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Adapting assessment processes to consider cultural mistrust in forensic practices: An example with the MMPI
Janelle N Dixon1, Tonneka M Caddell1, Apryl A Alexander2
1Department of Psychology, Patton State Hospital.
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).
Insights
Cultural mistrust items on the Minnesota Multiphasic Personality Inventory (MMPI-2-RF and MMPI-3) were identified. Black college students showed the highest endorsement, differing from clinical paranoia, while forensic patients showed fewer differences.
Area of Science:
- Psychological assessment
- Cultural psychology
- Psychometrics
Background:
- Distinguishing cultural mistrust from clinical paranoia is crucial in psychological assessments, particularly for diverse populations.
- The Minnesota Multiphasic Personality Inventory (MMPI) is a widely used tool, with updated versions like the MMPI-2-Restructured Form (MMPI-2-RF) and MMPI-3.
- Previous research has not fully elucidated culturally specific items that may reflect mistrust rather than psychopathology.
Purpose of the Study:
- To identify specific items on the MMPI-2-RF and MMPI-3 that may be endorsed due to cultural mistrust among people of color.
- To compare the endorsement rates of these cultural mistrust critical items (CMCIs) and the Ideas of Persecution scale (RC6) across different cultural groups.
- To examine these patterns in both nonclinical college students and forensic inpatient samples.
Main Methods:
- Expert raters (Black psychologists) identified potential CMCIs on the MMPI-2-RF and MMPI-3.
- Nonclinical samples of Black, Latina/o, and White college students were compared on CMCI and RC6 item endorsement.
- Forensic inpatient samples of Black, Latina/o, and White individuals were similarly compared using the MMPI-2-RF.
Main Results:
- Black college students endorsed CMCIs at higher rates than Latina/o and White students, with small-to-medium effect sizes.
- Latina/o college students showed intermediate endorsement rates.
- While some item-level differences were noted in the forensic sample, the overall pattern of CMCI endorsement did not significantly differ across cultural groups in this population.
Conclusions:
- The findings suggest that certain MMPI items may capture cultural mistrust, particularly among Black college students, distinct from clinical paranoia.
- The attenuated differences in the forensic sample highlight the complexity of interpreting these items in clinical settings with high psychopathology rates.
- Further research is needed to understand the multifaceted reasons for reporting cultural mistrust versus clinical paranoia in forensic assessments.
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