Millon Clinical Multiaxial Inventory Research Articles

Estudio de caso: ¿simulación o trastorno de personalidad múltiple?

The dissociative identity disorder (DID) can be considered a rare disorder because of its seemingly low prevalence. However, in recent years it points to the possible underdiagnosis because its complexity and confusion at the time of differential diagnosis. On the other hand, the malingering of mental psychopathology can have a major socio-economic and legal impact, particularly important in this type of disorder, given the inability it generates and its complex diagnostic. This paper refers the case of a patient admitted to the short-term hospitalization unit of Dr. Rodríguez Lafora Hospital (Madrid) with depressive symptoms. Then the patient seemed to become a TID case. The evaluation consisted of a psychological history and the application of the Structured Inventory of Malingered Symptoms (SIMS) and the Millon Clinical Multiaxial Inventory (MCMI-II). The results showed an altered personality profile as well as likely malingered symptoms, what prevented us from a DID diagnosis. In view of the results, possible implications of this case for the clinical setting are discussed.

Personality traits and psychotic symptoms in recent onset of psychosis patients

ObjectivePersonality in patients with psychosis, and particularly its relation to psychotic symptoms in recent onset of psychosis (ROP) patients, is understudied. The aims of this research were to study the relation between dimensional and categorical clinical personality traits and symptoms, as well as the effects that symptoms, sex and age have on clinically significant personality traits. MethodsData for these analyses were obtained from 94 ROP patients. The Millon Clinical Multiaxial Inventory and the Positive and Negative Syndrome Scale were used to assess personality and symptoms. Correlational Analysis, Mann–Whitney test, and, finally, logistic regression were carried out. ResultsThe negative dimension was higher in patients with schizoid traits. The excited dimension was lower for those with avoidant and depressive traits. The anxiety and depression dimension was higher for patients with dependent traits. The positive dimension was lower for patients with histrionic and higher for patients with compulsive traits. Logistic regression demonstrated that gender and the positive and negative dimensions explained 35.9% of the variance of the schizoid trait. The excited dimension explained 9.1% of the variance of avoidant trait. The anxiety and depression dimension and age explained 31.3% of the dependent trait. Gender explained 11.6% of the histrionic trait, 14.5% of the narcissistic trait and 11.6% of the paranoid trait. Finally gender and positive dimension explained 16.1% of the compulsive trait. ConclusionsThe study highlights the importance of studying personality in patients with psychosis as it broadens understating of the patients themselves and the symptoms suffered.

Prevalence of Personality Disorders and Clinical Syndromes Using the Millon Clinical Multiaxial Inventory III (MCMI-III) in an Iranian Clinical Sample

Personality objective inventories are commonly used for diagnosis of personality disorders. Personality assessment is effective in diagnosis, prognosis and treatment of psychiatric outpatients and in patients. Comorbid personality disorders and clinical syndromes may be more worth condition of the patients. The present study aimed to examine the diagnosis of personality disorders and clinical syndromes using the Farsi version of Millon Clinical Multiaxial Inventory III (3rd ed.; MCMI-III) in Iranian psychiatric outpatients. This was a descriptive cross-sectional study. The subjects of the project were 737 psychiatric outpatients. They were referred to the psychiatric and psychological clinics at the School of Behavioral Sciences and Mental Health-Tehran Institute of Psychiatry affiliated to Iran University of Medical Sciences, Tehran, Iran. The subjects were selected using convenience sampling during years of 2010-2015 and evaluated by the MCMI-III computerized Farsi version. Data were analyzed by descriptive methods and t test using SPSS/WIN 16.0 program. Results showed that the most frequent of personality disorders were Depressive (2B), Compulsive (7), and Histrionic (4); with double code types of Depressive- Dependent (2B3); and Histrionic- Depressive (42B) combinations. The most frequent of moderate clinical syndrome were Anxiety (A), and Dysthymia (D) and the severe syndromes was Thought Disorder (SS); with double codes of clinical syndromes of Anxiety- Post-Traumatic Stress Disorder (AR). There were significant differences between women and men patients in mean scores of some MCMI-III scales. Women had higher scores in Validity Scales of Disclosure (X) and Debasement (Z) than men. Depressive, Passive-Aggressive (Negativistic) (8A), Self-Defeating (8B) and Borderline (C) personality disorders were the most common in women than men. By contrast, Compulsive (7) personality disorder was the most common in men compare to women. Anxiety, Somatoform (H), Bipolar: Manic (N), Dysthymia (D), and Post-Traumatic Stress Disorder (R), Thought Disorder (SS), and Major Depression Disorder (CC) were the most common in women than men. The prevalence of diagnosis personality patterns and clinical syndromes in Iranian psychiatric outpatients is high and this should be taken into account in their assessment and treatment planning. Using of available sample and lack of random sample; possibility of comorbidity of other mental disorders with main diagnosis are limitations of the study. Utilization of item response theory (IRT); Structural Clinical Interviews for DSM Axis I and Axis II (SCID-I and SCID-II) along with MCMI-III; and MCMI-IV in an Iranian clinical sample are recommended.

