Introduction
Personality assessment forms a major function in applied psychology all over the world. In the European countries and the US, clinical psychologists use personality assessment tools in analytical and treatment decisions. The application of scientific methods of personality assessment has improved the status of clinical psychology especially in the developing countries where clinical psychology is still growing (Watson et al., 1984).
In less developed nations, personality assessment is an acquired discipline, following the traditions from the western nations and the psychological models. The most common personality assessment tests used in Asia are: the Minnesota Multiphasic Personality Inventory-2 (MMPI), Eysenck Personality Questionnaire (EPQ), State-Trait Anxiety Inventory (STAI), and the NEO-PI-R (Schneider et al., 2006).
The most common psychological evaluations include the achievements/aptitude tests, diagnostic psychological evaluations, intelligence tests, neuropsychological tests, personality tests, and occupational tests. This study focuses on personality assessment which is applied by psychologists in developing clinical diagnoses of individual trait.
Personality refers to the exceptional way in which each and every person reasons, acts, and feels although his/her life. Personality has two main components and these are personal traits/character and temperament. Character denotes value judgment of an individual’s moral or ethical behavior, while temperament refers to the enduring characteristics of an individual (Watson et al., 1984).
Theories of personality have emphasized on explaining personality and forecasting an individual traits based on such explanations. Gordon Allport established about 200 personal traits in which he felt were implanted into each individuals’ nervous system. Raymond Cattell further narrowed these traits into surface traits (the 200 described by Allport) and the source traits (16 traits) which are more fundamental and forms the center of personality.
Subsequent researchers narrowed this list to five source traits and developed the personality model referred to as the five-factor model. Five-factor model has the following traits: honesty, extraversion, sensitiveness, diligence, and happiness. The critics of this model argue that personal circumstances play a major role in shaping an individual’s character than what is suggested in the trait theory (Schneider et al., 2006).
Various techniques of assessing personality have been developed based on particular theories of personality as well as the diverse goals of classification, personal insight, and the diagnosis of psychological disorders. Psychologists most often use personality inventory to assess an individual(s).Personality inventory contains a questionnaire with standard listed questions that only requires a person to give specific answers such as “positive” or “negative”.
Examples of the commonly used personality inventories include MMPI-2, the Myer-Briggs Type Indicator (MPTI), Neuroticism/ Extraversion/Openness Personality Inventory (NEO-PI), and Cartell’s 16PF. The benefit of using personality inventories is that they are scored impartially, and have been discovered to be very reliable and have valid scores. Nevertheless, these personality inventories are still based on individual reports (Baer & Miller, 2002).
The Minnesota Multiphasic Personality Inventory-2 (MMPI)
The Minnesota Multiphasic Personality Inventory (MMPI) was developed in the late 30s by psychiatrists J.C. Mckinley and psychologist Starke Hathaway at the University of Minnesota. Nowadays MMPI is the most commonly used clinical testing tool and the most researched psychological test.
The MMPI is not faultless, but continues to be the most valuable instrument in the diagnosis and treatment of mentally disorderly persons. MMPI has also been utilized in other disciplines besides clinical psychology.
MMPI test is regularly used in court cases such as criminal defense and disputes involving custody of children. MMPI test has been used to human resource appraisal particularly in very risky jobs, even though this type of use has been contentious. The MMPI test has also been used to assess the effectiveness of treatment programs such as programs for treating drug addicts (Schneider et al., 2006).
During the period when the test was first published, critics questioned its accuracy. They argued that the original sample used was not sufficient. Others felt that the results were bias somehow, with sexist and racial questions. As a result of these, MMPI test was revised with many questions eliminated while others were added. In addition, new validity scale was introduced in the MMPI test.
The revised edition is what is known as the MMPI-2. The most recent revision to the MMPI test was carried out in 2001. Since MMPI-2 is a property of University of Minnesota, users must pay to administer and utilize the MMPI-2 test (Watson et al., 1984).
MMPI is applied, rated, and deduced by experts such clinical psychologists or psychiatrists with definite knowledge in MMPI usage. MMPI is used alongside other assessment instruments; therefore, diagnosis should not be based exclusively on the MMPI test. MMPI has both the manual and computerized version and is used only in adults (of age 18 years and above) (Baer & Miller, 2002).
Psychometric Features of MMPI Factor Scale
When MMPI is administered to a person, test’s validity scales are utilized to establish the probability of a particular psychological disorder. The test validity scale has been increasing with each and every version of MMPI introduced. In 1989 revision, this scale increased from four to seven to include Variable Response Inconsistency (VRIN), True Response Inconsistency (TRIN), Lie (L), Infrequency (F), Cannot say (?), Correction (K) and F back (F (b) (Graham, 1993).
All of these test validity scales have been intended to measure various scopes of validity or test distortions. For example, the Can not say (?) validity scale comprises of the sum of unanswered questions. This can result due to omission or confusion from the patient / test taker but leads to lower scale scores.
