Exploration of an Embedded Symptom Validity Overreporting Cutoff for the Perceived Stress Scale in a Diverse Adult Outpatient Neuropsychological Sample.

The utility of symptom (SVT) and performance (PVT) validity tests has been independently established in neuropsychological evaluations, yet research on the relationship between these two types of validity indices is limited to circumscribed populations and measures. This study examined the relationship between SVTs on the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and PVTs in a mixed neuropsychiatric setting. This cross-sectional study included data from 181 diagnostically and demographically diverse patients with neuropsychiatric conditions referred for outpatient clinical neuropsychological evaluation at an academic medical center. All patients were administered a uniform neuropsychological battery, including the MMPI-2-RF and five PVTs (i.e., Dot Counting Test; Medical Symptom Validity Test; Reliable Digit Span; Test of Memory Malingering-Trial 1; Word Choice Test). Nonsignificant associations emerged between SVT and PVT performance. Although the Response Bias Scale was most predictive of PVT performance, MMPI-2-RF SVTs generally had low classification accuracy for predicting PVT performance. Neuropsychological test performance was related to MMPI-2-RF SVT status only when overreporting elevations were at extreme scores. The current study further supports that SVTs and PVTs measure unique and dissociable constructs among diverse patients with neuropsychiatric conditions, consistent with literature from other clinical contexts. Therefore, objective evidence of symptom overreporting on MMPI-2-RF SVTs cannot be interpreted as definitively indicating invalid performance on tests of neurocognitive abilities. As such, clinicians should include both SVTs and PVTs as part of a comprehensive neuropsychological evaluation as they provide unique information regarding performance and symptom validity.

This study investigated the relationship between symptom validity scales on the Clinical Assessment of Attention Deficit-Adult (CAT-A) and the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in the context of Attention-Deficit/Hyperactivity Disorder (ADHD) evaluation. The sample comprised 140 consecutive patients referred for a neuropsychological evaluation of ADHD and were administered the CAT-A and the MMPI-2-RF and a battery of performance-based neurocognitive tests. Results indicated CAT-A/MMPI-2-RF symptom validity concordance of 51% between measures, with 38% concordant valid and 13% concordant invalid responses. Among those with discordance symptom validity results, rates of valid CAT-A/invalid MMPI-2-RF responding (41%) were more common than invalid CAT-A/valid MMPI-2-RF responding (8%). Results also indicated higher levels of ADHD symptoms among invalid responding within the CAT-A, whereas the MMPI-2-RF Cognitive Complaints scale did not differ by CAT-A validity status. Finally, symptom validity scales on both the CAT-A and MMPI-2-RF were largely discordant from neuropsychological test validity status per performance validity tests. Findings highlight the need for symptom validity testing when assessing ADHD and indicate that validity indices on broad personality assessments may assess different constructs than embedded validity indices in ADHD-specific measures.

B - 126 Posttraumatic Stress Disorder Symptoms as a Predictor of Invalid Attention-Deficit/Hyperactivity Disorder and General Psychiatric Symptom Reporting among Adult Neuropsychology Referrals

Several meta-analyses of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) have examined these instruments' ability to detect symptom exaggeration or feigning. However, limited research has directly compared whether the scales across these two instruments are equally effective. This study used a moderated meta-analysis to compare 109 MMPI-2 and 41 MMPI-2-RF feigning studies, 83 (56.46%) of which were not included in previous meta-analyses. Although there were differences between the two test versions, with most MMPI-2 validity scales generating larger effect sizes than the corresponding MMPI-2-RF scales, these differences were not significant after controlling for study design and type of symptoms being feigned. Additional analyses showed that the F and Fp-r scales generated the largest effect sizes in identifying feigned psychiatric symptoms, while the FBS and RBS were better at detecting exaggerated medical symptoms. The findings indicate that the MMPI-2 validity scales and their MMPI-2-RF counterparts were similarly effective in differentiating genuine responders from those exaggerating or feigning psychiatric and medical symptoms. These results provide reassurance for the use of both the MMPI-2 and MMPI-2-RF in settings where symptom exaggeration or feigning is likely. Findings are discussed in the context of the recently released MMPI-3.

