Millon Clinical Multiaxial Inventory Research Articles

Trastornos de personalidad y juego patológico en adolescentes y jóvenes con dependencia de las máquinas tragamonedas

The object of this study was to explore the relationship between patterns of maladaptive personality and pathological gambling in a group of gamblers addicted to slot machines. The sample consisted of 120 male and female subjects divided into two groups: a group of 60 pathological gamblers aged 18 to 24 who attended the Pathological Gambling Recovery Program at the Instituto de Psicologia Integral del Peru (IPIP), and a group of 60 non-gamblers aged 18 to 24 who were psychology students of a private university in Lima. Data was obtained using the Millon Clinical Multiaxial Inventory II (MCMI-II), the Pathological Gambling Brief Questionnaire (PGBQ), and the Structured Clinical Interview for Pathological Gambling (SCI-PG). The results showed that 81,7 % of the pathological gamblers addicted to slot machines had at least one personality disorder, in comparison with the other group which yielded 40%. The most prevalent personality disorder was the self-defeating disorder, followed by the passive-aggressive, narcissistic and borderline disorders. Moreover, there are significant differences in maladaptive personality patterns between gamblers and non-gamblers according to Millon’s theory.

The Psychological Implication of Learning Disabilities

Context: Attachment theory serves as a basis for examining relationship trauma and psychopathology and how these vary across adult attachment classifications. Objective: To examine differences in abuse history, psychopathology, and personality disorders between different adult attachment categories in a high-risk sample of mothers. Methods: Participants were 18 very high-risk mothers, 14 of which had formal maltreatment concerns about parenting of their own children. All completed the Childhood Trauma Questionnaire, Millon Clinical Multiaxial Inventory–III, Beck Depression Inventory–II (BDI), and the Adult Attachment Picture Projective (AAP) was administered to assess adult attachment representations. Results: Using clinical cutoff scores, very high levels of significant child abuse history (66%), Axis II Personality Disorders (94%), and Axis I Clinical Syndrome scores (44%) were found. On the AAP, none of the women were secure, four were dismissing, five were preoccupied, and nine unresolved. All women classified as preoccupied but none as dismissive reported clinical levels of psychopathology, with women unresolved being somewhat intermediate. The BDI results corroborated that many problems revolved around anxiety and depression, although other problems were found. Abuse history findings followed the same pattern as psychopathology. High rates of personality disorders were present in all groups, although Cluster B problems were most common.

Subjective quality of life in recent onset of psychosis patients and its association with sociodemographic variables, psychotic symptoms and clinical personality traits.

There is lack of research on the study of clinical personality traits in recent onset of psychosis (ROP) patients. The aims of this research were to study the relations among psychosocial, personality and clinical characteristics in ROP patients and also the effect that significant variables had on the different domains of Quality of Life (QoL). Data for these analyses were obtained from 81 ROP patients. The Millon Clinical Multiaxial Inventory, the Positive and Negative Syndrome Scale and the World Health Organization Quality of Life Brief Scale were used to assess personality, symptoms and QoL. Correlations between the negative symptoms and the physical, psychological and social domains of QoL, and the disorganized symptoms and physical domain, were found. Furthermore, the physical, psychological and social relationship domains of QoL were lower in patients with schizoid traits and the psychological domain was lower in patients with depressive traits. In contrast, the psychological and social domains were higher in patients with histrionic traits, while the physical domain was higher for patients with narcissistic traits. Multiple linear regressions demonstrated that negative symptoms and narcissistic and depressive traits explained 16.9% of the physical domain. Narcissistic and depressive traits explained 15% of the psychological domain. Finally, the negative symptoms and histrionic traits explained 13.7% of the social domain. QoL seems to be better explained by negative psychotic symptoms and some clinical personality traits. Our results support the importance of integrated intervention approaches that consider personality.

