Journal of Personality Assessment

ISSN: 0022-3891 (Print) 1532-7752 (Online) Journal homepage: http://www.tandfonline.com/loi/hjpa20

Couples in Marital Distress: A Study of Personality Factors as Measured by the MMPI-2 Stephen Hjemboe & James N. Butcher To cite this article: Stephen Hjemboe & James N. Butcher (1991) Couples in Marital Distress: A Study of Personality Factors as Measured by the MMPI-2, Journal of Personality Assessment, 57:2, 216-237, DOI: 10.1207/s15327752jpa5702_3 To link to this article: http://dx.doi.org/10.1207/s15327752jpa5702_3

Published online: 10 Jun 2010.

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JOURNAL OF PERSONALITY ASSESSMENT, 1991, 57(2), 216-237 Copyright 1991, Lawrence Erlbaum Associates, Inc.

Couples in Marital Distress: A Study of Personality Factors as Measured by the MMPI-2 Stephen Hjemboe and James N. Butcher Downloaded by [New York University] at 02:57 28 September 2015

University of Minnesota

This study examines the relationship between Minnesota Multiphasic Personality Inventory-2 (MMPI-2) measured personality characteristics and marital distress and provides empirical validation for using the MMPI-2 with a marital therapy population. Studied were 150 couples in marital therapy and 841 normal couples who participated in the MMPI-2 restandardization study. The MMPI-2, a biographical form, a partner rating form, and the Dyadic Adjustment Scale (DAS) were administered to all couples. The marital counseling group resembled previous marital counseling samples studied with the MMPI and scored significantly higher than the normative sample on several MMPI-2 scales. Relationships between the DAS and MMM-2 clinical and content scale scores are reported. The Psychopathic Deviate (Pd) clinical scale and Family Problems (FAM) content scale were the most powerful group discriminators and strongest correlates of the DAS; their use as indices of marital distress is tested. The meaning of Pd as an index in assessing personality factors in marital distress is explored.

Because the ability of an individual to function in an intimate relationship is a major dimension of psychological adjustment, a number of researchers have searched for reliable ways to assess relationship or marital adjustment on objective personality inventories. Much of this research has relied on the MMPI (Hathaway & McKinley, 1943). Two general strategies have been used to identify personality characteristics or psychopathology associated with marital distress. The most common method, which assumes a degree of sample homogeneity, has been to attempt to identify ~ e r s o n a l i maladjustment t~ from group profile characteristics (Barry, Anderson, & Thomas, 1967; Loeb, 1966; McCranie & Kahan, 1986; Murstein & Glaudin, 1968; Olsinski, 1980; Shapiro, 1978). The other, more configural approach, which assumes heterogeneity, is to identify a family of indices found more frequently among the maritally malad-

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justed than in the general population; the primary example of this approach, drawing heavily on clinic-based hypotheses, is the work of Arnold (1970),which generated some further research (Ollendick, Otto, & Heider, 1983; Snyder & Regts, 1990). This latter approach is most appropriate for better understanding clients already known to have marital ~roblems,whereas the first, more common approach serves the more general interests in understanding the covariation of relationship adjustment with personality characteristics and in identifying relationship distress in the context of routine psychological assessment. In previous MMPI research in this area, only one indicator, the Pd scale, has consistently demonstrated strength in identifying those with relationship problems. This power has been demonstrated across decades of research (Arnold, 1970; Cookerly, 1974; Murstein & Glaudin, 1968; Snyder & Regts, 1990; Swan, 1953, 1957). In these studies, Pd has been the most prevalent marker of distress or counselee status; for example, Arnold (1970) found Pd in the code types of 63.5% of the men and 55.6% of the women in his counseling sample; Cookerly (1974)found Pd in the code types of 49.6% of the men and 5 1.2% of the women. The Pd scale has also demonstrated its strength in distinguishing the maritally distressed from others in general mixed samples (Arnold, 1970; Barrett, 1974; Snyder & Regts, 1990),from psychiatric patients (Snyder &Regts, 1990), and in discriminating maritally maladjusted alcoholics from those who are not (Barry et al., 1967). Furthermore, it has been identified as the factor predicting divorce (Loeb, 1966) and even multiple divorce (McCranie & Kahan, 1986) in retrospective studies. Most recently, Snyder and Regts (1990) found it to be a better predictor than any of Arnold's (1970) 15 signs and nearly as effective as all five signs based in part on the Pd scale as the single most prominent - and differentiating-feature in the profiles of those who divorce. Studies examining MMPI scales associated with marital satisfaction measurement instruments have also demonstrated the strength of the Pd scale. It has been found to correlate strongly with the Locke-Wallace Marital Adjustment Scale (Locke &Wallace, 1959)in groups of counselees and controls of both sexes (Lewak, Wakefield, & Briggs, 1985): It was the second strongest (negative) correlate of marital adjustment among men and the second strongest ,among women, after the F scale, a general distress indicator. Among normal m~en,Pd was also second strongest and was second to K, a measure of defensiveness. Snyder and Regts (1990), in correlating MMPI scales to Snyder's (1981) Marital Satisfaction Inventory (MSI), found Pd to be the strongest and most consistent correlate to the MSI scales. The apparent stability of the Pd scale in the profiles of individuals over time in these samples is also impressive; this aspect is reflected particularly in follow-up studies (Cookerly, 1974; Loeb, 1966; McCranie & Kahan, 1986). These findings suggests that Pd represents a stable, enduring dimension of personality. As an indicator of marital distress, however, Pd has serious limitations. First,