Validity of Minnesota Multiphasic Personality Inventory – 2 – Restructured Form (MMPI-2-RF) scores as a function of gender, ethnicity, and age of bariatric surgery candidates

Little is known about attention-deficit/hyperactivity disorder (ADHD) in veterans. Practice standards recommend the use of both symptom and performance validity measures in any assessment, and there are salient external incentives associated with ADHD evaluation (stimulant medication access and academic accommodations). The purpose of this study was to evaluate symptom and performance validity measures in a clinical sample of veterans presenting for specialty ADHD evaluation. Patients without a history of a neurocognitive disorder and for whom data were available on all measures (n = 114) completed a clinical interview structured on DSM-5 ADHD symptoms, the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF), and the Test of Memory Malingering Trial 1 (TOMM1) as part of a standardized ADHD diagnostic evaluation. Veterans meeting criteria for ADHD were not more likely to overreport symptoms on the MMPI-2-RF nor to fail TOMM1 (score ≤ 41) compared with those who did not meet criteria. Those who overreported symptoms did not endorse significantly more ADHD symptoms; however, those who failed TOMM1 did report significantly more ADHD symptoms (g = 0.90). In the total sample, 19.3% failed TOMM1, 44.7% overreported on the MMPI-2-RF, and 8.8% produced both an overreported MMPI-2-RF and invalid TOMM1. F-r had the highest correlation to TOMM1 scores (r = -.30). These results underscore the importance of assessing both symptom and performance validity in a clinical ADHD evaluation with veterans. In contrast to certain other conditions (e.g., mild traumatic brain injury), ADHD as a diagnosis is not related to higher rates of invalid report/performance in veterans. (PsycINFO Database Record

The purpose of this study was to examine associations between substance use disclosure during the clinical interview and on the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) Substance Abuse Scale (SUB) among forensic inpatients. Of the 223 archival reports reviewed that had MMPI-2-RF data, 69% of the MMPI-2-RF protocols were valid based on standard validity criteria, resulting in a final sample of 154 patients (98 men, 56 women). We found that patients who endorsed alcohol or marijuana use during the clinical interview often concurrently denied substance use on the MMPI-2-RF SUB scale (the opposite was found for prescription drug abuse). We also found that the MMPI-2-RF SUB scale and other MMPI-2-RF externalizing scales were meaningfully associated with concurrent substance use variables from a record review form. Finally, we found that the MMPI-2-RF SUB scale demonstrated incremental validity over other MMPI-2-RF externalizing scales in the prediction of substance use problems. These results highlight the utility of SUB scale and other self-report instruments in assessing substance use problems. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

The present study extends the validation of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) Response Bias Scale (RBS; R. O. Gervais, Y. S. Ben-Porath, D. B. Wygant, & P. Green, 2007) in separate forensic samples composed of disability claimants and criminal defendants. Using cognitive symptom validity tests as response bias indicators, the RBS exhibited large effect sizes (Cohen's ds = 1.24 and 1.48) in detecting cognitive response bias in the disability and criminal forensic samples, respectively. The scale also added incremental prediction to the traditional MMPI-2 and the MMPI-2-RF overreporting validity scales in the disability sample and exhibited excellent specificity with acceptable sensitivity at cutoffs ranging from 90T to 120T. The results of this study indicate that the RBS can add uniquely to the existing MMPI-2 and MMPI-2-RF validity scales in detecting symptom exaggeration associated with cognitive response bias.

