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Journal of Personality Assessment Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/hjpa20

An Examination of the Stability of the MMPI Personality Disorder Scales Stephen W. Hurt , John F. Clarkin & Leslie C. Morey Published online: 22 Jun 2011.

To cite this article: Stephen W. Hurt , John F. Clarkin & Leslie C. Morey (1990) An Examination of the Stability of the MMPI Personality Disorder Scales, Journal of Personality Assessment, 54:1-2, 16-23 To link to this article: http://dx.doi.org/10.1080/00223891.1990.9673969

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JOURYAL OF PERSONALIT? ASSESSMEIiT, ?990 54(1 & 2 ) 15-25 Copyright o 19%, Lawrence Erbailm Assocnates, Inc

An Examination of the Stability of the MPI Personality Disorder Scales Downloaded by [Temple University Libraries] at 20:17 10 January 2015

Stephen 5-'IT. Hust and John P. Clarkin The New Ycrk Hospital- Cornell Medical Center Mrestckester Division

~ecent'iy.a ser 3r blznneso:a hlu1:iphasic Personaiky inventorL.(MMPI) scaies for the diagnos~s31 personaiity disorders have atxacted research attention. As personiiity disorders are thought rc represent long-standing :rxt disturbances, any measure n! these disorders shouid be stzbie cve: t i n e arid :tiarxei\: free from state inhences. This strrdy investigated the stability of the MMPI scales in 67 subjects across a brief mparient trea:men: for substance abuse. The resuits indicated high leveis of stahiiity across t h c _?-weektreacxenr period. 7

Since the introdxtion of the Diagnostic and S i ~ ~ k t i cM d a m d o j :;Mer,d Disorders (3rd ed. [DSM-!Ill, American Psychiatric Assncia&n, !980:, a great deal of research artention has beec directed at developing diagnosric methods fcar the p e r s o n a h disorders i: describes (Widiger 5r Kelsc, !?E3). Eri particuiar, the MMPl has been found ro be potentially use&l with respect t:c the ciiagnosis of several personality diso~ders(Morey & Smith, 1988). RecentIr, MMPI scales were derive$ thzt were specific& designed to assist ir, the assessment n i the DSM-II personality disorders (hforey-:Warrgh, Ex Biashfieici, 1985:. in concrasr to the MMPI ciiniczi scaEez, these scales were designed specificaUy to tap this particular diagnosric area, and, as such, the scares have rhe potentizi to r e h e the use of the h'lh@I wirh the personality 2isorders. The initial vaiidztiorr research findings exalriinilrg the characterisrics of these scales have been promising. For exarcpie, the internal consistency estinates obtained with these scales have been fairiy high {More? et al., 1965), in some cases higher than comparable estimates derived far the DSM-!I! criteria themselves (M/~loie~, 198-5; Widiger, Frances, Warne:, & E&fuf-rm,1986). Aiso, the relationships berweer: rhese scales and the MMPl clicical and research scales are

PERSONALIV DISORDER SCALES

f7

w ~ t huhar would be expected from the resxlts of jxevtods researcn (hhrev, 1987; More.; & Smith, 1988!, The pattern of mterrelatlonsh~psbetween the Mo-ej et al. t 1955) personai~tcJlsorder scales has been faund ro confom fa1r1.i.well to the hrpothetlcai structsre of personaiitv dlsorders proposed bu the DSM-IIi authors i h h e p , 1386;. Scores on the scales haire also been h ~ n ta J be sjgnlflcanth related co c:inicai d~agnosesmade bv c h c l a n s b l d to these measurer (Morev, SIash%id, Webb. 6r. jewell, 19881. Ernally, convergent i alrdatmn stud~esperformed utdmng :he Millon C;tn~calMutt~axralIn\~entorv th?CbA,I: Miiion, 1982), another self-report Inventcry that assesses carrstr~cts pertrnent to A m ;Idragnoses, hake generally f w d f a d \ good correspondenze between the two instrsments (Dubro, 198';. Dubro, Wetrier, & Kahn. 1988; Greene & Farr, i%;, h4orev 5r LeVlne, 1983). -i he purpose of osr study was to exarnlne the temporai stab~!itvof scores and cmfigurattons on the personailty dlsorder scaies. This w,ue 1s p a r t d a r l v relevant for ihe assessment of personal~tudlsorder, Secailse these d~sorclersare assumed to be enduring patterns that characrerrze long-term func:ion:ng rather than transrror\ states &nericar: Psvchratric Assocration. 1383, I W i . The stuily examnea the stabhty of these scales over a 3- to +week inpatlent hos~xalrzatronon a substance a h s e treatment unit, a settnng :n u4xch personai::y d~sordersare freq~entIvencountered. It 1s assumed that t h s hosp:tailzatlon, whrch 1s d~rectedpr~marrlvat detox~ficatlonand rehabi~ationrather than struct-lral personalitv charge, shouid resuit m wmptomatrc (:.e.. Axis I) improvement bzt should have a reiatlvei~minor impact on personaixv Ir.e., AXE 11) d~fficslttes.Thus, :t 1s hypo:hes~zed chat :he MMPi personai~tvd1sor3er scales shoul2 be relativeiy stable ol7er the csdrse oi rreatrnenr

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consistent

METHOD Subjects The 6'7 subjects m r h ~ sstudy were paaents t r e a d as inpatrents for s~bstance abuse d~sorders at The New York Eiospltal-Ccrnell k4edlca; Center, R estchester Dmslon. T h e ~ raverage age was 35.6 vea-s (SD = I!.:), and 52% were men. AXISi dzagnoses were assrgned according to DShl-I!I iArner~can Psvchratric Associatmn, :98t?! crlterna The rnosr frequent DSM-Ill .&.is I dtagnosis was Alcohol Dependence !61%\. ulth khxed Substance Abuse 1139c1 or Cocame ,413~se115?c! diagnoses character~xngthe majorlrv oi the remamng cases. A total of 42% of the patienrs rece:ved an Axrs 11 diagnosis, with Anrtsocia: (r. = a), h41xed jn and Dependent (I 5 ) d~agnosespredominatmg. ,MI subjects completed the MhlPI at the beg;nnmg a m ar rhe termna:Ion of EmXment, the average ::me betweer. rest administrations was 2 : 5 aats (SD = 6 ;I. Scores were calculared for the hth4T'I clrnrcal scales [K-corrected!

