The MMPI in neuropsychological assessment: a murky measure

Abstract

The Minnesota Multiphasic Personality Inventory (MMPI) is commonly used in neuropsychological assessment in hope of ferreting out the presence of psychiatric disorders and "emotional factors". This paper discusses whether or not the MMPI can in fact do this intended task. The conclusion is that the MMPI is a poor measure of emotional adjustment and a poor aide to differential psychiatric diagnosis because the question pool is contaminated by questions that can be endorsed by neurologic and other medical patients for reasons other than emotional maladjustment or psychiatric disorder. Several MMPI scales may be elevated in a neurologic patient's profile simply because his/her symptoms are consistent with a neurologic disorder and are not necessarily a reflection of pathological adaptation or poor emotional adjustment. The safe assumptions to make in interpreting the MMPIs of neurologic patients are presented. The need to use a comprehensive assessment process to understand personality, psychological reaction, and psychiatric disorder is emphasized.

Executive function in schizophrenia: what impact do antipsychotics have?

“…Given the importance of functional outcome as an index of pharmacological efficacy it is important to acknowledge suggestions that standard executive function tests may lack ecological validity (e.g. Cripe, 1996). Van Beilen et al (2005) suggest standard test procedures strongly prompt certain behaviours, thereby negating the influence of voluntary effort and not reflecting real life function.…”

Call for an Integrative and Multi-Disciplinary Approach to Traumatic Brain Injury (TBI)

“…While certain of the clinical scales of the MMPI-II are typically elevated with TBI, such as Pd, D and Sc (Burke, Imhoff, & Kerrigan, 1990;Leininger, Kreutzer, & Hill, 1991), there is no systematic relation between severity of injury and personality profile (Bornstein, Miller, & van Schoor, 1988). With severe TBI, Hy and Hs scales of the MMPI-II may, at times, be lower as compared to controls and indicative of a lack of awareness associated with the brain injury rather than a change in personality (Cripe, 1996). The Personality Assessment Inventory (Morey, 1991) has similar format to the MMPI-II, but has the advantage of being briefer (344 items) and TBI patients can more easily tolerate its administration.…”

Detecting Simulated Cognitive Impairment With MMPI-2 Neurocorrection Scales

“…Previous studies have produced equivocal results linking MMPI variables to neuropsychological variables (Cripe, 1996). For instance, several studies have indicated that the MMPI is insufficient at determining degrees of psychopathology for lateralized brain injuries and language disturbances (Dikmen & Reitan, 1974a;Dikmen & Reitan, 1974b;Moehle & Fitzhugh-Bell, 1988).…”

“…The understanding that items on the MMPI could reflect both neurological and psychiatric symptoms led to questioning the appropriateness of the MMPI / MMPI-2 in neuropsychological examinations (Cripe, 1996). One approach that attempted to address this issue is described as "neurocorrection."…”

“…Studies examining the use of the MMPI-2 in neuropsychological contexts have produced inconsistent results (Cripe, 1996). A large body of literature has identified additional variables that may influence MMPI-2 scale profiles.…”