THE DIAGNOSTIC SUITABILITY OF GOLDBERG'S 'RULE FOR THE MINI-MULT THESIS Presented to the Graduate Council of the North Texas State University in Partial Fulfillment of the Requirements For the Degree of MASTER OF SCIENCE By Dan Haynes Roberts, B. S. Denton, Texas December, 1975 379 N1
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THE DIAGNOSTIC SUITABILITY OF GOLDBERG'S
'RULE FOR THE MINI-MULT
THESIS
Presented to the Graduate Council of the
North Texas State University in Partial
Fulfillment of the Requirements
For the Degree of
MASTER OF SCIENCE
By
Dan Haynes Roberts, B. S.
Denton, Texas
December, 1975
379
N1
ABSTRACT
Roberts, Dan H., The Diagnostic Suitability of Goldberg's
Rule for the Mini-Mult. Master of Science (Clinical
1. Dates of Current Hospital Admissions,Dates of Testing, Number of PriorAdmissions to a Psychiatric Hos-pital and Ages of Subjects.*. . .
2. Means and Standard Deviations of theScale Scores for the Two Admi-nistrations of the Two Forms.
3. Students' t Vatues and Significanceof Differences Between Meansof Comparable Scales for Combi-nations of Two Administrationsof Two Test Forms.........*..
4. Correlations Between ComparableScales for all Combinationsof the Two Administrations ofthe Two Forms........ .0.....
5. Percentages of Agreement BetweenCombinations of the Two Admini-strations of the Two Test Forms .
6. Correlations of Goldberg's Psychotic-Neurotic Index Scores for Com-binations of the Two Admini-strations of the Two Test Forms .
26
35
. . .. 36
. . . . . 37
38
39
7. Means and Standard Deviations ofGoldberg's Index Scores for theTwo Administrations of the Two Forms.
8. Scores on Goldberg's Index for the TwoAdministrations of the Two Forms.
9. High Point Scales on the Four Tests. .
10. Two-Point Codes on the Four Tests.....
11. Raw Scores on Scale L on the Four Tests.
40
46
48
49
50
iv
Page
LIST OF TABLES--Continued
on Scale
on Scale
on Scale
on Scale
on Scale
on Scale
on Scale
on Scale
on Scale
on Scale
F
K
1
2
3
4
6
7
8
9
on the Four Tests.
on the Four Tests.
on the Four Tests*
on the Four Tests*
on the Four Tests*
on the Four Tests*
on the Four Tests*
on the Four Tests*
on the Four Tests*
on the Four Tests*
V
Table
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
Raw
Raw
Raw
Raw
Raw
Raw
Raw
Raw
Raw
Raw
Scores
Scores
Scores
Scores
Scores
Scores
Scores
Scores
Scores
Scores
Page
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CHAPTER I
INTRODUCTION
A. Statement of the Problem
In light of the widespread acceptance of the Minnesota
Multiphasic Personality Inventory as a measure of various
personality variables for people in many diverse settings,
it is surprising that until several years ago there was
no abbreviated form of the MMPI from which the standard
scale scores could be reliably predicted. There is a great
deal of clinical and research value in such an instrument.
Often in clinical settings, it is difficult to persuade
subjects to complete either the individual or group form
of the MMPI. The length of the standard inventory makes
it tedious for subjects to fill out, and some are unwilling
or unable to devote the time and concentration that is
required. In similar circumstances, many of the same
people would agree to answer a shorter set of questions
taken from statements on the longer standard MMPI. At times,
there may be a need for rapid evaluation and communication
of results, such as for consultation purposes or speedy
classification of patients in a hospital or clinic. In
addition to applied uses, a short version of the MMPI would
expedite and simplify personality research. A short form
1
2
could make it much easier to recruit subjects who may be
unwilling to devote the time necessary to complete the long
form. An abbreviated test could also reduce expenses and
increase efficiency in both clinical and research settings
by decreasing the amount of time spent in scoring and
interpretation on the part of professional personnel.
Kincannon (1968) developed the first short form of
the MMPI which accurately predicted the standard scale
scores. This version does not include clinical scales
5 and 0. All other basic scales are included on Kincannon's
Mini-Mult. Evidence from studies which will be discussed
in the following pages has shown that the clinical utility
of the short version is limited in scope. Research indi-
cates that the Mini-Mult enjoys variable success, depending
on the population it is used with, and the amount of
clinical information one attempts to extract from the scores.
