The utility of the Mini-Mult with hispitalizedpsychiatric patients and non-psychiatric patients

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Authors Fingado, Marta Lee

Publisher The University of Arizona.

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THE UTILITY OF THE MINI-MULT WITH HOSPITALIZED PSYCHIATRIC PATIENTS

AND NON-PSYCHIATRIC PATIENTS

byMarta Lee Fingado

A Thesis Submitted to the Faculty of theDEPARTMENT OF PSYCHOLOGY

In Partial Fulfillment of the Requirements For the Degree ofMASTER OF ARTS

In the Graduate CollegeTHE UNIVERSITY OF ARIZONA

1 9 7 2

STATEMENT BY AUTHOR

This thesis has been submitted in partial fulfill­ment of requirements for an advanced degree at The University of Arizona and is deposited in the University Library to be made available to borrowers under rules of the Library.

Brief quotations from this thesis are allowable without special permission, provided that accurate acknowl­edgment of source is made. Requests for permission for ex­tended quotation from or reproduction of this manuscript in whole or in part may be granted by the head of the major department or the Dean of the Graduate College when in his judgment the proposed use of the material is in the interests of scholarship. In all other instances, however, permission must be obtained from the author.

SIGNED

APPROVAL BY THESIS DIRECTOR This thesis has been approved on the date shown below:

( LX k -/ . ___I JOHN L. DELK ̂Assistant Professor of

Psychology11 «l2!'

ACKNOWLEDGMENTS

The author wishes to express her gratitude to Dr. John L. Delk, her thesis director, for his generous assis­tance and helpful direction in the planning and execution of the research herein reported. She also wishes to thank Drs. Lewis Hertz and George Hohmann for their help in the refinement of the experimental design and for other useful suggestions in the completion of this thesis.

TABLE OF CONTENTS

. PageLIST OF TABLES e o « o « ® « o o.®.© ® © © © © © © © © VLIST OF ILLUSTRATIONS . © © . . © » . . . » © » . . . viABSTRA-CT e « o © ©-,© o o o o e © © o o © © © © e o © ©INTRODUCTION e e © e © ® o © 0 0 0 © o © e e ® o © © o 1METHOD e © e e © © © © © © © e ® © ® o o e e o © e e © 5

S 3 "fcs © © © © o e © © o'© o © © o © © o o o 5Procedure.......... © © © © . . © © © © © . 5

RESULTS © © © © © © ©'© © © © © © © © ©-© © ©■© © © © 7Group Data . „ . . © . © © © © © . © o © © . © 7

Psychiatric Group .. © © © © © © © © © © 7Non-Psychiatric G r o u p ........ © © . . © 10

Individual Profile Pairs Data . © . © © © . © 10Validity . . . . . © . © . . © © ........ 10Brgh P o m t s ©© © © © © © © © * © © © © © 13Elevation © © © © © © © © © © © © © © © © 13

DISCUSSION © « © © © © © © © © © © © © © © © © © © © © -i-5Group Correspondence . © . . . . © . 15Individual Profile Pair Correspondence . © © . 16

CONCLUSION 17LIST OF REFERENCES . . © © © . © © . © © © © . . . . . 19

LIST OF TABLES

Table PageI, Mean Raw Scores and Correlations for

Standard MMPI and Mini-Mult Form forPsychiatric Patients . = = 8

2„ Mean Raw Scores and Correlations forStandard MMPI and Mini-Mult Form forNon-Psychiatric Patients .. s .<> o . . . . . . . . 11

v

LIST OF ILLUSTRATIONS

Figurelc Group Mean Profiles for Psychiatric

S U b j e C t S e e e e e e e o o e o o o e e o o

2o Group Mean Profiles for Non-PsychiatricSubjects . 0 0 . 0 . = o o . . o . . . . .

vi

Page

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ABSTRACT

The MMPI answer sheets of 30 psychiatric and 30 non-?- . psychiatric patients at a Veterans Administration Hospital were scored for the standard MMPI and the scales of Kincannon1 71-item Mini-Mult. Correlational data demonstrated good cor­respondence between the MMPI and the Mini-MuIt for groups. Correlations ranged from .62 to .85 for the psychiatric group and from .20 to .81 for the non-psychiatric group. The psy­chiatric group was somewhat superior to the non-psychiatric group in terms of correspondence, which was expected. Indi­vidual profile pairs were also compared. An analysis of the validity scales, high points, and general elevation indicated that the individual Mini-Mult profile was, in many cases, a poor predictor of its corresponding MMPI profile. Though the utility of the Mini-Mult in clinical practice is minimal, it could be usefully employed for research in group comparison.

