 Participants will be provided with an

overview of the MCMI-III

 Participants will be familiar with
interpretation guidelines for the MCMI-III
 Participants will have the opportunity to
practice interpretation of the MCMI-III
MCMI-III Overview
 Models to describe personality prototypes
› Behavioral: observable behavior
› Phenomenological: cognitive styles, object
representations, self-image
› Intrapsychic: regulatory mechanisms
› Biophysical: impact of mood and temperament
› Sociocultural: impact of interpersonal
relationships
 Millon’s theory draws on evolutionary theory
to explain personality
 Theodore Millon’s bioevolutionary theory
› Personality exists on a continuum that is a
combination of 3 polarities:
 Survival aims – survival/pleasure
 Adaptive modes – changing/reacting to environment
 Replication strategies – reinforcement/nurturing
› Similar to DSM but not an exact match
 DSM disorders
 Additional disorders (aggressive/sadistic, self-defeating)
 Medical illness analogy
› Axis I = fever and cough
› Axis II = immune system
› Axis III & IV = medical & psychosocial factors
 Test construction – deductive or rational
 Sequential validation strategy, 3 phases
› Theoretical-substantive: items are evaluated on
how well their content conforms to the theory
from which they were derived (e.g., DSM &
Millon’s)
› Internal-structural validation: evaluated internal
structure of the measure
› External-criterion validation: evaluated measure
externally
 Item assignment and weighting
 MCMI was originally published in 1977
 Theodore Millon was active with DSM-III
Axis II criteria work group
 MCMI-II was published in 1987 (same
year as DSM-III-R published adjusted
criteria)
 MCMI-III was published in 1994 (with
introduction of DSM-IV)
 MCMI-III is the 3rd most frequently used
psychological test
 90 items were revised or replaced
 Additional scales
 Noteworthy responses added
 Axis I scales were improved
 Item weighting scheme was changed
 Fewer items per scale
 New validity scale
 Grossman Facet scales
 New norms
 Make an inventory useful for diagnosing
DSM disorders
 Assist with distinguishing between:
› Persistent, life long characteristics (Axis II)
› Current symptom states (Axis I)
 Ability to reflect severity of pathology
 Designed for computer scoring and
analysis
 Base rate (BR) scores
 MCMI-III uses BR instead of T or Z scores
› Millon posits that these better reflect the skewed
distributions of personality disorders
 General interpretation guidelines for a BR
› BR 35 = normal population (non-clinical)
› BR 60 = standard for clinical population (this was
set by Millon)
› BR of 75-84 = some characteristics are present
› BR 85 and higher = most characteristics of a
disorder are present
› Note: BR under 75 are not considered clinically
significant and are not to be interpreted
 Five validity scales
 Eleven clinical personality patterns (Axis
II)
 Three scales of severe personality
pathology (Axis II)
 Seven clinical syndromes (Axis I)
 Three severe clinical syndromes (Axis I)
 MCMI-II Norms (1992)
› General norms (998 adults seeking therapy in
inpatient and outpatient settings)
› Correctional norms (1,676 incarcerated adults)
 MCMI-III New Norms (2008)
› Demographics:
 Sex: 397 (52.8%) women, 355 (47.2%) men
 Race/ethnicity: 83 (11%) African American, 4 (0.5%)
Native American, 11 (1.5%) Asian American, 70
(7.6%) Hispanic/Latino, 571 (76%) Caucasian, 12
(1.6%) Other
 Ages: 18-79
 Theoretically based
 Strongly corresponds with DSM-IV
 Assess both Axis I and Axis II
 Brief measure
 Strong norms
 Psychometrically sound
 Resources for interpretation
 Clinical population
 May indicate pathology when there is none
 Heavy item overlap
 Requires computer scoring
 Unconventional approach to norms (i.e.,
BR)
 Validity scales
 May be more reflective of theory than DSM
 Not all DSM diagnoses are well represented
 Designed for individuals with a suspected
mental health disorder
 Appropriate for age 18 and older
 Requires a 6th grade reading level
 175 True or False items
 Can be administered in group or
individual setting
 Typically requires 25-30 minutes
General MCMI-III Interpretive
Guidelines
 Consider the context of the testing (e.g., how this might impact
approach to test taking)
 Examine validity indices
 Review critical items
 Examine severe personality disorders
 Examine clinical personality patterns
 Grossman Facet scales
 Examine severe clinical syndromes
 Examine clinical syndromes
 Consider other data (e.g., background, hx, records review, other
test data, etc.)
