Do any psychiatrists administer/interpret MMPI's?

[reca]

I thought this was for psychologists only but I was told by a forensic psychiatrist that he had done the training and administered/interpreted his own MMPI's. I didn't even know that was an option or that there was training that a psychiatrist could do to administer MMPI's. Is this an actual thing and if so, any benefit to getting trained? I have no intention in using in a forensic setting, just clinically.

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[Sushirolls]

I don't see what the benefit is.
Time is a finite resource. And some times you really have to ask yourself, how do you want to spend your time?
Doing an MMPI is not one of them for me.

 

[Stagg737]

I thought this was for psychologists only but I was told by a forensic psychiatrist that he had done the training and administered/interpreted his own MMPI's. I didn't even know that was an option or that there was training that a psychiatrist could do to administer MMPI's. Is this an actual thing and if so, any benefit to getting trained? I have no intention in using in a forensic setting, just clinically.

Yep, I did a 4th year elective and learned to administer several psychologic exams (PAI, SCID-IV, Rorschach). I don't see myself actually administering any of these, but I do think it was beneficial in terms of understanding the results and their potential implications in diagnosis and treatment. Especially if you have access to the actual assessment forms and can see individual items.

I do research associated with a particular psychological test and it's nice being able to understand all the scales and interpretive measures without having to rely on someone else, though my psychology partners are far more adept with the exam than I am.

 

[splik]

I don't think there is much point in doing this clinically. It is going to be an extra expense rather than something profitable for psychiatrists.
In my forensic work, I do use these in criminal cases. In civil cases, best to have a psychologist do the testing since the money is usually there to pay for it.

There are usually certain prerequisites to be able to purchases these tests including courses in statistics and psychometrics. Most psychiatrists do not have any background in psychometrics.

But certainly many psychological tests including the MMPI were developed by psychiatrists and you can learn to do so. However it is not worth it for most people to do so.

 

[WisNeuro]

Clinically, you can administer it with somewhat minimal training. For it to be useful clinically, though, you're going to need more than a weekend workshop. Forensically, you need to have a very good grasp of the extant literature above and beyond the manual, otherwise expect to get toasted in depo/trial. At least for civil, I do very minimal criminal work.

 

[comp1]

Yes, you can do it with some training, but it's so extremely time intensive. As a psychiatrist, almost by definition, you have less experience than even a very inexperienced psychologist. Basically, only do it if you're salaried and really for some reason have nothing better to be doing with your time.

 

[whopper]

You refer out. While there's debate that the training required for it is overrated (I'm not saying it is, saying that lots of people debate it), and that psychologists have tried to make it squarely so no one else can do it for reasons that may be selfish, you refer this out cause:

1-Its not in our training.
2-It's not cost-effective for our own field to do it. You will have to literally spend hundreds of hours to get the training to do it. (Multivariate statistics course).
3-Doing these can get you in trouble if anyone cross examined you and asked you to recite directions, in front of a judge or jury, on doing the test that squarely state it should be done by a psychologist. "Please Dr. Quack, please read these lines so everyone in this court can year you." This has occurred in several legal cases where the psychiatrist was squarely pointed out for not following the directions of the test that clearly stated the test should only be administered by a psychologist, or for example "a licensed mental health professional with a graduate or higher degree, and verifiable training in psychometrics." (BTW Psychometrics IS NOT PART OF A PSYCHIATRY CURRICULUM ALTHOUGH IT SHOULD BE!")

Which will then be followed by the "do you usually ignore directions provided by the distributor of the test? Do you regularly violate other professional standards?" "Oh so would be fair to say that you believe you are allowed to make your own standards against the recommendation of several professional bodies?"

4-Dude you want to get mad cause we don't do MMPIs? Are you also going to get mad that we don't do our own MRIs of the brain, EEGs, common. Just one more thing you refer out. Just find yourself a colleague to work with to get these done for you.

 

[reca]

4-Dude you want to get mad cause we don't do MMPIs?

Care to point out anything in my post which suggest I'm "mad" at anything at all? Don't know why you're getting so worked up over a simple question.