Prevalence of Personality Disorders and Clinical Syndromes Using the Millon Clinical Multiaxial Inventory III (MCMI-III) in an Iranian Clinical Sample

Personality objective inventories are commonly used for diagnosis of personality disorders. Personality assessment is effective in diagnosis, prognosis and treatment of psychiatric outpatients and in patients. Comorbid personality disorders and clinical syndromes may be more worth condition of the patients. The present study aimed to examine the diagnosis of personality disorders and clinical syndromes using the Farsi version of Millon Clinical Multiaxial Inventory III (3rd ed.; MCMI-III) in Iranian psychiatric outpatients. This was a descriptive cross-sectional study. The subjects of the project were 737 psychiatric outpatients. They were referred to the psychiatric and psychological clinics at the School of Behavioral Sciences and Mental Health-Tehran Institute of Psychiatry affiliated to Iran University of Medical Sciences, Tehran, Iran. The subjects were selected using convenience sampling during years of 2010-2015 and evaluated by the MCMI-III computerized Farsi version. Data were analyzed by descriptive methods and t test using SPSS/WIN 16.0 program. Results showed that the most frequent of personality disorders were Depressive (2B), Compulsive (7), and Histrionic (4); with double code types of Depressive- Dependent (2B3); and Histrionic- Depressive (42B) combinations. The most frequent of moderate clinical syndrome were Anxiety (A), and Dysthymia (D) and the severe syndromes was Thought Disorder (SS); with double codes of clinical syndromes of Anxiety- Post-Traumatic Stress Disorder (AR). There were significant differences between women and men patients in mean scores of some MCMI-III scales. Women had higher scores in Validity Scales of Disclosure (X) and Debasement (Z) than men. Depressive, Passive-Aggressive (Negativistic) (8A), Self-Defeating (8B) and Borderline (C) personality disorders were the most common in women than men. By contrast, Compulsive (7) personality disorder was the most common in men compare to women. Anxiety, Somatoform (H), Bipolar: Manic (N), Dysthymia (D), and Post-Traumatic Stress Disorder (R), Thought Disorder (SS), and Major Depression Disorder (CC) were the most common in women than men. The prevalence of diagnosis personality patterns and clinical syndromes in Iranian psychiatric outpatients is high and this should be taken into account in their assessment and treatment planning. Using of available sample and lack of random sample; possibility of comorbidity of other mental disorders with main diagnosis are limitations of the study. Utilization of item response theory (IRT); Structural Clinical Interviews for DSM Axis I and Axis II (SCID-I and SCID-II) along with MCMI-III; and MCMI-IV in an Iranian clinical sample are recommended.

