ADHD DISCUSSION Deiden/fied archival data were examined from 1,110 inpa1ents with DSMIVTR psychiatric diagnoses, available at the 1me of tes1ng, from a large forensic psychiatric facility in the western United States. Mean age = 41 years (SD = 11.4). Invalid protocols due to noncontentbased invalid responding, underrepor/ng, and overrepor/ng were removed using standardized procedures (n = 469 cases excluded). Independent samples ttests were examined to assess whether differences between groups with and without each respec1ve dysfunc1on were sta1s1cally significant. Hedges’ g effect size indices were examined to evaluate the magnitude of differences between mean scores. Analyses: 1. Internalizing Dysfunc/on Diagnoses : Yes (n = 320) vs. No (n = 321) 2. Thought Dysfunc/on Diagnoses: Yes (n = 572) vs. No (n = 69) 3. Externalizing Dysfunc/on Diagnoses : Yes (n = 469) vs. No (n = 172) Table 1. MMPI2RF Means, Standard Devia/ons, and Hedges’ g Effect Size Indices for the Three Comparisons Mapping the MMPI2RF Substan1ve Scales onto Internalizing, Thought Dysfunc1on, and Externalizing Dimensions 1 California State University, Monterey Bay, 2 Kent State University, 3 Pa[on State Hospital Isabella Romero 1 , Nasreen Toorabally 1 , Danielle Burche[ 1 , Anthony Tarescavage 2 , & David M. Glassmire 3 INTRODUCTION Contemporary models of psychopathology—which encompass internalizing, externalizing, and more recently, thought dysfunc1on (psychosis) factors—have revealed highly correlated clusters of diagnoses/syndromes 1,2 . As psychopathology research evolves toward a new dimensional model of diagnosis, it is impera1ve that assessments are also able to reflect this organiza1on and dimensional nature 1 . The Minnesota Mul1phasic Personality Inventory—2 Restructured Form (MMPI2RF; BenPorath & Tellegen, 2008/2011), with its hierarchical and dimensional organiza1on of construct assessment, possesses these capabili1es 3 . Past research mapping these higher order dimensions onto the MMPI2RF has focused primarily on internalizing, externalizing, and thought dysfunc1on dimensions separately, or exclusively on specific scale sets (see Lee, Sellbom & Hopwood for a review, in press) 4 . AIMS & HYPOTHESES METHOD RESULTS REFERENCES 1 Krueger, R. F., & Markon, K. E. (2006). Reinterpre1ng comorbidity: a modelbased approach to understanding and classifying psychopathology. Annual Review of Clinical Psychology, 2, 111–133. ²Kotov, R., Ruggero, C. J., Krueger, R. F., Watson, D., Yuan, Q., & Zimmerman, M. (2011). New dimensions in the quan1ta1ve classifica1on of mental illness. Archives of General Psychiatry, 68(10), 1003–1011. ³BenPorath, Y. S. & Tellegen, A. (2008/2011). MMPI2RF manual for administraCon, scoring, and interpretaCon. Minneapolis: University of Minnesota Press. 4 Lee, T., Sellbom, M., Hopwood, C. (In press). Contemporary psychopathology assessment: Mapping major personality inventories onto empirical models of psychopathology. In Neuropsychological Assessment in the Era of EvidenceBased PracCce, S. C. Bowden (ed.) Oxford University Press. ACKNOWLEDGEMENTS: This research was made possible by a grant from the University of Minnesota Press, which supported data collec1on. It was also supported by the California State University, Monterey Bay McNair Scholars Program and University Research Opportuni1es Center (UROC). Note. * = sta/s/cally significant ttests; p < .05. Small, (|0.20||0.49|) medium (|0.50||0.79|), and large (|0.80+|) Hedges’ g values are bolded. Hypothesized differences are underlined. Unlike past research integra1ng these topics, the current study examined all of the MMPI2RF substan1ve scales to determine if they would exhibit significant mean score differences across three analyses comparing individuals with or without (1) Internalizing Dysfunc1on, (2) Thought Dysfunc1on, (3) Externalizing Dysfunc1on diagnoses. Assignment to these categories was based on the most recent empirical literature linking unique diagnoses to respec1ve dimensions. Hypotheses: 1. Those with (1) internalizing dysfunc/on will have significant differences on anxiety / internalizing scales (EID, RCd, RC2, RC7, all internalizing & interpersonal scales, low AES & MEC, NEGEr, INTRr) compared to those with no internalizing diagnoses. 