 

[PsyDr]

"Please Dr. Quack, please read these lines so everyone in this court can year you." This has occurred in several legal cases where the psychiatrist was squarely pointed out for not following the directions of the test that clearly stated the test should only be administered by a psychologist, or for example "a licensed mental health professional with a graduate or higher degree, and verifiable training in psychometrics." (BTW Psychometrics IS NOT PART OF A PSYCHIATRY CURRICULUM ALTHOUGH IT SHOULD BE!")

Which will then be followed by the "do you usually ignore directions provided by the distributor of the test? Do you regularly violate other professional standards?" "Oh so would be fair to say that you believe you are allowed to make your own standards against the recommendation of several professional bodies?"

This guy testifies.

 

[whopper]

RCA-I'm not saying you're mad, but in prior discussions on this same issue some psychiatrists on this forum made arguments that our own profession not being able to interpret the MMPI was a load of BS and then it led to the idiotic bashing of the field of psychology. I was referencing that and not you. Sorry if there was any interpretation of unintended accusation which I understand because I didn't mention the history.

 

[whopper]

Adding, I've found it quite STUPID that psychometrics isn't part of a required psychiatry curriculum unless it's been added since I last checked the requirements.

Seriously, the basis of the validity of pretty much every psychotropic med is based on measurements with psychometric tests and yet despite this we don't have to have training in it. It's like telling an MD he/she doesn't have to know statistics and then expect them to be able to interpret a published scientific study. While statistics and psychometrics are highly related, statistics doesn't substitute for psychometrics training.

Getting back to the original topic, I've found it an example of "these people are too stupid to know they're stupid" in the MMPI debate arena when psychiatrists without psychometrics or multivariate statistics training start arguing they should be able to interpret an MMPI and I'm comparing them to non-medical people who want to start telling the MD they feel they know the science better than the MD without doing the training. Yes patients can know their own bodies better, their own responses, but when I have a patient telling me the COVID vaccine doesn't work and that it's part of Bill Gates' microchip lizard man bull$hit, that they are basing their knowledge on Infowars, I'm going to tell the patient it's not true and they really don't know what they're talking about.

 

[FlowRate]

Seriously, the basis of the validity of pretty much every psychotropic med is based on measurements with psychometric tests and yet despite this we don't have to have training in it. It's like telling an MD he/she doesn't have to know statistics and then expect them to be able to interpret a published scientific study. While statistics and psychometrics are highly related, statistics doesn't substitute for psychometrics training.

I'd argue that, even despite having courses on it in med school and regular journal club meetings intended to review the stats, most MD's (myself included) don't have the requisite statistical knowledge to truly understand a lot of the statistical methods used in modern studies. "We did {methods} and then sent the data to a PhD in stats who did a bunch of acronymous and epynomous things to the data to get 'statistically significant results.'"

 

[whopper]

Intro to stats doesn't cover what's needed in some of the more powerful psychological tests. I've mentioned this in several prior threads regarding forensic psychiatry. Some of the best tests for malingering and other forensic tests require higher power statistics training that only Ph.D.s or Psy.Ds obtain. So for this reason go to a program that actually teaches this stuff. Several programs don't and still use the old-fashioned and unacceptable by Daubert Standard argument "I know he's not malingering because I have an MD from holier-than-thou University" without being able to back it by any objective measures.

While in medical school I had a rotation with a forensic psychiatry that won a teaching award who used the above argument. I asked him his objective evidence for not malingering, and he got upset, defensive, and couldn't mention any objective measure. Even mentioning BS such as "the the judge will believe me because I had a better suit, and didn't stumble on my words." Remember I was a resident who knew his head could get cut off by asking, and I asked him in a non-intrusive manner. Further this same psychiatrist had a reputation as a professor as being an a$$hole.

At my own fellowship, the late and great Doug Mossman, MD, who was our program director did graduate level psychometrics and graduate level statistics as a hobby. He did multivariate statistics for fun and his knowledge was on the doctoral level. That's how brilliant he was. So he was able, without the Ph.D., be rightfully able to interpret the higher power tests although he always walked into court having had a colleague psychologist still do the required work and give their final say on a psychologist-required test so a cross-examining lawyer couldn't use the traps I mentioned above.

