The MCMI as a measure of DSM-III axis II diagnoses: An empirical comparison

Piersma, Harry L.

doi:10.1002/1097-4679(198709)43:5<478::aid-jclp2270430508>3.0.co;2-z

Cited by 50 publications

(32 citation statements)

References 8 publications

(5 reference statements)

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“…Research on the diagnostic validity and efficiency of the MCMI-I and MCMI-II personality disorder scales is mixed: Some studies have found adequate discriminant and convergent validity (Craig, 1988;Dubro, Wetzler, & Kahn, 1988;Torgersen & Alnaes, 1990), whereas others have found poor validity with the DSM constructs (Piersma, 1987;Repko & Cooper, 1985;Wetzler & Dubro, 1990;Widiger & Sanderson, 1987). Although not a focus of our current study, we too found limited correspondence between the MCMI-III Alcohol Abuse, Drug Abuse, Antisocial, and Major Depression scales with those from the SCID.…”

Section: Protocol Sorting and Cluster Analysis Subtypesmentioning

confidence: 99%

Millon Clinical Multiaxial Inventory-III Subtypes of Opioid Dependence: Validity and Matching to Behavioral Therapies.

Ball

Nich²,

Rounsaville³

et al. 2004

Journal of Consulting and Clinical Psychology

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The concurrent and predictive validity of 2 different methods of Millon Clinical Multiaxial Inventory-III subtyping (protocol sorting, cluster analysis) was evaluated in 125 recently detoxified opioid-dependent outpatients in a 12-week randomized clinical trial. Participants received naltrexone and relapse prevention group counseling and were assigned to 1 of 3 intervention conditions: (a) no-incentive vouchers, (b) incentive vouchers alone, or (c) incentive vouchers plus relationship counseling. Affective disturbance was the most common Axis I protocol-sorted subtype (66%), antisocial-narcissistic was the most common Axis II subtype (46%), and cluster analysis suggested that a 2-cluster solution (high vs. low psychiatric severity) was optimal. Predictive validity analyses indicated less symptom improvement for the higher problem subtypes, and patient treatment matching analyses indicated that some subtypes had better outcomes in the no-incentive voucher conditions. Addiction subtyping research has identified constellations of personality dimensions (Barnes, Murray, Patton, Bentler, & Anderson, 2000) and psychiatric disorders (Kranzler & Rounsaville, 1998) that are associated with the onset and severity of substance abuse and may have relevance for predicting treatment response. The presence of co-occurring psychiatric disorders seems to indicate a need for specialized or more intensive addiction treatment, and depression, antisocial personality, and general psychiatric symptom severity have been the most commonly investigated problems. Depressed cocaine abusers benefit from cognitive-behavioral coping skills and pharmacotherapy (Carroll et al., 1994), and opiate abusers with greater psychiatric severity improve with more intensive psychosocial programs (McLellan et al., 1983). Antisocial alcohol abusers seem to have better outcomes with coping skills than with interactional approaches (Kadden, Cooney, Getter, & Litt, 1989;Longabaugh et al., 1994), although Kadden, Litt, Cooney, Kabela, and Getter (2001) failed to replicate this effect. Antisocial methadone patients do as well as (Brooner, Kidorf, King, & Stoller, 1998;Silverman et al., 1998), and perhaps better than (Messina, Farabee, & Rawson, 2003), non-antisocial patients when provided with potent behavioral incentives, individual psychotherapy (Woody, McLellan, Luborsky, & O'Brien, 1985), or enhanced psychosocial services (Cacciola, Alterman, & Rutherford, 1995;Cacciola, Rutherford, Alterman, McKay, & Snider, 1996). The current study evaluated psychopathology subtypes derived from the Millon Clinical Multiaxial Inventory-III (MCMI-III;Millon, 1994), the most recent edition of a widely used instrument that measures Axis I and II diagnoses of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) and is also rooted in a biopsychosocial personality theory that may be relevant to the treatments compared in this study. MCMI Psychopathology Subtyping ProceduresThe ability to prospe...

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Section: Protocol Sorting and Cluster Analysis Subtypesmentioning

confidence: 99%

Millon Clinical Multiaxial Inventory-III Subtypes of Opioid Dependence: Validity and Matching to Behavioral Therapies.