L-scale is aimed at identifying pretenders and dishonest individuals, while the F-scale indicates typical or unusual response patterns. Therefore, higher T-score on F validity scale means greater probability of a particular disorder. The K -validity scale is like the L-validity scale. K-validity scale identifies individual restrained effort to present oneself as either unfavorable light or unrealistically positive (Baer & Miller, 2002).
The VRIN, TRIN and F (b) validity scales are regarded as new additions to the original scales. F (b) is similar to F scale even though it gives an indication of the degree of typical responses by the individual to the item midway through the test.
The VRIN identifies inconsistency in the response provided during the test. To minimize errors/ inconsistency relating to the response given, computer scoring is the most suitable. Lastly, TRIN is similar to VRIN as it also attempts to find out any possibility of errors or inconsistency in response. However, TRIN concentrates on measuring positive responses which are contradictory or arbitrary made (Baer & Miller, 2002).
Once the test validity is established, the next step is the fundamental/ clinical scale. These scales include Masculinity-feminity (Mf), Paranoia (Pa), Psychopathic deviance (Pd), Depression, Hypochondriasis (Hs), Social introversion (Si), Schizophrenia (Sc), Psychasthenia (Pt), and Hypochondriasis (Hs). These scales are meant for specific psychological cases. For instance, Hs scale is for the identification of signs related to Hypochondriasis (Graham, 1993).
Besides the basic scales, MMPI also has content scales and Supplementary scales used to supplement or process information obtained from the clinical scale. They also provide extra information not available in the clinical scale. They include Groth-Marnat scale, Harris-Lingo and Si Subscale.
Scoring of these scales requires a professional and very knowledgeable individual. These scores are usually organized orderly to provide a summary of the results and the trend of the results. The blend of high scores with other information related to the respondent such as cultural background and demographic information must be used to maximize validity of the test results (Butcher, 1996).
Use of MMPI-2 in Assessing Suicide Risks among the American Public
Suicide was rated as the 11th cause of death in the United States according to the study carried out in 2004. Averagely, one person died of suicide every 16.2 minutes.
The study also found out that the third leading cause of death of the young population (those ranging between 15 to 25 years) was attributed to suicide; averagely these young people died of suicide every two minutes. Elderly (those aged 65 and above) had the highest suicide rate; one old person died of suicide every 1.7 minutes. These statistics show that suicide is a key health problem in U.S (Baer & Miller, 2002).
Suicide is powerfully attached to or influenced by personality disorders since these disorders, by definition , entail persistent difficulties in relationships and weak endurance strategies (Schneider et al., 2006).
Thus, the reactivity and sensitivity that is frequently noticeable in individuals with personality disorders necessitates further assessment of whether persons with personality disorders are specifically vulnerable to suicidal risk. MMPI has been widely researched and used to approximate suicide potential and to differentiate suicidal from non-suicidal individuals. Since originates from both personality traits and changing external factors, MMPI aids in predicting suicide (Baer & Miller, 2002).
Clopton and Baucom (1979) carried out a fascinating study. They requested medical psychologists to classify MMPI report of Suicidal or non-suicidal individuals and rank the variables pertinent to the suicide risk assessment. Nevertheless, they found out that clinicians could not precisely judge suicidal and non-suicidal patients based on the MMPI profiles and that the ratings did not adequately distinguish the two categories of patients.
They established that MMPI scale scores were not related to the technique or lethality of suicide attempts. Therefore, they concluded that no MMPI scale, MMPI profile analysis, or MMPI specifically developed suicide scale could consistently predict suicide (Clopton &Baucom, 1979). On the other hand, clinicians frequently use the MMPI to predict the probability of suicide even though most of the already carried out researches do not support such a move.
A report by Watson et al. (1984) discussed some categories of MMPI suicide- prediction study. The most common research is the comparison of the MMPI scale to establish suicidal-relevant scale. This type of research has led to outstandingly unreliable findings. The usual model used by researchers to identify suicidal potential on the MMPI contains an explanatory assessment of suicide attempters with patients with no background of suicide (Watson et al., 1984).
The report analyzed a number of published works comparing the MMPI profile of suicidal individuals. It established that most of those studies had been implicated as either affirmative or negative in relation to suicide prediction. However, not any of the 13 scales brought good results in over 3 of the 8 studies.
This finding shows that, even though most of the standard MMPI scales are perceptive to suicidal potential in a broad view, none is able to distinguish consistently suicidal and non-suicidal persons across diverse patient population. Many researchers have lost a lot faith in MMPI because of its inconsistency (Baer & Miller, 2002).
Very few researchers have been able to describe profile patterns which are frequent among groups who had committed, threatened, or pondered about suicide than among the non-suicidal group. Baer & Miller, (2002) found out that suicidal traits are related to despair, fear and masculinity in women, while high level of dejection, paranoia, Psychopathic imbalance, and Schizophrenia in the case of men (Schneider et al., 2006).
In short, several MMPI scales have been found to b very important in predicting suicide. Some studies found that suicide attempters have more unusual MMPI profile relative to psychiatric groups whereas other studies have not noticed the distinction between suicidal and non-suicidal patients. Even though this line of research has produced some positive results, the results nonetheless have remained unpredictable.