The relationship of the Severe Personality disorders with behavioral activation and inhibition systems in patients with paranoid, borderline and schizotypal personality disorders

Introduction: Given the disruptive effects of personality disorders on personal and family life, it is essential to recognize their predisposing factors to understand them more accurately, and identify their preventive measures treatment facilitators. Therefore, the present study aimed to examine the relationship of severe personality disorders with behavioral activation and inhibition systems in patients with paranoid, borderline and schizotypal personality disorders. Methods: The present descriptive-correlational study recruited patients with paranoid, borderline and schizotypal personality disorders presenting to psychiatry clinics in Ardebil using convenient sampling method. A total of 30 paranoid patients, 30 borderline patients and 20 schizotypal patients were selected by a psychiatrist through psychiatric examination, clinical interview and completing Millon Clinical Multiaxial Inventory (MCMI-III). The following instruments were used: MCMI- III and behavioral activation-inhibition system scale (BIS-BAS). The data were analyzed with Pearson’s correlation coefficient and stepwise regression. Results: BIS and BAS systems were both significant for predicting borderline and paranoid personality disorders, but only BIS was significant for predicting schizotypal personality disorder. Conclusion: These findings can help experts to have a better and more accurate understanding of personality disorders and use proper methods to predict the probability of these disorders and develop treatments. ne-height:115%;font-family:Times New Roman,serif;mso-fareast-font-family: Calibri;mso-ansi-language:EN-US;mso-fareast-language:EN-US;mso-bidi-language: FA'> In general, 6 weeks of high intensity interval training can effectively increase angiogenesis factors and improve myocardial function in male Wistar rats after MI.

Rasgos psicopatológicos en personas con disforia de género

ObjectivesFirstly, the aim is to evaluate psychopathological traits in people with gender dysphoria, and secondly, to establish if there are differences between groups of male to female and female to male. Participants and methodThe Millon clinical multiaxial inventory (MCMI-II) was applied to 32 subjects with gender dysphoria, of which 20 belong to the group of male to female and 12 to the group female to male. Participants were selected intentionally. ResultsNo significant psychopathological alterations are found. The highest scores were obtained in the schizoid, paranoid and delusional traits. There are statistically significant differences between the male to female and female to male in clinical patterns of schizoid (P=.012), compulsive (P=.047) and self-destructive personality (P=.040), and in moderate clinical syndrome, abuse of alcohol (P=.000). ConclusionsPeople with gender dysphoria are not characterized by psychopathological alterations. The traits with higher scores correspond with those pointed out in previous studies. Differences were appreciated between groups, but only in certain scales.

Borderline, avoidant, sadistic personality traits and emotion dysregulation predict different pathological skin picking subtypes in a community sample.

Pathological skin picking (SP) is a strongly impairing condition characterized by repetitive picking behaviors resulting in significant tissue damage and distress. Recent research suggested the presence of different subtypes of SP. No study has investigated which personality traits could be specifically associated with different subtypes. In a community sample (N=285, 71.20% females, mean age =34.98 years, standard deviation =15.91), this cross-sectional study investigated which personality traits and emotion regulation deficits could predict specific SP subtypes. Participants completed the Milwaukee Inventory for the Dimensions of Adult Skin Picking (MIDAS), Millon Clinical Multiaxial Inventory-III personality scales (MCMI-III), and Difficulties in Emotion Regulation Scale (DERS) questionnaires. Higher scores on the MCMI-III borderline (β=0.28, t=4.88, P<0.001), MCMI-III avoidant scale (β=0.18, t=2.59, P<0.01), and DERS difficulties engaging in goal-directed behavior (β=0.19, t=3.27, P<0.01) predicted higher scores on the MIDAS automatic scale. Higher scores on the MCMI-III borderline (β=0.30, t=5.23, P<0.001) and DERS difficulties engaging in goal-directed behavior (β=0.15, t=2.52, P<0.05) and DERS limited access to emotion regulation strategies (β=0.21, t=3.26, P<0.01) predicted higher scores on the MIDAS focused scale. Higher scores on the MCMI-III sadistic (β=0.19, t=3.30, P<0.001) and DERS difficulties engaging in goal-directed behavior (β=0.15, t=2.68, P<0.01) predicted higher scores on the MIDAS mixed scale. Implications for future research and treatment are discussed.

