moderate exaggeration of current emotional problems that is likely
to have been sufficiently corrected so that it does not affect the tests interpretive validity
- When scale X is low and Z and Y are high, the patient endorsed antithetical symptoms, raising validity concerns.
- Low on X and high on Y- examinees trying to portray themselves in the best possible light
- Elevation of X and Z- "cry for help"
* Response style is likely to be informative in and of itself
* Computer-generated interpretive report has an interpretation of these scales.