(p. 120) Interpreting Clinical Scale Scores on the MMPI-2
This chapter provides descriptive information for each Minnesota Multiphasic Personality Inventory-2 (MMPI-2) clinical scale. The information is based on a large body of empirical research. The most usual practice is to consider T scores above 65 as high scores; however, the higher scores are, the more likely it is that the descriptive information will apply. Limited and conflicting data concerning the meaning of low scores indicate that they should not be interpreted for most clinical scales. Exceptions are Scale 5 (Masculinity-Femininity) and Scale 0 (Social Introversion). These two scales are basically unidimensional with low scores indicating the opposite of high scores. Descriptors presented here should be treated as hypotheses that should be validated using information from other MMPI-2 scales, other tests, and nontest sources (e.g., behavioral observation, interview, history).
Scale 1 (Hypochondriasis)
• Scale 1 originally was developed to identify patients manifesting symptoms associated with hypochondriasis. The syndrome is characterized by preoccupation with the body and concomitant fears of illness and disease.
• Scale 1 is the most homogeneous and unidimensional clinical scale. All of the items deal with somatic concerns or with general physical competence. Patients with bona fide physical problems typically show somewhat elevated T scores on Scale 1 (approximately 60). Elderly individuals tend to produce Scale 1 scores that are slightly more elevated than those of adults in general, probably reflecting the declining health typically associated with aging.
• Persons with high scores on Scale 1 typically present with somatic complaints that may include chronic pain, headaches, and gastrointestinal discomfort. They view their problems as being medical in nature, seek medical treatment for their symptoms, and resist psychological interpretations. They tend to be quite self-centered and demanding of attention and support from others.
Scale 2 (Depression)
• Scale 2 originally was developed to assess symptomatic depression. The primary characteristics of depression are poor morale, lack of hope in the future, and a general dissatisfaction with one’s life situation. Many of the items in the scale deal with aspects of depression such as denial of happiness and personal worth, psychomotor retardation, withdrawal, and lack of interest in one’s surroundings.
• Scale 2 is an excellent index of discomfort and dissatisfaction with one’s life situation. Whereas highly elevated scores on this scale suggest clinical depression, more moderate scores tend to be indicative of a general (p. 121) attitude or lifestyle characterized by poor morale and lack of social involvement.
• Scale 2 scores are related to age, with elderly persons typically scoring approximately 5–10 T-score points higher than the mean for the total MMPI-2 normative sample. Some individuals who have recently been hospitalized or incarcerated tend to show moderate elevations on Scale 2 that reflect dissatisfaction with current circumstances rather than clinical depression.
Scale 3 (Hysteria)
• This scale was developed to identify patients who were utilizing hysterical reactions to stress situations. The hysterical syndrome is characterized by involuntary psychogenic loss or disorder of function.
• Some of the items in Scale 3 deal with a general denial of physical health and a variety of rather specific somatic complaints, including heart or chest pain, nausea and vomiting, fitful sleep, and headaches. Other items involve a general denial of psychological or emotional problems and of discomfort in social situations.
• It is important to take into account the level of scores on Scale 3. Whereas marked elevations (T > 80) may be indicative of a pathological condition characterized by classical hysterical symptoms, moderate levels are associated with characteristics that are consistent with hysterical disorders but do not include the classical hysterical symptoms. As with Scale 1, patients with bona fide medical problems for whom there is no indication of psychological components to the conditions tend to obtain T scores of about 60 on this scale.
• High scorers on Scale 3 may react to stress and avoid responsibility by developing physical symptoms. They display a marked lack of insight concerning the possible underlying causes of their symptoms. They are likely to see their symptoms as medical in nature, and they want to be treated medically. They tend to be immature psychologically and expect a great deal of attention and affection from others.
Scale 4 (Psychopathic Deviate)
• Scale 4 was developed to identify patients diagnosed as having a psychopathic personality, asocial or amoral type. Whereas persons in the original criterion group were characterized in their everyday behavior by such delinquent acts as lying, stealing, sexual promiscuity, excessive drinking, and the like, no major criminal types were included.
• The items in Scale 4 cover a wide array of topics, including difficulties with authorities, family problems, delinquency, sexual problems, and absence of satisfaction in life. Scores on Scale 4 tend to be related to age, with younger people scoring slightly higher than older people.