Therefore, by using the Mini-Mult on an optimal
population for a limited purpose of general diagnostic
classification, it may be possible to delineate a specific,
valid, clinical use for the Mini-Mult.
Several advantages of the short form have already
been mentioned. If the Mini-Mult is able to provide
reasonably accurate discrimination between psychotics and
neurotics, mental health officials could begin appropriate
intervention without waiting for more complicated and time
consuming assessment procedures to be completed. The oral
3
form of the Mini-Mult will allow testing of illiterate
subjects. It may also reduce the necessity for lengthy
observation periods before treatment is initiated.
B. Purpose of the Study
Methods of psychological and psychiatric intervention
may be influenced by psychological assessment of the
problems to be dealt with. Assessment may take the form
of interviews, behavioral observations, evaluation of
psychological tests, examination of historical data pro-
vided by significant others, or professionals or agencies
consulted by the individual in the past. It may involve
a combination of two or more of these. Intervention can
also be influenced by the results of histological, sero-
logical, or neurological tests. Inferences drawn from
various assessment techniques may be interpreted on
three levels, depending on the individual clinician's
theoretical bias, and on the questions he wishes to
answer with assessment procedures.
On the lowest level, the information about the client
is directly related to the decisions to be made. An
example would be the inference made by a college official
after looking at a potential student's entrance test score.
A decision to accept or reject the candidate is based
on the score. The inference drawn must be either that
the candidate is qualified, or that he is not. On the
4
second level, inferences may be descriptive generalizations
and/or hypothetical constructs concerning the client. The
third level inferences are similar to those at level two,
varying only in complexity. In other words, assessment
procedures are more involved in an attempt to learn as
much about the client as possible. The goal is to develop
a clear, complete representation of the client, and his
behavior patterns.
Intervention techniques may include chemotherapy,
milieu therapy, electro-convulsive therapy, and psycho-
therapies based on various theoretical viewpoints of
abnormal behavior. Behavior modification techniques are
also widely used. Various levels of intervention include
personal, family, small group, organization, and community.
The specific type of therapy may depend on the nature of
the problem and on the therapist's decision to treat the
symptoms observed, or the underlying causes. This decision
is affected by the therapist's bias and is limited by
his specific areas of competency. Therapeutic goals may
be restricted by available facilities and/or priorities
held by different agencies. A client's treatment can
also depend on his financial and emotional resources, as
well as his intellectual abilities, educational background,
and cultural milieu.
In a state hospital setting, intervention procedures
usually depend mainly on the initial diagnosis. If a
5
patient has a record of previous hospitalization, that may
affect the decisions made about him. Initial decisions in
such settings include consideration of: hospitalzation vs.
non-hospitalization, use of anti-psychotic drugs vs. other
or no drugs, use of ECT vs. no ECT, and whether patient is
suicidal or non-suicidal, etc.
The purpose of this study is to evaluate a method of
assessment which may be used to classify people for
psychological or psychiatric purposes. The assessment
procedure under investigation is a mathematical inter-
pretation of MMPI scores which allows the tester to make
a lower level inference about the test subject. By applying
a simple additive formula, one is able to discriminate a
psychotic person from a neurotic person, on the basis of
scale scores combined in a linear fashion. This linear
combination of scores is known as Goldberg's index. A
subject whose index falls above a certain cutoff score
is classified as psychotic. If the index is below the
cutoff score, the subject is classified as neurotic.
C. Review of the Literature
The Minnesota Multiphasic Personality Inventory,
of MMPI, has long been used to make decisions in problems
of differential diagnosis in various settings. Meehl
(1946) proposed a set of rules for making such decisions,
which were based on configural properties of MMPI profiles.
6
His effort was one of the first attempts to set explicit
rules for making specific diagnostic decisions. In this
study he evaluated the MMPI for use in differential
diagnosis of psychosis, psychoneurosis, and "conduct
disorder." He found that a set of rules could be used
to arrive at a diagnosis with greater success than a
simple examination of high point scales would allow. More
recently, Meehl and Dahlstrom (1960) developed a more
effective set of rules for discriminating psychotic from
neurotic profiles. Profiles which could not be classified
as psychotic or neurotic were designated as "indeterminate."
