Millon multiaxial personality patterns differentiate purpose in life
The clinical use of the Purpose In Life Test in a group of outpatients
By Giuseppe Crea – Vienna 2014
Frankl’s basic contention is that a new type of neurosis is increasingly seen in the clinics today in contrast to the hysterias and other classical patterns, and that this new syndrome – which he terms noogenic neurosis – arises largely as a response to a complete emptiness of purpose in life.
The chief dynamic is "existential frustration" created by a vacuum of perceived meaning in personal existence, and manifested by the symptom of boredom.
According to Frankl, the essence of human motivation is the "will to meaning"; when meaning is not found, the individual becomes "existentially frustrated."
This may or may not lead to psychopathology, depending upon other dynamic factors, but he feels that the incidence of clinical cases thus rooted is of major significance.
According to Yalom (1980) a lack of meaning is associated with psychopathology, whereas positive life meaning relate to self-transcendence values, membership groups, clear life-goals.
Meaning in life is consistently related to positive mental health outcomes, while meaninglessness is associated with pathological outcomes.
Moreover sources of meaning change over a person’s life, and need to be viewed from a developmental perspective.
Millon’s model for personality characteristics focuses on some basic coping patterns with which individuals can find and achieve positive reinforcements that promote growth and avoid negative reinforcements that impede growth.
Sources of reinforcement can be either from ourselves or from others, while instrumental behavior patterns can be active (the person takes initiative) or passive (the person reacts to the environment). Combining source of reinforcement and the dimensions of instrumental behavior pattern results in a matrix of eight basic personality coping patterns. These personality coping patterns are: Antisocial, Narcissistic, Histrionic, Dependent, Passive-Aggressive, Compulsive,
Avoidant, Schizoid (Table 1). These patterns of personality styles are self-perpetuating through the preferred personality orientation in the environmental and interpersonal interactions.
The present study is intended to explore this developmental perspective, by investigating the relationship between the meaning of life as measured by the Purpose in Life Test and the personality disorders that can be considered as “pathological extensions” of the personality patterns of the individual.
Specifically, the study inspected the relationship between the PIL and measures of the personality disorders (PD) of the Millon Clinical Multiaxial Inventory-III (Meyer – Gray &
Calculator, 2008).
We want to see if some types of psychopathology are related to a failure to find meaning, and conversely the attainment of meaning is related to mental health. From this perspective changes in life meaning are seen as a precursor to changes in psychological treatment, and can influence change in positive direction.
Our purpose is to examine the differences in personality traits that might exist with outpatients, with purpose in life as operationally measured by the instrument of PIL, and to determine whether the MCMI-III might reflect this proposed difference.
1

Research question
Against this background the aim of the present study is to test the association between purpose in life (conceptualised and measured in terms of Purpose in Life Test ) and personal neurosis (conceptualised and measured in terms of personality disorders scales, PD) among a sample of outpatients. Two specific hypotheses are being tested by this study.
The first hypothesis posits a significant negative association between personality disorders and purpose in life. This hypothesis is shaped by the consensus of previous research and by the assumption that people who come in therapy generally have a low level of purpose in life.
The second hypothesis posits a causal relation between purpose in life and the PD patterns.
This hypothesis is shaped by the consensus of previous research and by the assumption that personality patterns can be predicted by purpose in life.
Subjects and Procedure
Sample
Subjects were 58 patients entering research trials as part of their initial assessment.
They were 30 females (51.7% of the total sample) and 48 males (48.3 of the total sample), with a mean age of 40 years and with standard deviation 11,8 years. The youngest participant was
20 and the oldest 70 years.
Subjects completed the two techniques in less than one hour. The subjects who participated in the study sought therapy voluntarily. The questionnaires were administered during the first three therapeutic sessions.
Measures
Purpose In Life Test (PIL) . A 20-item, 7-point Likert-type scale, developed by Crumbaugh and
Maholick (1969) to measure the degree to which an individual experiences purpose in his daily life.
The aim of the test is to detect purpose in life as described by Frankl. Numerically higher scores reflect increased purposefulness or self-transcendence. The scale has generally demonstrated good convergent validity with measures of well-being and distress and good internal consistency (e.g., α=
.91; Zika&Chamberlain, 1992). The PIL has been shown to have significant association with social attitudes, depression and subjective well-being.