This kind of inconsistency is accredited to numerous factors such as sampled group and their subsequent heterogeneity (for instance gender), to the varying gap in time between MMPI administration and the suicide act, and to the meaning of suicide itself. In a nutshell, efforts to utilize the MMPI data to predict suicidal acts among psychiatric patients have not produced reliable and consistent results (Baer & Miller, 2002).
Ethical Consideration and Problems Associated with the Use of MMPI in Predicting Suicidal Behavior
First, representativeness of the sample restricts the generalization of the results. The results of the clinical population may not apply to the general population/community. Furthermore, there has been a major disparity among the groups used in these studies. The number used in the sample is often relatively small since suicide is not a common phenomenon (Boden et al., 2007).
Secondly, studies more often examine whether personality profile of individuals who have tried to commit suicide and not those who are anticipated to be suicidal based on the profile would actually commit suicide. Therefore, the findings of these studies do not point out if the results would actually aid the clinicians to make precise prediction of future suicide attempts. Therefore, these findings do not confirm that the patients are on a suicidal risk or in a risk of attempting another suicide.
On the other hand, these results could be placed into algorithms and computerized reports to alert the clinicians that the patient do not exhibit any suicide history (Schneider et al., 2006).
Another point is that, there is a big difference in time lag between suicide attempt and the application of the MMPI in many studies. This time interval restricts the measurement of the personality factors that were in action when a particular individual attempted to commit suicide since MMPI measures not only static characteristics but also the dynamic reactions (Baer & Miller, 2002).
Use of MMPI is restricted to adults only. This makes it a discriminatory tool for personality assessment. In addition, most studies carried out in U.S have revealed that cases of suicide are prevalent among the adolescents and therefore the use of MMPI is limited in this case.
Analysis and interpretation of the results of MMPI test requires high level of professionalism preferably those with postgraduate level of education. Thus, accurate interpretation of the test scores in conjunction with other external factors influencing suicidal risks requires a lot of experience and training in MMPI (Graham, 1993).
Furthermore, MMPI and other Personality assessment instruments have often failed to identify that an individual’s suicidal behavior is affected more by his/her social setting. Therefore, universal use of standardized MMPI should be rejected and customized version should be introduced in line with people’s social background (Graham, 1993).
The main reason for administering MMPI is to provide tangible results on an individual personality trait, but this has not been the case when used in predicting suicidal risks among the public. From the study, it is very apparent that the use of MMPI in predicting suicidal behaviors provides inconsistent and unreliable results. Its use for this purpose is unethical but some clinical psychologists and psychiatrists still administer it (Baer & Miller, 2002).
Conclusion
Psychologists use various techniques in assessing personality. These techniques have been developed based on particular theories of personality as well as the diverse goals of classification, personal insight, and the diagnosis of psychological disorders. Psychologists most often use personality inventory to assess individuals; Personality inventory contains a questionnaire with standard listed questions that only requires a person to give specific answer.
One of the instruments/personality inventory used is the Minnesota Multiphasic Personality Inventory-2 (MMPI). MMPI is the most commonly used clinical testing tool and the most researched psychological test. MMPI carries on to be the most significant tool in the analysis and curing of many psychological disorders including mental problems. MMPI has also been found to be very useful in other disciplines besides psychology.
The first time MMPI was published critics doubted its accuracy because the sample used was not representative. These doubts have not subsided; some researchers still question the consistency and reliability of MMPI in predicting certain disorders. As a result of this, MMPI should be used alongside other personality assessment instruments in predicting or curing psychological disorders. This study focused on the use of MMPI in predicting suicidal traits.
References
Baer, R. A., & Miller, J. (2002). Underreporting of psychopathology on the MMPI-2: A meta-analytic review. Psychological Assessment, 14, pp.16-26.
Boden, J. M., Fergusson, D. M., & Horwood, J. L. (2007). Anxiety disorders and suicidal behaviors in adolescence and young adulthood: findings from a longitudinal study. Psychological Medicine, 37(3), pp.431-440.
Butcher, J. N. (Ed.) (1996). International adaptations of the MMPI – 2. Minneapolis, MN: University of Minnesota Press.
Clopton, J. R., & Baucom, D. H. (1979). MMPI ratings of suicide risk. Journal of Personality Assessment, 43(3), pp.293-296.
Graham, J. R. (1993). MMPI – 2 (2nd Ed.). NewYork: Oxford University Press.
Schneider, B., Wetterling, T., Sargk, D., Schneider, F., Schnabel, A., Maurer, K., & Fritze, J. (2006). Axis I disorders and personality disorders as risk factors for suicide. European Archives of Psychiatry and Clinical Neuroscience, 256, 17-27.
Watson, C. G., Klett, W. G., Walters, C., & Vassar, P. (1984). Suicide and the MMPI: A cross-validation of predictors. Journal of Clinical Psychology, 40(1), 115-119.