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the meaning of this very heterogeneous scale among the maritally distressed is unclear a?d has not been investigated systematically, as Arnold (1970) called for; substquent MMPI studies have not provided substantial extra test information on its meaning. Typically, Pd has been interpreted as an indicator of psychopathy or of psychopathic deviance (e.g., Arnold, 1970; Barrett, 1974; Loeb, 1966; McCranie & Kahan, 1986), assumptions that have no clear support in this population and violate the standard clinical admonition to consider sample base rates when interpreting profile characteristics (e.g., Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989; Graham, 1977). No study has reviewed inspected Pd subscale information (e.g., Harris & Lingoes, 1955), in spite of Pd's clear heterogeneity. Such ambiguity might lead not only to a misunderstanding of the personality factor in marital maladjustment and divorce, but also to erroneous clinical impressions and inappropriate treatment planning. A second major problem with the Pd scale is its low hit rate. In Arnold's (1970) study, Pd was not present in the 2-point codes of 48% of the female and 37% of the male counselees. Snyder and Regts (1990)found that Pd identified too many false positives and false negatives in their sample, identifying many happily married people and missing many highly distressed people. Clearly, there is a need for less ambiguity in the identification of marital disturbance, as noted by several researchers (Bloomquist & Harris, 1984; Snyder & Regts, 1990), with respect to meaning and hit rates. In response to these needs, this study compared MMPI-2 characteristics of a group of marital counselees with a large sample of normal couples, focusing particularly on identifying and evaluating the strongest indicators of marital distress. The development of the MMPI-2 (Butcher et al., 1989) holds new promise for this area, particularly through its newly developed content scales (Butcher, Graham, Williams, & Ben-Porath, 1990), constructed in part from new MMPI-2 test items. Such scales as Family Problems (FAM), Antisocial Practices (ASP), and Anger (ANG),as well as extra test information on the subjects, might help to identify marital maladjustment and to clarify the meaning of Pd elevations among the maritally maladjusted.

METHOD Subjects This study employed two sets of subjects: people experiencing relationship distress (n = 150) and currently engaged in marital or couples counseling, and a control group of normative couples (n = 841) obtained from the MMPI-2 restandardization sample (Butcher et al., 1989). Counselee couples were obtained from therapists and marriage counselors,

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who were initially selected through telephone directory listings of psychologists, private clinics specializing in marital and family therapy, and community !mental health settings. Each practitioner or agency director received a letter of invitation describing the study and a follow-up telephone call to answer questions and encourage participation. From 45 sites initially contacted, 21 clinicians actively participated. Although considerable effort was made to involve settings serving lower socioeconomic status (SES) groups, the professionals who chose to participate were all private practitioners, except for two from community mental health settings. Eighteen of the clinicians were in practice in the Minneapolis-St. Paul metropolitan area, and the other 3 were in a private clinic in Scottsdale, Arizona. The only stipulation for involvement in the stutdy was that couples be presenting with marital yoblems as a primary issue. Although not typical of the general population of the U.S. in SES, this sample is comparable to other clinical samples in studies of this type (Arnold, 1970; Barrett, 1974). A control sample for the study was obtained from the MMPI restandardization project (Butcher et al., 1989). This project was designed to obtain a representative sample of the U.S. adult population with respect to age, race, income, marital status, and residential setting (urban vs. rural), using 1980 census figures as guidelines. In order to represent the population's geographic distribution, subjects were drawn from Minnesota, Ohio, North Carolina, Washington, Virginia, Pennsylvania, and California. Subjects were randomly solicited and paid a small fee for their participation. A number of volunteers for the MMPI-2 restandardization study were asked to invite their significant other to also participate. Additional information was solicited about various aspects of their relationships, and personality ratings of their partners were collected primarily to provide external validation data for use in test redevelopment. These data made this sample particularly suitable as a control for the current study. A total of 841 normative couples was obtained from this sample. This comparison group provides a diverse control sample because of its close similarity to the demographic characteristics of the general population. Control samples for previous MMPI marital samples have been far less representative, typically being White, middle class, and professional (e.g., Arnold, 1970; Barrett, 1974). However, this control sample was not screened for the absence of psychopathology or defined in terms of its marital happiness. In this study, then, the marital counseling sample was compared not to a happily married or well-adjusted group but rather to a sample more truly representative of the population. The inclusion of a natural range of marital adjustment in the normative sample also provides an ideal sample for cross-validational study on indices of marital distress. Subjects were excluded from the study on the basis of the same criteria used for MMPI-2 restandardization sample: a raw deviant response (F) scale score

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greater than 20, a Back-Page Infrequency Scale (Fb) score greater than 20, or a cannot say (7) score greater than 40 out of 704. The L and K validity scales were not used to exclude subjects on the grounds that extreme elevations might be diagnostic. The samples also were limited to mixed-sex spouses or unmarried heterosexual partners sharing a home (for stylistic brevity, however, relationship distress in this study is referred to as marital distress). Eight percent of both samples were cohabiting and not married to one another, which is about twice the national average of 4.5% of unmarried cohabiters in the population (U.S. Bureau of the Census, 1983). Spouses married but separated (1%of the controls, 10% of the counseling couples) were retained. These exclusions disqualified 33 couples from the 1983 counseling couples tested, leaving 150 in the sample. From the normal sample, 773 of 836 couples were retained, excluding 63.

Instruments All subjects completed each of the following paper-and-pencil inventories.

1. The MMPI-2 was scored from a 704-item experimental version of the MMPI prepared for the MMM restandardization project. It included all of the original 550 items (omitting the 16 duplicates). Eighty-two items were modified to update archaic expressions, improve grammar, reduce misunderstandings, and improve cultural neutrality. These changes have been found to improve face validity and leave their psychometric properties unchanged (Ben-Porath & Butcher, 1988). In addition, 154 new items were incorporated to cover content dimensions not covered in the original item pool, including new items relating to familial relationships. The MMPI clinical and validity scale structures have been left virtually intact. The new MMM-2 content scales (Butcher et al., 1989) were also scored for both samples. 2. Biographical information included personal data sheet covering marital status, length of marriage, education level, occupation, income, and current physical and mental health. It also covered history of legal troubles, psychological treatment, alcohol and drug use, and treatment for self and family members. 3. Recent life events were evaluated using a checklist of 41 significant life events for the past 6 months, which is a slight modification of the Schedule of Recent Experiences (Holmes & Rahe, 1967). 4. The DAS is a measure of marital satisfaction (Spanier, 1976) developed factor analytically to clarify previous definitions of marital adjustment; although it yields both four-factor scores and an additive adjustment score; only the latter was used in our study. It provides a continuous measure of marital satisfaction as opposed to reliance on assumptions of satisfaction based on sample membership typically made in studies not using such a measure. The DAS has gained broad acceptance as a standard measure of marital adjustment. The form used for the restandardization project was shortened by two items on one subscale to avoid