Investigating Personality and Psychopathology in Patients With Psoriasis

Abstract. A broad range of literature reported higher rates of psychopathology and personality disorders among patients affected by skin conditions. Specifically, depression, anxiety, and suicidal ideations are more frequently reported by patients affected by skin diseases. This study aimed to examine psychopathology and personality in a group of patients affected by psoriasis by means of a self-report measure (Millon Clinical Multiaxial Inventory – MCMI-III) and a performance-based technique (Wartegg Drawing Completion Test [WDCT], CWS). Study results showed a higher rate of passive-aggressiveness and paranoia among psoriatic patients (MCMI-III). When assessing patients through the performance-based technique (WDCT, CWS), a higher rate of global rejection (GR) – linked by previous literature to suicidal ideation – and a lower affective quality of the drawings emerged. We discuss the clinical importance of detecting psychological issues in dermatology patients by means of a multimethod assessment that goes beyond patients’ self-evaluation of their symptoms and emotions.

Vulnerability to Psychopathology and Dimensions of Personality in Patients With Fibromyalgia.

Fibromyalgia (FM) patients may present psychopathology and some characteristic personality traits that may affect their adaptation to the disease. The aim of this paper was to study the relationship between personality dimensions according to the psychobiological model of Cloninger and the presence of psychopathology. The study sample consisted of 42 patients with FM and 38 pain-free controls. The assessment instruments administered were the Temperament and Character Inventory-Revised and the Millon Clinical Multiaxial Inventory. A higher proportion of clinical psychopathologic syndromes (CPS) was observed in the FM group than in the control group, the most prevalent being anxiety disorder and dysthymia. Patients with FM (with CPS or without CPS) presented higher Harm Avoidance than the control group, and the presence of a CPS also increased Harm Avoidance scores. FM patients with CPS had low Self-directedness (SD) compared with both the control group and with their FM peers without CPS. Purposefulness and Anticipatory worry-Pessimism explained 38% of the variance of dysthymia, and anticipatory worry-Pessimism explained 18% of the variance of anxiety disorders. Patients with FM have a high probability of anxious-depressive-type psychopathologic alterations. Their vulnerability to these conditions may be determined by personality traits. The SD character dimension may have implications for therapy, as low SD is associated with the presence of psychopathology and with a low capacity to cope with the disease.

Personality traits in recent-onset-of-psychosis patients compared to a control sample by gender

Personality traits in recent onset of psychosis (ROP) patients are an under-researched area. Our aim was to examine clinical and clinically significant personality traits in ROP patients compared with a healthy control sample by gender. Data were obtained from 94 ROP patients and a control sample matched in gender and age. The Millon Clinical Multiaxial Inventory and a sociodemographic scale were used. T for independent samples, U-Mann-Whitney and Fisher tests were applied to make comparisons. All personality traits were significantly higher in ROP than control participants in the general sample, except histrionic, narcissistic, and compulsive traits which were higher in controls. Clinically significant schizoid, avoidant, dependent and antisocial personality traits were more common in the ROP than the control participants. However, histrionic clinically significant trait was more common in the control sample. In relation to the males and female samples, more significant differences were found in the male sample in comparison to their control counterparts than in the female sample. These results highlight the importance of the study of clinical personality traits in patients with ROP and the importance of viewing these differences in relation to gender because of the possible therapeutic implications.

Basic Emotion Recognition According to Clinical Personality Traits

Disturbances in the ability to recognize emotional faces have been attributed to individuals with specific personality disorders. Considering the importance of the dimensional models of psychopathology, studies involving healthy participants are becoming increasingly relevant in the domain of personality disorders. In this context, our main goal was to assess how clinical personality traits affect the ability to recognize basic emotions in a sample of subclinical participants. Photographs of faces expressing six basic emotions (happiness, sadness, fear, anger, disgust and surprise) were presented to 72 undergraduate students (42 women; M age = 23.3 yr., SD = 3.4), whose dominant personality traits (narcissistic, histrionic and compulsive) were assessed using the Millon Clinical Multiaxial Inventory-III. Data were analyzed using both a whole sample regression approach (relating personality traits with emotion recognition performance) and a group comparison approach (comparing groups of participants with dominant personality - narcissistic, histrionic and compulsive - as well as comparing groups with subclinical symptomatology for anxiety and hypomania). The main results suggested a poor recognition of sadness in narcissistic participants and a higher difficulty for anger recognition in participants with anxiety symptoms. These results are discussed within the theoretical framework suggesting that the difficulties in basic and social emotions recognition have implications in interpersonal interactions experienced in different social contexts.