 Establish diagnosis
 Generate treatment recommendations
 Write report
 Provide Feedback
 Omitted items – do not interpret if more than 10 items were omitted
 Inconsistency Index (W): 44 pairs
 Validity Index (V): 3 items of an improbable nature
› No BR
› True response to 1 of these items = questionable profile; True response to 2 of these
items = invalid (do not interpret)
 Disclosure (X): Self-revealing vs. defensive
› No BR
› Degree of deviation from midrange of an adjusted composite raw score total for
the 11 personality scales
› If raw score is below 34 = invalid
› If raw score is above 178 = invalid
 Desirability (Y): favorable light
› 21 item scale
› BR, if BR is greater than 74 = “faking good”
 Debasement (Z): negative light
› 33 item scale
› BR, if BR is 85 = “cry for help” or “faking bad”
 Severe Personality Disorder Scales
› Schizotypal (S)
› Borderline (C)
› Paranoid (P)
 Should be interpreted first (prior to clinical personality
patterns)
 Interpret 3 highest personality elevations
 Base rate interpretations:
› BR 35 = normal population (non-clinical)
› BR 60 = standard for clinical population (this was set by Millon)
› BR of 75-84 = some characteristics are present
› BR 85 and higher = most characteristics of a disorder are present
› Note: BR under 75 are not considered clinically significant and
are not to be interpreted
 Clinical Personality Disorder Scales
› Schizoid (1)
› Avoidant (2a)
› Depressive (2b)
› Dependent (3)
› Histrionic (4)
› Narcissistic (5)
› Antisocial (6a)
› Aggressive-sadistic (6b)
› Compulsive (7)
› Passive-aggressive (8a)
› Self-defeating (8b)
 Should be interpreted after severe personality disorder scales
 Interpret 3 highest personality elevations
 Guidelines for BR interpretation remain the same
 Severe Clinical Syndrome Scales
› Thought disorder (SS)
› Major depression (CC)
› Delusional disorder (PP)
 Should be interpreted first (prior to
clinical syndromes)
 BR interpretation guidelines remain the
same
 Clinical Syndrome Scales
› Anxiety disorder (A)
› Somataform disorder (H)
› Bipolar: Manic disorder (N)
› Dysthymic disorder (D)
› Alcohol dependence (B)
› Drug dependence (T)
› Posttraumatic stress disorder (R)
 Should be interpreted after severe clinical
syndrome scales
 Guidelines for BR interpretation remain the
same
Practice Interpretation
 Patient – fictitious and created for the purpose of practice
interpretation
› Female, 53 years old, Caucasian
› Married with 2 college age children
› Family hx: no hx of bipolar or psychosis, paternal depression and
alcohol abuse, maternal depression
› Successful 20+ year military career, 2 deployments to OIF
(combat trauma exposure)
› Childhood sexual abuse by an uncle
› Retired from Army 2 years ago
› One psychiatric hospitalization (4 months ago)
› Civilian career in health care administration
› Is not applying for or interested in service connection
› Has a diagnosis of breast cancer
› New to outpatient mental health treatment – requesting help
with managing anxiety related to work, previous trauma, and
recent cancer diagnosis
 Consider the context of the testing (e.g., how this
might impact approach to test taking)
 Examine validity indices
 Review critical items
 Examine severe personality disorders
 Examine clinical personality patterns
 Grossman Facet scales
 Examine severe clinical syndromes
 Examine clinical syndromes
 Consider other data (e.g., background, hx, records
review, other test data, etc.)
 Establish diagnosis
 Generate treatment recommendations
Resources & References
 Craig, R. (1999). Interpreting Personality
Tests: A Clinical Manual for the MMPI-2,
MCMI-III, CPI-R, and 16PF. New York: Wiley.
 Groth-Marnat, G. (2003). The Handbook of
Psychological Assessment. New York: John
Wiley & Sons. (Directed Reading)
 Millon, T. (Ed). (1996). The Millon Inventories.
New York: Guilford.
 Millon, T., Millon, C., Davis, R., & Grossman, S.
(2010). MCMI-III: Independent study training
program for the Millon Clinical Multiaxial
Inventory (MCMI-III) test. Pearson.