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redundancy with data collected elsewhere; scores for this subscale were thus prorated to compensate for the item deletions. With this correction, mean scores for the normative sample were within a point of those of the original normative groups for the DAS (Spanier, 1976). 5. A partner rating form was developed for external validation work on the MMPI-2 restandardization project. This form asks each participant to rate his or her partner on 110 items surveying a broad range of attitudes and behaviors.

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Data-Collection Procedures for the Marital Counseling Sample Maritally distressed couples were recruited by their therapists, who explained that results would be used in treatment planning. Typically, clients were assessed at the beginning of treatment. The clinician explained the nature of the study to the clients according to instructions provided and then obtained written consent from each participant for use of the data in research. Couples were provided with a packet of test materials that included a bound set of forms for each partner, precoded with identification numbers. Clinicians were instructed to provide supervision for test administration and not to allow clients to remove material from the office. As compensation, the therapists were provided MMPI scoring, computerized reports of the original MMPI, and DAS scores.

RESULTS AND DISCUSSION Demographic and Psychological History Characteristics Counseling men and women were an average of 38 and 36 years old, respectively, approximately 4 years younger on average than controls; average length of relationship was 14 years among counselees and 18 years among controls. The racial constituency of the normative sample, 87% White and 13%minority, was more representative of the U.S. population (U.S. Bureau of the Census, 1983) than the counseling sample, which was 96% White and 4% minority. Sixtyeight percent of the counselees reported being in a managerial or professional occupation, as opposed to 47% of the controls. Counselees median household income was in the $45,000-55,000 range, whereas the controls were in the $30,000-35,000 range. The counselees also had more education: 55% had college degrees, compared with 46% of controls. Although the counseling sample appears to be of a higher SES than that of controls, preliminary analyses did not indicate that demographic differences had appreciable impact on the variables of interest in this study. Comparison of the mean MMPI profiles of our sample with those of two others (Arnold, 1970; Barrett, 1973)shown in Figures 1 and 2, further indicates that, in terms of profile

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Barrett 1 9 7 Y

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Arnold

L

F

K

Hs

D H y Pd M f Pa P t S c M M P I Scales

Ma

1970

Si

Original

FIGURE 1 Mean MMPI clinical scaie profiles for three samples of men in marital counseling.

characteristics, this marital counselee sample appears to be quite typical. Because all three of these samples were comprised predominantly of middle-class individuals, a sample with lower mean SES characteristics might differ from these general patterns.

Group Differences in Dyadic Adjustment Mean differences on the DAS indicated a sharp separation between samples, with the counseling female group (CF) looking slightly more distressed than the counseling male group (CM). The mean DAS score for the normative control males (NM)was 115.0, SD = 17.8; for the normative females (NF),the mean was 114.4, SD = 19.2. The mean score for the CM was 90.7, SD = 19.1; for the CF, the mean score was 86.7, SD = 21. Differences between the means across samples were highly significant: for men, t (908) = 15.11, P < .0001; for women, t(922) = 16.34, p < .0001. At the frequently used cutting score of 100 on the DAS (Spanier, 1976), 75% of the counseling and 18% of the normal sample fell outside the well-adjusted range.

MMPI-2 AND MARITAL DISTRESS

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Borrett 1979

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Arnold

1970

so

L

F

K

H s D H y Pd Mf Pa P t S c M a O r i g i n a l MMPI S c a l e s

Si

FIGURE 2 Mean MMPI clinical scale profiles for three samples of women in marital counseling.

Group Differences on MMPI-2 Indicators of Psychological Maladjustment

Mean profile differences. Psychological maladjustment was explored by examining mean sample differences on measures of maladjustment as well as differences in sample composition and by viewing the relative percentages of individuals present at varying levels of MMPI-2 measured psychological disturbance. Comparison of the validity and clinical scales for the four groups show the counseling sample achieved significantly more elevated mean scores, as shown in Tables 1 and 2. All scale scores reported are uniform T-scores, with K-corrections, except Masculinity-Femininity (Mf) and Social Introversion (Si) which are linear T-scores. These elevations are also presented graphically in Figures 3 and 4. At a .002 significance criterion, used to compensate for the 26 t tests conducted, Table 1 indicates that the CM group scored significantly higher than the NM group on the Hysteria (Hy), Psychopathic Deviate (Pd), Paranoia (Pa), Psychasthenia (Pt), and Schizophrenia (Sc) scales. The CM group scored slightly lower than the NM group only on Si. Each of these scales, except K, and Hy, are

TABLE 1 Comparison of MMPI-2 Validity and Clinical Scale K-Corrected T-Scores Between Normal and Counseling Samples for Men

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Nwmal"

Counselingb

Scale

M

SD

M

SD

L F K Hs D HY Pd Mf Pa Pt Sc Ma Si M'

49.6 48.7 50.1 50.0 49.5 50.1 48.7 49.6 49.8 49.4 48.9 49.1 50.1 49.2

9.74 9.09 9.79 9.79 9.50 9.83 9.45 9.65 9.88 9.60 9.32 9.58 9.83 6.19

48.5 49.7 52.5 51.0 52.0 55.2 57.3 51.1 53.5 53.7 52.3 50.4 48.6 53.7

8.91 9.49 9.96 9.99 10.80 10.79 11.46 8.54 10.15 11.42 10.21 10.21 10.17 7.90

F 1.19 1.09 1.03 1.04 1.29* 1.20 1.47*** 1.28 1.06 1.41** 1.20 1.13 1.07

df

t Valuec

92 1 921 92 1 921 196 92 1 190 92 1 92 1 192 921 92 1 92 1

- 1.26 1.23 2.75** 1.19 2.70** 5.75*** 8.59*** 1.71 4.23*** 4.31*** 4.00*** 1.42 - 1.67

"n = 773. bn = 150. Two-tailed probability. dIf p o f F < .05, spearate variance estimates are used in t test. 'Computed on Scales Hs through Si, excluding Mf. *p < .05. **p < .Ol. ***p < .OOl.

