Adapting assessment processes to consider cultural mistrust in forensic practices: An example with the MMPI instruments.

OBJECTIVE: Our first goal in this study was to identify cultural mistrust critical items (CMCIs) on two versions of the Minnesota Multiphasic Personality Inventory (MMPI)-the MMPI-Second Edition-Restructured Form (MMPI-2-RF) and MMPI-Third Edition (MMPI-3)-that might be endorsed by people of color because of cultural mistrust rather than clinical paranoia. Our second goal was to determine whether CMCIs and items on the MMPI-2-RF/MMPI-3 Ideas of Persecution scale (Restructured Clinical Scale 6 [RC6]) were endorsed at different rates across cultural groups in a nonclinical college sample and a forensic inpatient sample. HYPOTHESES: Our primary hypothesis was that expert raters would reliably identify a subset of MMPI-2-RF and MMPI-3 items as reflective of cultural mistrust. Black college students would endorse the highest level of CMCIs, followed by Latina/o students, and then White students. We hypothesized that the same pattern of findings would occur in forensic inpatients but that the differences would be attenuated because of the high base rate of psychiatric symptomatology and the nature of the forensic assessment setting. METHOD: Three Black female and three Black male psychologists rated the degree to which each item on the MMPI-2-RF and MMPI-3 reflected cultural mistrust. Black (n = 90), Latina/o (n = 83), and White (n = 100) college students were compared on CMCIs and on MMPI-2-RF/MMPI-3 RC6 item endorsement. The same comparisons were made among Black (n = 221), Latina/o (n = 142), and White (n = 483) forensic inpatients who completed the MMPI-2-RF. RESULTS: Black college students endorsed the highest levels of cultural mistrust, followed by Latina/o students, and then White students, resulting in small-to-medium effect sizes (Hedges's gs = 0.14-0.52). Although we observed some item-level differences in forensic patients, the overall pattern of item endorsement did not significantly differ in this group. CONCLUSIONS: There are multiple reasons for the reporting of clinical paranoia and cultural mistrust in forensic assessment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Assessment of response bias in personality disorder research.

Most research on personality disorders (PDs) relies upon self-reported information, commonly collected via standardized self-report inventories or structured interviews. Such data might, for instance, be culled from archival records from applied evaluative contexts or collected as part of dedicated anonymized research studies. Many factors-such as disengagement, distractibility, or motivation to appear in a certain manner-may influence whether self-reported information accurately reflects an examinee's genuine personality characteristics. Despite resultant risks to the validity of collected data, very few measures used in PD research include embedded indicators of response validity. In this article, we review the need for validity measures and strategies that exist to identify invalid self-report data, and we offer several suggestions for PD researchers to consider in order to detect invalid self-reported information and improve the quality of their data. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Association between MMPI-2-RF SUB items/scale and interview-reported substance abuse history among forensic psychiatric inpatients.

The purpose of this study was to examine associations between substance use disclosure during the clinical interview and on the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) Substance Abuse Scale (SUB) among forensic inpatients. Of the 223 archival reports reviewed that had MMPI-2-RF data, 69% of the MMPI-2-RF protocols were valid based on standard validity criteria, resulting in a final sample of 154 patients (98 men, 56 women). We found that patients who endorsed alcohol or marijuana use during the clinical interview often concurrently denied substance use on the MMPI-2-RF SUB scale (the opposite was found for prescription drug abuse). We also found that the MMPI-2-RF SUB scale and other MMPI-2-RF externalizing scales were meaningfully associated with concurrent substance use variables from a record review form. Finally, we found that the MMPI-2-RF SUB scale demonstrated incremental validity over other MMPI-2-RF externalizing scales in the prediction of substance use problems. These results highlight the utility of SUB scale and other self-report instruments in assessing substance use problems. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Methodological considerations for developing and evaluating response bias indicators.

In the near-100 years of their existence, response bias indicators have undergone significant advancements in design, as have efforts at examining their validity. However, opportunities remain for greater sophistication in the development and study of these indicators. We discuss important definitional issues pertaining to response bias before turning to a review of common methods used in this area of research followed by discussion of innovations that could further advance response bias investigation. Specifically, we focus on considerations for conducting research on the need for, evaluation, and design of response bias indicators. We review established and innovative research approaches and how they can be used to further this line of work. Throughout, we identify areas in need of additional study as we work to advance knowledge about the impact of invalid responding and the utility of the indicators available to detect it. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Examination of differential validity of MMPI-2-RF scores by gender and ethnicity in predicting future suicidal and violent behaviors in a forensic sample.