 

[nexus73]

Intro to stats doesn't cover what's needed in some of the more powerful psychological tests. I've mentioned this in several prior threads regarding forensic psychiatry. Some of the best tests for malingering and other forensic tests require higher power statistics training that only Ph.D.s or Psy.Ds obtain. So for this reason go to a program that actually teaches this stuff. Several programs don't and still use the old-fashioned and unacceptable by Daubert Standard argument "I know he's not malingering because I have an MD from holier-than-thou University" without being able to back it by any objective measures.

While in medical school I had a rotation with a forensic psychiatry that won a teaching award who used the above argument. I asked him his objective evidence for not malingering, and he got upset, defensive, and couldn't mention any objective measure. Even mentioning BS such as "the the judge will believe me because I had a better suit, and didn't stumble on my words." Remember I was a resident who knew his head could get cut off by asking, and I asked him in a non-intrusive manner. Further this same psychiatrist had a reputation as a professor as being an a$$hole.

At my own fellowship, the late and great Doug Mossman, MD, who was our program director did graduate level psychometrics and graduate level statistics as a hobby. He did multivariate statistics for fun and his knowledge was on the doctoral level. That's how brilliant he was. So he was able, without the Ph.D., be rightfully able to interpret the higher power tests although he always walked into court having had a colleague psychologist still do the required work and give their final say on a psychologist-required test so a cross-examining lawyer couldn't use the traps I mentioned above.

Have you been retained for expert witness work, get several hours into the case, reviewing records, IME, then say, hey retaining attorney, you need to also get a psychologist to come in and do some psychological tests that I'm not trained to do, like MMPI, IQ testing, SIRS, etc? How does that usually go? Are attorneys asking, why the hell have I paid you for 10 hours of work when I could have paid a psychologist 10 hours and they could do the testing we need? Or do they just go with it, I guess a second opinion that aligns with yours adds strength to the case.

 

[romanticscience]

Have you been retained for expert witness work, get several hours into the case, reviewing records, IME, then say, hey retaining attorney, you need to also get a psychologist to come in and do some psychological tests that I'm not trained to do, like MMPI, IQ testing, SIRS, etc? How does that usually go? Are attorneys asking, why the hell have I paid you for 10 hours of work when I could have paid a psychologist 10 hours and they could do the testing we need? Or do they just go with it, I guess a second opinion that aligns with yours adds strength to the case.

At this stage in my forensic career, I’m seeing two general types of cases. The higher stakes, well funded, and experienced lawyers v the little cases with a grinding, cost conscious attorney. In the first kind of case, the firm knows what they are doing (eg, usually already have a psychologist retained as well). The later either don’t know, would balk, or wouldn’t care that I did it.

 

[whopper]

Have you been retained for expert witness work, get several hours into the case, reviewing records, IME, then say, hey retaining attorney, you need to also get a psychologist to come in and do some psychological tests that I'm not trained to do, like MMPI, IQ testing, SIRS, etc? How does that usually go? Are attorneys asking, why the hell have I paid you for 10 hours of work when I could have paid a psychologist 10 hours and they could do the testing we need? Or do they just go with it, I guess a second opinion that aligns with yours adds strength to the cas

Yes. And guess what? You work with a psychologist they're going to need you too for medication and other physiology areas of mental health. You work together as collaborators.

 

[psyguru]

Have you been retained for expert witness work, get several hours into the case, reviewing records, IME, then say, hey retaining attorney, you need to also get a psychologist to come in and do some psychological tests that I'm not trained to do, like MMPI, IQ testing, SIRS, etc? How does that usually go? Are attorneys asking, why the hell have I paid you for 10 hours of work when I could have paid a psychologist 10 hours and they could do the testing we need? Or do they just go with it, I guess a second opinion that aligns with yours adds strength to the case.

There are 2 ways of collaborating with a forensic psychologist. The psychologist just does the testing and you review the findings and discuss it in your report. Or the psychologist could do an independent parallel IME. Often attorneys balk but if you go with the first option above and remind the attorney psychologists charge less they should be ok. Sometimes attorneys don't want testing.