Personality disorders among depressed outpatients as identified by the MCMI

Jw, Libb; Stankovic, Srdjan; Freeman, Arthur M.; Sokol, Roberta S.; Switzer, Paul K.; Houck, C

doi:10.1002/1097-4679(199005)46:3<277::aid-jclp2270460305>3.0.co;2-i

Cited by 15 publications

(5 citation statements)

References 14 publications

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“…In addition to the potential overrepresentation of the nonpsychotic diagnostic categories by the MCMI-I, there was a high incidence of reported personality disorders relative to clinical judgment. This finding has been documented previously (e.g., Libb et al, 1990;Piersma, 1987b;Repko & Cooper, 1985;Wetzler & Dubro, 1990) and may reflect a bias of the MCMI t o overdiagnose personality disorders, especially when Axis I disorders are present. Alternatively, there may be a tendency on the part of clinicians to underdiagnose personality disorders relative to DSM-111-R guidelines (Wetzler & Dubro, 1990).…”

Section: Discussionsupporting

confidence: 81%

Diagnostic utility of the MCMI-I and MCMI-II with psychiatric outpatients

Inch¹,

Crossley²

1993

J. Clin. Psychol.

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Research indicates that the Millon Clinical Multiaxial Inventory (MCMI-I) lacks diagnostic accuracy when compared to clinically generated DSM-111-R diagnoses. This shortcoming is most evident for the identification of psychotic disorders. The MCMI-I1 was designed to reflect more accurately the DSM-111-R diagnostic formulation, but its diagnostic efficacy has yet to be determined with clinical samples. In the present investigation, two consecutive samples of psychiatric patients who were attending an outpatient day treatment program were administered either the MCMI-I (N = 39) or the MCMI-I1 ( N = 37). MCMI diagnoses were compared with clinician-generated DSM-111-R diagnoses. Relative to clinical judgment, both versions of the MCMI underestimated the incidence of psychotic disorders and overestimated the incidence of nonpsychotic disorders and personality disorders.The Millon Clinical Multiaxial Inventory (MCMI) is a 175-item, self-report inventory that describes personality characteristics and clinical syndromes in individuals with psychiatric disorders. The first version (MCMI-I;Millon, 1983) consists of 11 personality scales and 9 clinical syndrome scales. The computer scoring system available for the MCMI-I produces reports that include raw and base rate (BR) scores for the 20 scales, descriptive narratives, and DSM-I11 diagnoses. The MCMI has undergone extensive revisions, and Millon recently has released a new version (MCMI-11;Millon, 1987). The MCMI-I1 includes two new personality scales, 45 new items (to replace 45 discarded items), and a new scoring system that assigns differential weights to items for different scales and incorporates three new validity ("modifier") scales.

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Section: Discussionsupporting

confidence: 81%

Diagnostic utility of the MCMI-I and MCMI-II with psychiatric outpatients

Inch¹,

Crossley²

1993

J. Clin. Psychol.

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“…For this study, we evaluated four personality patterns, including Avoidant, Dependent, Passive-Aggressive, and Self-Defeating scales. Acceptable psychometric properties for depressed outpatients have been documented (Libb et al, 1990).…”

Section: Millon Clinical Multiaxial Inventory-ii (Mcmi-ii)mentioning

confidence: 99%

“…Research also indicates that depressed treatment responders with an accompanying personality disorder, particularly in the of the "anxiousfearful" cluster of personality disorders (e.g. avoidant, dependent, obsessive-compulsive, and passive-aggressive) have relapsed more quickly than individuals without such diagnoses (Hart et al, 2001;Ilardi et al, 1997;Libb et al, 1990;Mundt, Kronmuller, Backenstrauss, Reck and Fiefler, 1998;Pilkonis and Frank, 1988;Shea, Glass, Pilkonis, Watkins and Docherty, 1987;Peselow, Fieve and DiFiglia, 1992;Pfohl, Coryell, Zimmerman and Stangl, 1987;Thompson, Gallagher and Czirr, 1988). Clinically, an examination of personality dimensions using a continuous measure may clarify mechanisms of risk for relapse.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Depressive Relapse During a Two Year Prospective Follow-up after Cognitive and Behavioral Therapies

Gollan

Gortner²,

Dobson

2006

Behav. Cognit. Psychother.

