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

Abstract

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.

Dynamic of Change in Pathological Personality Trait Dimensions: A Latent Change Analysis Among at-Risk Women

“…For example, Jane, Oltmanns, South and Turkheimer, (2007) identified a differential item functioning in the diagnostic features of 10 personality disorder categories, suggesting that men and women with equivalent levels of pathology tend to endorse items of common PD inventories at different rates. This points out another limit of this study: its reliance on a self-report measure which usually maps only partially onto PD-related behavior (e.g., Rogers et al 1999), although this format is commonly used to capture dimensional “trait models” of maladaptive personality (Westen & Muderrisoglu, 2006). …”

“…In addition, questions have emerged regarding the ability of this instruments to discriminate between distinct PD categories and to serve as robust diagnostic tool in practical settings given the rather high overlap between MCMI-III PD scales (e.g., Rogers, Salekin & Sewell, 1999). This overlap suggests that a careful examination of MCMI structure is needed to reveal the higher-order constructs (PPTDs) underlying the covariation between scale scores (Philippe Rushton and Irwing, 2009).…”

Psychiatric Comorbidity and Other Psychological Factors in Patients with “Chronic Lyme Disease”

“…Personality disorders can co-occur with clinical disorders, but by definition represent an enduring pattern of maladaptive personality traits that are relatively stable over time and apparent in the absence of a clinical disorder such as Major Depressive Disorder25. The most extensively used written assessment instrument for personality disorders, the Millon Clinical Multiaxial Inventory-III31–32, was used to evaluate personality disorders. The single highest scale score was considered the best indicator of personality style.…”

A Case Law Survey of the Personality Assessment Inventory: Examining Its Role in Civil and Criminal Trials

“…A broad array of instruments appears to be used to address an equally broad array of legal issues arising in civil litigation (e.g., child custody evaluations, personal injury litigation) and criminal cases (e.g., insanity defenses, sentencing evaluations). Despite this extensive use, several critics have raised questions and concerns about the relevance of psychological testing in court cases in general (e.g., American Academy of Child and Adolescent Psychiatry, 1994) as well as in relation to specific instruments in civil and criminal trials (e.g., Carr, Moretti, & Cue, 2005;DeMatteo & Edens, 2006;Otto, Edens, & Barcus, 2000;Rogers, Salekin, & Sewell, 1999).…”