Given the diversity of individuals who undergo psychological assessment, examining whether cultural bias exists in psychological assessment instruments (i.e., differential validity) is crucial. This issue occurs when a measure systematically over- or underpredicts a criterion across demographic groups or is associated with the criterion unequally across the groups. We tested the differential validity of a widely used psychological test, the Minnesota Multiphasic Personality Inventory (MMPI)-2-Restructured Form (MMPI-2-RF), as a function of gender (male, female) and ethnicity (Caucasian, African American, and Hispanic/Latino American) in large samples of forensic psychiatric inpatients. Regression models were estimated in a multigroup framework. The analyses yielded negligible to small statistical evidence of differential validity in MMPI-2-RF scores predicting the number of future suicidal behaviors and violent behaviors in the samples. This evidence supports use of the MMPI-2-RF as a generally unbiased instrument for predicting key criteria across genders and ethnicities in a forensic psychiatric population. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Minnesota Multiphasic Personality Inventory-2-Restructured Form markers of future suicidal behavior in a forensic psychiatric hospital.

Past research indicates a need to integrate objective psychological testing with clinical interview data during suicide risk assessment. The current study evaluated the utility of the Minnesota Multiphasic Personality Inventory (MMPI)-2 Restructured Form (MMPI-2-RF) in the prediction of future suicidal behaviors in a sample of 1,110 forensic inpatients (807 males, 303 females). Results indicated that scales from all substantive domains of the MMPI-2-RF were significantly positively associated with future suicidal behaviors. Consistent with expectations, the best predictors were scale scores from the internalizing and externalizing domains of the inventory. Relative Risk Ratios indicated that individuals producing elevations on these scales were at 2 to 4 times greater risk of future suicidal behaviors compared with those who did not produce elevations. Implications of these findings and limitations of this study are discussed. (PsycINFO Database Record

The Role of Dimensional Personality Psychopathology in a Forensic Inpatient Psychiatric Setting.

The Minnesota Multiphasic Personality Inventory-2 Restructured Form is a widely used measure of psychopathology and includes the Personality Psychopathology Five (PSY-5) scales, which measure dimensional maladaptive personality traits similar to those in the DSM-5 alternative model for personality disorder (PD) diagnosis. The current study evaluated the role of these dimensional personality psychopathology characteristics in a sample of 1,110 inpatients in a forensic psychiatric setting, where personality psychopathology plays a significant but understudied role. The authors examined the extent to which dimensional personality psychopathology characteristics (as measured by the PSY-5) were associated with borderline and antisocial PD diagnoses and institutional aggression. Results support the usefulness of measuring dimensional personality traits for understanding PD diagnoses, as well as incidents of institutional aggression. More specifically, the PSY-5 scales appear to measure the core features of borderline and antisocial PDs. This study supports the inclusion of dimensional personality assessment in understanding aggressive behavior in inpatient settings.

Mapping the MMPI-2-RF Substantive Scales Onto Internalizing, Externalizing, and Thought Dysfunction Dimensions in a Forensic Inpatient Setting.

Contemporary models of psychopathology-encompassing internalizing, externalizing, and thought dysfunction factors-have gained significant support. Although research indicates the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008 /2011) measures these domains of psychopathology, this study addresses extant limitations in MMPI-2-RF diagnostic validity research by examining associations between all MMPI-2-RF substantive scales and broad dichotomous indicators of internalizing, externalizing, and thought dysfunction diagnoses in a sample of 1,110 forensic inpatients. Comparing those with and without internalizing diagnoses, notable effects were observed for Negative Emotionality/Neuroticism-Revised (NEGE-r), Emotional/Internalizing Dysfunction (EID), Dysfunctional Negative Emotions (RC7), Demoralization (RCd), and several other internalizing and somatic/cognitive scales. Comparing those with and without thought dysfunction diagnoses, the largest hypothesized differences occurred for Thought Dysfunction (THD), Aberrant Experiences (RC8), and Psychoticism-Revised (PSYC-r), although unanticipated differences were observed on internalizing and interpersonal scales, likely reflecting the high prevalence of internalizing dysfunction in forensic inpatients not experiencing thought dysfunction. Comparing those with and without externalizing diagnoses, the largest effects were for Substance Abuse (SUB), Antisocial Behavior (RC4), Behavioral/Externalizing Dysfunction (BXD), Juvenile Conduct Problems (JCP), and Disconstraint-Revised (DISC-r). Multivariate models evidenced similar results. Findings support the construct validity of MMPI-2-RF scales as measures of internalizing, thought, and externalizing dysfunction.