2. Those with (2) thought dysfunc/on will have significant differences on thought dysfunc1on scales (THD, RC6, RC8, RC9, ACT, PSYCr) compared to those with no thought dysfunc1on diagnoses. 3. Those with (3) externalizing dysfunc/on will have significant differences on externalizing scales (BXD, RC4, RC9, ACT, JCP, SUB, AGG, AGGRr, DISCr) compared to those with no externalizing dysfunc1on diagnoses. Par/cipants Measure Procedure MMPI2RF is a 338item selfreport measure that includes 51 scales measuring protocol validity, psychopathology, and personality constructs 3 . The statements and opinions in this poster are those of the authors and do not constitute the official views or policy of the California Department of State Hospitals, DSH-Patton, or the State of California. MMPI2RF Substan/ve Scales Internalizing Dysfunc/on Thought Dysfunc/on Externalizing Dysfunc/on Yes (n = 320) vs. No (n = 321) Yes (n = 572) vs. No (n = 69) Yes (n = 469) vs. No (n = 172) Higher Order Scales g 1 g 2 g 3 EID Emotional / Internalizing Dysfunction 0.39* -0.35 0.10 THD Thought Dysfunction 0.03 0.27 0.01 BXD Behavioral/Externalizing Dysfunction 0.11 -0.04 0.46* Restructured Clinical Scales RCd Demoralization 0.35* -0.24 0.13 RC1 Somatic Complaints 0.33* 0.04 0.17 RC2 Low Positive Emotions 0.22 -0.49* 0.05 RC3 Cynicism 0.16 -0.16 -0.04 RC4 Antisocial Behavior 0.15 -0.20 0.48* RC6 Ideas of Persecution 0.03 0.07 0.00 RC7 Dysfunctional Negative Emotions 0.37* -0.03 0.11 RC8 Aberrant Experiences 0.07 0.23 0.11 RC9 Hypomanic Behavior 0.21 0.14 0.10 Somatic / Cognitive Specific Problems Scales MLS Malaise 0.29* 0.08 0.04 GIC Gastrointestinal Complaints 0.31* -0.07 0.36* HPC Head Pain Complaints 0.15 -0.08 0.09 NUC Neurological Complaints 0.35* 0.09 0.08 COG Cognitive Complaints 0.26* -0.02 0.07 Internalizing Specific Problems Scales SUI Suicidal/Death Ideation 0.30* -0.40* 0.10 HLP Helplessness / Hopelessness 0.25* -0.32 -0.02 SFD Self-Doubt 0.33* -0.20 0.11 NFC Inefficacy 0.25* 0.0 0.09 STW Stress/Worry 0.33* -0.13 0.00 AXY Anxiety 0.25* -0.22 0.16 ANP Anger Proneness 0.35* -0.15 0.15 BRF Behavior-Restricting Fears 0.26* -0.03 0.04 MSF Multiple Specific Fears 0.28* 0.12 -0.04 Externalizing Specific Problems Scales JCP Juvenile Conduct Problems 0.10 -0.11 0.44* SUB Substance Abuse 0.16 0.11 0.65* AGG Aggression 0.14 -0.16 0.15 ACT Activation 0.27* 0.08 0.11 Interpersonal Specific Problems Scales FML Family Problems 0.29* -0.14 0.07 IPP Interpersonal Passivity -0.01 -0.46* 0.05 SAV Social Avoidance 0.12 -0.53* -0.04 SHY Shyness 0.19 -0.02 0.12 DSF Disaffiliativeness 0.09 -0.25 0.02 Interest Scales AES Aesthetic-Literary Interests 0.01 0.33 -0.12 MEC Mechanical-Physical Interests -0.21 0.12 0.17 Personality Psychopathology Five Scales, Revised AGGR-r Aggressiveness-Revised 0.02 0.30 0.03 PSYC-r Psychoticism-Revised 0.00 0.22 0.04 DISC-r Disconstraint-Revised 0.02 0.03 0.43* NEGE-r Negative Emotionality / Neuroticism- Revised 0.40* -0.13 0.06 INTR-r Introversion/Low Positive Emotionality- Revised 0.06 -0.57* -0.04 Internalizing Thought Dysfunc/on Externalizing Depressive Disorders Anxiety Disorders Psycho/c Disorders Major Depression Depressive Episode Phobias Generalized Anxiety Schizophrenia Paranoia Delusions Mania Externalizing Disorders Ina[en/ve/ Hyperac/vity An/social PD Conduct Disorder Substance Abuse Original N = 1,110 Valid N = 641 EID THD BXD Yes (n = 320) No (n = 321) Yes (n = 562) No (n = 69) Yes (n = 469) No (n = 172) Hypothesis 1 was generally supported, as most hypothesized scales demonstrated sta1s1cally and