Ball

Nich²,

Rounsaville³

et al. 2004

Journal of Consulting and Clinical Psychology

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“…An interviewer can easily fail to appreciate the extent to which patients' self-descriptions are being distorted by their mood. Significant reductions in personality disorder symptomatology after only brief hospitalizations (equivalent to those reported for self-report inventories [63,64]) were obtained in a study that argued for the resilience of semistructured interviews [61].…”

Section: Boundaries With Axis I Mental Disordersmentioning

confidence: 89%

“…The inclusion of items assessing adaptive, healthy self-esteem and self-confidence as indicators for the presence of a narcissistic personality disorder is probably a major reason for the paradoxical treatment outcome findings of Piersma [63,64] in which scores on MCMI narcissistic scales increased after treatment rather than decreased. Such findings are obviously problematic if these scales are to be understood as indicators for the presence of a narcissistic personality disorder.…”

Section: Gender Biasmentioning

confidence: 99%

Current issues in the assessment of personality disorders

Widiger

Chaynes²

2003

Curr Psychiatry Rep

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Most patients will have clinically significant maladaptive personality traits. These personality traits can substantially complicate the effective treatment of other mental disorders, and they can also be the focus of effective treatment. The assessment of personality disorders is of considerable clinical importance. However, this assessment can also be highly problematic. This article discusses the major issues in the assessment of personality disorders (eg, differentiation from other mental disorders, from normal personality functioning, and gender bias) and summarizes existing research on the convergent and discriminant validity of the semistructured interviews and self-report inventories, which have been developed to improve the reliability and validity of personality disorder assessment.

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“…One issue concerns whether self-report instruments such as the PDQ and the MCMI-I are less accurate than assessor-rated and interview-based insmments such as the SlDP (see Nazikian et al, in press). For example, overinflation in the frequency of self-report PD diagnoses relative to interview-based instruments (see e.g., Hogg et al, in press, Nazikian et al, in press) and to clinician diagnoses (Hyler et al, 1989;Piersma. 1987 clinicians are likely to underdiagnose PDs, and parsimoniously make a single PD diagnosis (not allowing for multiple PD diagnoses), even though the clinical picturehistory would be best encompassed by the latter.…”

Section: Discussionmentioning

confidence: 99%

Using the MCMI-I to diagnose personality disorders in inpatients: AXIS I/axis N associations and sex differences

Jackson¹,

Rudd²,

Gazis³

et al. 1991

Australian Psychologist

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The present investigation examined the Millon Clinical Multiaxial Inventory (MCMI-I) personality disorder (PD) diagnostic categories and personality disorder dimensional (BR) scores in 87 patients, to evaluate Diagnostic and Statistical Manual (Third Editioflevised) (DSM-III/R) statements as regards Axis l/Axis II associations and PD sex differences. Patients formed three clearly diagnosed Axis I groups: a schizophrenic group (n = 35); an affective group (n = 30); and a mixed group who were given a range of nonaffective. nonschizophrenic diagnoses (n = 22). Using the MCMI-I, PD scores were compared across the three groups. The strongest results in line with DSM-IIT/R statements were that the affective group was much more likely than the remaining two groups to obtain borderline PD diagnoses, and females were significantly more likely to obtain a borderline diagnosis. Contrary to DSM-ID/R statements, the schizophrenic group did not obtain greater proportions of schizoid, schizotypal, or paranoid PDs. compared to the other two Axis I groups. Issues pertaining to the validity of the MCMI-I are raised, and the possible impact on results are discussed.

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The MCMI as a measure of DSM-III axis II diagnoses: An empirical comparison

Cited by 50 publications

References 8 publications

Millon Clinical Multiaxial Inventory-III Subtypes of Opioid Dependence: Validity and Matching to Behavioral Therapies.

Millon Clinical Multiaxial Inventory-III Subtypes of Opioid Dependence: Validity and Matching to Behavioral Therapies.

Current issues in the assessment of personality disorders

Using the MCMI-I to diagnose personality disorders in inpatients: AXIS I/axis N associations and sex differences

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