Exploring Potential Ethnic Bias Among MMPI-3 Scales in Assessing Personality Psychopathology.

This study examined statistical bias in the measurement of personality psychopathology in the Latinx population using the Minnesota Multiphasic Personality Inventory-3 (MMPI-3). Data were extracted from two studies that yielded a composite data set of 103 White individuals and 250 Latinx individuals. All participants were administered the MMPI-2-Restructured Form-Extended Battery (MMPI-2-RF-EX) or MMPI-3 and the Personality Inventory for the DSM-5 Short Form (PID-5-SF). First, we conducted correlation analyses between theoretically overlapping scales of the PID-5-SF and the MMPI-3 among White and Latinx individuals. The majority of theoretically associated scales were found to be at least moderately associated in the total sample. In addition, Steiger's z-tests indicated that correlations were similar in magnitude across the White and Latinx ethnic groups. Hierarchical regression subsequently determined the presence of slope and/or intercept bias. Only one analysis (the MMPI-3 Anger Proneness prediction of PID-5-SF Negative Affectivity) indicated statistically significant intercept bias. No evidence of slope bias was found. In other words, these analyses indicated that the vast majority of the relationships between MMPI-3 scales and associated personality psychopathology constructs (as measured by the PID-5-SF) remained consistent across both ethnic groups. Overall, the results supported the appropriate cross-cultural use of the MMPI-3 to assess personality psychopathology.

Clinical assessment in the time of COVID-19: Introduction to the special issue.

The COVID-19 pandemic placed much of the practice of psychological assessment in unchartered territory-including assessment via telehealth, assessment with masks or other safety measures, and accounting for the impact of a major global event in measuring performance or psychopathology. The goal of this special issue was to highlight research that addresses the numerous ways in which the pandemic impacted psychological assessment, covering three broad areas. Several articles addressed pandemic restrictions (i.e., telehealth assessment due to lockdown or social distancing, masks) and their impact on the assessment process or test validity. Another set of articles examined the impact of the pandemic on psychopathology and assessment performance more broadly, highlighting the impact on assessment and normative expectations, including in the areas of neuropsychological performance, academic achievement, and levels of psychopathology. Finally, several articles examined the validity of measures developed specifically to assess COVID-19 pandemic-related experiences. Each study is briefly reviewed, and implications for clinical practice are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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).

Psychological pain: A moderating factor between personality psychopathology and self-harm.

Objective: Self-harm and personality psychopathology have been linked, with the most robust correlations existing between negative affectivity and self-harm. Psychological pain, an emotionally-based aversive feeling, has been linked to self-harm. Considering the connection between personality psychopathology and self-harm, psychological pain may enhance self-harm risk. Participants: Analyses were conducted on 525 undergraduate students in the Spring and Fall semesters of 2019. Methods/Results: Correlation analyses indicated that self-harm was moderately correlated with Negative Affectivity, Detachment, Antagonism, Disinhibition, and Psychoticism. Additionally, self-harm was correlated with psychological pain. When examining if psychological pain moderates the relation between personality psychopathology and self-harm, results were mixed. In the cases of Disinhibition and Psychoticism, psychological pain enhanced self-harm. There was no moderating effect on the relations with Negative Affectivity, Detachment, or Antagonism. Conclusions: These findings support the role of psychological pain in self-harm outcomes for those experiencing personality psychopathology; however, this varies depending on the maladaptive traits.

Antisocial personality disorder and psychopathy: The AMPD in review.

The current review examines the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) alternative model for personality disorders' (AMPD) operationalization of antisocial personality disorder (ASPD), particularly as it relates to the construct of psychopathy. We review the available literature on the AMPD conceptualization of ASPD, its potential improvement over previous versions of the DSM, and its relationship to established measures of psychopathy. In addition, we review the literature on the AMPD's psychopathy specifier, including its utility in differentiating between ASPD and psychopathy. We provide a critical commentary for what these findings mean moving forward and discuss areas for future research direction. We argue that the DSM-5 conceptualization of ASPD is a vast improvement over previous iterations of the diagnosis; however, we discuss potential limitations and disagreements that could arise in its overlap with the construct of psychopathy. Finally, we argue that work moving forward should focus more broadly on dimensional traits and their prediction of outcomes, rather than continuing to seek diagnostic accuracy in conceptualizing ASPD and/or psychopathy and that the AMPD provides a good framework for this work. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Measurement of Eating Pathology Using the Minnesota Multiphasic Personality Inventory-3 (MMPI-3).