Self-Reported Disorders Among Serial Homicide Offenders: Data From the Millon Clinical Multiaxial Inventory–III

ABSTRACTThis project reports the results of 60 male serial homicide offenders’ profiles on the Millon Clinical Multiaxial Inventory–III (MCMI-III). The geographical distance between potential participants increases the difficulty in effectively measuring psychological features. Therefore, self-report is a viable option for this type of research. Using a computer-generated correctional report, the Severe Personality Pathologies and Clinical Personality Patterns were analyzed for possible traits relating to Axis I and Axis II suggested diagnoses.1 Results show that the majority of murderers sampled had at least one Axis I classification and nearly half had more than one. All participants had either features or traits of an Axis II disorder, with slightly more than half having met the cutoff for a diagnosed disorder. The measurement of a highly violent specialized group requires many considerations and extensive resources, but a preliminary understanding is possible with a carefully gauged approach.

HIV-transmission-related risk behavior in HIV+ African American men: Exploring biological, psychological, cognitive, and social factors

ABSTRACTThis article seeks to identify factors associated with HIV-transmission-related risk behavior among HIV+ African American men. We examined biological, psychological, cognitive, and social factors and recent HIV-transmission-related risk behavior (i.e., needle sharing, unprotected sex, exchange sex) among a sample of HIV+ African American men. A binary logistic regression showed that individuals under age 50 (OR = 4.2), with clinically-elevated masochism scores (OR = 3.9) on the Millon Clinical Multiaxial Inventory-III (MCMI-III), current substance abuse/dependence (OR = 2.6), and higher sensation-seeking (OR = 1.3) were more likely to report recent risk behavior. We conclude that reducing substance use, addressing self-defeating attitudes, and improving self-control may be avenues for future prevention and intervention research among HIV+ African American men engaging in HIV-transmission-related risk behavior.

The role of alcohol as men desist from physical intimate partner violence

Although researchers have examined the relationship between alcohol and perpetration of intimate partner violence (IPV), little research has examined the role of alcohol within the process of desistance from IPV, which was the aim of this study. A mixed-methods approach was taken as both psychometric test and interview data were analysed. Scores on the Millon Clinical Multiaxial Inventory III alcohol dependence subscale of 37 men deemed to have desisted from IPV, 50 deemed to be persisting with IPV and 49 non-violent controls were compared. In addition, data about alcohol use from interviews with 13 desisters, 9 persisters, 9 IPV intervention facilitators and 7 female survivors were analysed using thematic analysis to understand the role of alcohol in IPV desistance and persistence. No differences were found between the groups' self-reported alcohol dependence based on their Millon Clinical Multiaxial Inventory III scores. However, analysis of the interview data revealed that compared with persisters, desisters reported having changed their attitudes towards alcohol and their consumption of it in order to facilitate their cessation of violence. Static measures of alcohol dependence need to be used with caution if looking to identify progress with desistance from IPV. For individuals for whom alcohol played a role in their IPV, changing attitudes and their use of alcohol were described as being important in the process of desistance. Self-reported attitudes and alcohol use could therefore be used to identify men who are making progress in the process of desistance from IPV. [Walker K. The role of alcohol as men desist from physical intimate partner violence. Drug Alcohol Rev 2017;36:134-142].

Prevalence and predictors of Axis I disorders in a large sample of treatment-seeking victims of sexual abuse and incest

BackgroundChildhood sexual abuse (CSA) is a common occurrence and a robust, yet non-specific, predictor of adult psychopathology. While many demographic and abuse factors have been shown to impact this relationship, their common and specific effects remain poorly understood.ObjectiveThis study sought to assess the prevalence of Axis I disorders in a large sample of help-seeking victims of sexual trauma, and to examine the common and specific effects of demographic and abuse characteristics across these different diagnoses.MethodThe participants were attendees at four treatment centres in Denmark that provide psychological therapy for victims of CSA (N=434). Axis I disorders were assessed using the Millon Clinical Multiaxial Inventory-III (MCMI-III). Multivariate logistic regression analysis was used to examine the associations between CSA characteristics (age of onset, duration, number of abusers, number of abusive acts) and 10 adult clinical syndromes.ResultsThere was significant variation in the prevalence of disorders and the abuse characteristics were differentially associated with the outcome variables. Having experienced sexual abuse from more than one perpetrator was the strongest predictor of psychopathology.ConclusionsThe relationship between CSA and adult psychopathology is complex. Abuse characteristics have both unique and shared effects across different diagnoses.

