Program 1: MCMI-III
Overview
TM
Pearson Assessments
and the Institute for Advanced Studies
in Personology and Psychopathology
Learning Objectives…
• Understanding of central role of
personality in multiaxial assessment
• Overview of the Millon Clinical
Multiaxial Inventory–III (MCMI-III )
• MCMI-III psychometrics and basic
interpretation considerations
• Recent advances in MCMI-III
assessment
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Interactive Nature of the Multiaxial System
AXIS III & IV
Medical & Psychosocial
AXIS II
Personality Dynamics
AXIS I
Clinical Presentation
(Anxiety, Dysthymia
= Fever, Cough)
(Borderline, Histrionic
= Immune System)
(Marital, Economic, Health
= Infectious Agents)
Instrumentation: Deductive
Personologic Assessment
Test Construction
Traditions…
Construction of a
Psychological Inventory…
• Burisch (1984), following Loevinger’s (1957)
scale construction paradigm, outlined three
primary methods for the construction of
item-driven objective instruments…
• External (Criterion) Method
• Inductive Method
• Deductive Method
External—Criterion Method
• Externalists: Consider selves to be “scientific
realists”
•World exists in “categories” such as diagnoses
•Develop huge item pools; only qualification is if it
differentiates categories
•Generate large, loose item pools, disparate
variation sources, moderate alpha statistics
•Questions of causality/context left for other
researchers
Inductive-Statistical
Method
• Believe in latent dimensional structure of
personality; accessible via statistical
methodology such as factor analysis
• No presumption regarding overarching
theory; what’s found in sampling is what is
• Advantage: most internally consistent,
statistically sound method
• Disadvantage: can be prone to
mathematical distortion; no real
implications for motivating aims
Deductive-Rational Method
• Believe structure of personality accessible via
overarching theoretical means; statistics used
post hoc to substantiate theory.
• Test construction: items and structure derived
from theorist’s principles, written to represent
operational definition of theory
• Advantages: Consistency with inherent
definition of “construct” (Cronbach & Meehl,
1955); allows for full explanatory system and
context; does not make leap between
observation and theory, as with inductivists
• Drawback: Nearly any theory possible, some
better than others.
Construction of the MCMI-III
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Data pool: 993 subjects
Self-Report Inventory
Ages: 18-65+
14 Axis II scales; 10 Axis I scales; 4 validity indices
Designed to assess Axis I complaint in context with Axis II
personality style/disorder
• BR scores rather than T-scores; anchored to estimates of
prevalence data for a particular disorder; no assumption of
normal curve
• Constructed via Jane Loevinger’s (1957) logic for test
development…
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Theoretical-Substantive
 Internal-Structural
 External-Validational
Development of the MCMI-III
TM
• Items written as operational definitions of the
theorist’s overarching principles (theoreticalsubstantive)
• Items subject to internal consistency scrutiny
including Cronbach’s Alpha and Repeated
Measures (internal-structural) processes
• Items tested against comparable personality
measures as well as more unilateral measures
such as the BDI
• Scales designed to be closely-coordinated to
DSM constructs
Item Assignment for the
MCMI-III
TM
• Prototypal vs. Non-prototypal items…
– Each of the 175 items on MCMI-III is prototypal on one
scale only, weighted (2)
– Each of the 175 items may also be a non-prototypal
(supportive) item on another scale, weighted (1)
– System is consonant w/ polythetic personality constructs,
but sometimes reduced discriminant validity
– System allows for greater detail of profile report, within a
relatively brief inventory
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MCMI-III : Validity Scales
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Scale
Validity
12
N of items
Alpha
3
n/a
Disclosure
n/a
n/a
Desirability
21
.85
Debasement
33
.95
MCMI-III : Clinical Personality Patterns
TM
Scale
N of Items
Alpha
Schizoid
16
.81
Avoidant
16
.89
Depressive
15
.89
Dependent
16
.85
Histrionic
17
.81
Narcissistic
24
.67
Antisocial
17
.77
Sadistic
20
.79
Compulsive
17
.66
Negativistic
16
.83
Masochistic
15
.87
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MCMI-III : Severe Personality Pathology
TM
Scales
N of items
Alpha
Schizotypal
16
.85
Borderline
16
.85
Paranoid
17