The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) is commonly used to assess psychological factors that may adversely impact weight loss. Research is limited on the specific MMPI-2-RF scales that may predict poor postoperative outcomes following bariatric surgery. The current study compared preoperative MMPI-2-RF profiles associated with postoperative weight change to novel component scores in a bariatric surgery sample. One hundred twenty-seven patients completed a preoperative medical evaluation, a test of reading ability, and the MMPI-2-RF. Percent weight loss was obtained postoperatively at 6 and 12months. Principal components analysis (PCA) generated five novel subcomponents from within the internalizing, externalizing, and interpersonal substantive scales of the MMPI-2-RF. Among these components, higher externalizing and social conflict scores at baseline were predictive of less percent weight change postoperatively at 6months. A similar trend was observed with higher insecurity scores predicting less weight loss at 6months postoperatively. At 12-month follow-up, higher insecurity scores at baseline remained predictive of lower percentage weight loss, while social conflict trended toward significance in the same direction. Model comparisons of traditional MMPI-2-RF scales were found to be more sensitive than the novel subcomponents. Specifically, demoralization (RCd), antisocial behavior (RC4), hypomanic activation (RC9), family problems (FML), and shyness (SHY) significantly predicted weight change after surgery. Results suggested that specific problems scales were not more effectively differentiated into more sensitive and specific component scores, but demonstrated supportive evidence that the traditional MMPI-2-RF scales indicating higher degrees of behavioral dysregulation, poor self-efficacy, and lower social support predict reduced postoperative weight loss.

Reflecting the need to prevent violence, structured professional judgment assessment tools have been developed specifically to assess the likelihood of future violence. These tools typically integrate data from clinical interviews and collateral records to assist in the conceptualization of violence risk, but objective psychological testing may also be useful in completing the instruments. The authors describe the advantages of using the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in this manner with the Historical Clinical Management-20 Version 3 (HCR-20V3). Accordingly, they have 2 purposes. First, they sought to identify conceptual links between the constructs measured by the tools and introduce a model to integrate MMPI-2-RF findings into an HCR-20V3 risk assessment. Second, although the authors did not have collateral HCR-20V3 ratings, they sought to examine associations between the MMPI-2-RF scales and future violence in a sample of 303 psychiatric patients (233 males, 70 females) adjudicated as not guilty by reason of insanity. The authors found that the MMPI-2-RF scales demonstrated significant, meaningful associations with a count of future violent acts at the hospital. The largest associations involved scales measuring emotional dysregulation and externalizing dysfunction. These associations were qualified by relative risk ratio analyses indicating that patients producing elevations on these scales were at 1.5 to 2.5 times greater risk of future violence than those without elevations. Overall, the findings indicated that most MMPI-2-RF scales conceptually linked to the HCR-20V3 risk factors were associated with future violence. In light of these findings, the authors discuss recommendations for integrating the MMPI-2-RF when interpreting HCR-20V3 risk factors. (PsycINFO Database Record

Chronic pain has become a significant medical issue. The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) is a broadband psychological test that has been validated for use across various medical settings and can aid in the assessment and treatment planning of chronic pain. In the current investigation, it was hypothesized that the somatic complaints scales of the MMPI-2-RF would demonstrate good convergent validity from a structured psychodiagnostic interview and other measures of pain and somatization, and lack gender bias. Patients (n = 200) who produced valid MMPI-2-RFs in an outpatient chronic pain clinic were included in the study. Patients were also administered the Modified Somatic Perception Questionnaire (MSPQ), Pain Disability Index (PDI), and the Structured Clinical Interview for DSM-IV-TR (SCID). Zero-order and partial correlations (controlling for gender) were calculated between MMPI-2-RF scale scores and other criteria. Stepdown hierarchical regression analyses were used to detect bias. By and large, higher scale scores on the somatic/cognitive scales of the MMPI-2-RF were modestly or substantially correlated with MSPQ scores, PDI scores, and SCID Somatization symptom count, even after controlling for gender. Regression analyses suggested that the MMPI-2-RF scale scores were not biased as a function of gender. These findings support the validity of specific MMPI-2-RF scales to help identify somatization and psychosocial functioning among patients with chronic pain. Identification of somatization early within the course of treatment of chronic pain may help focus treatment targets, including referrals for psychological interventions such as cognitive behavior therapy for chronic pain.