• One way of conceptualizing what Scale 4 assesses is to think of it as a measure of rebelliousness, with higher scores indicating rebellion and lower scores indicating acceptance of authority and the status quo. The highest scorers on the scale rebel by acting out in antisocial and criminal ways; moderately high scorers may be rebellious but may express the rebellion in more socially acceptable ways; and low scorers may be overly conventional and accepting of authority.
• High scorers on Scale 4 tend to be psychologically immature and impulsive. They are easily bored and tend to seek out excitement and stimulation. They accept little responsibility for their own problems. They make good first impressions, but relationships tend to be superficial and unrewarding.
Scale 5 (Masculinity-Femininity)
• Scale 5 originally was developed by Hathaway and McKinley to identify homosexual invert males. The test authors identified only a very small number of items that differentiated homosexual from heterosexual men. Thus, items were added to the scale if they differentiated between men and women in the standardization sample. Items from an earlier interest test were also added to the scale.
• The test authors attempted, without success, to develop a corresponding scale for (p. 122) identifying “sexual inversion” in women. As a result, Scale 5 has been used for both men and women. Fifty-two of the items are keyed in the same direction for both genders, whereas four items, all dealing with frankly sexual content, are keyed in opposite directions for men and women. After obtaining raw scores, T-score conversions are reversed for the sexes so that high raw scores for men yield high T scores, whereas high raw scores for women yield low T scores. The result is that high T scores for both sexes are indicative of deviation from one’s own sex.
• Although a few of the items in Scale 5 have clear sexual content, most items are not sexual in nature, instead covering a diversity of topics, including work and recreational interests, worries and fears, excessive sensitivity, and family relationships.
• For men, high T scores indicate persons who tend not to have stereotypically masculine interests (e.g., sports, mechanics), and low T scores indicate persons who describe stereotypically masculine interests and activities. For women, high T scores indicate persons who do not describe stereotypically feminine interests and who are described as assertive and competitive. Low T scores for women indicate persons who describe traditionally feminine interests (e.g., cooking, child rearing). More educated women with low scores on Scale 5 present as more androgynous in interests and activities.
Scale 6 (Paranoia)
• Scale 6 originally was developed to identify patients who were judged to have paranoid symptoms such as ideas of reference, feelings of persecution, grandiose self-concepts, suspiciousness, excessive sensitivity, and rigid opinions and attitudes. Although some of the items in the scale deal with frankly psychotic behaviors (e.g., excessive suspiciousness, ideas of reference, delusions of persecution, grandiosity), many items cover such diverse topics as sensitivity, cynicism, asocial behavior, excessive moral virtue, and complaints about other people.
• The higher the score on Scale 6, the more likely it is that frankly psychotic symptoms will be present. Modest elevations (T = 60–70) suggest characteristics that are consistent with a paranoid orientation but do not necessarily indicate psychosis. Elevated scores at all levels indicate persons who are excessively sensitive and overly responsive to the opinions of others. High scorers may feel that they are getting a raw deal from life, and they tend to blame others for their problems. High scorers tend to be seen by others as suspicious and guarded and as exhibiting hostility and resentment.
Scale 7 (Psychasthenia)
• Scale 7 originally was developed to measure the general symptomatic pattern labeled psychasthenia. Among currently popular diagnostic categories, the obsessive-compulsive disorder is closest to the original meaning of the psychasthenia label. Such persons have thinking characterized by excessive doubts, compulsions, obsessions, and unreasonable fears.
• Some items in Scale 7 deal with uncontrollable or obsessive thoughts, feelings of fear and/or anxiety, and doubts about one’s own ability. Unhappiness, physical complaints, and difficulties in concentration also are represented in the scale.
• High scores on Scale 7 indicate a great deal of psychological discomfort and turmoil. High scorers tend to feel anxious, tense, and agitated. They may experience difficulties with concentration and memory, and decision making. They are lacking in self-confidence and often feel unhappy, sad, and pessimistic. They do not cope well with stress, often overreacting to even minor problems.
• High scorers on Scale 7 tend to be neat, orderly, and organized. They are seen by others as reliable and dependable and as capable of forming meaningful relationships.