.84
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MCMI-III : Clinical Syndromes
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Scale
N of Items
Alpha
Anxiety
14
.86
Somatoform
12
.86
Bipolar/Mania
13
.71
Dysthymia
14
.88
Alcohol Dependence
15
.82
Drug Dependence
14
.83
PTSD
16
.89
15
MCMI-III : Severe Clinical Syndromes
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Scale
N of items
Alpha
Thought Disorder
17
.87
Major Depression
17
.90
Delusional Disorder
13
.79
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MCMI-III :
Interpretive Hallmarks
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BR score 60+: Possible presence of traits at the domain
level
BR score 75-84: Likely psychopathology is present, may still
be at trait or feature level
BR score 85+: Prevalence of the disorder, likely to be at an
impairing level
MCMI-III :
Interpretive Procedure
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Validity: 3 validity items, under- or over-report on disclosure
scale, general trend on desirability/debasement
Critical items: suicidality, childhood abuse, eating disorder,
interpersonal alienation, emotional dyscontrol
Personality: Check elevations on severe scales, flesh out
spikes w/ clinical personality scales, look for 1-2 pt. high code
on clinical personality scales
Syndromal: Severe syndrome scales, then basic clinical
syndromes, convergence with personality styles
Clinical decision making: Clinician’s contextual read of the
overall profile in tandem with presenting picture
Overall Strengths of the MCMI-III
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Close consonance with DSM-IV constructs
Contextualization of Axis I and II
Brief Instrument – minimal clinical time
Ability to decipher admixtures of personality patterns
Ability to deduce motivating dynamics of personality
pathology, clinical syndromes
BR scoring consonant with personality pattern
prevalences
Large, stratified, representative sample
Some Non-Strengths of the MCMI-III
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Population served: clinical ONLY
Item overlap drawbacks: some discriminant validity
issues, difficulty in conducting research
Complex hand-scoring system
Some positive predictive power difficulties on several
scales (generally, non-DSM scales)
General statistical difficulties of a deductively-derived
instrument
Less robust validity indices than comparable
instruments
Recent Advances in
MCMI-III Assessment…
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The Grossman Facet
Subscales of the
TM
MCMI-III …
Domain by Disorder Matrix
Behavioral
Acts
Interpersonal
Conduct
Cognitive
Style
Self-Image
Schizoid
Impassive
Unengaged
Impoverished
Avoidant
Fretful
Aversive
Depressive
Disconsolate
Defenseless
Dependent
Incompetent
Histrionic
Narcissistic
Dramatic
Representations
Object
Regulatory
Mechanisms
Morphologic
Organization
Mood/
Temperament
Complacent
Meager
Intellectualization
Undifferentiated
Apathetic
Distracted
Alienated
Vexatious
Fantasy
Fragile
Anguished
Pessimistic
Worthless
Forsaken
Asceticism
Depleted
Melancholic
Submissive
Naive
Inept
Immature
Introjection
Inchoate
Pacific
AttentionSeeking
Flighty
Gregarious
Shallow
Dissociation
Disjointed
Fickle
Admirable
Contrived
Rationalization
Spurious
Insouciant
Acting-Out
Unruly
Callous
Haughty
Exploitive
Expansive
Antisocial
Impulsive
Irresponsible
Deviant
Autonomous
Debased
Sadistic
Precipitate
Dogmatic
Combative
Pernicious
Isolation
Eruptive
Hostile
Concealed
Reaction
Formation
Compartmentalized
Solemn
Abrasive
Compulsive
Disciplined
Respectful
Negativistic
Resentful
Contrary
Skeptical
Discontented
Vacillating
Displacement
Divergent
Irritable
Masochistic
Abstinent
Deferential
Diffident
Undeserving
Discredited
Exaggeration
Inverted
Dysphoric
Schizotypal
Eccentric
Secretive
Autistic
Estranged
Chaotic
Undoing
Fragmented
Distraught
or Insentient
Borderline
Spasmodic
Paradoxical
Capricious
Uncertain
Incompatible
Regression
Split
Labile
Paranoid
Defensive
Provocative
Suspicious
Inviolable
Unalterable
Projection
Inelastic
Irascible
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Constricted Conscientious
Grossman Subscale Domains are highlighted
Avoidant Facet Subscales:
Sample Items
1: Interpersonally aversive
146
T I always wonder what the real reason is when someone is acting
especially nice to me.
48
T A long time ago, I decided it's best to have little to do with people.
2: Alienated self-image
47
T
I tend to always blame myself when things go wrong.
40
T
I guess I'm a fearful and inhibited person.
