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The recent publication of the MMPI-3 has sparked controversy in the scientific community. Although presented as a new version of the famous personality inventory, the MMPI-3 differs significantly from its predecessor, the MMPI-2.
To fully understand the scope of this controversy, it is essential to examine the key elements that made the MMPI-2 famous.
The MMPI-2 is a personality tool used to diagnose, describe, and guide therapeutic interventions. It identifies an individual's psychological dynamics, distinguishing itself from other self-reported instruments through its empirical approach.
What is the empirical approach of the MMPI-2?
The empirical approach establishes objective links between responses to items and specific clinical or diagnostic characteristics, regardless of the content of those items. Thus, the MMPI-2 does not assume which items will be endorsed by a particular group (e.g., a group of individuals with schizophrenia). Items in a scale are selected only if they differentiate a clinical group from the normative group.
Moreover, the interpretation of the client's profile only considers the proven empirical relationships between elevation on two or three scales, called "code types," and the diagnosis or personality traits of individuals who share the same code type, such as self-concept or interpersonal relationships.
This approach thus offers an objective assessment of personality.
However, the MMPI-2 had certain limitations, such as scales measuring similar traits and sharing common items. This made score interpretation complex and reduced the discriminant validity between the basic clinical scales.
Is it possible to overcome the limitations of the MMPI-2?
Yes! To solve these problems, the publisher first introduced the so-called restructured clinical scales, which are interpreted in complementarity with the basic clinical scales. This interpretation identifies the clinical factors underlying an elevation, for example, by removing the variance associated with emotional distress contained in the basic clinical scales (which were constructed with patients who all had relatively common distress, regardless of the criterion group used in constructing the scale).
Then, the publisher introduced a complete alternative to the MMPI-2, with a specific name: the MMPI-2-RF (Restructured Form), which includes the restructured scales and other scales created using a factor analysis based on item content. The basic clinical scales on which code types and profile interpretation based on the empirical approach rely are eliminated.
As a result, the scales at the content level are now purer and more discriminant, but they no longer have any connection to the empirical data from 70 years of research that documented the relationships between code types and related personality traits. By adopting a content approach, the MMPI-2-RF goes against the empirical approach that made the tool strong.
What is the content approach introduced with the MMPI-2-RF?
The content approach focuses on the thematic content of items and their relevance to specific domains of personality or psychopathology. For example, in the MMPI-2-RF, MMPI items are selected and grouped into scales based on their thematic content, rather than their ability to discriminate between different groups of participants and predict client personality characteristics and behaviors, such as their ability to engage in psychotherapy. Score interpretation is based on the assumption that high or low scores reflect high or low levels of the characteristic or symptom represented by the content of the items.
Unlike the MMPI-2-RF, the MMPI-2 offered an interesting combination of two opposing psychometric worlds (empirical interpretation and content interpretation), which is essential to master for correct interpretation (see our training on the subject).
These fundamental differences led the publisher to present the MMPI-2-RF as an alternative form that did not replace the MMPI-2. [NDA: This subtlety was lost in French-speaking Europe].
And what about the MMPI-3?
During the much-hyped announcement of the MMPI-3, the authors boasted of a complete overhaul of the tool, rendering all previous versions obsolete. However, the MMPI-3 is simply an enhanced version of the MMPI-2-RF. There are no longer any code types and therefore no interpretation based on empirical correlates.
The instrument has become an inventory that includes scales that rely on content interpretation. It's a bit like if the inkblots of the Rorschach test were replaced by photographs with a choice of response to group people with the same condition. The tool has become a shadow of its original version: less ambitious and clinically less rich.
And now?
Many institutions and decision-makers are unaware of the difference between version 2 and version 3 of the inventory. The name of the tool suggests that it is an improved version of the same instrument when they actually have little in common.
There is a natural pressure to adopt the latest version, putting us in a difficult and conflicting situation: abandoning an instrument to be "cutting-edge" but losing important information for our practice.
It is essential not to take for granted that we agree with the choices made by psychometricians or tool publishers. As psychologists and psychotherapists, we have the responsibility and expertise to choose the most suitable tools for our clients and our missions.
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