Scale 8 (Schizophrenia)
• Scale 8 was developed to identify patients with diagnoses of schizophrenia. This category included a heterogeneous group of disorders characterized (p. 123) by disturbances of thinking, mood, and behavior. Misinterpretations of reality, delusions, and hallucinations may be present. Ambivalent or constricted emotional responsiveness is common. Behavior may be withdrawn, aggressive, or bizarre.
• Some items in Scale 8 deal with such frankly psychotic symptoms such as bizarre mentation, peculiarities of perception, delusions of persecution, and hallucinations. Other items deal with social alienation, poor family relationships, sexual concerns, and difficulties with impulse control.
• Very high scores on Scale 8 are suggestive of a psychotic disorder. Confusion, disorganization, and disorientation may be present. Unusual thoughts or attitudes, sometimes even delusional in nature, and extremely poor judgment may be evident. High scorers often feel as if they are not part of their social environments, and they may feel alienated, misunderstood, and unaccepted by peers. Consideration should be given to consultation concerning appropriateness of psychotropic medication and a structured treatment setting.
• Persons who are feeling demoralized and depressed may obtain relatively high scores on Scale 8. Some elevations on the scale can be accounted for by persons who are reporting a large number of unusual experiences, feelings, and perceptions related to the use of prescription and nonprescription drugs, especially amphetamines. Also, some persons with disorders such as epilepsy, stroke, or closed-head injury endorse sensory and cognitive items, leading to high scores on Scale 8.
Scale 9 (Hypomania)
• Scale 9 originally was developed to identify psychiatric patients manifesting hypomanic symptoms. Hypomania is characterized by elevated mood, accelerated speech and motor activity, irritability, flight of ideas, and brief periods of depression.
• Some of the items in Scale 9 deal specifically with features of hypomanic disturbance (e.g., activity level, excitability, irritability, grandiosity). Other items cover topics such as family relationships, moral values and attitudes, and physical or bodily concerns.
• Scores on Scale 9 are related to age. Younger people (e.g., college students) typically obtain scores in a T-score range of 50–60. For elderly people, Scale 9 T scores slightly below 50 are common.
• Scale 9 can be viewed as a measure of psychological and physical energy, with high scorers having excessive energy. When Scale 9 scores are high, one expects that characteristics suggested by other aspects of the profile will be acted out. For example, high scores on Scale 4 suggest asocial or antisocial tendencies. If Scale 9 is elevated along with Scale 4, these tendencies are more likely to be expressed overtly in behavior.
• High scores on Scale 9 may be indicative of a manic episode. Persons with such scores are likely to show excessive, purposeless activity and accelerated speech; they may have delusions of grandeur; and they are emotionally labile. Unrealistic self-appraisal may be present. High scorers may be involved in many activities, but they do not use energy wisely and often do not see projects through to completion. They often create good first impressions, but relationships tend to be rather superficial and not very rewarding.
Scale 0 (Social Introversion)
• Scale 0 was designed to assess a person’s tendency to withdraw from social contacts and responsibilities. Items were selected by contrasting high and low scorers on the Social Introversion-Extroversion Scale of the Minnesota T-S-E Inventory. Scores on Scale 0 are quite stable over extended periods.
• High scorers on Scale 0 are insecure and uncomfortable in social situations. They tend to be shy, timid, and retiring. They are more comfortable by themselves or with a few close friends. They are quite concerned about what others think about them and are likely to be troubled about their lack of (p. 124) involvement with other people. Low scorers on Scale 0 tend to be much the opposite of high scorers. They are socially extraverted, self-confident, and comfortable in social situations.
References and Readings
Butcher, J. N., Graham, J. R., Ben-Porath, Y. S., Tellegen, A., Dahlstrom, W. G., & Kaemmer, B. (2001). Minnesota Multiphasic Personality Inventory-2 (MMPI-2): Manual for administration, scoring, and interpretation. Minneapolis: University of Minnesota Press.Find this resource:
Graham, J. R. (2012). MMPI-2: Assessing personality and psychopathology (5th ed.). New York: Oxford University Press.Find this resource:
Graham, J. R., Ben-Porath, Y. S., & McNulty J. L. (1999). MMPI-2 correlates for outpatient community mental health settings. Minneapolis: University of Minnesota Press.Find this resource: