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ABUSE AND MISUSE OF THE MMPI TESTIN TRAUMATIC BRAIN INJURY LITIGATION
Edward K. Le
Edward K. Le, PLLC135 Park Ave N.
Renton, Wa 98057425-336-2255
Fax 425 902-0180www.edwardkle.com
Email: [email protected]
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A TEST TO DIAGNOSE BEHAVIOR IS NOW INCREASINGLY ABUSED AND MISUSED BY FORENSIC PSYCHOLOGISTS IN BRAIN INJURY LITIGATION TO
ATTACK THE VICTIMS
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RATHER THAN SCRUTIZINE THE BRAIN INJURY CLAIM, THE STRATEGY NOW IS TO DIVERT FROM THE REAL ISSUES BY ATTACKING THE PATIENT’S BEHAVIORAL TRAIT BY USE OF THE MMPI.
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TO GOAL IS TO PORTRAY THE VICTIM AS EITHER AN EXXAGERATOR, MALINGERER, HYPOCHONDRIAC, OR MANIPULATOR
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BECAUSE THE MMPI EMPLOYS MORE VALIDITY MEASURES THAN THE STANDARD NEUROPSYCHOLOGICAL EXAM, THE FORENSIC EXAMINERS WILL BE QUICK TO POINT OUT ANY PERFORMANCE IS LESS THAN CLEAR
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THERE IS HUGE GAP BETWEEN PERCEPTION AND REALITY IN THE BRAIN INJURY LITIGATION CONTEXT
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HERE ARE THE TOP 10 THINGS TO KNOW
ABOUT THE MMPI IF YOU REPRESENT A BRAIN
INJURED CLIENT
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1. It is Not a Diagnostic Tool to Assess Cognitive Deficits
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THE MMPI EVALUATES
PERSONALITY AND BEHAVIOR
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IT CANNOT NOT EVALUATE COGNITIVE DEFICITS
www.edwardkle.comIT CANNOT EVALUATE VISUAL-SPATIAL SKILLS OR LOGIC
www.edwardkle.comIT CANNOT EVALUATE PSYCHOMOTOR DEFICITS
www.edwardkle.comIT CANNOT EVALUATE MEMORY DEFICITS
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2. It is Not a Substitute for Objective Radiological Assessment
www.edwardkle.comIT CANNOT DETECT DIFFUSE AXONAL SHEARING
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Diffuse Axonal Shearing – What Occurs in Traumatic Brain InjuryWhat Normal Axons Look Like
www.edwardkle.comIT CANNOT IDENTIFY BRAIN ABNORMALITIES
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3. It Is Not Intended to Be Used as the Exclusive Tool to Assess Personality
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9.02 Use of Multiple Sources of Information
Forensic practitioners ordinarily avoid relying solely on one source of data, and corroborate important data whenever feasible (American Educational Research Association, American Psychological Association, & National Council on Measurement in Education, in press).
Specialty Guidelines for Forensic Psychology
Pre-Morbid Records
More Sensitive Personality
Tests
Collateral Interviews Behavioral
Observations
OTHER IMPORTANT DATA THAT PSYCHOLOGISTS OVERLOOK BUT READILY JUMP TO CONCLUSIONS REGARDING PATIENT’S PSYCHOLOGICAL PROFILE
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DID THEY INVESTIGATE EVERY DOOR AND AVENUE BEFORE ARRIVING AT THEIR DIAGNOSIS?
