MMPI Sub-scales for Depression – Evaluation of the Sub-Scales in Assessing Depression
Introduction
The assessment for depression and low mood, among other mental health disorders, is essential to effective intervention. Mental health professionals should know the problem before they implement a solution. They should have the means to understand the patient before adopting a treatment plan. As a result, mental health experts develop assessment tools; some stand the test of time, and others become ineffective and no longer used. The Minnesota Multiphasic Personality Inventory (MMPI), developed in the late 1930s, is used widely in mental health (Ingram et al., 2020). It has been revised and updated numerous times to improve its validity and accuracy. Evaluating its efficacy is necessary to continue its use and probably inform further revision and updates. Despite a few limitations, such as bias and false positives, MMPI accurately and adequately assesses depression and low mood due to its evidence-based support of efficacy and validity.
Historical Background of the Minnesota Multiphasic Personality Inventory
The Minnesota Multiphasic Personality Inventory remains a vital assessment tool in mental health and assessing mental health issues. In the 1930s, mental health professionals realized the need to evaluate patients’ problems by asking their thoughts and feelings. Starke R. Hathaway and J. Charnley McKinley, a neuropsychiatrist, designed the tool in 1937 for use at the University of Minnesota’s Department of Psychology (Schilling & Casper, 2015). The main objective of developing the tool was to have an objective mechanism to assess mental health conditions and their seriousness. They wanted to create a highly accurate tool for assessing mental health conditions and developing effective interventions. As a result, the MMPI was created as a self-report inventory that conducts evaluations focusing on numerous mental health problems. Once set, it took a short time to become a standard personality assessment tool in mental health care. They initially developed test items by choosing questions approved by individuals already diagnosed with a specific mental health condition. The incident created a limitation that needed to be addressed to improve it and ensure it is used more in assessing mental issues, such as depression.
The tool has gone through several updates and revisions to improve its effectiveness regardless of continued usage. The process was also informed by the need to eradicate limitations to accuracy and validity. When it was first created, the inventors realized that the tool was quite transparent in its self-report inventories, making it possible for users to guess their intentions. They also realized that it was easy for individuals to manipulate results easily. Besides, the accuracy of the test was another cause for concern, especially noting the inadequacy of the original sample. Other critics suggested that test bias in the answers was possible. Hence, to address the concerns, major revisions were conducted in the 1980s. For example, in 1989, it was revised and modernized, becoming the MMPI-2. The modifications allowed them to change, such as removing some questions, rewording, and adding others. They also incorporated new validity scales. The MMPI-2 was further revised in 2001 and updated in 2003 and 2009 (Schilling & Casper, 2015). Other versions of the test include MMPI-2-RF (the Minnesota Multiphasic Personality Inventory-2-Restructured Form) released in 2008, MMPI-A-RF (Minnesota Multiphasic Personality Inventory-Adolescent-Restructured Form) released in 2006, and MMPI-3 (which is the latest edition of 2020 that takes only 25 to 50 minutes to complete. It has also been translated into different cultures and languages, adapting it to the environment it is used. The newest version is available in English, Spanish, and French (Pearson, 2020). Since then, it has become the widely studied and used assessment in the United States.
Effectiveness of the Minnesota Multiphasic Personality Inventory
One of the areas to consider when evaluating the tool’s efficacy in mental health evaluation is whether the instrument is evidence-based. According to Tarescavage et al. (2915), the MMPI was developed after rigorous empirical research to confirm its effectiveness and applicability in practice. Through research, mental health professionals have proven the objectivity of the tool in evaluating psychological functioning. The modern versions are more objective and effective since they are founded on the current view of psychopathology. Providing accurate data is also more likely since fewer items eradicate patient burden when responding. Recent evidence indicates that the latest version has a normative sample, making it more representative of the United States population. Furthermore, they restructured its clinical scales, reducing intercorrelations in earlier editions. As a result, evidence from reliable studies indicates a much more accurate tool for assessing depression and low mood.
The usability of the tool in assessing depression and mood disorders has been proven successful for the years it has been operational. The MMPI-2 is proven to provide its user with a score on a scale addressing critical clinical issues, such as depression. It also allows the information that a provider can use to appraise the readiness of the patient to disclose important details to support treatment. It also indicates the potential level of frankness to self-report data, which plays a critical role in interventions (Tarescavage et al., 2015). Once the patient is ready to cooperate and provide helpful information, the measure is proven effective in the assessment and points the practitioner to the problem. The tool has been revealed to delineate the psychological health symptoms, personality characteristics, and other issues the patient could undergo in such conditions. Thus, the tool can be effectively used to assess and recognize depression and low mood, assisting in implementing the right intervention.
When used correctly, the Minnesota Multiphasic Personality Inventory has shown a higher efficacy in assessing depression and mood disorders. The ability to obtain the correct result in determining mental health problems has motivated ongoing research to establish the tool’s efficacy. They also continue to research other ways of improving the test. According to Semel et al. (2021), the Minnesota Multiphasic Personality Inventory has played a positive role in determining the presence of psychological disorders and defects in personality. The tool collects specific data that practitioners use to make conclusions regarding the existence of mental pathologies, such as depression. The data is on the characteristics of an individual that compares the results with the norm, which the test taker uses to make a conclusion and implement the proper intervention. The tool has been useful in assessing and determining ambiguous clinical pictures to prevent cases of erroneous treatment. They also support the creation of generalizable data related to a plethora of potential disorders.
Practitioners focus on theorized mental disorders constructs that can help determine the specific condition when using the tool. The test is then administered through 567 true /false items for patients to respond. For instance, the assessor has an accompanying answer sheet, which assists in scoring the responses and plot on an X-Y graph. They use a different version of the interpretation of the results for male and female individuals. The X-axis has 14 scales (‘content scales’-the first four) and 10 (‘clinical scales’). The first four are used to determine the test validity, while the other 10 determine the presence of a mental disorder. For example, 2 or ‘D’ is used to determine depression. Therefore, the test is appropriate for deciding clinical depression in a patient. Its effectiveness in this area has been supported by research evidence.
The creation of the tool was a breakthrough in helping practitioners to assess and make an accurate judgment regarding a mental health condition. The revisions provide streamlined interpretations and minimal overlaps, focusing more on growth and development within the field. As the rate of depression increases, it is helpful to have a tool that provides highly objective data (Sellbom, 2019). The blend of high-scoring categories presents important mental health constructs instead of nebulous findings evident in earlier assessment tools. They provide adequate information that can be used to inform treatment and other interventions. Therefore, mental health experts have an effective tool to evaluate and assess people for depression and other mental illnesses. However, even in its use, it is necessary to understand that it has some limitations that should continue to be addressed to make it more useful.
Potential Limitations of the Minnesota Multiphasic Personality Inventory
One of the Minnesota Multiphasic Personality Inventory limitations is the tendency to be sample-specific. Semel et al. (2021) established that the use of adult norms in assessing teenagers causes gross inaccuracies in the findings. Such acts cause elevated obtained T-score values on clinical scales like 4, 8, and 9. Thus, the tool requires that adolescents’ norms differ from those used in adults. For example, evaluators should always ensure they have the right tool for each population. Using the alternative can distort the results without the right tool. Also, applying adolescent norms generated normal (T < 70) range mean profiles for adolescent groups with serious cerebral abnormalities (Semel et al., 2021). Thus, using the tools requires considerable care to avoid situations where incorrect results are used to inform treatment. The occurrence of a false positive can have detrimental implications on the treatment of depression and other mental health conditions.
Another potential limitation that might affect the efficacy of the Minnesota Multiphasic Personality Inventory in assessing mental disorders, such as depression, is the shortening and reconceptualization of the newer editions, such as the Minnesota Multiphasic Personality Inventory-2-Restructured Form revised from MMPI-2. Some experts have wondered whether the revision process creates advances in the earlier version. The controversy causes doubts regarding the reliability and validity of the tool in assessing depression and low mood. Sellbom (2019) suggests that from the point of view of feigning and other response styles, the new version does not have the depth and breadth of the Minnesota Multiphasic Personality Inventory-2. Improvement in its validity-scale interpretations focused on elevating a normative cohort that is no-clinical one involved in developing the norms. Nonetheless, as revealed in Minnesota Multiphasic Personality Inventory-2, clinical samples can be prone to high elevations. Thus, considering such implications on the results is essential.
The assessment tool’s interpretation and the result also introduce some level of subjectivity, which causes a bias in the findings. The outcome can also affect the classification of subjects. For example, practitioners must use previous history and corroboration of results in some settings. The subjectivity can potentially affect the results’ accuracy and reliability. Besides, experts have not addressed the impact of subjectivity on the assessment outcome; it is not empirically tested (Semel et al., 2021). However, it is essential to note that studies on the newest version of the tool are underway, and with time it will be possible to know whether there is a need for new revisions. Addressing the limitations through further evidence plays a crucial role in improving the tool’s accuracy, validity, and reliability to provide better results. Major large-scale studies are still necessary to give better results.
Conclusion
Limitations exist in using the Minnesota Multiphasic Personality Inventory in assessing depression and mood disorders, but they are not severe enough to hinder its usage in practice. Besides, no tool is entirely foolproof. Each has some limitations that affect the accuracy of generated results. However, the tool must be administered by a competent test taker who can interpret the results accurately for more accurate results. The process is also necessary to ensure the results inform the proper treatment. Using the correct results in any mental health setting is essential to aid fast recovery and enable the person to return to regular daily routines. Hence, since accurate results should inform the interventions, the Minnesota Multiphasic Personality Inventory remains one of the most effective tools. It is commonly used and can assess depression and other mood-related problems.
References
Ingram, P. B., Golden, B. L., & Armistead-Jehle, P. J. (2020). Evaluating the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) over-reporting scales in a military neuropsychology clinic. Journal of clinical and experimental neuropsychology, 42(3), 263-273.
Pearson (2020). Minnesota Multiphasic Personality Inventory-3 (MMPI-3).
Schilling, R., & Casper, S. T. (2015). Of psychometric means: Starke R. Hathaway and the popularization of the Minnesota Multiphasic Personality Inventory. Science in context, 28(1), 77-98.
Sellbom, M. (2019). The MMPI-2-Restructured Form (MMPI-2-RF): Assessment of personality and psychopathology in the twenty-first century. Annual Review of Clinical Psychology, 15, 149-177.
Semel, R. A., Pinsoneault, T. B., Drislane, L. E., & Sellbom, M. (2021). Operationalizing the triarchic model of psychopathy in adolescents using the MMPI-A-RF (Restructured Form). Psychological Assessment.
Tarescavage, A. M., Corey, D. M., & Ben-Porath, Y. S. (2015). Minnesota Multiphasic Personality Inventory–2–Restructured Form (MMPI-2-RF) predictors of police officer problem behavior. Assessment, 22(1), 116-132.