Influence of Psychiatric and Personality Disorders on Smoking Cessation Among Individuals in Opiate Dependence Treatment

ABSTRACTObjective: We aimed to evaluate how psychiatric and personality disorders influence smoking cessation goals and attempts among people with opiate dependence who smoke. This information could aid the development of more effective cessation interventions for these individuals. Methods: Participants (N = 116) were recruited from two methadone clinics, completed the Millon Clinical Multiaxial Inventory-III, and were asked about their smoking behavior and quitting goals. We used the Least Absolute Shrinkage and Selection Operator (LASSO) method, a technique commonly used for studies with small sample sizes and large number of predictors, to develop models predicting having a smoking cessation goal, among those currently smoking daily, and ever making a quit attempt, among those who ever smoked. Results: Almost all participants reported ever smoking (n = 115, 99%); 70% (n = 80) had made a serious quit attempt in the past; 89% (n = 103) reported current daily smoking; and 59% (n = 61) had a goal of quitting smoking and staying off cigarettes. Almost all (n = 112, 97%) had clinically significant characteristics of a psychiatric or personality disorder. White race, anxiety, and a negativistic personality facet (expressively resentful) were negative predictors of having a cessation goal. Overall, narcissistic personality pattern and a dependent personality facet (interpersonally submissive) were positive predictors of having a cessation goal. Somatoform disorder, overall borderline personality pattern, and a depressive personality facet (cognitively fatalistic) were negative predictors of ever making a quit attempt. Individual histrionic (gregarious self-image), antisocial (acting out mechanism), paranoid (expressively defensive), and sadistic (pernicious representations) personality disorder facets were positive predictors of ever making a quit attempt. Each model provided good discrimination for having a smoking cessation goal or not (C-statistic of .76, 95% CI [0.66, 0.85]) and ever making a quit attempt or not (C-statistic of .79, 95% CI [0.70, 0.88]). Conclusions: Compared to existing treatments, smoking cessation treatments that can be tailored to address the individual needs of people with specific psychiatric disorders or personality disorder traits may better help those in opiate dependence treatment to set a cessation goal, attempt to quit, and eventually quit smoking.

Patterns of Personality in Living Kidney Donors

BackgroundThe decision to undergo living donor transplantation determines a particular condition characterized by strong mental and emotional anguish, both for the patient and his family. Many recent studies showed the concern of living donors who, rather than being driven by altruistic reasons, meet the decision to donate with ambivalence, liabilities, and/or in response to family pressures. The aim of this study was to analyze the more frequently encountered personality variables in a sample of potential kidney living donors, together with any psychological variables that can express possible risks of an impulsive decision and/or poorly processed from a cognitive and emotional point of view. MethodsWe examined 32 potential kidney donors. The personality study was performed using The Millon Clinical Multiaxial Inventory-III. The psychic symptoms were studied through the Symptom Checklist-90-R. The quality of life was studied through the Complete Form Health Survey (SF-36). ResultsThe study showed that the ability to express free and therefore invalid consent, in the role of donor, is an expression of specific personality patterns, cognitive, emotional aspects and interpersonal experiences. ConclusionsThe psychological–psychiatric evaluation of potential donors is fundamental to certify the state of mental health and psychological well-being, an indispensable prerequisite for the donation.

The purpose of this research was standardizing the questionnaire of personality disorder Cluster A

Introduction As more or less stable personality traits of the person, temperament, intellect and body that makes an individual unique compatibility with the environment. Objective The purpose of this research was standardizing the questionnaire of personality disorder Gluster A. On the basis of realizing criterion standard, DSM-5. Method A total of 1303 people from universities of Tehran and Alborz provinces (753 females and 550 males) were examined by using the randomized sampling method. The questions of the questionnaire were conformed Dr. Shahram Vaziri on the basis of Iran s population and culture. Then the reliability was tested and accomplished simultaneously Millon (MCMI-III) questionnaire. Result After computing the correlation scales of Millon test with each of the questions, 20 questions that showed the highest correlation and diagnosis coefficient were chosen and scored again in next stage. Conclusions Investigating the psychometric component of three scales (Paranoid 60%, Schizoid 66%, Schizotypal 59%) shows that they are reliable and defensibly valid. It can be said that questions related to all three measures paranoid, schizoid and schizotypal of acceptable psychometric properties and reliability are desirable.