Millon Clinical Multiaxial Inventory-III . Personality disorder traits were assessed with the 175-item
Millon Clinical Multiaxial Inventory-III (MCMI-III; Millon, 1994). This instrument is designed to assess both the problematic behaviors and clinical conditions of Axis I, and the personality variables of Axis II. Measures of internal consistency are strong, with alpha coefficients greater than 0.80 for 20 of 26 scales. An important feature of the MCMI-III is its use of actuarial base rate data rather than normalized standard score transformations or percentile rates.
The nonoverlapping PD scales were used in this research, as the difference with the overlapping and the nonoverlapping PD scales are quite similar in their correlation. As it appears from previous studies, «the overall pattern of scale associations is not dramatically different from the pattern that exists between the more stable, non overlapping, prototype scales» (Dyce J.A. et al.,
1997, 578-579).
Following the study of Freeman we consider the Millon scores not as continuous variables but as dichotomous variables in such a way that they denotes presence versus absence of a variable
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and not a continuous gradation. This presence or absence is determined by a cutoff score ≥ 75.
Scores below the cutoff are considered equal and denote absence of the variable in question
(Freeman et al., 1999, p. 74).
The Millon data was analyzed using contingency analysis methods. The score variables were dichotomized into present (score ≥ 75) or absent (score < 75) and then contrasted with the subject group, i.e., Major purpose in life.
Results
The first step in data analysis concerns an examination of the indices of purpose in life.
The data presented demonstrate that the measure of purpose in life achieved good levels of internal consistency reliability (Table 2).
The second step in data analysis concerns an examination of the bivariate correlations between the eight indices of personality disorders and the indices of purpose in life, and age.
Personality dimensions were correlated with the different dimension of PD (Table 3).
Those who have style of Schizoid, Avoidant, Depressive , which correspond to the prototypical and basic style of Avoidant (according to the evolutionary model of personality of
Millon, Table 1), as well as those who have style Negativistic and Masochistic, which correspond to the prototypical and basic style of Ambivalent , correlated negatively with the
PIL scales.
It means that those who are not interested in the others or are afraid to be neglected, have a negative sense of life. As well as those who are ambivalent, as they experience conflict between hostility toward others and fear of social disapproval.
Next, using hierarchical multiple regression, we further examined the associations between the eight indices of personality disorders and the indices of purpose in life which concerns the personal wellbeing conceptualised and measured in terms of purpose in life theory.
To predict psychological mental health dimension we conducted step-wise regression analyses, with the Purpose in Life Test (PIL) as the dependent variable, and the indices of personality disorders as predictors. These dimensions were entered to determine which variables significantly contributed to the variance in our model.
The results for the regression analyses (Table 4) showed that Purpose in Life (22% of the variance) is predicted through schizoid pattern (
β
= -.46; p < .001), showing that those who have less the tendency to isolate and to limit social interactions show a positive life meaning, confirming that meaning in life is related to positive relational patterns of personality.
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Table 1 Eight mildly severe personality disorders
(Taken from Millon & Everly 1985, p. 38)
Instrumental
Behavior Pattern
Active
(proactive)
Passive
(reactive)
Independent
(Self)
Antisocial
Narcissistic
Sources of reinforcement
Dependent (Others)
Histrionic
Ambivalent
(Confused)
Passive-Aggressive
Dependent Compulsive
Table 2
Scale properties
Detached (Neither)
Avoidant
Schizoid scale
N items
20
Purpose in Life
Alpha
.86
Mean
100.55
SD
16.4
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Table 3
Correlation matrix
1. TOT_PIL
2. Schizoid
3. Avoidant
4. Depressive
5. Dependent
6. Histrionic
7. Narcissistic
8. Antisocial
9. Sadistic
10. Compulsive
11. Negativistic
12. Masochistic
2 3 4
-,401** -,408** -,302*
1 0,257
1
,531**
,438**
5
-,288*
-0,046
,329*
6
0,245
-,307*
-,404**
1 ,297*
1
-0,231
0,022
1
7 8 9
-0,085 -0,035 -0,119
0,169
,334*
,352**
0,199
-0,075
0,116
10
-0,191
0,073
11
0,174 -,354** -,306*
0,106
,414**
12
,698**
,387**
,324*
0,094
,353*
0,064
,290*
0,136
-0,213 ,586**
0,162 ,342*
,673**
0,088
0,261
1
-0,076
,380**
1
0,221
,565**
,406**
1
,294*
0,205
-0,11
0,236
1
0,087
,516**
0,129
1
-0,229
0,209
0,219 ,340*
,586** -0,021
-0,152
0,266
1
Table 4
Regression Analysis Predicting Purpose in Life
Schizoid p* < .05 **p < .001
β
-.46
5 t
-3,06**