TABLE 2 Comparison of MMPI-2 Validity and Clinical Scale K-Corrected T-Scores Between Normal and Counseling Samples for Women ---

Normal" Scale

L F K Hs D HY Pd Mf Pa Pt Sc Ma Si Me

Counselingb

M

SD

M

SD

F Valuecpd

df

t Valuec

49.9 48.4 50.2 49.6 49.9 49.9 48.6 49.2 49.6 49.8 48.5 48.2 50.5 49.3

9.51 8.82 9.85 9.71 9.75 9.79 9.42 9.58 9.45 9.98 9.32 9.27 10.17 6.1

49.1 50.7 52.6 52.1 55.3 55.7 56.6 47.3 54.6 53.9 53.0 48.1 51.1 53.7

8.80 8.76 9.16 10.10 12.09 11.37 10.10 8.76 10.23 10.30 9.05 9.13 10.56 7.26

1.17 1.01 1.16 1.08 1.54*** 1.35** 1.15 1.20 1.17 1.07 1.06 1.03 1.08

934 934 934 934 197 203 934 934 934 934 934 934 934

- .94 3.02** 2.83** 2.88** 5.23*** 6.01*** 5.59*** - 2.33* 5.98*** 4.66*** 5.54*** - .07 .70

"n = 780. bn = 156. 'Two-tailed probability. dIf p of F < .05, spearate variance estimates are used in t test. 'Computed on Scales Hs through Si, excluding Mf. *p < .05. **p < .01. ***p < .001.

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225

Normal M a l e s

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Counseling M a l e s

L

F

K

Hs

D

Hy

Pd

MMPL-2

Mf Pa SCALES

Pt

Sc

Ma

Si

FIGURE 3 Mean MMPI-2 clinical profiles for the men in marital counseling compared with the men from the normative sample.

negatively and significantly correlated with the D14S in the NM group, whereas only Pd is significantly correlated with the DAS in the CM group. The coefficients are displayed in Table 3. Women (Table 2) showed a similar pattern, with CW being differentiatedby higher elevations on the Hy, Pd, Pa, Pt, Sc, and Depression (D). Again, all clinical scales that differentiate the samples are significantlycorrelated with the DAS among the controls, whereas only Pd, and Sc are significant among the CF group at a .001 level. K is positively correlated with the DAS in all four groups. The DAS is a measure of well-being without psychometric correction for a social desirability response set (Spanier, 1976); hence K and the DAS work together either as measures of well-being or of denial. In any case, K attenuates the relationship between the DAS and all corrected scales that correlate negatively with the DAS. Among the scales differentiating the samples, only Pd shows consistently high correlation with the DAS. Although other scales clearly indicate clinically significant differences, Pd is the most unambiguous marker of marital problems. Mean MMPI-2 profile elevations also show significant group differences (Tables 1 and 2). Men and women score very similarly in each group: The CM mean elevation is 53.2, compared to a CF elevation of 53.7; mean elevations were 49.5 for NM and 49.3 for NF. Both intersample differences are statistically

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I

L

F

K

Hs

D H y Pd MMPI-2

Mf P a SCALES

PC

Sc

Ma

+

Normal Females

Counseling Females

Si

FIGURE 4 Mean MMPI-2 clinical profiles for the women in marital counseling compared with women from the normative sample.

significant. Note that their standard deviations are quite similar, indicating that the variability of the groups is quite comparable. Profile elevation is strongly correlated with the DAS in the controls but only among CFs (Table 3). The weaker correlations in the counseling sample appears related to the restricted range of DAS scores in that sample; correlations in the normative sample probably more closely represent population relationships between the DAS and other variables. In both samples, women's elevations are more closely tied to dyadic adjustment, perhaps indicating the greater identification of women with their marriage within the culture. Tables 4 and 5 display sample differences between groups on the MMPI-2 content scales, which are graphically displayed in Figures 5 and 6. At a .002 significance level- again, to minimize Type I error over multiple tests-men and women show almost identical score patterns: CM and CF both scored signifiThe cantly higher on FAM and Anxiety (ANX), and lower on Cynicism (0. FAM scale registers extreme familial discord, involving an unloving, conflictual, quarrelsome, and unpleasant home life; ANX measures anxiety symptomatology; high CYN scale scores tend to hold negative attitudes and beliefs about others, expecting hidden, self-centered motives in their behavior (Butcher et al., 1990). CW also showed more subjective depression as measured by the

MMPI-2 AND MARITAL DISTRESS

227

TABLE 3 Correlation of DAS Scores With MMPI-2 Scales in Normative and Counseling Samples Women

Men

MMPI Scales L

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F

K HS D HY Pd Mf Pa Pt SC Ma Si Profile Elevation Content Scales ANX FRS OBS DEP HEA BIZ ANG CYN ASP TPA LSE SOD FAM WRK TRT

Nonnative

Counseling

Normative

Counseling

.I582 - .2964*** .2305*** - .1594*** - .1305*** - .0030 - .3660*** - .0872 - .1422*** - .2471*** - .3338*** - .1585*** - .1552*** - .3061***

.0322 -.I194 .0336 .0284 - ,0059 -.1432* - .2698*** - .0452 - .0977 .0256 -.0551 - .0370 - .0426 - .0968

.1592*** - .2942*** .2384*** - .1743*** - .2270*** -.0901** - .4462*** .0699* - .1364*** - .2573*** - .3352*** -.1361*** - .2020*** - .3375***