3: Vexatious representations
99
T In social groups I am almost always very self-conscious and tense.
174
T Although I'm afraid to make friendships, I wish I had more than I do.
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Narcissistic Facet Subscales:
Sample Items
1: Admirable self-image
141
F I feel that most people think poorly of me.
94
F People can easily change my ideas, even if I thought my mind
was made up.
2: Cognitively Expansive
26
T
Other people envy my abilities.
67
T
I have many ideas that are ahead of the times.
3: Interpersonally Exploitive
38
T
I do what I want without worrying about its effect on others.
5
T
I know I'm a superior person, so I don't care what people think.
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MILLON CLINICAL MULTIAXIAL INVENTORY - IIITM
FACET SCORES FOR THREE HIGHEST PERSONALITY SCALES BR65 OR HIGHER
CODE
SCORE
PROFILE OF BR SCORES
RAW
BR
5.1
6
53
Admirable Self-Image
5.2
2
45
Cognitively Expansive
5.3
6
92
Interpersonally Exploitive
CODE
0
SCORE
60
70
FACET SCALES
80
90
100
PROFILE OF BR SCORES
RAW
BR
8A.1
2
43
Discredited Representations
8A.2
1
10
Cognitively Diffident
8A.3
5
69
Undeserving Self-Image
CODE
0
SCORE
60
70
FACET SCALES
80
90
100
PROFILE OF BR SCORES
RAW
BR
C.1
4
62
C.2
4
67
Interpersonally Paradoxical
C.3
6
75
Uncertain Self-Image
25
0
60
70
80
FACET SCALES
90
100
Temperamentally Labile
MILLON CLINICAL MULTIAXIAL INVENTORY - III
TM
COMPLETE LISTING OF MCMI-III GROSSMAN FACET SCALE SCORES
1 Schizoid
6B Sadistic
1.1 Temperamentally Apathetic
1.2 Interpersonally Unengaged
1.3 Expressively Impassive
2A Avoidant
6B.1 Temperamentally Hostile
6B.2 Eruptive Organization
6B 3 Pernicious Representations
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2A.1 Interpersonally Aversive
2A.2 Alienated Self-Image
2A.3 Vexatious Representations
2B Depressive
7.1 Cognitively Constricted
7.2 Interpersonally Respectful
7.3 Reliable Self-Image
8A Negativistic
2B.1 Temperamentally Woeful
2B.2 Worthless Self-Image
2B.3 Cognitively Fatalistic
3 Dependent
8A.1 Temperamentally Irritable
8A.2 Expressively Resentful
8A.3 Discontented Self-Image
8B Masochistic
3.1 Inept Self-Image
3.2 Interpersonally Submissive
3.3 Immature Representations
4 Histrionic
8B.1 Discredited Representations
8B.2 Cognitively Diffident
8B.3 Undeserving Self-Image
S
4.1 Gregarious Self-Image
4.2 Interpersonally Attention-Seeking
4.3 Expressively Dramatic
5 Narcissistic
6A.1 Expressively Impulsive
6A.2 Acting-Out Mechanism
6A.3 Interpersonally Irresponsible
Schizotypal
S.1 Estranged Self-Image
S.2 Cognitively Autistic
S.3 Chaotic Representations
C
5.1 Admirable Self-Image
5.2 Cognitively Expansive
5.3 Interpersonally Exploitive
6A Antisocial
Compulsive
Borderline
C.1 Temperamentally Labile
C.2 Interpersonally Paradoxical
C.3 Uncertain Self-Image
P
Paranoid
P.1 Cognitively Mistrustful
P.2 Expressively Defensive
P.3 Projection Mechanism
What does this offer?
• New potential in personality assessment
– Ability to gain perspective w/ either DSM or personologic
criteria, or both
– Ability to gauge problematic personologic domains, even in
the absence of Axis II Dx
– Finally: Ability to compare/contrast and specify problematic
domains in a personologic subtype…
• New potential in personality research
– Ability to generate research based on dimensionality of
personality, rather than limited to categorical distinction (e.g.,
age considerations for personality change).
Beyond Assessment
• Treatment Implications
– Personalized Therapy
• Follows same model as MCMI-III and the
subscales, recognizing facets, and suggesting
treatment strategies.
– Established, traditional integrative schemes (e.g.,
CBT, Cognitive/Pharmacologic, etc.)
– Newer brief models utilizing similar synergistic
approaches (e.g., cognitive/psychodynamic
modes
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