prac1cally significant effects in dis1nguishing between those with and without Internalizing diagnoses. (see Table 1, g 1 ). Hypothesis 2 was par1ally supported with mainly small prac1cally significant differences observed between groups with and without thought dysfunc1on disorders on psycho1cismrelated scales (see Table 1, g 2 ). Hypothesis 3 was mainly supported with small to moderate sta1s1cally and prac1cally significant differences observed between groups with and without externalizing disorder(s) on externalizingrelated scales (see Table 1, g 3 ). The present study extended the empirical literature demonstra1ng the ability of the MMPI2RF to differen1ate between forensically commiped groups of individuals diagnosed with internalizing, thought dysfunc1on, and/or externalizing dysfunc1ons. In line with exis1ng literature as well as the MMPI2RF Technical Manual², individuals with each respec1ve dysfunc1on tended to display significant paperns of differences on conceptually and empirically related scales throughout the assessment hierarchy. Interes1ngly, internalizing scales related to anxiety—such as the SP scales (IPP, SAV, SHY, DSF) and PSY5 Introversion scale (INTRr)—did not display significant differences between groups, as hypothesized (see Table 1, g 1 ). Also interes1ng, the only significant effects found on scales associated with mania and externalizing dysfunc1on (RC9, ACT) were for the internalizing comparison. Overall, results demonstrate the ability of the MMPI2RF to map onto this contemporary model of psychopathology, as well as provide support for many constructs currently linked to these higher order dimensions.
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ADHD
DISCUSSION
Deiden/fied archival data were examined from 1,110 inpa1ents with DSM-‐IV-‐TR psychiatric diagnoses, available at the 1me of tes1ng, from a large forensic psychiatric facility in the western United States. Mean age = 41 years (SD = 11.4).
Invalid protocols due to non-‐content-‐based invalid responding, underrepor/ng, and overrepor/ng were removed using standardized procedures (n = 469 cases excluded).
Independent samples t-‐tests were examined to assess whether differences between groups with and without each respec1ve dysfunc1on were sta1s1cally significant.
Hedges’ g effect size indices were examined to evaluate the magnitude of differences between mean scores.
Analyses: 1. Internalizing Dysfunc/on Diagnoses: Yes (n = 320) vs. No (n = 321) 2. Thought Dysfunc/on Diagnoses: Yes (n = 572) vs. No (n = 69) 3. Externalizing Dysfunc/on Diagnoses: Yes (n = 469) vs. No (n = 172)
Table 1. MMPI-‐2-‐RF Means, Standard Devia/ons, and Hedges’ g Effect Size Indices for the Three Comparisons
Mapping the MMPI-‐2-‐RF Substan1ve Scales onto Internalizing, Thought Dysfunc1on, and Externalizing
Dimensions 1California State University, Monterey Bay, 2Kent State University, 3Pa[on State Hospital
Isabella Romero1, Nasreen Toorabally1, Danielle Burche[1, Anthony Tarescavage2, & David M. Glassmire3
INTRODUCTION Contemporary models of psychopathology—which encompass internalizing, externalizing, and more recently, thought dysfunc1on (psychosis) factors—have revealed highly correlated clusters of diagnoses/syndromes1,2.
As psychopathology research evolves toward a new dimensional model of diagnosis, it is impera1ve that assessments are also able to reflect this organiza1on and dimensional nature1.
The Minnesota Mul1phasic Personality Inventory—2 Restructured Form (MMPI-‐2-‐RF; Ben-‐Porath & Tellegen, 2008/2011), with its hierarchical and dimensional organiza1on of construct assessment, possesses these capabili1es3.
Past research mapping these higher order dimensions onto the MMPI-‐2-‐RF has focused primarily on internalizing, externalizing, and thought dysfunc1on dimensions separately, or exclusively on specific scale sets (see Lee, Sellbom & Hopwood for a review, in press) 4.