.1311** - .2354** .1445* - .1853** -.15404 -.1370* - .3372*** .0528 -.1922** - .1702** - .2626*** - .1098** -.I036 - .2775***

- .2629*** -.0910** -.1910*** - .2996*** - .1448*** - .1006** - .1893*** - .1447*** -.1741*** - .1554*** - .1784*** - .1548*** - .3909*** - .2524*** - .2386***

- .0824 .0273 - .0509 - .0353 ,0106 -.0572 .0109 - .0077 .0576 - .0139 .0357 .0450 - .2625*** .a40 - .0573

- .2942*** -.1219*** - .1964*** - .3287*** - .1518*** - .1096*** - .2698*** - .1551*** - .1578*** - .1380*** - .2344*** -.1790*** - .4218*** - .2645*** - .2853***

- .1426* .0094 - .2463*** - .2330*** - J,317*** -.1313* - .1314* -.1383* -.lo76 - .0956 -.2191*** - .1678** - .2834*** - .2052*** - .2057***

*p < .05. **p < .01. ***p < .001.

-

Subjective Depression (DEP) scale. Also notable is the lower mean score on ASP among both counseling groups, although the significance of the differences misses the criterion; the ASP scale assesses a history of trouble with the law or petty crime, enjoying the antics of criminals, and so on (Butcher et al., 1990). Significant differences are not seen on ANG for either sex; this scale measures anger control problems, irritability, and stubbornness (Butcher et al., 1990), and may be less sensitive to situational anger. The FAM scale is the content scale most strongly correlated with the 13AS and is a better index of marital adjustment among men than Pd, as Table 4

TABLE 4 Comparison of Mean MMPI-2 Content Scale T-Scores Between Normal and Counseling Samples for Men

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Normal"

Counselingb

Scale

M

SD

M

SD

ANX FRS OBS DEP HEA BIZ ANG CYN ASP TPA LSE SOD FAM WRK TRT

49.5 49.9 49.7 49.1 49.8 49.1 50.0 49.3 49.2 49.9 49.9 49.9 49.1 49.7 49.6

9.49 9.71 9.86 9.30 9.53 9.24 9.74 9.65 9.55 9.88 9.56 9.86 9.38 9.64 9.82

53.0 48.4 48.0 51.0 48.6 48.8 49.9 45.3 46.7 48.3 48.7 48.0 54.0 49.1 49.0

12.13 9.06 10.40 11.09 10.45 9.35 9.35 8.84 8.83 9.67 10.29 9.77 10.40 10.38 10.39

F 1.63*** 1.15 1.11 1.42** 1.20 1.02 1.09 1.19 1.17 1.04 1.16 1.02 1.23 1.16 1.12

df 186 92 1 92 1 191 92 1 92 1 92 1 921 92 1 92 1 92 1 921 92 1 92 1 92 1

t Valuec

3.27***

- 1.83

- 1.92 1.92 - 1.44 -0.28 -0.17 -4.68*** - 2.97** - 1.84 - 1.45 -2.08* 5.76*** - 0.69*** - 1.16

"n = 773. bn = 150. 'Two-tailed probability. d I f p o f F < .05, separate variance estimates are used in t test. *p < .05. **p < .Ol. ***p < .001.

TABLE 5 Comparison of Mean MMPI-2 Content Scale T-Scores Between Normal and Counseling Samples for Women Normal"

Counselingb

Scale

M

SD

M

SD

ANX FRS OBS DEP HEA BIZ ANG CYN ASP TPA LSE SOD FAM WRK TRT

49.7 49.8 49.8 49.1 49.8 49.2 49.6 48.5 48.6 49.8 50.2 50.1 48.9 49.6 49.3

10.05 9.50 9.69 9.58 9.49 8.97 9.51 8.91 9.16 9.92 10.08 9.95 9.14 10.12 9.80

53.1 47.3 48.3 52.1 50.0 48.3 50.2 44.3 46.3 47.8 50.3 51.5 53.3 50.6 48.1

10.61 9.01 9.29 10.24 9.88 8.51 9.54 7.10 8.22 9.33 10.46 10.50 10.70 10.67 9.42

F ~alue'.~ 1.12 1.11 1.09 1.14 1.08 1.11 1.01 1.57*** 1.24 1.13 1.08 1.11 1.37* 1.11 1.09

df 934 934 934 434 934 934 934 263 934 934 934 934 203 934 934

t Valuec

3.78***

- 2.99**

-1.71 3.48*** 0.23 -1.21 0.72 -6.52*** -2.91h* -2.33* 0.03 1.56 4.89*** 1.11 - 1.24

A = 780. bn = 156. 'Two-tailed probability. dIf p o f F < .05, separate variance estimates are used i n t test. *p < .05. **p < .01. ***p < .001.

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MMPI-2 AND MARITAL DISTRESS

.

229

Normal M a l e s

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Counseling M a l e s

30'

i

i

A N X F R S OBS D E P HEA BIZ ANG CYNASP T P A LSE S O D F A M W R K T R T

MMPI-2

SCALES

FIGURE 5 Mean MMPI-2 content scale profiles for the men in marital counseling compared with the men from the normative sample.

indicates. The ANX and DEP scales are the next strongest correlates with the DAS in the normative sample and less so in the counseling sample. The low correlation of ASP with the DAS among counselees- as well as their low mean scores-rules out ASP as a marker of marital distress. It also argues against Pd, which is higher in this sample, as indicating in counselees the kind of antisocial qualities represented by ASP. Similarly, CYN, which bears a strong relationship conceptually and correlationally to Pd and to ASP, also does not register as a strong element in counselees or correlationally among the strongest indices. Sample Differences in Prevalence of Psychopathology Because mean scores obscure intrasam~lediversity, the frequency of psych~ological disturbance in each sample was also assessed. This was done by tabulating the number of subjects with scale elevations in the clinical range in each sample. The clinical range is here taken as greater than or equal to a T-score of 65, as is conventional in MMPI-2 interpretation (Butcher et al., 1989).The results of this examination are displayed in Table 6. As indicated, 65% of NM and 61% of NW have no elevated scales, compared with 52% of CM and 44% of CW. Greater percentages of the counseling samples, relative to the normals, appear in almost all elevation categories. From

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.