Eating disorders are prevalent among college student populations. Although previous iterations of the instrument did not include specific measurement of eating pathology, the Minnesota multiphasic personality inventory-3 (MMPI-3) now includes a specific scale (i.e., Eating Concerns [EAT]) to assess problematic eating behaviors. The current study examined the MMPI-3 assessment of eating pathology among 249 undergraduate women. A pattern emerged where symptoms of internalizing psychopathology on the MMPI-3 were generally associated with symptoms of eating disorder. However, the newly included EAT scale demonstrated the strongest associations with most areas of eating dysfunction. Further, hierarchical regression analyses suggested that the EAT scale added substantial incremental predictive utility (up to 23%) over other MMPI-3 scales combined in assessing eating pathology. Classification accuracy statistics yielded high sensitivity and specificity coefficients when predicting eating disorder risk at an EAT scale score cutoff of 75 T or higher. These findings support the use of the MMPI-3 in assessing eating pathology in college women, although its performance with men and with women not of college age remains to be studied.

Evaluation of the moderated-expression and differential configuration hypotheses in the context of "successful" or "noncriminal" psychopathy.

The concept of "successful" psychopathy has intrigued the field, yet relatively little actual science exists to understand what makes those high in psychopathic traits more or less successful, or even what constitutes "success." In the current study, we examined the validity of the moderated expression hypothesis, including an elaborated version that considers differential configuration of psychopathy traits, as accounting for differences in criminal and noncriminal (the most common operationalization of "success") expressions of psychopathy. The latter was conceptualized from the perspective of the triarchic psychopathy model. We recruited a community sample (n = 212) that had been overweighted toward psychopathic personality traits. The triarchic psychopathy domains of boldness, meanness, and disinhibition were modeled as latent constructs based on scores from multiple psychopathy measures. We examined affective processing dysfunction, various executive cognitive deficits, substance misuse, and socioeconomic indicators (income, education) as potential moderators of associations between psychopathy and criminality. We estimated a series of latent regression models in which we tested interaction effects between hypothesized moderators and a latent criminality variable. We found that affective processing dysfunction, substance misuse, and the triarchic psychopathy domain of disinhibition all moderated the association between meanness and criminality, in that the latter association was stronger as these moderators increased in severity. Disinhibition was also moderated by substance misuse and boldness by both personal income and commission errors from a go/no-go task, though in the case of the latter domain, these moderators served as protective factors against criminality. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The MacCAT-CA and the ECST-R in Competency to Stand Trial Evaluations: A Critical Review and Practical Implications.

There is debate regarding the utility of standardized instruments in the assessment of competence to stand trial (CST). Though the field generally has a positive view of the second-generation nomothetic instruments available, the frequency of use falls far behind this favorable impression. The current paper reviewed two standardized instruments used in CST evaluations, the Evaluation of Competency to Stand Trial - Revised (ECST-R) and the MacArthur Competence Assessment Tool-Criminal Adjudication (MacCAT-CA). We first review the psychometric properties of both instruments, including a review of limitations. Next, we discuss the legal standing of both instruments, including a review of past admissibility challenges and a discussion of potential issues in cross-examination. Finally, we end with practical guidance for clinicians; namely, that these instruments are generally valid indicators of competence to stand trial and are likely to be particularly useful in cases where competence is ambiguous and the clinician would benefit from additional standardized data to make a clear clinical decision.

Attachment, Mentalization, and Criterion B of the Alternative DSM-5 Model for Personality Disorders (AMPD).