AIMS & HYPOTHESES
METHOD
RESULTS
REFERENCES 1Krueger, R. F., & Markon, K. E. (2006). Reinterpre1ng comorbidity: a model-‐based approach to understanding and classifying psychopathology. Annual Review of Clinical Psychology, 2, 111–133. ²Kotov, R., Ruggero, C. J., Krueger, R. F., Watson, D., Yuan, Q., & Zimmerman, M. (2011). New dimensions in the quan1ta1ve classifica1on of mental illness. Archives of General Psychiatry, 68(10), 1003–1011. ³Ben-‐Porath, Y. S. & Tellegen, A. (2008/2011). MMPI-‐2-‐RF manual for administraCon, scoring, and interpretaCon. Minneapolis: University of Minnesota Press. 4Lee, T., Sellbom, M., Hopwood, C. (In press). Contemporary psychopathology assessment: Mapping major personality inventories onto empirical models of psychopathology. In Neuropsychological Assessment in the Era of Evidence-‐Based PracCce, S. C. Bowden (ed.) Oxford University Press.
ACKNOWLEDGEMENTS: This research was made possible by a grant from the University of Minnesota Press, which supported data collec1on. It was also supported by the California State University, Monterey Bay McNair Scholars Program and University Research Opportuni1es Center (UROC).
Note. * = sta/s/cally significant t-‐tests; p < .05. Small, (|0.20|-‐|0.49|) medium (|0.50|-‐|0.79|), and large (|0.80+|) Hedges’ g values are bolded. Hypothesized differences are underlined.
Unlike past research integra1ng these topics, the current study examined all of the MMPI-‐2-‐RF substan1ve scales to determine if they would exhibit significant mean score differences across three analyses comparing individuals with or without (1) Internalizing Dysfunc1on, (2) Thought Dysfunc1on, (3) Externalizing Dysfunc1on diagnoses.
Assignment to these categories was based on the most recent empirical literature linking unique diagnoses to respec1ve dimensions.
Hypotheses: 1. Those with (1) internalizing dysfunc/on will have significant differences on anxiety / internalizing scales (EID, RCd, RC2, RC7, all internalizing & interpersonal scales, low AES & MEC, NEGE-‐r, INTR-‐r) compared to those with no internalizing diagnoses.
2. Those with (2) thought dysfunc/on will have significant differences on thought dysfunc1on scales (THD, RC6, RC8, RC9, ACT, PSYC-‐r) compared to those with no thought dysfunc1on diagnoses.
3. Those with (3) externalizing dysfunc/on will have significant differences on externalizing scales (BXD, RC4, RC9, ACT, JCP, SUB, AGG, AGGR-‐r, DISC-‐r) compared to those with no externalizing dysfunc1on diagnoses.
Par/cipants
Measure
Procedure
MMPI-‐2-‐RF is a 338-‐item self-‐report measure that includes 51 scales measuring protocol validity, psychopathology, and personality constructs3.
The statements and opinions in this poster are those of the authors and do not constitute the official views or policy of the California Department of State Hospitals, DSH-Patton, or the State of California.