N o r m a l Sample

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Counseling Sample

3

O

J

!

;

;

!

;

!

!

;

!

!

!

!

!

!

4

ANX F R S OBS DEP HEA BIZ A N G CYN ASP TPA LSE SOD F A M WRKTRT

FIGURE 6 Mean MMPI-2 content scale profiles for the women in marital counseling compared with the women from the normative sample.

this perspective, it is clear that a greater percentage of the counseling sample shows clinically significant psychological disturbance, as shown by chi-square analyses for men, X2(9,N = 935) = 35.78, p < .0001; and for women, X2(8,N = 935) = 35.78, P < .0001. Dyadic adjustment scores do decline significantly among the NM and NF groups with the number of elevated scales (F = 4.419, p < .001; F = 10.386, p < .001, respectively), but not among the CM and CF groups.

Predicting Marital Discord As indicated in Table 4, the Pd and FAM scales are the strongest scale predictors of dyadic adjustment. Correlations between test and criterion can be misleading for the clinician, however, in the absence of information concerning how well an index works in identifying cases. Only 15% of the counseling sample attained a Pd score greater than or equal to 65; lowering the cutting score to 60 identifies 30%. Statistics for the FAM scale were identical, although not all high scorers on one scale scored highly on the other. Clearly, these scales do not identify all distressed people: The high false negative rates indicate that low scores on these scales cannot reliably rule out marital distress. However, the scales may still be valuable indices if high scores indicate a high likelihood of distress.

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To test the efficiency of high scores in identifying distress, the high and low scorers on each of the two scales were broken down by marital distress. For these analyses, the normative sample was used, because it represents a more natural distribution of marital distress. A cutting core of 100 on the DAS was again used to differentiate distressed from nondistressed, and cutting scores of T-score 60 and 65 on Pd and FAM were tested. Although a T-score of 65 is the recommended cutoff for clinical significance (Butcher et al., 1989), it forces a large number of false negatives, because only 7% of the population are theoretncally above a T-score of 65, and the rate for marital distress in this sample is .18. The hits and misses are shown in Table 7. These analyses heed Meehl and Rosen's (1955) admonition to consider false positives in assessing the diagnostic efficiency of a positive score on a psychometric sign or test. At a T-score of 65 on the Pd scale, true positives outnumber the false positives; the diagnosis of marital distress at this elevation has a greater than even chance of being correct. The FAM scale works almost as well, identifying correctly just two fewer than it incorrectly identifies. At the lower cutting score, both scales are less efficient, although scores at that level might still warrant clinical investigation.

Combining the indices. To determine the efficacy of combining the two signs, the independent contributions of Pd and FAM to the DAS were assessed through a stepwise multiple regression analysis. As shown in Table 8, both scales contributed significant unique variance to the prediction equation. This demonstrates not only that the two variables together provide a more reliable

TABLE 4 Number of Subjects With MMPI-2 Scale Scores Greater Than 65

Men Number of Elevated Scales 0 1 2 3 4 5 6 7 8 9 Totals

Normal

Women Counseling

Normal

Counseling

Frequency

%

Frequency

%

Frequency

%

Frequency

%

510 173 49 27 11 5 4 3 2 1 785

65.0 22.0 6.2 3.4 1.4 0.6 0.5 0.4 0.3 0.1 99.9

78 34 11 7 7 6 4 3 0 0 150

52.0 22.7 7.3 4.7 4.7 4.0 2.7 2.0 0.0 0.0 100.1

482 177 59 23 25 10 3 6 0 0 785

61.4 22.5 7.5 2.9 3.2 1.3 0.4 0.8 0.0 0.0 100.0

67 31 21 11 6 6 3 4 1 0 150

44.7 20.7 14.0 7.3 4.0 4.0 2.0 2.7 0.7 0.0 LOO.1

-

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TABLE 7 Hits and Misses of the Pd and FAM Scales in Identifying Marital Distress at Two Cutting Scores for Normative Sample Pd T-Score

Distresseda Nondistressed

FAM T-Score

< 60

r 60

2 65

< 60

r 60

r 65

175 1138

125 131

59 42

I81 1144

I03 125

51 53

aDAS score < 100.

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TABLE 8 Multiple Regresson of Pd and FAM Scales to DAS in Normal Sample Variable FAM Pd

Multiple R

B

Beta

t

P

.33 .41

-.55 -.51

- .27 - .26

- 10.22

.01 -01

-9.57

TABLE 9 Mean Pd Subscale Scores for Normative and Counseling Samples -

-

--

-

Men Variable

Normative

Women Counseling

Normative

Counseling

measure than either of them taken alone, but that they appear to be tapping somewhat different dimensions of marital distress.

The meaning of Pd scores. To better understand Pd scale elevations among counselees, a number of further analyses were undertaken. First, the Pd (Harris & Lingoes, 1955) subscale scores in each sample were compared (Table 9). The subscale with the greatest elevation among counselees, as well as the greatest deviation from the normative sample, is Pdl , Familial Discord: for men, t(921) = 8.55, p < .001; and for women, t(921) = 7.43, p < .001. The only other subscale to deviate from the normative sample at a .O1 significance level is Pd4A, Social Alienation: for men, t(921) = 6.70, p < .001; and for women, t(934) = 7.41, p < .001). This subscale is sensitive to feelings of estrangement, being misunderstood, and not being loved, as well as concerns about social relationships-issues consistent with marital discord (Graham, 1977). The relative elevation of both these subscales again argues against interpreting Pd

