Million Clinical Multiaxial Inventory Research Articles

Validation of the Millon Clinical Multiaxial Inventory for Axis II disorders: does it meet the Daubert standard?

Relevant to forensic practice, the Supreme Court in Daubert v. Merrell Dow Pharmaceuticals, Inc. (1993) established the boundaries for the admissibility of scientific evidence that take into account its trustworthiness as assessed via evidentiary reliability. In conducting forensic evaluations, psychologists and other mental health professionals must be able to offer valid diagnoses, including Axis II disorders. The most widely available measure of personality disorders is the Million Clinical Multiaxial Inventory (MCMI) and its subsequent revisions (MCMI-II and MCMI-III). We address the critical question, "Do the MCMI-II and MCMI-III meet the requirements of Daubert?" Fundamental problems in the scientific validity and error rates for MCMI-III appear to preclude its admissibility under Daubert for the assessment of Axis II disorders. We address the construct validity for the MCMI and MCMI-II via a meta-analysis of 33 studies. The resulting multitrait-multimethod approach allowed us to address their convergent and discriminant validity through method effects (Marsh, 1990). With reference to Daubert, the results suggest a circumscribed use for the MCMI-II with good evidence of construct validity for Avoidant, Schizotypal, and Borderline personality disorders.

Use of the Million Clinical Multiaxial Inventory in clinical practice.

A review of recent survey data indicates that the Million Clinical Multiaxial Inventory (MCMI) ranks among the most frequently used tests by practicing clinicians. This instrument is surpassed only by the MMPI or MMPI-2 in the area of objective personality assessment.

Assessment of schizophrenic inpatients with the MCMI

The Million Clinical Multiaxial Inventory (MCMI) Psychotic Thinking scale previously was found insensitive in the detection of schizophrenia. The MCMI also was shown to be susceptible to undetected "faking good." We hypothesized that the insensitivity of the MCMI Psychotic Thinking scale was due to an unwillingness of schizophrenic patients to report psychotic symptoms. The MCMI was administered to 258 male schizophrenic inpatients who were classified as symptom-reporters or nonreporters based upon whether they endorsed psychotic symptoms on a separate problem checklist. Willingness to report psychotic symptoms was a significant factor in MCMI Psychotic Thinking scale scores as well as many other MCMI scales.

A Comparison of Four Measures to Diagnose DSM-III-R Borderline Personality Disorder in Outpatients

After three decades of clinical controversy and research, a clinical consensus has formed that borderline personality disorder (BPD) exists as a unique entity which can be defined by DSM-III-R diagnostic criteria. The purpose of this study was to evaluate the relative abilities of four different approaches to the identification of borderlines and to differentiate a DSM-III-R BPD group from a control group of other diagnoses. The approaches were the Kernberg's Structural Interview, the Diagnostic Interview for Borderline Personality Disorders (DIB), the Borderline Syndrome Index (BSI), and the Million Clinical Multiaxial Inventory (MCMI). Sixty outpatient volunteers (27 men and 33 women) from a community mental health center served as subjects. The volunteers included 30 BPDs and 30 other diagnoses, including 11 non-BPD personality disorders. Point biserial correlations indicated that the best method for identifying DSM-III-R BPD was the DIB, and the second best was the Kernberg Structural Interview, although all four identified DSM-III-R BPDs at better than chance levels. Multiple regression results showed that the DIB accounted for 61.5% of the BPD variance, while the Kernberg approach added 4.9% more unique variance prediction. MCMI dimensions and personal history characteristics were used to identify differentiators of BPD from all other diagnoses and from other personality disorders.

Validity of the MCMI Drug Abuse Scale Varies as a Function of Drug Choice, Race, and Axis II Subtypes

The validity of the Drug Abuse Scale (T) from the Million Clinical Multiaxial Inventory (MCMI) was studied by administering the MCMI to 110 male veterans seeking treatment for opioid or cocaine dependence. Only 26 and 23% of the sample obtained base rate (BR) scores above the clinical relevant cutoffs of 84 and 74, respectively. Covariables associated with elevated scores on the T Scale were Black race, presence of narcissistic/antisocial personality features, and more severe psychopathology in general. The authors urge caution in using the Drug Abuse Scale for the purpose of identifying drug abusers.