Predictors of early dropout in treatment for gambling disorder: The role of personality disorders and clinical syndromes

Several treatment options for gambling disorder (GD) have been tested in recent years; however dropout levels still remain high. This study aims to evaluate whether the presence of psychiatric comorbidities predicts treatment outcome according to Millon's evolutionary theory, following a six-month therapy for GD. The role of severity, duration of the disorder, typology of gambling (mainly online or offline) and pharmacological treatment were also analysed. The recruitment included 194 pathological gamblers (PGs) to be compared with 78 healthy controls (HCs). Psychological assessment included the South Oaks Gambling Screen and the Millon Clinical Multiaxial Inventory-III. The “treatment failure” group (n = 70) comprised PGs who prematurely dropped out of the treatment whereas the “abstinent group” (n = 124) included PGs who completed the treatment regardless of whether the outcome was successful or not. As expected, the presence of psychiatric comorbidities was highlighted as a significant predictor in dropping out of the therapy. Specifically negativistic personality disorder, antisocial personality disorder, drug dependence and PTSD were associated with early dropout. These variables were predictive of treatment outcome independently from the typology of gambling, severity, duration of the disorder and pharmacological treatment. Implications for psychological and psychiatric care are discussed.

Personality Patterns and Forgiveness Among University Students in Ardabil, Iran

Background: Forgiveness is associated with many psychological and personality factors such as severe and clinical personality patterns. Objectives: The aim of this study was to determine the role of severe and clinical personality patterns in prediction of forgiveness in a sample of university students. Methods: A cross-sectional study was conducted on 375 students (175 female, 200 male) from university of Mohaghegh Ardabili in 2012-2013. The subjects were asked to fill out Millon clinical multiaxial inventory-III and interpersonal forgiveness inventory. The data were analyzed by SPSS version 22 using Pearson correlation coefficient and stepwise multiple regression analysis at 95% significance level. Results: The results showed that schizoid (r = -0.28), avoidant (r = -0.38), depressive (r = -0.38), dependent (r = -0.37), negativistic (r = -0.44), masochistic (r = -0.52), schizotypal (r = -0.43), borderline (r = -0.41), and paranoid (r = -0.55) personality patterns were negatively associated with forgiveness. The results of stepwise multiple regression analysis showed that paranoid and borderline personality patterns among severe personality patterns, and masochistic, antisocial, narcissistic, and negativistic personality patterns among clinical personality patterns were significant predictors of forgiveness (P < 0.001). Conclusions: The findings of the present study identified individuals’ ability and capacity in relation to forgiveness; accordingly, it gave a realistic vision for experts and consultants in resolving interpersonal conflicts and therefore, developed the existing knowledge in the area of forgiveness.

Current Patterns of Training in Personality Assessment During Internship.

Training in broad-based objective and projective personality assessments has been a mainstay of applied psychology. Stedman (2007) and Piotrowski (2015) have documented a decline in projective training during internship. This study investigated internship directors' current expectations regarding graduate school training with objective and projective instruments, their ratings of the importance of that training, and current training patterns with objective and projective instruments during internship. Participants were 355 psychology internship programs, representing 46.1% of the Association of Psychology Postdoctoral and Internship Centers. Results indicated the following current internship training patterns: Minnesota Multiphasic Personality Inventory (68% to 51%), Personality Assessment Inventory (59% to 25%), Millon Clinical Multiaxial Inventory (51% to 34%), Rorschach (35 to 26%), story telling (41% to 19%), sentence completion (41% to 18%), and drawings (36% to 9%). Adult program directors reported higher percentages for objective tests; child program directors reported higher percentages for projective tests. A decreased valuation of projective techniques is now typical of current internship training programs.