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elevations in counselees as signs of antisocial or psychopathic qualities-a~sdoes the relative association of high FAM scores compared with ASP. Because not all the maritally distressed subjects had high Pd. scores and not all high scorers were distressed, high and low scorers among the counselees were compared next on a number of dimensions related to marital functioning or that are commonly associated with Pd: number of marriages, drug or alcohol problems, arrest record, and so on. Partner behavior ratings related to Pd scores were also inspected. Because Pd elevations were found to be related to number of divorces (McCranie & Kahan, 1986), both samples were grouped by number of marriages, and mean Pd scores were computed for each group. Counselees divorced two or more times and NFs divorced three or more times tended to have higher mean Pd scores than their less-divorced counterparts-generally in the range of a T-score of 60-but the numbers were small in these categories, so the evidence is only suggestive. No significant difference was seen between Pd scores of the never-divorced and the once-divorced: Analyses of variance (AMOVAs) for all four subsamples were insignificant. . Because drug and alcohol abuse are more prevalent among counselees and also are frequently related to high Pd scores (Graham, 1977), the numbers of high scorers in the counseling sample who reported such histories were compared to those did not. A significantly greater number of men with high Pd scores (T-scores of 60 or greater or 38% of the sample) had received drug or alcohol dependency treatment, x2(2, N = 149) = 6.51, P < .05: Eighteen percent of that group received treatment compared with 5% in the low Pd group. Sixteen percent of the high Pd group men reported a current or past ~roblem with illicit drugs, compared with 4% in the low Pd group-a significant difference, x2(3, N = 149) = 8.28, P < .05. Thirty percent had arrest records, compared with 12% for the low group-a highly significant difference,X2(1, N = 149) = 7.86, p < .01. Such striking differences were not seen in high Pd-scoring women (33% of the female sample); however, 14% had been hospitalized for psychiatric reasons, compared with 4% of low scorers-a difference just missing significance, x2(2, N = 156) = 5.41, p < .07. This finding suggests a greater prevalence of psychological instability among women with high Pd scores. Finally, partner ratings from the partner rating form were correlated with Pd scores, separately by sex, as a further means of understanding the meaning of Pd in this sample of counselees. Partner ratings indicate for both men and women that high scorers are described by their mates as: moody, irritable, unpleasant, resentful, and craving attention. In addition, high-scoring women are described as likely to be easily upset, to have temper tantrums, to get angry and yell, to be hostile, to be difficult to get along with, to be jealous of others, and to feel that others do not care about them. These ratings point to general qualities of negative emotionality, poor conflict management skills, and overall poor interpersonal adjustment. Although high scores on FAM are also described in terms

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of negative emotionality, their descriptions include elements of interpersonal oversensitivity, poignancy, and fearfulness, which do not appear in the Pd correlates.

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SUMMARY This study affirmed the positive relationship between marital distress and psychopathology. The counseling sample showed significant elevations on a number of clinical and content scales that, although not elevated into ranges expected of a psychiatric sample, are nonetheIess indicative of psychological disturbance. The relationship between these elevations and distress is confirmed by correlations in the normal sample, in which marital adjustment was distributed more evenly through the range of normality: The relationship of full profile and particular scale elevations with perceived relationship quality appeared strong and negative. Aside from Pd and FAM, the two most prominent scales associated with the counselees and with marital distress, most of the scales on which the samples differed most significantly and which were strongly correlated with the DAS generally clustered around symptoms of anxiety and depression, specifically: Pt, ANX,and DEP. In addition, the Pa and Sc scales were significantly elevated among counselees, although these elevations were significantly correlated with marital distress levels only in women. The Pa scale elevations may indicate heightened interpersonal sensitivity in this sample, whereas the Sc scale elevation is likely related to feelings of alienation and to inaccuracy of social perception. The association of the Pd scale with marital distress found in this study is consistent with almost all previous MMPI research with marital samples. The association of FAM, which was found to be comparably strong, lends validational support to it as a measure of family problems. The two scales appear to be tapping somewhat different content, however, as indicated by their independent significance in predicting marital distress. Because the FAM scale was specifically constructed as a homogeneous content scale, the domain it taps is relatively unambiguous (Butcher et al., 1990). The meaning of the Pd scale among counselees has presented more of a mystery and thus was explored at some length. The relationship of Pd with other scales as well as its subscale elevation in this sample argue against any simple interpretation of the scale as an indicator of antisocial or psychopathic qualities: The general picture that emerges is of a dimension of personality more related to severe relationship difficulties than to antisocial practices. In the sample, the FAM scale is elevated, but the ASP and the CYN scales are not. The Pd subscales most elevated in the counselingsample relate to familial discord and social alienation, both consistent with marital distress.

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That only 30% of the counselees scored at or above a T-score of 60 on Pd indicates its low discriminant validity, however, although the likelihood of marital distress in either sample is quite high at this level. What vitiates its discriminant power is that many maritally distressed individuals show no Pd scale elevations-a finding that raised the hypothesis that this scale identifies a subgroup of distressed persons. Behavioral ratings, which appeared to distinguish high scorers as a group from other counselees, associate higher scorers with strong, negative emotionality, self-centeredness, interpersonal unpleasantness, and high levels of interpersonal conflict. Clinically, these individuals may show particularly low maturity and poor conflict resolution skills. Previously found evidence of the temporal stability of Pd among counselees (Cookerly, 1974), as distinguished from scales such as a D and Pt, as well as its strong association with divorce (Loeb, 1966; McCranie & Kahan, 1986), support interpreting the scale as a stable characteristic that is maladaptive in a close relationship. There also appears to be a higher prevalence of antisocial characteristics among the high-scoring men: Compared with the other counselees, a higher proportion of them have a history of arrest and of serious alcohol and illicit drug prolblems. High-scoring women tend to be assessed by their partners in terms similar to men, but little was found in their personal histories which distinguished them from other CFs. The finding that neither the Pd scale nor the Fi4M scale identify a majority of marital counselees, but these scales are strongly associated with the measure of marital distress in this study, appears to indicate that they are more useful in identifying and describing significanttypes of marital counselees than as general prediction indices. Future research in this area might fruitfully be devoted to using personality information to develop specific predictors of marital distress.