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Patient characteristics may partly explain individual differences in long-term maintenance of treatment gains in response to cognitive and behavioral therapies (CBT). This study evaluated the relative contribution of negative cognitive style, behavioral activation, and personality patterns, measured at the end of treatment among treatment responders, towards the risk of relapse of major depressive disorder over a 2-year prospective follow-up. The sample included depressed adults who were randomized and received an adequate dose of one of three forms of CBT, who then fully responded and completed a 2-year prospective follow-up (N = 93) (Jacobson et al., 1996;Gortner, Gollan, Dobson and Jacobson, 1998). Cox regression analyses revealed that for treatment responders, self-devaluative depressogenic cognitive style did not predict relapse during the 2-year follow-up. Separate cox regression analyses indicated that without considering the contribution of personality patterns, it was important to distinguish the level of behavioral activation (e.g. frequency of pleasant events) from its associated pleasure in predicting relapse. With the introduction of personality patterns; however, an integrated model revealed that only dependent personality pattern was associated with hazard of relapse during the 2-year prospective follow-up. Dependent personality pattern may increase relapse through behavioral passivity.

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“…10As a cautionary note, findings of Libb, Stankovic, Freeman, Sokol, Switzer, and Houck (1990) suggest that Axis I-Axis II interactions may invalidate these scales. On the MCMI, depressed outpatients warranted 55.5% fewer Schizoid, Avoidant, and Borderline personality disorders after only 12 weeks of treatment for their depression.…”

mentioning

confidence: 99%

Validation of the Millon Clinical Multiaxial Inventory for Axis II disorders: Does it meet the Daubert standard?

Rogers

Salekin

Sewell

1999

Law and Human Behavior

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Relevant to forensic practice, the Supreme Court in Daubert v. Merrell Dow Pharmaceuticals, Inc. (1993) established the boundaries for the admissibility of scientific evidence that take into account its trustworthiness as assessed via evidentiary reliability. In conducting forensic evaluations, psychologists and other mental health professionals must be able to offer valid diagnoses, including Axis II disorders. The most widely available measure of personality disorders is the Million Clinical Multiaxial Inventory (MCMI) and its subsequent revisions (MCMI-II and MCMI-IIl). We address the critical question, "Do the MCMI-II and MCMI-III meet the requirements of Daubert?" Fundamental problems in the scientific validity and error rates for MCMI-III appear to preclude its admissibility under Daubert for the assessment of Axis II disorders. We address the construct validity for the MCMI and MCMI-II via a meta-analysis of 33 studies. The resulting multitrait-multimethod approach allowed us to address their convergent and discriminant validity through method effects (Marsh, 1990). With reference to Daubert, the results suggest a circumscribed use for the MCMI-II with good evidence of construct validity for Avoidant, Schizo typal, and Borderline personality disorders.The Supreme Court's decision in Daubert v. Merrell Dow Pharmaceuticals, Inc. (1993; hereinafter cited as Daubert) changed the landscape of expert testimony. Recent commentaries on Daubert have emphasized its general implications for psychological (Goodman-Delahunty, 1997; Rotgers & Barren, 1996) and psychiatric (Zonana, 1994) evidence, but do not grapple with the admissibility of specific psychological tests. As an overview, the relevance of Daubert and subsequent cases to psychological practice is examined. We then consider the development and validation of the Millon Clinical Multiaxial Inventory (MCMI) in light of Daubert.

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Personality disorders among depressed outpatients as identified by the MCMI

Cited by 15 publications

References 14 publications

Diagnostic utility of the MCMI-I and MCMI-II with psychiatric outpatients

Diagnostic utility of the MCMI-I and MCMI-II with psychiatric outpatients

Predictors of Depressive Relapse During a Two Year Prospective Follow-up after Cognitive and Behavioral Therapies

Validation of the Millon Clinical Multiaxial Inventory for Axis II disorders: Does it meet the Daubert standard?

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