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Assessment of schizophrenic inpatients with the MCMI
J L Jackson1, R L Greenblatt, W E Davis
1Edward Hines, Jr. Veterans Affairs Hospital, Illinois 60141.
Abstract:
The Million Clinical Multiaxial Inventory (MCMI) Psychotic Thinking scale previously was found insensitive in the detection of schizophrenia. The MCMI also was shown to be susceptible to undetected "faking good." We hypothesized that the insensitivity of the MCMI Psychotic Thinking scale was due to an unwillingness of schizophrenic patients to report psychotic symptoms. The MCMI was administered to 258 male schizophrenic inpatients who were classified as symptom-reporters or nonreporters based upon whether they endorsed psychotic symptoms on a separate problem checklist. Willingness to report psychotic symptoms was a significant factor in MCMI Psychotic Thinking scale scores as well as many other MCMI scales.
Insights
Schizophrenia patients" unwillingness to report psychotic symptoms significantly impacts assessment scores on the Million Clinical Multiaxial Inventory (MCMI). This finding suggests a need for improved methods in detecting schizophrenia using psychological assessments.
Area of Science:
- Psychiatry
- Clinical Psychology
- Psychometrics
Background:
- The Million Clinical Multiaxial Inventory (MCMI) Psychotic Thinking scale has demonstrated insensitivity in detecting schizophrenia.
- The MCMI is also susceptible to individuals intentionally presenting themselves in a more favorable light ('faking good').
Purpose of the Study:
- To investigate whether schizophrenic patients' reluctance to report psychotic symptoms contributes to the insensitivity of the MCMI Psychotic Thinking scale.
- To examine the influence of symptom reporting willingness on MCMI scale scores in male schizophrenic inpatients.
Main Methods:
- Administered the MCMI to 258 male schizophrenic inpatients.
- Classified patients into symptom-reporters or non-reporters based on endorsement of psychotic symptoms on a separate checklist.
Main Results:
- Willingness to report psychotic symptoms was a significant factor influencing MCMI Psychotic Thinking scale scores.
- Symptom reporting also significantly affected scores on numerous other MCMI scales.
Conclusions:
- The unwillingness of schizophrenic patients to disclose psychotic symptoms is a key reason for the MCMI Psychotic Thinking scale's limited effectiveness in detecting schizophrenia.
- Assessment strategies for schizophrenia may need to account for patients' willingness to report symptoms to improve diagnostic accuracy.