ACKNOWLEDGMENTS We thank the many marital therapists who collected data from their clients for this study, especially: Joyce Anderson, Annette Brandes, Ralph Earle, M.arlene Feldman, Mick Hunter, Pat Lilligren, and Gail Ross. Thanks are also extended to Yossef Ben-Porath for his discussions on data analysis and to Karen Gayda and other members of the MMPI office staff in the Department of Psycholiogy at the University of Minnesota for many hours of assistance in data collection and handling. We also acknowledge the IJniversity of Minnesota Press, National Computer Systems, and Academic Computing Services and Systems at the University of Minnesota for their support of this research.

REFERENCES Arnold, P. D. (1970). Marriage counselee MMPI profile characteristics with objective signs that discriminate them from married couples in general (Doctoral dissertation, University of Minnesota, 1970). Dissertation Abstracts International, 1971, 32, 548B.

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Barrett, R. K. (1974). The relationship of emotional disorder to marital adjustment and disruption (Doctoral dissertation, Kent State University, 1973). Dissertation Abstracts International, 34, 4651B. Barry, I. R., Anderson, H. E., &Thomas, 0 . B. (1967). MMPI characteristicsof alcoholic males who are well and poorly adjusted to marriage. Journal of Clinical Psychology, 23, 355-360. Ben-Porath, Y., & Butcher, J. N. (1988). The psychometric stability of rewritten MMPI Items. Journal of Personality Assessment, 53, 645-653. Bloomquist, M. L., & Harris, W. G. (1984). Measuring family functioning with the MMPI: A reliability and concurrent validity study of three MMPI family scales. Journal of Clinical Psychology, 40, 1209-1214. Butcher, J. N., Dahlstrom, W. G., Graham, J. R., Tellegen, A., & Kaemmer, B. (1989). Minnesota Multiphasic Personality Inventory-2 (MMPI-2): Manual for admmistration and scoring. Minneapolis: University of Minnesota Press. Butcher, J. N., Graham, J. R., Williams, C. L., & Ben-Porath, Y. S. (1990). Development and use of the MMPI-2 content scales. Minneapolis: University of Minnesota Press. Cookerly, J. R. (1974). The reduction of psychopathology as measured by the MMPI cllnical scales in three forms of marriage counseling. Journal of Marriage and the Family, 36, 332. Graham, J. R. (1977). The MMPI: A practical guide. New York: Oxford University Press. Harris, R., & Lingoes, 1. (1955). Subscales for the Minnesota Mult~phasicPersonality Inventory (Mimeographed materials). San Francisco: University of California, Department of Psychology. Hathaway, S. R., & McKinley, J. C. (1943). The Mmnesota Multiphasic Personality Schedule. Minneapolis: University of Minnesota Press. Holmes, T. H., & Rahe, R. H. (1967). The social readjustment rating scale. Journal of Psychosomatic Research, 11, 213-218. Lewak, R., Wakefield, J. A., Jr., & Briggs, P. F. (1985). Intelligence and personality in mate choice and marital satisfaction. Personality and Individual Differences, 6, 471-477. Locke, H. J., & Wallace, K. M. (1959). Short marital adjustment and prediction tests: Their reliability and validity. Journal of Marriage and Family Living, 21, 251-255. Loeb, J. (1966). The personality factor in divorce. Journal of Consulting Psychology, 30, 562. McCranie, E. W., &Kahan, J. (1986). Personality and multiple dmorce: A prospective study. Journal of Nerwous and Mental Disease, 174, 161-164. Meehl, P. E., & Rosen, A. (1955). Antecedent probability and the efficiency of psychometric signs, patterns, or cutting scores. Psychological Bulletm, 52, 194-216. Murstein, B. I., & Glaudin, V. (1968). The use of the MMPI in the determination of marital adjustment. Journal of Marriage and the Family, 30, 651-655. Ollendick, G. D., Otto, J. B., & Heider, S. M. (1983). Marital MMPI characteristics: A test of Arnold's signs. Journal of Clinical Psychology, 39, 240-245. Olsinski, P. K, (1980). A study of the effect of some Minnesota Multiphasic Personality characterIstics on the adjustment of married, marriage-counseled, and divorced individuals (Doctoral dissertation, St. John's University, 1980). Dissertation Abstracts International, 41, 539. Osborne, D. (1971). An MMPI index of disturbed marital interaction. Psychological Reports, 29, 851-854. of those who divorce and those who remain Shapiro, T. H. (1978). Comparison of MMPI married (Doctoral dissertation, University of Iowa, 1977). Dissertation Abstracts International, 38, 3965A. Snyder, D. K. (1981). Manual for the Manta1 Satisfaction Inventory. Los Angeles: Western Psychological Services. Snyder, D. K., & Regts, J. M. (1990). Personality correlates of marital satisfaction: A comparison of psychiatric, maritally distressed, and nonclinic samples. Journal of Sex and Marital Therapy, 16, 34-43. Spanier, G. B. (1976). Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads. Journal of Marnage and the Family, 38, 15-28.

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Swan, R. J. (1957). Using the MMPI in marriage counseling. Journal of Counseling Psychology, 4, 239-244. Swan, R. J. (1953). The application of a couple analysis approach to the MMPI in marriage counseling (Doctoral dissertation, University of Minnesota, 1953). Dissenation Abstraas Intemational, 13, 1095. U.S. Bureau of the Census. (1983). Charactmistics of the population: Number of inhabitants, United Stares summary. Washington, DC: U.S. Government Printing Office.

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Stephen Hjemboe Department of Psychology University of Minnesota Minneapolis, MN 55455 October 3 1, 1990 Revised December 8, 1990

Couples in marital distress: a study of personality factors as measured by the MMPI-2.

This study examines the relationship between Minnesota Multiphasic Personality Inventory-2 (MMPI-2) measured personality characteristics and marital d...
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