MMPI-‐2-‐RF Substan/ve Scales
Internalizing Dysfunc/on
Thought Dysfunc/on
Externalizing Dysfunc/on
Yes (n = 320) vs. No (n = 321)
Yes (n = 572) vs. No (n = 69)
Yes (n = 469) vs. No (n = 172)
Higher Order Scales g1 g2 g3 EID Emotional / Internalizing Dysfunction 0.39* -0.35 0.10 THD Thought Dysfunction 0.03 0.27 0.01 BXD Behavioral/Externalizing Dysfunction 0.11 -0.04 0.46* Restructured Clinical Scales RCd Demoralization 0.35* -0.24 0.13 RC1 Somatic Complaints 0.33* 0.04 0.17 RC2 Low Positive Emotions 0.22 -0.49* 0.05 RC3 Cynicism 0.16 -0.16 -0.04 RC4 Antisocial Behavior 0.15 -0.20 0.48* RC6 Ideas of Persecution 0.03 0.07 0.00 RC7 Dysfunctional Negative Emotions 0.37* -0.03 0.11 RC8 Aberrant Experiences 0.07 0.23 0.11 RC9 Hypomanic Behavior 0.21 0.14 0.10 Somatic / Cognitive Specific Problems Scales MLS Malaise 0.29* 0.08 0.04 GIC Gastrointestinal Complaints 0.31* -0.07 0.36* HPC Head Pain Complaints 0.15 -0.08 0.09 NUC Neurological Complaints 0.35* 0.09 0.08 COG Cognitive Complaints 0.26* -0.02 0.07 Internalizing Specific Problems Scales SUI Suicidal/Death Ideation 0.30* -0.40* 0.10 HLP Helplessness / Hopelessness 0.25* -0.32 -0.02 SFD Self-Doubt 0.33* -0.20 0.11 NFC Inefficacy 0.25* 0.0 0.09 STW Stress/Worry 0.33* -0.13 0.00 AXY Anxiety 0.25* -0.22 0.16 ANP Anger Proneness 0.35* -0.15 0.15 BRF Behavior-Restricting Fears 0.26* -0.03 0.04 MSF Multiple Specific Fears 0.28* 0.12 -0.04 Externalizing Specific Problems Scales JCP Juvenile Conduct Problems 0.10 -0.11 0.44* SUB Substance Abuse 0.16 0.11 0.65* AGG Aggression 0.14 -0.16 0.15 ACT Activation 0.27* 0.08 0.11 Interpersonal Specific Problems Scales FML Family Problems 0.29* -0.14 0.07 IPP Interpersonal Passivity -0.01 -0.46* 0.05 SAV Social Avoidance 0.12 -0.53* -0.04 SHY Shyness 0.19 -0.02 0.12 DSF Disaffiliativeness 0.09 -0.25 0.02 Interest Scales AES Aesthetic-Literary Interests 0.01 0.33 -0.12 MEC Mechanical-Physical Interests -0.21 0.12 0.17 Personality Psychopathology Five Scales, Revised AGGR-r Aggressiveness-Revised 0.02 0.30 0.03 PSYC-r Psychoticism-Revised 0.00 0.22 0.04 DISC-r Disconstraint-Revised 0.02 0.03 0.43* NEGE-r Negative Emotionality / Neuroticism-Revised
0.40* -0.13 0.06
INTR-r Introversion/Low Positive Emotionality-Revised
0.06 -0.57* -0.04
Internalizing Thought Dysfunc/on
Externalizing
Depressive Disorders
Anxiety Disorders
Psycho/c Disorders
Major
Depression
Depressive
Episod
e
Phob
ias
Gen
eralized
An
xiety
Schizoph
renia
Parano
ia
Delusion
s
Man
ia
Externalizing Disorders
Ina[en/ve/ Hyperac/vity
An/social PD
Cond
uct
Disorder
Substance
Abuse
Original N = 1,110
Valid N = 641
EID
THD
BXD
Yes (n = 320)
No (n = 321)
Yes (n = 562)
No (n = 69)
Yes (n = 469) No (n = 172)
Hypothesis 1 was generally supported, as most hypothesized scales demonstrated sta1s1cally and prac1cally significant effects in dis1nguishing between those with and without Internalizing diagnoses. (see Table 1, g1).
Hypothesis 2 was par1ally supported with mainly small prac1cally significant differences observed between groups with and without thought dysfunc1on disorders on psycho1cism-‐related scales (see Table 1, g2).
Hypothesis 3 was mainly supported with small to moderate sta1s1cally and prac1cally significant differences observed between groups with and without externalizing disorder(s) on externalizing-‐related scales (see Table 1, g3).
The present study extended the empirical literature demonstra1ng the ability of the MMPI-‐2-‐RF to differen1ate between forensically commiped groups of individuals diagnosed with internalizing, thought dysfunc1on, and/or externalizing dysfunc1ons.
In line with exis1ng literature as well as the MMPI-‐2-‐RF Technical Manual², individuals with each respec1ve dysfunc1on tended to display significant paperns of differences on conceptually and empirically related scales throughout the assessment hierarchy.
Interes1ngly, internalizing scales related to anxiety—such as the SP scales (IPP, SAV, SHY, DSF) and PSY-‐5 Introversion scale (INTR-‐r)—did not display significant differences between groups, as hypothesized (see Table 1, g1).
Also interes1ng, the only significant effects found on scales associated with mania and externalizing dysfunc1on (RC9, ACT) were for the internalizing comparison.
Overall, results demonstrate the ability of the MMPI-‐2-‐RF to map onto this contemporary model of psychopathology, as well as provide support for many constructs currently linked to these higher order dimensions.
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