BACKGROUND: The mentalization theory posits that interpersonal difficulties and maladaptive personality traits develop from an insecure attachment pattern with one's caregiver and corresponding deficits in mentalizing-the ability to understand others' and one's own mental states. Mentalizing deficits have been theorized as the basis for all psychopathology, with the paradigmatic case being Borderline Personality Disorder. Nevertheless, developments in the personality field indicate personality pathology is best represented dimensionally, and such a proposal was outlined by the Alternative DSM-5 Model for Personality Disorders (AMPD). Despite evidence linking the mentalization theory to personality disorders, however, it has yet to be applied to Criterion B of the AMPD. The aim of the present study was to evaluate the moderating role of mentalizing in the relation between attachment and Criterion B maladaptive trait function in a sample of undergraduates. We hypothesized a model in which: (1) attachment insecurity would be positively associated with the Negative Affectivity, Antagonism, and Disinhibition personality domains; (2) mentalizing ability would be negatively associated with these domains; and, (3) there would be an interaction effect between attachment and mentalizing when predicting these same domains. METHODS: Personality domains were measured dimensionally via the Personality Inventory for DSM-5 (PID-5-SF), while the dependence and avoidance domains of attachment were assessed via the Relationship Questionnaire (RQ). Mentalizing ability was tapped by the Movie for the Assessment of Social Cognition (MASC). The AMPD personality domains and trait facets were examined as dependent variables; attachment dependence, attachment avoidance, and overall mentalizing ability were entered as independent variables; and interaction terms between mentalizing and each attachment dimension were used to test moderation via MANCOVAs. RESULTS: Consistent with expectations, results indicated overall mentalizing moderated the relation between attachment avoidance and Negative Affectivity. Posthoc analyses revealed similar effects on the relations between attachment avoidance and the Emotional Lability, Hostility, and Perseveration trait facets; however, there were no significant moderation findings related to attachment dependence. CONCLUSIONS: These results support the mentalization theory's application to Criterion B of the AMPD, particularly in relation to the links between Negative Affectivity and borderline-related traits, and encourage future research of dimensional maladaptive personality. They further bolster support for understanding maladaptive personality as a dimensional construct.

Assessing ICD-11 personality trait domain qualifiers with the MMPI-2-RF.

OBJECTIVE: The current study examined the utility of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in assessing ICD-11 personality psychopathology trait domain qualifiers. METHOD: Using a community sample (N = 217) weighted for externalizing dysfunction, this study evaluated the convergence between ICD-11 trait domains as measured by the personality inventory for DSM-5 (PID-5) with hypothesized MMPI-2-RF scales. Particular emphasis was placed on evaluating the convergence between the ICD-11 trait domain qualifiers and the MMPI-2-RF personality psychopathology-5 (PSY-5) scales, as the latter are meant to represent broadband domains of personality pathology. RESULTS: Correlation and regression analyses demonstrated expected associations between ICD-11 domains and conceptually expected MMPI-2-RF scales, with some minor exceptions. Notably, the Anankastia domain showed associations with scales assessing negative affect, but did not show expected negative associations with scales related to disinhibition. CONCLUSIONS: The findings generally supported the use of the MMPI-2-RF in assessing individual expressions of personality dysfunction from the ICD-11 trait domain qualifier perspective.

An Examination of the Reliability and Validity of the Comprehensive Assessment of Traits Relevant to Personality Disorder-Static Form (CAT-PD-SF).

The current study examined the reliability and validity of the Comprehensive Assessment of Traits Relevant to Personality Disorder-Static Form (CAT-PD-SF), a dimensional measure of personality psychopathology. Specifically, we used exploratory factor analysis to determine the best higher order structure for the CAT-PD-SF traits. Results suggested a five-factor structure, albeit with marginal model fit. Second, we used correlation analyses to compare the CAT-PD-SF with two additional dimensional measures of personality, the Personality Inventory for DSM-5-Brief Form and the Five-Factor Model Rating Form. The results demonstrated the CAT-PD-SF scale scores were associated with domain and facet scores from these two models in a conceptually expected manner. Finally, we explored the association between the CAT-PD-SF scores and functional impairment and found moderate associations between CAT-PD-SF trait and functional impairment scores (as measured by the Measure of Disordered Personality Functioning Scale). Overall, findings add support to the structure of the CAT-PD model, and the use of the CAT-PD-SF in measuring dimensional personality psychopathology and impairment.

Construct validity of the Comprehensive Assessment of Psychopathic Personality (CAPP) Lexical Rating Scale.