The comparative capacity of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and MMPI-2 Restructured Form (MMPI-2-RF) validity scales to detect suspected malingering in a disability claimant sample.

The current study expands on past research examining the comparative capacity of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher et al., 2001) and MMPI-2 Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008/2011) overreporting validity scales to detect suspected malingering, as assessed by the Miller Forensic Assessment of Symptoms Test (M-FAST; Miller, 2001), in a sample of public insurance disability claimants (N = 742) who were considered to have potential incentives to malinger. Results provide support for the capacity of both the MMPI-2 and the MMPI-2-RF overreporting validity scales to predict suspected malingering of psychopathology. The MMPI-2-RF overreporting validity scales proved to be modestly better predictors of suspected psychopathology malingering-compared with the MMPI-2 overreporting scales-in dimensional predictive models and categorical classification accuracy analyses. (PsycINFO Database Record

Resilience in the United States Air Force: Psychometric properties of the Connor-Davidson Resilience Scale (CD-RISC).

Results are presented for the largest study (N = 53,692) ever conducted on the 25-item Connor-Davidson Resilience Scale (CD-RISC), a popular measure of resilience. We examined the internal consistency of the CD-RISC items and associated mean resilience levels within a sample of enlisted basic trainees in the United States Air Force. In addition, the predictive validity of the CD-RISC Total Score was examined for real-life military outcomes, including attrition from service and mental health diagnosis. The CD-RISC items demonstrated strong internal consistency. Item-level examinations of scores revealed that most trainees reported relatively high resilience. Results indicated that resilience measured at the beginning of military service is a significant predictor of (a) attrition from service and (b) obtaining a mental health diagnosis within 6 months of entry. Implications and future directions are discussed. (PsycINFO Database Record

The impact of underreporting and overreporting on the validity of the Personality Inventory for DSM-5 (PID-5): A simulation analog design investigation.

The Personality Inventory for DSM-5 (PID-5) is a 220-item self-report instrument that assesses the alternative model of personality psychopathology in Section III (Emerging Measures and Models) of DSM-5. Despite its relatively recent introduction, the PID-5 has generated an impressive accumulation of studies examining its psychometric properties, and the instrument is also already widely and frequently used in research studies. Although the PID-5 is psychometrically sound overall, reviews of this instrument express concern that this scale does not possess validity scales to detect invalidating levels of response bias, such as underreporting and overreporting. McGee Ng et al. (2016), using a "known-groups" (partial) criterion design, demonstrated that both underreporting and overreporting grossly affect mean scores on PID-5 scales. In the current investigation, we replicate these findings using an analog simulation design. An important extension to this replication study was the finding that the construct validity of the PID-5 was also significantly compromised by response bias, with statistically significant attenuation noted in validity coefficients of the PID-5 domain scales with scales from other instruments measuring congruent constructs. This attenuation was found for underreporting and overreporting bias. We believe there is a need to develop validity scales to screen for data-distorting response bias in research contexts and in clinical assessments where response bias is likely or otherwise suspected. (PsycINFO Database Record

Evaluating item endorsement rates for the MMPI-2-RF F-r and Fp-r scales across ethnic, gender, and diagnostic groups with a forensic inpatient sample.