Personality Disorders and Psychological Functioning Among Latina Women with Eating Disorders

Little is known about personality disorders (PD) and comorbidities among Latinas with eating disorders (ED). The dysregulation and chronicity of PDs can complicate and augment the symptomatology of EDs. This set of analyses provides a preliminary examination of PD and psychopathology in a sample of Latina women with ED. Participants (N = 34) were administered the Structured Clinical Interview for the Diagnostic and Statistical Manual, Eating Disorders Examination, and Millon Clinical Multiaxial Inventory-III to assess personality pathology, and questionnaires (Beck Depression Inventory-II and Brief Symptom Inventory) to assess psychological functioning. Results indicated the most common clinically significant trait in the sample was depressive personality (50% of the sample had a score of 75 or higher on this trait). For Bulimia Nervosa (BN) and Binge Eating Disorder (BED), avoidant (41%) and depressive (65%) personalities, respectively, were the most common clinically significant traits. Anxiety disorders were the most common psychiatric diagnoses, and 52.9% of the sample reported both clinically significant PD traits and other major psychopathology. There were no significant differences between the BED and BN groups on prevalence of PD traits and psychopathology. This pilot study highlights the need for further examination of PD and psychopathology in Latinas with ED. Unlike previous research with White women, we found no differences on PD and psychopathology between BED and BN, and the most prevalent PDs among Latinas were different than White women. Personality and psychological functioning should be assessed in all patients with ED, with ongoing research focused on identifying patterns in understudied groups such as Latinas, a practice that may improve treatment for this underserved population.

Between the Pew and the Pulpit: Can Personality Measures Help Identify Sexually Abusive Clergy?

There has been limited conclusive research examining the personality characteristics of clergy who perpetrate abuse. To address this dearth of research, the current study aimed to develop a personality profile that distinguishes clergy members who sexually abuse children from other clergy. Personality and psychopathology were assessed using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the Millon Clinical Multiaxial Inventory-III (MCMI-III). Data were analyzed from a sample of clergy members, who comprised four comparison groups: clergy members referred to treatment for (a) child sexual abuse, (b) sexual misconduct with adults, (c) general clinical problems, or (d) routine employment evaluations with no previously identified clinical or sexual issues. While differences were found between groups, only the Aggressive/Sadistic scale of the MCMI-III consistently distinguished clerics who sexually abused children from all other clergy members. Findings are discussed in regard to the utility of the MMPI-2 and MCMI-III as a screening tool for clerical applicants for the Catholic Church.

Psychopathy and its relation to personality psychopathology in a South African female forensic context

There is a paucity of research about personality pathology among female offenders. This study aims to address this gap in the forensic psychology empirical base by examining the relationship between female psychopathy, as measured by the Psychopathy Checklist–Revised, and personality disorders, as measured by the Millon Clinical Multiaxial Inventory-III in a South African forensic context. Participants included 108 purposively sampled female offenders incarcerated in South Africa. The Kruskal–Wallis H test and Mann–Whitney U test revealed a number of significant differences in levels of personality pathology between groups. Importantly, the results support international findings that significantly higher rates of Cluster B personality pathology are found among psychopathic offenders compared to non-psychopathic offenders.

Analysis of Clinical Data From a Cognitive Diagnosis Modeling Framework

ABSTRACTWe propose a general cognitive diagnosis model framework to diagnose mental disorders using item scores obtained from clinical measurement instruments. This framework can be used to validate the extent to which the items measure the specific disorders. The method is illustrated using data obtained with the Dutch version of Millon Clinical Multiaxial Inventory-III.

Personality disorders in cluster headache: a study using the Millon Clinical Multiaxial Inventory-III.

