Substance Use impact on MMPI-3 or 2-RF

[lbergeson014]

Hello!

I am currently completing my assessment practice at a Max-Level Correctional Facility. I was assessing a client for substance-induced psychosis versus psychosis related disorder.

This particular individual completed the MCMI-IV and the MMPI-3 (approximately 20 days apart). The MCMI-IV had no notable elevations. In my training experience, I was under the influence that the MCMI-IV is more sensitive to elevations and I should be extra cautious with overpathologizing my clients. However, when I administered the MMPI-3, he had elevations on all the H-O scales, with the highest elevation being the Thought Disorder scale. I thought this discrepancy was odd, and wonder whether my client was under the influence of substances at the time he completed the MMPI-3.

Does anyone have any research (either on the MMPI-3 and 2-RF) or experience with clients who may have been under the influence of a substance when completing the MMPI-3? Honestly, any advice/direction would be helpful at this point!

Thanks in advance!

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[WisNeuro]

Not aware of a lot of lit about these scales being done under the influence, rather there is a great deal in assessing people with SUDs. Rather, I'd have to imagine that if one was worried about validity of the instruments of someone under the influence of a substance, the validity markers on the MMPI would pop somewhere. Likely in the VRIN and F scales.

 

[lbergeson014]

Not aware of a lot of lit about these scales being done under the influence, rather there is a great deal in assessing people with SUDs. Rather, I'd have to imagine that if one was worried about validity of the instruments of someone under the influence of a substance, the validity markers on the MMPI would pop somewhere. Likely in the VRIN and F scales.

Thank you for the information, upon review, it appears that his VRIN is at a T score of 50 and his F scale is at 75 (with significant variability between the other F scales).

 

[WisNeuro]

Fp, FBS, RBS?

 

[Justanothergrad]

Hello!

I am currently completing my assessment practice at a Max-Level Correctional Facility. I was assessing a client for substance-induced psychosis versus psychosis related disorder.

This particular individual completed the MCMI-IV and the MMPI-3 (approximately 20 days apart). The MCMI-IV had no notable elevations. In my training experience, I was under the influence that the MCMI-IV is more sensitive to elevations and I should be extra cautious with overpathologizing my clients. However, when I administered the MMPI-3, he had elevations on all the H-O scales, with the highest elevation being the Thought Disorder scale. I thought this discrepancy was odd, and wonder whether my client was under the influence of substances at the time he completed the MMPI-3.

Does anyone have any research (either on the MMPI-3 and 2-RF) or experience with clients who may have been under the influence of a substance when completing the MMPI-3? Honestly, any advice/direction would be helpful at this point!

Thanks in advance!

The MMPI-2-RF/3 (and personality instruments more broadly) are a primary area of my research and clinical practice, particularly when it comes to validity determinations about the profile interpretability. Certainly active use (as with active psychosis) would deviate from standard interpretation of the MMPI-family of instruments / assessments in general. This deviation might result in an elevated pattern of validity scale scores (non-content and content-based) that suggest you should not interpret the instrument; however, I wouldn't rely solely on that expectation because of how the over-reporting scales are developed. Elevations beyond the point of invalidity are also rarer than one would anticipate (e.g., many known group malingers fall below recommended cut scores). I would take a look at the endorsement pattern of items to get a sense of content patterns. H-O pulls from a variety of scales, so more nuance evaluation may help understanding. It's very possible that the item-level responses reference SUD-induced phenomenon. Lots of THD elevations occur in populations/individuals where they may not be expected (see college students), and that trend has increased between the RF and 3 (as well as higher rates of general pathology endorsement.). If I were you, I would do a follow-up on those individual item endorsements to get clarification.