INTRODUCTION

An abbreviated form of the MMPI has been in demand for some time. Because of its length,' patients are often either uncooperative or unable to maintain the necessary at­tention to complete the questionnaire. When used for person­nel selection, the MMPI takes up a considerable amount of the applicant's time, a criticism also valid when used as a re­search tool. For many reasons, a shorter but equally reli­able form of the test would be most useful.

There have been attempts to shorten the MMPI, but none has been able to maintain a reasonable degree of accu­racy in terms of predicting the full scale MMPI (e.g., Jorgenson, 1958? Danielson and Clark, 1954). Recently, how­ever, Kincannon developed a short form of the MMPI which con­sists of 71 of the original 566 items (Kincannon, 1968). The 71 statements chosen from the MMPI were converted to ques­tions requiring "yes-no" answers and is administered orally. The Mini-Mult, as it is termed, is said to predict the va­lidity and clinical scales of the standard MMPI with fairly good reliability and correspondence for a psychiatric popu­lation in a general hospital setting. In fact, by comparing the similarity of profiles produced by the MMPI and Mini- Mult to the similarity of two MMPI profiles completed over

the same brief time span, Kincannon reports only a further • /decrease of nine percent in reliability and 14 percent in pro­file correspondence„ Kincannon; concludes that when it is not feasible to administer the standard form of the MMPI, the further error incurred by utilizing the Mini-Mult would be tolerable.

Several authors have reported on the utility of the Mini-Mult, but the results of the studies are conflicting. Lacks and Powell (1970) investigated the relationship between the MMPI and the Mini-Mult involving applicants for a psy­chiatric attendant position. Though they simply scored the Mini-Mult from the standard answer sheet rather than admin­ister the questionnaire orally, they found sufficient group reliability between the two to conclude that the Mini-Mult might be used to adequately screen psychiatric attendants. Lacks (1970), in a different study, again scored MMPI answer sheets for both the standard MMPI and the Mini-Mult, using . inpatients at an acute, intensive treatment center. Her re­sults replicated Kincannon's findings? i.e.., that the Mini- MUlt predicts the results of the full MMPI with a high degree of accuracy.

Another set of studies has made an attempt to study the utility of the Mini-Mult in a setting different from that prescribed by Kincannon and to examine the data differ­ently. Dahlstrom and Welsh (1960) have shown that profile characteristics vary with, the respondents' psychiatric

status» age, sex, intelligence, and so on. It cannot be con­cluded that the Mini-Mult can predict equally well the scales that represent different clinical populations. Consequently, Armentrout and Rbuzer (1970) studied the accuracy of the Mini-Mult in a non-psychiatric population of institutionalized adolescents. Overall similarity between group results were compared, in addition to determining the proportion of cases in which the Mini-Mult profile accurately mirrored the MMPI profile according to various clinical criteria. In this case, the MMPI was administered orally as it was originally designed. The results were less encouraging. While group MMPI and Mini-Mult results showed good correspondence, indi­vidual profile pairs did not. Armentrout (1970) conducted another study, this time utilizing a college undergraduate population. Again he found a disappointing lack of corres­pondence between the MMPI and the Mini-Mult. The group mean profiles were similar and high correlations were found be­tween MMPI and Mini-Mult scores for separate scales. Indi­vidual profile pairs, however, showed the Mini-MuIt did not reflect its corresponding MMPI profile in those aspects of validity, high points, or general elevation.

This study investigated the ability of the Mini-Mult to accurately predict features of the Standard MMPI in a hospital setting with both a psychiatric population and a non-psychiatric population. It was the author's purpose to

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determine the overall similarity of the Mini-Mult to the MMPI, the correspondence of individuals' profile pairs, and the utility of the Mini-Mult relative to the two different populations = .

METHOD

Attempts were made in this study to administer the Mini-Mult and the MMPI as closely together as feasible. This was done in order to reduce the possibility of intervening variables which might affect the results. The order of ad­ministration of the questionnaires was counter balanced so that factors such as fatigue would not affect the overall results of just one of the tests.

SubjectsThe subjects in the experiment were 60 hospitalized

patients at the Veterans Administration Hospital in Tucson, Arizona. Patients were divided into two groups: 30 non­psychiatric patients who were hospitalized for medical prob­lems, and 30 patients residing in the psychiatric ward. Sub­jects were all male and of varying ages.