The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) F(p) (Infrequency-Psychopathology) scale was developed to measure overreporting in a manner that was minimally confounded by genuine psychopathology, which was a problem with using the MMPI-2 F (Infrequency) scale among patients with severe mental illness. Although revised versions of both of these scales are included on the MMPI-2-Restructured Form and used in a forensic context, no item-level research has been conducted on their sensitivity to genuine psychopathology among forensic psychiatric inpatients. Therefore, we examined the psychometric properties of the scales in a sample of 438 criminally committed forensic psychiatric inpatients who were adjudicated as not guilty by reason of insanity and had no known incentive to overreport. We found that 20 of the 21 Fp-r items (95.2%) demonstrated endorsement rates ≤ 20%, with 14 of the items (66.7%) endorsed by less than 10% of the sample. Similar findings were observed across genders and across patients with mood and psychotic disorders. The one item endorsed by more than 20% of the sample had a 23.7% overall endorsement rate and significantly different endorsement rates across ethnic groups, with the highest endorsements occurring among Hispanic/Latino (43.3% endorsement rate) patients. Endorsement rates of F-r items were generally higher than for Fp-r items. At the scale level, we also examined correlations with the Restructured Clinical Scales and found that Fp-r demonstrated lower correlations than F-r, indicating that Fp-r is less associated with a broad range of psychopathology. Finally, we found that Fp-r demonstrated slightly higher specificity values than F-r at all T score cutoffs. (PsycINFO Database Record

Introduction of a conceptual model for integrating the MMPI-2-RF into HCR-20V3 violence risk assessments and associations between the MMPI-2-RF and institutional violence.

Reflecting the need to prevent violence, structured professional judgment assessment tools have been developed specifically to assess the likelihood of future violence. These tools typically integrate data from clinical interviews and collateral records to assist in the conceptualization of violence risk, but objective psychological testing may also be useful in completing the instruments. The authors describe the advantages of using the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in this manner with the Historical Clinical Management-20 Version 3 (HCR-20V3). Accordingly, they have 2 purposes. First, they sought to identify conceptual links between the constructs measured by the tools and introduce a model to integrate MMPI-2-RF findings into an HCR-20V3 risk assessment. Second, although the authors did not have collateral HCR-20V3 ratings, they sought to examine associations between the MMPI-2-RF scales and future violence in a sample of 303 psychiatric patients (233 males, 70 females) adjudicated as not guilty by reason of insanity. The authors found that the MMPI-2-RF scales demonstrated significant, meaningful associations with a count of future violent acts at the hospital. The largest associations involved scales measuring emotional dysregulation and externalizing dysfunction. These associations were qualified by relative risk ratio analyses indicating that patients producing elevations on these scales were at 1.5 to 2.5 times greater risk of future violence than those without elevations. Overall, the findings indicated that most MMPI-2-RF scales conceptually linked to the HCR-20V3 risk factors were associated with future violence. In light of these findings, the authors discuss recommendations for integrating the MMPI-2-RF when interpreting HCR-20V3 risk factors. (PsycINFO Database Record

The Effect of Response Bias on the Personality Inventory for DSM-5 (PID-5).

Valid self-report assessment of psychopathology relies on accurate and credible responses to test questions. There are some individuals who, in certain assessment contexts, cannot or choose not to answer in a manner typically representative of their traits or symptoms. This is referred to, most broadly, as test response bias. In this investigation, we explore the effect of response bias on the Personality Inventory for DSM-5 (PID-5; Krueger, Derringer, Markon, Watson, & Skodol, 2013 ), a self-report instrument designed to assess the pathological personality traits used to inform diagnosis of the personality disorders in Section III of DSM-5. A set of Minnesota Multiphasic Personality Inventory Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008 / 2011 ) validity scales, which are used to assess and identify response bias, were employed to identify individuals who engaged in either noncredible overreporting (OR) or underreporting (UR), or who were deemed to be reporting or responding to the items in a "credible" manner-credible responding (CR). A total of 2,022 research participants (1,587 students, 435 psychiatric patients) completed the MMPI-2-RF and PID-5; following protocol screening, these participants were classified into OR, UR, or CR response groups based on MMPI-2-RF validity scale scores. Groups of students and patients in the OR group scored significantly higher on the PID-5 than those students and patients in the CR group, whereas those in the UR group scored significantly lower than those in the CR group. Although future research is needed to explore the effects of response bias on the PID-5, results from this investigation provide initial evidence suggesting that response bias influences scale elevations on this instrument.

Clinical utility of the MMPI-2-RF SUI items and scale in a forensic inpatient setting: Association with interview self-report and future suicidal behaviors.