A great deal of studies suggests that cluster headache (CH) patients are usually comorbid to anxiety-mood spectrum disorders and psychopathological symptoms; however, the personality profiles reported in the literature strictly depend on type of assessment used. Psychiatric comorbidities have been extensively studied in migraine and they are recognized to represent a major risk factor associated with poorer outcome, playing a role in the headache chronification process at once as cause and consequence of it. By contrast the incidence and role of psychopathological aspects in CH is still not clarified, insufficiently explored as the striking severity of such a physical pain apparently leaves no room to psychological explanations. The aim of the present study is to describe psychopathological aspects of CH patients by means of the Millon Clinical Multiaxial Inventory-III (MCMI-III), a psychological assessment tool compatible to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) that correlates personality disorders (PDs) and clinical syndromes. We included all consecutive inward patients with CH between January 2014 and December 2016. Patients were evaluated using the MCMI-III a validated inventory assessing 14 PDs Scales (coordinate with DSM-IV Axis II disorders) and ten Clinical Syndrome Scales (coordinate with DSM-IV Axis I disorders). Twenty-six CH patients (24 chronic CH) were tested. Personality disorders were present in 92% of the patients. The most frequent PDs were: obsessive-compulsive (30.8%), histrionic (26.9%), narcissistic (11.5%), paranoid (11.5%) and avoidant (11.5%). According to the MCMI-III, patients with CH showed a high prevalence of personality disorders (Axis II-DSM-IV). PDs in CH patients can play an important role in determining CH course toward chronification. These preliminary results suggest that behavioral treatments can find room to support more conventional drug and neurostimulation therapies in these patients. In addition, the very high prevalence of PDs in our patients suggests that CH could in some cases be considered among the spectrum of somatoform and pain syndromes in patients with PDs.

The Italian Version of the Depressive Experiences Questionnaire: Psychometric Properties and Validation in Students, Community, and Clinical Groups.

The current study evaluated the psychometric properties of the Italian validation of the Depressive Experiences Questionnaire (DEQ), conceived as a measure of self-criticism and dependency, i.e. two personality factors acting, according to Blatt (2004), as risk factors for depression in particular and psychopathology in general. A series of standardized measures [Beck Depression Inventory-II (BDI-II), DEQ, Symptom Checklist-90-R (SCL-90-R), Millon Clinical Multiaxial Inventory, 3rd edition (MCMI-III)] was administered to three samples (i.e., students, community and clinical). Factorial validity was evaluated along with convergent and predictive validity. In order to evaluate the reliability and internal consistency, a specific subgroup of participants was retested on the DEQ and BDI-II. Results showed correlations between DEQ dimensions and some personality traits of the MCMI-III. The traditional three-factor model of the DEQ structure as identified by principal component analysis appears to be as stable factors as typically found in American samples, although some items showed elevated cross-loading or low loadings on any factor. Clinical and diagnostic implications of the findings will be discussed.

Personality traits and disorders among adult ADHD Patients: Is borderline personality disorder as common as we expect?

IntroductionPatients with Attention Deficit/Hyperactivity Disorder (ADHD) have shown a high risk to develop a DSM cluster B (i.e., Borderline, OR = 13.16; Antisocial, OR = 3.03; Narcissistic, OR = 8.69) and DSM Avoidant personality disorder (OR = 9.77). Similarly, higher rates of DSM cluster B personality disorder were found among adult ADHD patients (6-25%) than general population. Although some authors investigated the prevalence of personality traits and disorders among adult ADHD patients, no studies have been yet reported about the assessment of Millon's Evolution-Based Personality profiles in adult ADHD patients.AimsTo explore the prevalence of personality traits and disorders among adult ADHD patients.MethodsMillon's personality traits and disorders were assessed in a consecutive sample of 35 adult ADHD outpatients accessing the Service for Adult ADHD of the AOU San Luigi Gonzaga (Orbassano, TO) using the Millon Clinical Multiaxial Inventory–III (MCMI-III).ResultsAccording to the MCMI-III manual, ADHD patients in our sample showed more frequently both Cluster C and Cluster A traits and disorders, with a high prevalence of avoidant/depressive (8.6%/14.3%) and negativistic/self-defeating (20%/5.7%) personality disorders. Conversely, we found a low prevalence of Narcissistic (5.7%) and Histrionic (5.7%) traits, and no patient showed Borderline personality traits or disorder.ConclusionsUnexpectedly, the dimensional assessment of adult ADHD personality reveals a high prevalence of cluster C and cluster A personality traits and disorders, and a low prevalence of cluster B personality disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Clinical personality patterns in patients with acute lymphoblastic leukemia waiting for bone marrow transplantation