ProcedureAll patients were administered the MMPI, Form R, and

the oral Mini-Mult by the investigator. Half of the psychi­atric and non-psychiatric groups were administered the tests in reverse order; i.e., the Mini-Mult first and the MMPI sec­ond. This procedure was used to balance any effects order

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■ ' . ■ ■■ ■■.■■ 6 might have on the results. The lapse in time between thetwo tests was at most several hours,

The.answer sheets to the Mini-Mult were scored in the same manner as in Kincannon's study. Predicted raw scores of the MMPI were obtained from the prediction table developed by Kincannon. The MMPI was hand scored with the exception of scales Mf and Si (these scales are not predicted by the Mini-Mult). . Each subject had two sets of MMPI scores: one based on the standard MMPI and one based on the predic­tion of the independently administered Mini-Mult.

RESULTS

Results are reported separately for the psychiatric : and non-psychiatric groups. The first group of data pre­sented, represents the overall correspondence of the Mini- Mult to the MMPI, analyzed for each of the two groups. The data for individual profile pairs and their correspondence follows.

Group DataMean raw scores and standard deviations were computed

for each scale of the MMPI and the Mini-Mult. Product-moment correlations were then obtained between each group's two scores for each scale. The two sets of scores are those from the MMPI and those predicted by the Mini-Mult.

Psychiatric GroupTable 1 presents the data for the psychiatric group.

Group mean raw scores for comparing the Mini-Mult to the MMPI are plotted on the profile presented in Figure 1. The correlations are all significant at least at the .005 level. The profiles are also quite similar, thus suggesting a very close correspondence, between the Mini-Mult and the MMPI for psychiatric subjects as a group.

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8TABLE 1

MEAN RAW SCORES AND CORRELATIONS FOR STANDARD MMPI AND MINI-MULT FORM FOR PSYCHIATRIC PATIENTS

Scale

Standard MMPI Raw Scores

Mini-Mult Raw Scores

CorrelationMean MeanL 3.93 4.60 .70 *F 13.37 10.33 .71 *K 10.17 11.23 .62 *

Hs 17.20 17.43 .85 *D 26.73 28.50 .83 *

Hy 23.53 26.07 .71 *Pd 28.97 28.70 .66 *Pa 14.83 14.47 .68 *Pt 34.37 33.17 .73 *Sc 37.03 36.03 .72 *Ma. 23.90 22.13 .75 *

* p <,,005

-Score

Mean T-Score

9

80

70

MMPIMini-Mult

40 Pd Pa Pt ScHyHs MaFigure 1. Group Mean Profiles for Psychiatric Subjects

80

70

60 r- O '

MMPIMini-Mult

40Pd Pa PtF Hy ScL K Hs D Ma

Figure 2. Group Mean Profiles for Non-Psychiatric Subjects

Non-Psychiatric Group .Table 2 presents the data for the nOn-psychiatric

group<, The correlations» in this case, were less high. The Pa scale failed to reach significance at the = 025 level? Hy and K were significant at the =025 level, and Pd was signif­icant at the =01 level. The rest of the scales were again significant at the =005 level. Group mean profiles compar­ing the MMPI to the Mini-Mult for non-psychiatric subjects are presented in Figure 2. The profiles are configuratively quite similar.

Individual Profile Pairs DataThe utility of the Mini-Mult was further investigated

by examining individual profile pairs. This method of exam­ining the data was used in order to evaluate how accurately the individual Mini-Mult predicted its corresponding MMPI. Good predictive ability with the individual is vital for its clinical use, if not for group research. Comparisons were made in the following areas: validity of the profiles, highpoints, and elevation of scales.