The current study investigated the internal structure and validity of a self-rating form for the Comprehensive Assessment of Psychopathic Personality (CAPP) model in a large sample consisting of American (n = 463) and Australian (n = 94) undergraduates along with a U.S. community sample (n = 182). More specifically, we explored the factor structure of the CAPP Lexical Rating Scale and examined its associations with measures of psychopathy, antisocial behavior, and broad pathological personality traits. Neither exploratory factor analysis nor bass-ackward analyses supported the six proposed domains. Exploratory factor analysis supported a three-factor structure, generally representing the behavioral, interpersonal, and affective domains of psychopathy. Correlations with conceptually relevant external criteria demonstrated the identified three-factor structure was not superior to the six proposed rational domains with respect to construct validity. Symptom-level analyses supported the use of CAPP symptom as measures of individual symptoms with good convergent validity. Overall, the current study supports the construct validity of the CAPP model, and the Lexical Rating Scale in particular, but more research is needed to further explore the optimal structure of the model. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The Association Between Sexually Aggressive Cognitions and Pathological Personality Traits in Men.

Sexual aggression, harassment, and sexually aggressive cognitions (victim blaming, sexual entitlement) are serious societal problems. Although research has examined attributes of individuals who engage in overt sexual assault, few studies have focused on individual characteristics of those who perpetuate problematic negative beliefs surrounding sexual assault. This study sought to examine the relationship between pathological personality and sexually aggressive cognitions among 242 community men. Results showed that traits including antagonism, disinhibition, and negative affectivity were associated with sexually aggressive cognitions. These results have implications for understanding sexual aggression and the role personality plays in perpetuating sexually aggressive attitudes.

Patient-Reported ICD-11 Personality Disorder Severity and DSM-5 Level of Personality Functioning.

This study evaluated the Standardized Assessment of Severity of Personality Disorder (SASPD) proposed for ICD-11 and the Level of Personality Functioning Scale-Brief Form 2.0 (LPFS-BF) developed for DSM-5 Section III and their relationships with external correlates. We used a clinical sample (N = 150; 33% women) of 65 psychiatric outpatients and 85 incarcerated addicts, who self-reported the SASPD and the LPFS-BF. We conducted correlation and regression analyses in order to determine the relative associations of these two measures with relevant external criteria. SASPD predominantly captured externalizing and other-related problems (e.g., potential harm to others), whereas LPFS-BF predominantly captured internalizing and self-related problems (e.g., identity and distress). Generally, LPFS-BF explained more variance of the external criteria relative to SASPD. The findings seem to reflect that the ICD-11 oriented SASPD emphasizes interpersonal and aggressive features, whereas the DSM-5-oriented LPFS-BF emphasizes self-pathology and distress. More conclusive findings warrant interview-rated personality functioning.

Elucidating somatization in a dimensional model of psychopathology across medical settings.

Research using a categorical-polythetic classification system for mental illness has raised concern regarding the validity of categorical classification systems. Recent efforts suggest psychopathology is better understood from a dimensional framework, though there has been varying evidence of a somatization factor. The current investigation seeks to produce and validate a dimensional model of psychopathology, with a particular emphasis on the placement of somatization, across three nonoverlapping medical samples. Using a bariatric surgery seeking sample (n = 1,268), a spine surgery/spinal cord stimulator seeking sample (n = 1,711), and a chronic pain treatment seeking sample (n = 1,388), a dimensional model of psychopathology was replicated across all three samples using a dimensional measure of psychopathology (the Minnesota Multiphasic Personality Inventory-2-Restructured Form [MMPI-2-RF]). Clear evidence of a separate somatization factor was found in addition to broad internalizing, externalizing, and social detachment factors. Constructs assessable with the model yielded good convergent and discriminant validity coefficients with external criteria, and further supported the presence of a higher-order somatization construct. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Reasonable Accommodations for Meeting the Unique Needs of Defendants with Intellectual Disability.

The Americans with Disabilities Act has allowed for greater participation of individuals with disabilities across a variety of contexts, most notably in employment settings. Individuals with intellectual disability (ID) are still precluded, however, from full participation in other contexts, and they are often relegated to the forensic arena without sufficient support, including after being adjudicated incompetent to stand trial (IST). Frequently, individuals who are adjudicated IST due to ID are committed to inpatient psychiatric hospitals that are unable to meet their unique needs. We argue that the provision requiring reasonable accommodations to secure meaningful participation in state-funded restoration efforts, explicitly covered by Title II of ADA, is both relevant and imperative for this group. Further, we argue that simple modifications to the forensic assessment process, as well as the trial itself, can provide the scaffolding to facilitate individuals' full and complete participation in the process, reducing the likelihood of an inappropriate determination as IST. In our opinion, failing to appropriately modify the forensic assessment, treatment, and trial process systematically excludes and uniquely disadvantages this population because individuals with ID are often able to meet the essential functions of participation except for interference from deficits commensurate with ID.