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and the complete version of the personalltv disorder scales described by Morev et a). t1985), ufilmng T scores srandardced against normative data (Merep & Smith, 1688) gathered ar the Mayo C h i c as part of ~ h Mh4FI e restandardizeticn project (Colirgar,, Osborne. Swenson. & Offord: 3963).

En this s t d y , rhe assessment of scale stability was addressed in f o x &&rent ways: (a1test-rerest r e h a b i l ~ t (b) ~ , magnitude oi scaie change, (c.1 consistency of h g h porn:. and td\ profile ionfigurat~cmreimbi&:rr' For caxparison purposes, these measures were calcsiated for the traci~t~onal MMPI c!mrcai scales as well as the p e r s e n a h disorder scaies. The cl~nicalscaies assess a mrxture of tharaaerrstics thar include 'so& p e r s o n a h and svaptomadc features. As such. and because the personaky disorder scales were demsed from the same ~ z m pool, the personaiitv disorder scales should be at ieast as srabhe, IE not more sta'hie, than the ziinicai scaies. Wowever, the k.fMPI clinical scales are much lengthier (average iength = 54.5 :terns) than rhe ?ersonalrtp $isorder scales (average ,. length = 24.1 items;., and ionger scaies are more relzable. aEi else bemg equal [Nunraallv, I9P9r. Ar. adjmstment for scale iength uriimng the Spearman-Drown prophecy formuia (Nsccaliy, 1973) allowed e dlrect cornparism of the stabhty hgures obtained for the two sets of scales. Estimated reiiabilntr of each personahty drsorder scaie was c a l d a t e t for the iength of the sverage MMPI c h c d scale (r.e., 54.5 Items)

RESULTS Test-Retest Reliability The test-retes: rellabhry correlatrorns of the MMPI persocalxv disorder scaies and clinical scaies are gwen in Table 1. Fo? the perso>ahtv disorder scaies. the adj~stedrelrzblbty values usrng the Spearman-Brown prophecy formula are also presented. As can be seen fro= the table, the unacijusted values for the personalrtv disorder scales are slightlr larger than the values obtained h r the clnnrcal scaies, clnce ad~usted,these values are considerably higher. A s ordrnal comparison betweer: t i e adjusted retiabhp hgures for the personaiir-c disorder sceles and the clin1ca3 scale reIiabiin:ies indacaced that the values for the personaErcv dasorder scales were signrfacaarl~rlarger, Mann-Whitrazv Lj(681 13.0, t < .333. in general, the unadjusted values ~ndkcateveq good test-retest rehability for scaies 3f t h ~ sbrevity. Standard errors of measurement for each r~ersonalitvdmrcier scale, calcuiated usng these unadjusted reirabiky values, are aiso presexed In Tabie I.

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PERSONALII?' DISORDER SCALES

.~madjus:ei .

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Sxfe

Ta-Re:est Reiiabilit.;.

7

I

Siak

esl-Xetes:

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Ad1wedC

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S:an&d ETDT3.! >kc~r~-rmer~ t

"XST = Histnonk, K.4k = Narc~ssls:ic: B n i = B~rderhne:ANT = .4n:isw!a:. 3 E P = Dependex; CPS = Cornpuisive; PAG = Passwe-.Aggress!{r P.AR = Paranoid;

,Magnitude of Scale Change The mean pretreatment and posttreacmenr hlMPI scores, and the results of pared-d~fference1 tests cornpar~ngthese i z l ~ e s are , presented i f i Table A3 snores are presented as standard I-score .\ alues t c ellovi a blrezr comparison of rhe nagnltude of change. i\iso ~ncluciedin this rabie are the mean a'hsold:e change values for each of the scales: this latter f~gurerepresent< bo:h m-r eases and decreases in scale scores. -4 cornparlson of these Iatter :daes :ndicates that the average absolute T-score change observed on the personalty disorder scale i'vl = 6.! 3 was s~gnlhcandsless than the absoiute I-score change observed or. :he c l ~ n i ~scales al = 7 651, ti!0.66! = 2.45, p < .C33 It 1s trnportant to note as a char many of the persona!:rv &order scales dld change s~gn~hcantlv iunctnon of treatment, ~rnplymgthat they are senslt1r.e to change5 associated with short-term rnpatrenc creatrnent. Sach changes should be e~peitec!because cerram features of perscnalitv d~sorderare nor endurtng and rnav be ~nfluenced bv AXE I psvchopathoiogv (W~diger,Frances, Sptzer. & 'Sl ill~anrs, 19681. However, the magn~tucieof these changes was sufficmtb, small to s.ggesr (ha? major personailtv changes, as measured by these scales, had not taker. place As expected, the personaliti dlsorder scales showed smaller changes thar, the cl:mcal scaies over the 3-week treatment perlod

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HURT, CLARKIN MOREY TABLE 2 Magnatude of Chznges Observed With T~eatmenton MMPI Scales

M.VP1 Scde

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Pc:red-Diff~ence

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An examination of the stability of the MMPI Personality Disorder Scales.

Recently, a set of Minnesota Multiphasic Personality Inventory (MMPI) scales for the diagnosis of personality disorders have attracted research attent...
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