Among the most pressing considerations in psychological injury litigation is potential overreporting of symptoms or impairments by the plaintiff. It is thus imperative for psychological injury evaluators to possess a working understanding of the conceptual and empirical foundations of symptom validity tests (SVTs). This literature review first covers foundational knowledge to guide evaluators in the careful interpretation of SVTs. It then focuses on two of the most well-established SVTs, i.e., the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and the Personality Assessment Inventory (PAI). Each instrument is reviewed for its overreporting scales, including scale development strategies, standard cutoff values, and research support, with particular attention afforded to psychological injury litigation considerations. Findings from this narrative review suggest that both the MMPI-2-RF and the PAI are sound SVTs with growing bodies of empirical support. However, they must be interpreted with special caution in the unique context of psychological injury evaluations, where there runs a greater risk of false-positive identification of overreporting. The strengths of each measure are contrasted, revealing general themes. Notably, the MMPI-2-RF excels in its accumulation of research support and civil litigant-specific norms, whereas the PAI leads SVT research in innovation and advanced detection techniques. Both measures are better equipped to detect feigned psychopathology than cognitive or medical impairments. Recommendations for forensic evaluators and areas for future research are presented accordingly.

Nonsuicidal self-injury (NSSI), the deliberate destruction of one’s own body tissue without suicidal intent, is a prevalent problem linked to adverse outcomes. Many assessment tools designed to assess for NSSI risk are limited by their behavioral focus, which does not cover the numerous affective, cognitive, and interpersonal correlates. The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) is a widely used inventory of personality and psychopathology that assesses a range of empirical correlates of NSSI risk. The purpose of this study was to investigate the utility of the MMPI-2-RF for assessing these NSSI-related constructs. On the basis of a review of the literature and item content, we pre-identified MMPI-2-RF measures of constructs associated with NSSI risk. Correlations between scores on these scales and the number of methods of NSSI identified several meaningful results, including some small but consistent gender differences in these associations. Zero-inflated negative binomial regression analyses indicated that scores on some expected MMPI-2-RF scales independently predicted NSSI variability. Relative risk ratio analyses demonstrated the potential clinical utility of MMPI-2-RF scale scores for assessing risk of engagement in NSSI. These findings indicate that the MMPI-2-RF may be a useful tool for assessing risk for NSSI among college students.

The purpose of this study was to investigate the predictive validity of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in a sample of law enforcement officers. MMPI-2-RF scores were collected from preemployment psychological evaluations of 136 male police officers, and supervisor ratings of performance and problem behavior were subsequently obtained during the initial probationary period. The sample produced meaningfully lower and less variant substantive scale scores than the general population and the MMPI-2-RF Police Candidate comparison group, which significantly affected effect sizes for the zero-order correlations. After applying a correction for range restriction, MMPI-2-RF substantive scales demonstrated moderate to strong associations with criteria, particularly in the Emotional Dysfunction and Interpersonal Functioning domains. Relative risk ratio analyses showed that cutoffs of 45T and 50T maintained reasonable selection ratios because of the exceptionally low scores in this sample and were associated with significantly increased risk for problematic behavior. These results provide support for the predictive validity of the MMPI-2-RF substantive scales in this setting. Implications of these findings and limitations of these results are discussed.

Objective: The Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PID-5), is a trait-based measure of pathological personality designed to assess Criterion B of an alternative diagnostic system for personality disorders (PDs). In this study, we aimed to evaluate the relations among the PID-5 and the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF); a commonly used self-report instrument with a hierarchical structure. Method : We examined the joint structure of the PID-5 scales along with levels of the MMPI-2-RF hierarchy to understand whether conceptually expected structures tend to be loaded with each other. Data were collected from 536 participants from the general population of Iran. Results: Findings of Pearson's correlation analyses exhibited the generally expected patterns between the two mentioned measures on most scales, with some divergences. Similarly, although applying a set of joint exploratory structural equation modeling (ESEM) exhibited some factor loadings for PID-5 facets within the hierarchical framework of MMPI-2-RF scales that were different to what was theoretically expected, both measures were generally loaded in a conceptually expected way, indicating that they have a similar dimensional structure. Conclusion: Our findings provide support for adequate convergence of maladaptive personality traits and psychopathology structures, as well as for utilizing MMPI-2-RF to measure personality psychopathology from a dimensional perspective. The implications of these results are discussed by the authors.