IntroductionPersonality disorders are rather widespread in oncology settings demanding special attention of clinician. Serious illness threatening person's life as well as severe treatment and side effects lead to specific self-regulatory emotional and cognitive efforts. Personality could both play an important role in this process predicting adjustment and survival and change in line with illness pathogenesis.ObjectivesThe personality patterns could be important predictors of operation success and further adjustment for patients with acute lymphoblastic leukemia (ALL) waiting for bone marrow transplantation.AimTo reveal personality patterns specific for patients with ALL.MethodsTwenty-five patients with ALL (11 males, 37.4 ± 9.5 years old) filled Millon Clinical Multiaxial Inventory–III and Big Five Questionnairie–2. Comparison group included 180 people of the same age and gender without history of mental or severe somatic disorders.ResultsMale patients comparing to healthy males were lower on emotional control and higher in negativistic personality pattern (P &lt; .05). Female patients were higher on dynamism but lower in openness to culture and antisocial pattern (P &lt; .05). They rarely expressed patterns of borderline disorder and drug dependence but reported more compulsive traits (P &lt; .05).ConclusionsSevere illness could increase likelihood of emotion regulation difficulties and passive-aggressive coping in male patients while stimulate activity and compulsive behaviour in females. These patterns should be taken into account in psychological support of patents to bone marrow transplantation.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Personality patterns and Smoking behavior among students in Tabriz, Iran.

IntroductionPsychological factors have always been considered for their role on risk taking behavior such as substance abuse, risky driving and smoking. The aim of this study was to determine the association between smoking behavior and potential personality patterns among high school students in Tabriz, Iran.MethodsThrough a multistage sampling in a cross-sectional study, 1000 students were enrolled to represent the final grade high school student population of Tabriz, Iran in 2013. The personality patterns along with smoking status and some background information were collected through standard questionnaires along with Millon Clinical Multiaxial Inventory-III (MCMI-III). Fourteen personality patterns and ten clinical syndromes. ANOVA and Kruskal Wallis tests were used to compare numeric scales among the study participants, with respect to their smoking status. Stata version 13 statistical software package was used to analyze the data. Multivariate logistic regression was used to predict likelihood of smoking by personality status.ResultsTwo logistic models were developed in both of whom male sex was identified as a determinant of regular smoking (1st model) and ever-smoking (2nd model). Depressive personality increased the likelihood of being a regular smoker by 2.8 times (OR=2.8, 95% CI: 1.3–6.1). The second personality disorder included in the model was sadistic personality with an odds ratio of 7.9 (96% CI: 1.2–53%). Histrionic personality increased the likelihood of experiencing smoking by 2.2 times (OR=2.2, 95% CI: 1.6–3.1) followed by borderline personality (OR=2.8, 95% CI: 0.97–8.1).ConclusionHistrionic and depressive personalities could be considered as strong associates of smoking, followed by borderline and sadistic personalities. A causal relationship couldn’t be assumed unless well controlled longitudinal studies reached the same findings using psychiatric interviews.

Pathways into psychopathology: Modeling the effects of trait emotional intelligence, mindfulness, and irrational beliefs in a clinical sample.

Self-perception constructs concerning one's beliefs about oneself have a major impact on the likelihood of developing psychopathological symptoms. Emotional perceptions captured by trait emotional intelligence were stronger predictors of psychopathology than either or both mindfulness and irrational beliefs in a clinical sample of adults. If the seed factors of psychopathology are mainly psychological, rather than mainly biological, and given that psychological constructs, like trait emotional intelligence, mindfulness, and irrational beliefs, are amenable to training and optimization, the findings herein provide the impetus for a much needed shift of emphasis from pharmacological to psychological treatments.