Henrichs (1964) attempted to derive a rule to extend the
applicability of the Meehl and Dahlstrom results. He was
unable to come up with rules which allowed a hit rate
exceeding 50% for the new classification of "character
disorder." The new classification could not be made with
the same degree of accuracy possible with the rules for
diagnosis for the other general categories. Although the
hit rate is high, it has little clinical promise.
Schmidt (1945) found that by analyzing MMPI profiles,
differential diagnoses for major clinical classifications
could be made with statistical significance. The major
diagnostic groups in this study were inadequate personality,
sexual psychopathy, mild psychoneurosis, severe psycho-
neurosis, and psychosis. Hovey (1949) compared three
psychoneurotic groups on the basis of profiles. He
7
discovered that the dissociative-conversion group produced
a relatively consistent pattern, while patterns produced
by anxiety and somatization groups were less consistent.
Guthrie (1950) discovered that a high degree of diagnostic
accuracy could be achieved by examination of code types.
He used six profile patterns reported by Gough (1946)
and Schmidt (1945). The diagnostic groups were anxiety
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TABLE 9
HIGH POINT SCALES ON THE FOUR TESTS
Subject Testm m20 E
123456789
101112131415161718192021222324252627282930
882242448888828478888827294866
882284288888821328898828848896
628262341868824248868824794887
722242442263241144114924294847
Note: Abbreviated: Mi=MMPI-first standard admini-stration, M2=MMPI-second standard administration,O=oral Mini-Mult-independent administration, E=extracted Mini-Mult-taken from Ml.
Note: Abbreviated: M =MMPI-first standard admini-stration, M2 =MMPI-second standard administration,O=oral Mini-Mult-independent administration, E=extracted Mini-Mult-taken from M1.
49
TABLE 11
RAW SCORES ON SCALE L ON THE FOUR TESTS
Subject Test
m m2 0 E
123456789,
101112131415161718192021222324252627282930
463673
1112521063
10393769145426412
533683
1412220213
12491873953348133
4866
104
1010662448
1010122
12128688664246
644866
108442264
106
10286
10266446444
Note: Abbreviated: Mi=MMPI-first standard admini-stration, M2=MMPI-second standard administration,O=oral Mini-Mult-independent administration,E=extracted Mini-Mult-taken from Mi.
50
TABLE 12
RAW SCORES ON SCALE F ON THE FOUR TESTS
Subject Test
m M2 0 E
123456789
101112131415161718192021222324252627282930
16298
102876
1428352137115
2774
32343125119
20191122313127
18191013186
25253740194016101884
34316
26236
34203
36333229
161196
142
11119
306
2594
1164
23111616282
1111146
231114
142369
2144
162128212844
1464
28181616286
1116149
162323
Note: Abbreviated: Mi=MMPI-first standard admini-stration, M2=MMPI-second standard administration,O=oral Mini-Mult-independent administration,E=extracted Mini-Mult-taken from Mi.
51
TABLE 13
RAW SCORES ON SCALE K ON THE FOUR TESTS
Subject Test
m0M2 E
123456789
101112131415161718192021222324252627282930
101115171413251810646
10101414251113151004
1411131854
16
101613171915271859818
112516257
10184
2449
12181323
16
1113141717112418141311117
112013241121201178
181514187
1015
111114201411201713858
10131114241113111447
1714131887
18
Note: Abbreviated: M =MMPI-first standard admini-stration, M2=MMPI-second standard administration,O=oral Mini-Mult-independent administration,E=extracted Mini-Mult-taken from M1 .
Note: Abbreviated: M1 =MMPI-first standard admini-stration, M2 =MMPI-second standard administration,O=oral Mini-Mult-independent administration,E=extracted Mini-Mult-taken from M1 .
56
TABLE 18
RAW SCORES ON SCALE 6 ON THE FOUR TESTS*
Subject Test
Mm E
123456789
101112131415161718192021222324252627282930
1922131116141310232418251314158
1424239
21251319251121242531
19219
11158
142123261526171119131124171121201220228
20222534
21128
14227
12108
22122287
147
1222101214211419171210211712
131710101210108
17171719101287
1415128
19171415211215171922
*K = corrected scores.
Note: Abbreviated: M 1 =MMPI-first standard admini-stration, M2=MMPI-second standard administration,O=oral Mini-Mult-independent administration,E=extracted Mini-Mult-taken from Ml.
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