In this study, we examined whether the 5 Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008/2011) Suicidal/Death Ideation (SUI) items (93, 120, 164, 251, and 334) would provide incremental suicide-risk assessment information after accounting for information garnered from clinical interview questions. Among 229 forensic inpatients (146 men, 83 women) who were administered the MMPI-2-RF, 34.9% endorsed at least 1 SUI item. We found that patients who endorsed SUI items on the MMPI-2-RF concurrently denied conceptually related suicide-risk information during the clinical interview. For instance, 8% of the sample endorsed Item 93 (indicating recent suicidal ideation), yet denied current suicidal ideation upon interview. Conversely, only 2.2% of the sample endorsed current suicidal ideation during the interview, yet denied recent suicidal ideation on Item 93. The SUI scale, as well as the MMPI-2-RF Demoralization (RCd) and Low Positive Emotions (RC2) scales, correlated significantly and meaningfully with conceptually related suicide-risk information from the interview, including history of suicide attempts, history of suicidal ideation, current suicidal ideation, and months since last suicide attempt. We also found that the SUI scale added incremental variance (after accounting for information garnered from the interview and after accounting for scores on RCd and RC2) to predictions of future suicidal behavior within 1 year of testing. Relative risk ratios indicated that both SUI-item endorsement and the presence of interview-reported risk information significantly and meaningfully increased the risk of suicidal behavior in the year following testing, particularly when endorsement of suicidal ideation occurred for both methods of self-report. (PsycINFO Database Record

"False feigners": Examining the impact of non-content-based invalid responding on the Minnesota Multiphasic Personality Inventory-2 Restructured Form content-based invalid responding indicators.

Misinterpretation of non-content-based invalid (e.g., random, fixed) responding as overreporting or underreporting is likely to adversely impact test interpretation and could bias inferences about examinee intentions. We examined the impact of non-content-based invalid responding on the following Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) content-based invalid responding indicators: Infrequent Responses (F-r), Infrequent Psychopathology Responses (FP-r), Infrequent Somatic Responses (FS), Symptom Validity (FBS-r), Response Bias Scale (RBS), Uncommon Virtues (L-r), and Adjustment Validity (K-r). In 4 samples from which invalid responders were excluded, we systematically inserted increasing percentages of random, acquiescent, or counter-acquiescent item responses ranging from 0% to 100% and examined the impact that non-content-based invalid response styles had on the content-based invalid responding indicators. F-r, FP-r, FS, RBS, and L-r were susceptible to non-content-based invalid responding, whereas FBS-r and K-r were unaffected. Individuals with Variable Response Inconsistency (VRIN-r) and True Response Inconsistency (TRIN-r) elevations were removed, and the frequencies of content-based invalid responding elevations were then reexamined for false indications of feigning. Findings were consistent across samples and emphasize the need to screen for non-content-based invalid responding before screening for content-based invalid responding in the assessment of personality and psychopathology. VRIN-r and TRIN-r were useful in detecting most-but not all-cases of non-content-based invalid responding. A small but meaningful percentage of the remaining individuals were misclassified as overreporters (i.e., false feigners) by FP-r and FS. Clinicians should interpret FP-r and FS with some caution in the presence of moderate levels of non-content-based invalid responding. Post hoc examinations of scale characteristics indicated that the most susceptible scales were brief, consisted of rarely endorsed items, included a relatively high percentage of true-keyed items, and required a low percentage of endorsed items to reach clinical significance. (PsycINFO Database Record

The impact of overreporting on MMPI-2-RF substantive scale score validity.

This study examined the impact of overreporting on the validity of Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) substantive scale scores by comparing correlations with relevant external criteria (i.e., validity coefficients) of individuals who completed the instrument under instructions to (a) feign psychopathology or (b) feign somatic complaints, with validity findings for a control group of individuals who completed the MMPI-2-RF under standard instructions. Validity coefficients for MMPI-2-RF substantive scale scores were much weaker for feigners than for controls. The authors also found mean profiles to be more elevated for feigners than for controls. Effects were more extreme for psychopathology feigners than for somatic feigners. The results demonstrate the detrimental effect that overreporting psychopathology or somatic problems has on the validity of MMPI-2-RF scale scores. The findings illustrate the need for validity indices in self-report measures of personality and psychopathology.