ValidityValidity of the MMPI profiles was defined originally

as the condition in which no T-score above 70 whs evident for any of the three validity scales, L, F, and K. For the psy­chiatric subjects, 50 percent of the standard MMPI profiles were invalid, whereas 30 percent of the Mini-Mult profiles

11TABLE 2

MEAN RAW SCORES AND. CORRELATIONS. FOR STANDARD MMPI AND MINI-MULT FORM FOR NON-PSYCHIATRIC

PATIENTS

Standard MMPI Raw Scores

Mini-Mult Raw Scores

Scale Mean Mean CorrelationL 5.33 5.60 .61 ***F 6.00 6.27 .58 ***K 15.30 14.03 .39 *

Hs 19.67 17.50 o78 ***

D 25.30 24.70 .71 ***

Hy 27.03 24.60 .39 *Pd 25.27 24.60 .45 **Pa 9.40 9.90 .20Pt 26.97 25.67 .81 ***Sc 27.93 26.60 .66 ***Ma 20.17 19.43 .56 ***

* p <.025** p < .01*** p <.005

.. 12were invalid. Only 8 of the 15 invalid MMPI profiles corre­sponded with invalid Mini-Mult profiles, For the non-psy­chiatric population, 16 percent of the MMPIs were invalid, whereas 13 percent of the Mini-MuIts were invalid. In this case, only 2 of 5 invalid MMPIs had corresponding invalid Mini-Mults,

An additional analysis was conducted similar to that reported by Armentrout (1970)„ Validity was redefined as a T-score of L less than 60, or F less than 80, and with no restriction on K. These criteria slightly decreased the overall number of psychiatric invalid profiles and increased the overall number of non-psychiatric invalid profiles. The psychiatric subjects had 43 percent invalid MMPIs and 23 per­cent invalid Mini-Mults with only 6 of the 13 invalid MMPIs corresponding with invalid Mini-Mults. The non-psychiatric

i ■ ;group had 23 percent invalid MMPIs and 27 percent invalid Mini-Mults. In this case, 5 of 7 invalid MMPIs corresponded with invalid Mini-Mults. It is evident that by either defi­nition of validity, the,Mini-Mult largely fails to predict, invalid standard MMPIs. By the first definition, the Mini- Mult predicted 3 invalid profiles which were in fact valid and by the second definition predicted 4 profiles falsely in terms of validity on the MMPI.

High PointsCorrespondence of high points between profile pairs

was determined by ordering each profile as to its highest and its second highest scale, according to the T-seore. For both groups, 52 percent of the cases had the same highest T—score on both the MMPI and the Mini-Mult. However, only 25 percent of the cases had the same two high points in. the same order. Thirty-seven percent of the cases had the same two high points (12 percent in reversed order). Though these results are higher than those reported by Armentrout, almost half the cases had different high point clinical scales. As this information is very important for clinical evaluation, such a low percentage does not assure the psy­chologist of an accurate prediction. Ten percent of the cases had no corresponding high point profile pairs. The data indicates that the Mini-Mult does not correspond ade­quately with the MMPI for properly diagnosing in the tradi­tional method of looking at high point pairs.

ElevationSimilarity in elevation of the profile pairs was de­

termined by comparing the number of cases which had the same clinical scales with T-scores above or below 70 on both the MMPI and the Mini-Mult. For psychiatric subjects, 7 of ttie 30 cases had the same pattern of clinical scales above and below a T-score of 70. For non-psychiatric subjects, only

; . , . ■ ' - if -14

1 of 30 cases had the same pattern. For psychiatric subjects, 3 of the 30 standard MMPI profiles had no clinical scales over 70= Of these 3, 2 had Mini-Mults with no clinical scale over 70. In one case, the Mini-Mult had no scale over 70 whereas its corresponding MMPI did have at least one scale over 70. For non-psychiatric subjects, 8 had no MMPI scales over 70 and 6 of the 8 had matched Mini-Mults. However, 5 Mini-Mults had no scales above 70, whereas this was not true of the corresponding MMPls. For both groups, only 8 of the 60 pairs had corresponding clinical scales above and below 70.

DISCUSSION

The results of this study must be viewed within the perspective of their usefulness to the field of psychology. This section deals with the utility of the Mini-Mult in terms of group research and clinical applicability.

Group Correspondence Results of this study indicate that the MMPI and the

Mini-Mult compare reasonably well in terms of group corre­spondence. The group mean profiles were quite similar and the correlations between raw scores for each scale were, with a few exceptions in the non-psychiatric group, reasonably high.

Since the group mean data demonstrated very close correspondence between the two forms, the Mini-Mult might serve a useful purpose in a different realm of investigation than was originally intended. Research, in which personality characteristics of various groups of people are compared, . could substitute the Mini-Mult for the MMPI. Results of this study and previous research indicate that group data tends to produce quite accurate measures. Particularly for research in group comparison, the Mini-Mult eliminates the

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16length, tedium, and inconvenience of the MMPI and yet pro­duces comparable results.