Implications for the Measurement of Psychopathy in the DSM-5 Using the Computerized Adaptive Test of Personality Disorder.

This study investigated the ability of the Computerized Adaptive Test of Personality Disorder (CAT-PD) model to capture psychopathy in a sample consisting of U.S. (n = 565) and Australian (n = 99) undergraduates and a U.S. community sample (n = 210). More specifically, this study examined (a) the association between CAT-PD facets, particularly those consistent with DSM-5 Section III antisocial personality disorder (ASPD), and measures of psychopathy, (b) the extent to which CAT-PD ASPD traits improve on DSM-5 Section II ASPD in measuring psychopathy, and (c) the utility of measuring functional impairment in additional to dimensional traits in assessing psychopathy. Analyses revealed CAT-PD ASPD traits, including traits' associations with Section III psychopathy specifier, were strongly associated with measures of psychopathy. Furthermore, CAT-PD ASPD was found to be an improvement over DSM-5 Section II ASPD in measuring psychopathy, and the dimensional nature of the CAT-PD was found to render the addition of measures of impairment unnecessary. These findings generally support the utility of the CAT-PD in the measurement of psychopathy, particularly as it relates to the dimensional assessment of psychopathy in the DSM-5 alternative model for personality disorder.

Evaluating the role of functional impairment in personality psychopathology.

DSM-5's Section III Alternative Model for Personality Disorder (AMPD) model states that an individual must show impairment in self and interpersonal functioning for PD diagnosis. The current study investigated dimensional personality trait associations with impairment, including differential patterns of impairment across specific PDs, and whether traits have improved our assessment of functional impairment in PDs. Two-hundred and seventy-seven participants were administered measures of Antisocial PD, Avoidant PD, Borderline PD, Narcissistic PD, Obsessive-Compulsive PD, and Schizotypal PD from the perspectives of Section II (PDQ-4) and Section III (PID-5) PD models, as well as measures of functional impairment in interpersonal and intrapersonal domains. Pearson correlations showed associations between ratings of impairment and most Section II and Section III PDs and trait facets, with the exception of narcissistic PD. Hierarchical regression analyses revealed that Section III PDs added predictive validity beyond Section II PDs in predicting impairment, except narcissistic PD. These findings provide support both for the impairment criterion in the AMPD and for the association between trait-based PDs and impairment, and suggest that this trait-based measurement adds uniquely to the understanding of functional impairment.

Utility of the Personality Inventory for DSM-5-Brief Form (PID-5-BF) in the Measurement of Maladaptive Personality and Psychopathology.

The Diagnostic and Statistical Manual of Mental Disorders-Fifth edition ( DSM-5) Personality and Personality Disorders workgroup developed the Personality Inventory for the DSM-5 (PID-5) for the assessment of the alternative trait model for DSM-5. Along with this measure, the American Psychiatric Association published an abbreviated version, the PID-5-Brief form (PID-5-BF). Although this measure is available on the DSM-5 website for use, only two studies have evaluated its psychometric properties and validity and no studies have examined the U.S. version of this measure. The current study evaluated the reliability, factor structure, and construct validity of PID-5-BF scale scores. This included an evaluation of the scales' associations with Section II PDs, a well-validated dimensional measure of personality psychopathology, and broad externalizing and internalizing psychopathology measures. We found support for the reliability of PID-5-BF scales as well as for the factor structure of the measure. Furthermore, a series of correlation and regression analyses showed conceptually expected associations between PID-5-BF and external criterion variables. Finally, we compared the correlations with external criterion measures to those of the full-length PID-5 and PID-5-Short form. Intraclass correlation analyses revealed a comparable pattern of correlations across all three measures, thereby supporting the use of the PID-5-BF as a screening measure of dimensional maladaptive personality traits.