Evaluation of Emotional Self-Awareness and Impulse Control in Drug-Dependent Individuals With and Without Borderline Personality Characteristics Undergoing Methadone Maintenance Treatment (MMT)

Background: Drug addiction is one of the most significant problems related to general health in the world, creating various mental problems in addicts and leading to social and family difficulties. Emotional factors also play a key role in treating addiction. Objectives: The purpose of this study is to examine emotional self-awareness and impulse control in drug-dependent individuals with and without borderline personality characteristics undergoing methadone maintenance treatment (MMT). Patients and Methods: This was a descriptive-correlational study. The population of the study included 361 drug-dependent individuals under Methadone Maintenance Treatment (MMT) who were selected randomly among referrals to substance abuse treatment clinics in Zahedan, Iran, in 2013. To obtain data, emotional self -awareness and impulse control were assessed using Bar-On Emotional Quotient Inventory (EQI) and Millon Clinical Multiaxial Inventory III (MCMI-III). Data were analyzed using SPSS software version 16. Results: The findings indicated no significant differences between these two groups in terms of their emotional self-awareness (P ≥ 0.01). With regard to impulse control, the results revealed significant differences between these two groups (P ≤ 0.01). Conclusions: It can be indicated that reinforcing components of emotional intelligence, especially emotional-awareness and impulse control, are effective methods to develop against substance use in among drug-dependent individuals.

Diagnostic Agreement Between Clinicians and Clients: The Convergent and Discriminant Validity of the SWAP-200 and MCMI-III Personality Disorder Scales.

A particularly controversial aspect in the field of personality assessment is the use of self-report measures, versus clinicians' evaluations, for diagnosing personality disorder (PD). No studies have systematically documented the agreement between these sources for the entire array of DSM-5 PDs using comprehensive measures and experienced clinicians' judgments. The present work fills this gap by indexing the agreement between patients' self-descriptions and clinicians' judgments, relying on standardized and thorough PD instruments. The Shedler-Westen Assessment Procedure-200 (SWAP-200; Westen & Shedler, 1999a, 1999b) and the Millon Clinical Multiaxial Inventory-III (Millon, Davis, & Millon, 1997) were both completed in a clinical series of 56 adult outpatients. Analyses highlighted moderate correlations between the two measures for the 10 DSM-5 PDs (Mdn = .35). Agreement was highest for psychological features that are more easily observable by the clinicians. Furthermore, results revealed problematic discriminant validity between the two instruments.

Prevalence and differential profile of patients with drug addiction problems who commit intimate partner violence.

The objectives of this study were, first, to explore the prevalence of aggressors with lifetime intimate partner violence (IPV) among patients in the Proyecto Hombre of Navarra (Spain) addiction treatment programme; and second, to know the specific and differential characteristics of patients presenting IPV as aggressors. A sample of 162 patients (119 men and 43 women) was assessed. Data on socio-demographic and substance consumption characteristics, IPV variables, psychopathological symptoms, and personality variables were obtained. The profiles of patients in addiction treatment with and without a history of violence towards their partners were compared. The results showed that 33.6% of people in treatment for addiction had committed violence against their partners. This prevalence was significantly higher (χ(2) = 15.6, p < .001) in women (63.3%) than in men (24.2%). In the 98.4% of the cases the IPV was bidirectional. Patients with a history of IPV perpetration showed greater severity in substance consumption variables, psychopathological symptoms, and personality traits. Gender, the family scale on the European version of the Addiction Severity Index (EuropASI), and the aggressive-sadistic scale on the Millon Clinical Multiaxial Inventory (MCMI-III) were the main variables related to the presence of IPV as aggressors. There was a differential profile in patients with IPV perpetration, showing more psychopathological and personality symptoms. Moreover, in this study being a woman was one of the main predictors of committing IPV.