Individual Profile Pair CorrespondenceIndividual profile pair comparisons, however, did not

merit such a rating. It is in this respect that the utility of the Mini-Mult diminishes. In neither the psychiatric nor the non-psychiatric group did the data for individuals show high enough correspondence to acclaim the Mini-Mult'S poten­tial utility.

The Mini-Mult of individual profile pairs allowed few conclusions regarding validity, high points, or general elevation of its corresponding MMPI profile. Even consis­tency of error was lacking? i.e., the Mini-Mult reported some valid MMPls as invalid and yet reported some invalid MMPls as valid. In addition, the Mini-Mult failed in most cases to reliably predict its paired MMPls high points. Patterns of clinical scales elevated also differed consider­ably between the two. This evidence of poor comparability between individual profile pairs suggests that the Mini-MuIt lacks utility for predicting individual MMPI profiles. Clin­ical use relies on assessing the individual's personality pattern. Judgments based on the MMPI profile add important insights about the patient and about a treatment program. Though greater correspondence does occur with a hospitalized psychiatric population than a non-psychiatric population, the results do not warrant its use as a substitute for the MMPI.

CONCLUSION

The results of this study are in accord with Armentrout*s and Armentrout and Rouzer's data? i.e., there is a lack of correspondence between the individual MMPI and Mini-Mult profile pairs, though group correspondence is rea­sonably good. Kincannon and Lacks and Powell might have reached similar conclusions had they interpreted their data in a different manner. The latter two studies demonstratedclose group correspondence but did not examine individualprofile pairs according to those classifications important to clinical analyses. In addition. Lacks and Powell did not administer the Mini-Mult as it was devised? i.e., orally and in question form. They simply scored the statements from the MMPI answer sheet. Percell (1972) in a recent study, notes that scoring the Mini-MuIt from the MMPI does tend to increase the product-moment correlations, though this in­crease is not great. In this present study, it is suspected that the correlations may have been influenced, by the oral administration of the Mini-Mult to make subjects by an in­terested female investigation. Responses may have differed to a male investigation or to a taped voice.

It is difficult to determine precisely what mechanismaccounts for the lack of relationship between the .MMPI and

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18Mini-MuIt on individual profiles. Certainly the scarcity of items for each clinical scale greatly reduced the reliabil­ity of the test. In addition, the conversion tables for changing a Mini-Mult raw score into an equivalent MMPI score may require revision. Other item clusters may more accurately predict profiles for the non-psychiatric group than the items now used. Dahlstrom reports that the scales of the MMPI were developed from cases grouped according to a standard psychi­atric nosological system. The medical patients used to stan­dardize the MMPI did not fit this system as concisely. Perhaps the Mini-Mult suffers a further lack of correspondence in re­lating its items to its specific categories. In any case, further manipulations and investigation must occur before the Mini-Mult can be used to confidently predict the individual's MMPI profile when dealing with hospitalized psychiatric and non-psychiatric patients.

LIST OF REFERENCES

Araentrout, James A. Correspondence of the MMPI and Mini- Mult in a college population» Journal of Clinical Psychology, 1970, Vol. 26, No. 4, 493-495.

Armentrout, James A., and David L. Rouzer. Utility of the Mini-Mult with delinquents. Journal of Consulting and Clinical Psychology, 1970, Vol. 34, No. 3, 450.

Dahlstrom, W. Grant, and George S. Welsh. An MMPI Handbook: A guide to use in clinical practice and research. Minneapolis: The University of Minneapolis Press,1960. '

Danielson, J. R., and J. H. Clark. A personality inventory for induction screening. Journal of Clinical Psy­chology , 1954, 10, 137-143.

Jorgenson, C. A short form of the MMPI. Australian Journal of Psychology, 1958, 10, 341-350.

Kincannon, James C. Prediction of the standard MMPI scale scores from 71 items: the Mini-Mult. Journal ofConsulting and Clinical Psychology, 1968, 32, 319- 325.

Lacks, Patricia B. Further investigation of the Mini-Mult.Journal of Consulting and Clinical Psychology, 1970, Vol. 35, No. 4, 126-127.

Lacks, Patricia B., and Barbara J. Powell. The Mini-Mult as a personnel screening technique: a preliminaryreport. Psychological Reports, 1970, 27, 909-910.

Percell, Lawrence P. The relative usefulness of three forms of the Mini-Mult with college students. Unpublished master's thesis. University of Arizona, Tucson, 1972

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