Factor-based special scales for the MCMI

Factor analytic work with the Million Clinical Multiaxial Inventory (MCMI) has shown a remarkably stable factor structure. The eight Basic Personality scales have a three-factor structure: Aloof/Social, Submissive/Aggressive, and Labile/Restrained. These dimensions appear to be the same as those suggested by the DSM-III-R advisory committee on personality disorders. The MCMI as a whole has a five-factor structure: Detached, Submissive, Suspicious, High Social Energy, and General Distress. The present work operationalizes these two sets of factors into scales for use by clinicians and researchers. The resultant scales show excellent reliabilities across three subject samples (N = 253, N = 185, N = 184) and demonstrate appropriate convergent and divergent validity estimates against the MCMI itself.

Factor structure of the Millon Clinical Multiaxial Inventory (MCMI) with an offender sample.

One thousand two hundred inmates were given the Millon Clinical Multiaxial Inventory (MCMI) in a midwestern reception and diagnostic center. Two groups of 600 were randomly divided, and their test results were subjected to a principal components factor analysis. Four factors were derived in both groups and were similar, indicating successful cross-validation. Three of the four factors bore similarity to factors found in other samples (drug abusers, psychiatric population, Viet Nam veterans), and the fourth was unique to the offender population.

Validity of Million's computerized interpretation system for the MCMI: comment on Moreland and Onstad.

Moreland and Onstad (1987) reported the results of a "controlled study" to determine the incremental validity of Million's computerized interpretive system for the Million Clinical Multiaxial Inventory (MCMI) in relation to the Barnum effect. Eight clinicians rated the accuracy of actual case reports and paired control reports that were randomly generated but designated experimental. However, in view of several limitations of their experimental design and statistical analyses, the authors may have prematurely concluded that the perceived accuracy of the interpretive system exceeds a Barnum base rate.

The Impact of Shared Items on the Internal-Structural Validity of the Mcmi

The Million Clinical Multiaxial Inventory (MCMI) utilizes a relatively large number of shared items among its 20 scales in maximizing external validity and minimizing the length of the test. This study evaluates the impact of this practice upon assessing the internal-structural validity of the MCMI. Analysis discloses that the relationship among the correlations between scales after extracting shared-item effects is not significantly different from the relationship prior to extraction of these effects. However, because the high percentage of shared items among scales does restrict the minimum magnitude of correlation coefficients among all pairs of scales, correlation coefficients obtained in cross-validation studies are not sufficiently free to vary from correlations obtained with the construction sample. Consequently, it is recommended that as a matter of practice cross-validation of inventories utilizing shared items also make comparisons between correlation coefficients after the effect of shared items has been extracted. A method for doing this task is reported herein.

Personality Styles in the Treatment of Older Alcoholics

An area devoid of research is that of personality style and alcoholism in later-life people. This study presents frequency data on personality styles and the relationship of personality styles to health and depression ratings. Fifty older alcoholics in the Alcohol Treatment Unit were given the Million Clinical Multiaxial Inventory (MCMI), Minnesota Muliphasic Personality Inventory (MMPI), Beck Depression Inventory (BDI-21), and were rated on their current health status. Results show that each personality style has its own pattern of health and depression, and that this pattern has an influence on treatment. Four case histories are given to show the influence of personality style on the experiencing of symptoms and behavior.

Personality characteristics of drug addicts and alcoholics on the Millon Clinical Multiaxial Inventory.

The Million Clinical Multiaxial Inventory (MCMI) was administered to 106 alcoholics and 100 addicts in separate VA inpatient rehabilitation treatment programs. The alcoholics scored higher on the personality style scales of Avoidant, Passive-Aggressive, Schizotypal, Borderline and Paranoid, while the opiate addicts scored higher on the Narcissistic personality disorder scale. Separate cluster analyses for both groups further revealed common personality styles among both groups. Several MCMI scales showed significant correlations with age, but in no case were the effects attributed to age larger than 5% of the total variance. The MCMI may alert clinicians to subtle similarities and differences between and among alcoholics and opiate addicts.