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Overreport on the MCMI-III: concurrent validation with the MMPI-2 using a psychiatric inpatient sample
C Don Morgan1, Mike R Schoenberg, Darwin Dorr
1Department of Psychiatry, University of Kansas School of Medicine, Wichita 67214-3199, USA.
Abstract:
The MCMI-III (Millon, Davis, & Millon, 1997) is a widely used measure of personality often used in inpatient psychiatric settings. Although patients in such settings often overreport or exaggerate their symptoms, relatively little is known about how such a response set presents on the validity indexes of the MCMI-II. In this study, we used a sample of 191 psychiatric inpatients and compared MCMI-III modifier indices (Disclosure, Desirability, and Debasement) with the validity measures (L, F, Fb, F(p), K, and F - K) of the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). In addition, the MCMI-III Disclosure Index (Scale X, which imposes a set cutoff score for invalidity due to overreport) was compared to several cutoff scores on the validity scales of the MMPI-2. Although the MCMI-III indexes generally performed as expected, the MCMI-III had a very high tolerance for overreport. When contrasted with MMPI-2 F scale, the MCMI-II Disclosure Index (which gauges overreport) remained valid until scores on MMPI-2 F scale approached a T score of 120. In addition, the Disclosure Index was at the upper end or slightly exceeded the highest recommended cutoff scores on all other MMPI-2 validity scales except F - K. Clinicians using the MCMI-III alone are cautioned to consider the high tolerance the MCMI-III has for overreport.
Insights
The Millon Clinical Multiaxial Inventory-III (MCMI-III) shows high tolerance for symptom overreporting in psychiatric inpatients. Clinicians should be aware of this limitation when interpreting MCMI-III results alone.
Area of Science:
- Psychological assessment
- Clinical psychology
- Psychopathology
Background:
- The Millon Clinical Multiaxial Inventory-III (MCMI-III) is frequently used in inpatient psychiatric settings.
- Patients in these settings may exaggerate symptoms, but the impact on MCMI-III validity indices is not well understood.
Purpose of the Study:
- To investigate how symptom overreporting affects the validity indices of the MCMI-III.
- To compare the MCMI-III Disclosure Index with validity scales of the MMPI-2.
Main Methods:
- 191 psychiatric inpatients were studied.
- MCMI-III modifier indices (Disclosure, Desirability, Debasement) were compared with MMPI-2 validity measures (L, F, Fb, F(p), K, F-K).
- The MCMI-III Disclosure Index was compared against MMPI-2 validity scale cutoffs.
Main Results:
- MCMI-III indices generally performed as expected but demonstrated a high tolerance for overreporting.
- The MCMI-III Disclosure Index remained valid even when MMPI-2 F scale scores approached T=120.
- The Disclosure Index met or exceeded recommended cutoffs on most MMPI-2 validity scales, excluding F-K.
Conclusions:
- Clinicians should exercise caution when relying solely on the MCMI-III due to its significant tolerance for symptom overreporting.
- Awareness of this limitation is crucial for accurate interpretation of MCMI-III results in clinical practice.
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