Screening for Maladjustment in College Students: An Application of Receiver Operating Characteristic Curve to MMPI Scales

Abstract

The ability of two scales derived from the Minnesota Multiphasic Personality Inventory (MMPI) to identify emotional maladjustment in a college setting was examined. The scales were the College Maladjustment scale (Mt) developed by Kleinmuntz (1961) and the Health Opinion Survey based Emotional Disorder scale (Ed). Emotional maladjustment was defined by criteria established in the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, 1987) and assessed through a computerized Diagnostic Interview Schedule. Subjects were 94 female and 62 male students, 51 of whom (33%) met criteria for at least one DSM-III-R disorder. Substance use disorders were most frequent (13.5%), followed by anxiety disorders (11.5%) and depressive disorders (7.1%). Both Mt and Ed had no relationship to substance use disorders but were moderately related to nonsubstance use maladjustment (r approximately .47); receiver operating characteristic (ROC) analysis was employed, and Mt and Ed proved to be a fair-to-good indicator of nonsubstance use maladjustment. Types of decision errors are discussed, and tables provide information concerning predictive accuracy across the entire range of scores.

Psychometric Properties and Predictive Validity of the Mt Scale of the MMPI-2

“…A much more refined study (Svanum & Ehrmann, 1993) examined the ability of the Mt Scale to discriminate (a) between persons who did/did not have a Diagnostic and Statistical Manual of Mental Disorders (3rd ed.) (DSM-III) (American Psychiatric Association, 1980) diagnosis and (b) between persons having specific disorders.…”

“…Using this cutoff score, 91.2% of the combined validation and cross-validation samples would be correctly classified as either having been in treatment for three or more sessions or having been seen for only a routine screening. Subsequent research has compared the utility of this cutting score with an "expert" (Fowler, Stevens, Coyle, & Marlowe, 1968) and with alternative cutting scores (Svanum & Ehrmann, 1993). Fowler et al (1968) compared two procedures for identifying maladjusted college students.…”

“…The most refined study to examine different cutting scores (Svanum & Ehrmann, 1993) computed receiver operating characteristic (ROC) curves, which make it possible to identify utility scores along the entire range of possible values. This study revealed that overall accuracy reached 65% with a cutting score of 15 and varied from 80% to 84% with cutting scores from 20 to 32.…”

Validity of the MMPI‐2 College Maladjustment Scale

“…Kleinmuntz (1961) also suggested that the Mt scale is more accurate when it is used for identifying existing emotional problems than when it is used for predicting future emotional problems. Svanum and Ehrmann (1993) used the original Mt scale and found it was weak to moderately related to maladjustment when compared with participants with Diagnostic a d Statistical Manual-III-R (American Psychiatric Association, 1987) defined maladjustment.…”

“…Although the Mt scale seems to have proven reliability, it is difficult to have confidence in the validity of the Mt scale in the detection of maladjustment. Svanum and Ehrmann (1993) pointed out that all studies that have directly addressed emotional maladjustment have used clinical judgments with unclear criteria and uncertain reliability in identifying adjusted and maladjusted groups. Second, the most pertinent validation studies were conducted decades ago; therefore, the scale may not be sensitive to some problems experienced by contemporary college students.…”