Relationship between personality traits and perceived internalized stigma in bipolar patients and their treatment partners

Internalized stigma of mental disorders has significant negative outcomes for patients with bipolar disorder and their families. The aim of this study is to evaluate the association between personality traits and internalized stigma of mental disorders in bipolar patients and their treatment partners. Five different questionnaires were utilized in this study: (1) Demographic data questionnaire, (2) Millon Clinical Multiaxial Inventory-III (MCMI-III) for personality traits, (3) Internalized Stigma of Mental Illness (ISMI) for stigma, (4) Self Report Manic Inventory (SRMI) for mania and (5) Center for Epidemiological Studies-Depression Scale (CES-D) for depression. The scores of personality traits were combined to create externalizing and internalizing personality trait scores. Results showed that patients with bipolar disorder and their treatment partners both experienced internalized stigma of mental health disorders. There was a significant positive correlation between internalized stigma and internalizing personality traits, but not externalizing traits. In a multi-variate regression analysis, internalizing personality trait score was found to be a significant predictor of internalized stigma. In conclusion, patients with bipolar disorder and their treatment partners perceive higher level of internalized stigma of mental disorders if they have internalizing personality traits.

Child Custody Evaluations: Review of the Literature and Annotated Bibliography

This review of custody evaluation literature encompasses a number of perspectives gleaned from the following: practitioners who perform the evaluations; the professional organizations that recognize the necessity to establish performance standards for practitioners; and the judges who depend on the findings and recommendations in the evaluations to assist with difficult custody decisions.General agreement exists among practitioners about the components of a comprehensive evaluation (interviews of adults responsible for child care, interviews of children and their preferences, life histories, observations, psychological testing, document review, and collateral source data), though little consensus exists about the details of performance concerning a given component. For instance, many authors recommend direct parent-child observations, but there is little agreement about observational protocols (Hynan, 2002). Choice of psychological test(s) is largely left to the discretion of the evaluator (Turkat, 2005), though evaluators are urged to choose tests that address issues of parenting capacity (AFCC Standards, 2006; DeWard, 2005). Stark differences of opinion exist concerning the suitability of using several commonly employed tests, including the Minnesota Multiphasic Personality Inventory (MMPI), the Thematic Apperception Test (TAT), Rorschach, and the Millon Clinical Multiaxial Inventory - III (MCMI-III). One author believes these tests were designed for other uses and should be excluded from the custody evaluation process (Ericson, 2007), while others assert that these tests are helpful to verify information reported by parents, children, and others in disputed custody cases (Jaffe & Mandeleew, 2008). Parent inventory tests designed for use in custody evaluations, such as the Parent-Child Relationship Inventory (Gerard, 2005) and the Parenting Stress Index (Abidin, 1995), are used more frequently since the inception of the American Psychological Association (APA) guidelines (1994) (Quinnell & Bow, 2001).

Millon's Contributions to Preadolescent and Adolescent Personality Assessment: Searching Onward and Upward

Theodore Millon was one of the most influential personality theorists of the 20th century. His theory was originally rooted in biosocial learning models and later reconceptualized as an evolutionary model. This foundation of Millon's work encompasses the entire life span. He had a genuine concern for humankind, especially children. His theory encompasses a comprehensive understanding of the relationship among childhood experiences, parenting styles, and recurring events throughout the life span in shaping the personality. Notable contributions to child and adolescent assessment are the Millon Adolescent Personality Inventory (Millon, Green, & Meagher, 1982), the Millon Adolescent Clinical Inventory (Millon, Millon, & Davis, 1993), and the Millon Pre-Adolescent Clinical Inventory (M–PACI; Millon, Tringone, Millon, & Grossman, 2005). Given Millon's influence on the personality disorders section of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the aforementioned instruments have personality constructs tied to familiar DSM categories, and among them, cover the age range of 9 to 18 years old. His development of the Millon Inventories revolutionized personality assessment in the United States and abroad. Millon's legacies will live on through his works and through the respect and compassion he demonstrated toward others.