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IF NOT, THEY HAVE INCOMPLETE PROFILE OF THE PATIENT
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4. It is Not Empirically Validated Across All Culture & Ethnic Groups
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CULTURAL NORMS SUCH AS VERBAL AND NONVERBAL REACTIONS VARY ACROSS CULTURE
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ETIQUETTE AND MEANS OF EXPRESSION VARY ACROSS CULTURE
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BEHAVIORAL AND PERSONALITY CONSTRUCTVARY ACROSS CULTURES
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SOME CULTURES ENDORSE BLUNTNESS AS A VIRTUE WHILE OTHERS BELIEVE THAT IT SHOULD BE TIPTOED AROUND WITH
SUBTLETY AND NUANCES
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MMPI NOT NORMED FOR THE ALL CULTURE BECAUSE THERE ARE SO MANY DIFFERENT CULTURAL WAYS THAT PEOPLE EXPRESS THEMSELVES
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5. It is Not Normed For Universal Scoring Across Gender Line
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SELF-REPORTING STYLES & COMMUNICATION OF SYMPTOMS VARY WIDELY ACROSS GENDER WHICH AFFECT THE SCALES
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SCIENTIFIC DATA PROVES THAT EXPRESSION OF SELF-
PERCEPTION VARY BETWEEN MALES & FEMALES
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MMPI SCALE SCORES BETWEEN MALES & FEMALES WITH CHRONIC PAIN
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6. IT CANNOT Differentiate Between Organic and Behavioral Complaints
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MMPI HAS DIFFICULTY DIFFERENTIATING PATIENTS WITH REAL PAIN FROM SOMATIC PAIN
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CHRONIC PAIN PATIENTS WILL USUALLY HAVE HIGHER Hs, D, And Hy SCALE SCORES THAN THE SAMPLE MMPI POPULATION
SAMPLE
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6. It Cannot Addressing Confounding Variables That Occurs in the Test Environment
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COGNITIVE PROBLEMS SUCH AS MEMORY, CONCENTRATION AND ATTENTION PROBLEMS MAY DISTORT THE MMPI REPORTING SCALES. YET, THE PATIENT’S TEST RESULTS MAY BE
INTERPRETED AS A DELIBERATE ATTEMPT TO DISTORT THE TEST RESULTS
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PEOPLE WHO ARE EXPERIENCING PAIN WHILE TAKING THE MMPI WILL LACK ABILITY TO CONCENTRATE, PAY ATTENTION, OR PROVIDE SIGNIFICANTLY HEIGHTEND SCORES THAT WILL
BE INTERPRETED AS AA DELIBERATE ATTEMPT TO DISTORT THE TEST RESULTS
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PATIENTS WHO HAVE VESTIBULAR DISORDER MAY HAVE PROBLEMS FINISHING THE TEST BECAUSE OF THER VERTIGO AND/OR TINNITUS. THIS MAY DISTORT THE MMPI SCALES.
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EVEN PATIENTS WHO EXPERIENCE HEADACHES DURING THE TEST MAY HAVE DISTORTED TEST RESULTS THAT ARE LATER INTERPRETED AS A DELIBERTATE ATTEMPT TO DISTORT THE MMPI.
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FIND OUT FROM THESE EXAMINERS:
1. HOW DID YOU RECONCILE MY CLIENT’S PERFORMANCE WITH THEIR EXPERIENCE OF PAIN DURING TESTING?
2. HOW DOES PAIN, DEPRESSION, OR A BALANCE DISORDER AFFECT A PERSON’S ABILITY TO PAY ATTENTION AND GIVE FULL CONCENTRATION TO COMPLETE THE TEST?
3. IF THEY HAVE A BRAIN INJURY, ISN’T IT TRUE THAT THEIR ABILITY TO COMPLETE THE MMPI WAS COMPROMISED BY THEIR ATTENTION CONCENTRATION DEFICIT?
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7. It is Not Immune from the “Practice Effect”
www.edwardkle.comPRACTICE EFFECT = BETTER SCORES WITH REPEAT TESTING
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www.edwardkle.comIF MMPI IS REPEATED MULTIPLE TIMES ON PATIENT, ITS
VALIDITY IS QUESTIONNABLE DUE TO THE PRACTICE EFFECT
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8. It is Not a Test That Can Predict a Patient’s Level of Functioning
www.edwardkle.comIT CANNOT MEASURE THE ATTENTION/CONCENTRATION
FUNCTIONALITY OF A PATIENT
www.edwardkle.comIT CANNOT MEASURE THE DAILY INTELLECTUAL TASKS
PATIENTS MUST CONFRONT ON A DAILY BASIS
www.edwardkle.comIT CANNOT MEASURE THE PATIENT’S PSYCHOMOTOR SKILLS
www.edwardkle.comIT CANNOT MEASURE THE PATIENT’S ABILITY TO MULTITASKS OR MULTIPLE
PROJECTS AT THE SAME TIME
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9. It Is Not Accurate as the Defense Claims
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• I am troubled by attacks of nausea and vomiting.
• I have nightmares every few nights.
• I find it hard to keep my mind on a task or job.
• My sleep is fitful and disturbed.
• Much of the time, my head seems to hurt all over.
SAMPLE ITEMS ON THE FAKE BAD SCALE OR SYMPTOM VALIDITY SCALE
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• I am so touchy on some subjects that I can't talk about them.
• I have more trouble concentrating than others seem to have.
• I feel tired a good deal of the time.
• I am so sick of what I have to do every day that I just want to get out of it all.
• I have recently considered killing myself.
• My sex life is not satisfactory.
SAMPLE ITEMS ON THE FAKE BAD SCALE OR SYMPTOM VALIDITY SCALE
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BALANCE DISORDERBRAIN INJURY
DEPRESSION CHRONIC PAIN
IF THE PATIENT HAS THESE CONDITIONS, THEIR HONEST REPORT WOULD RESULT IN POSITIVE FINDINGS ON “FAKE BAD” SCALES
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THE PREDICTIVE VALIDITY FOR THESE PATIENT WOULD BE QUESTIONNABLE
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10. Its Acceptance by the Court Is Not Automatic
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