MMPI CLINICAL AND CONTENT NORMS FOR A MIXED PSYCHIATRIC ADOLESCENT POPULATION'

NEILL WATSON

College of William and Mary

WILLIAM G . HARRIS AND JAMES H. JOHNSON

Illinois Institute of Technology

AND

LOUIS LABECK*

Psych Systems Baltimore. Maryland

Presented a set of MMPI norms for a mixed psychiatric group of adolescents (N = 1022). Normative information is stratified according to five age categories and includes means and standard deviations for the validity, clinical, and 48 content scales. The usefulness of these norms for clinicians is discussed.

During the last several decades the MMPl has been used with increased regularity to assess the psychological functioning of adolescents. Support for its application with adolescents has been derived from several large-scale studies. Early research in this area primarily investigated the personality of the youthful offender (Ball, 1962; Hathaway & Monachesi, 1963; Wirt & Briggs, 1959). These studies were followed by investigations that focused on the normal adolescent (Hathaway & Monachesi, 1963; Marks, Seeman, & Haller, 1974). From these large samples of adolescent MMPI protocols meaningful psychological benchmarks have been obtained for teenage populations. For example, Marks et al. (1974) gathered a sample from 6 states and systematically developed code- types and gender specific norms for a white, normal adolescent population (N = 1806, females = 854, males = 952), ranging from 13 to 17 years of age.

Research comparing the adolescent and adult norms has shown that age affects the discrimination power of the MMPl (Gynther, 1979). Davis, Mozdzierz, and Macchitelli (1973) and Davis (1972) found that the MMPl lost discrimination power when applied to older or younger psychiatric patients. Klinge and Strauss (1976) compared the standard adult norms (Dahlstrom, Welsh, & Dahlstrom, 1972) and the Marks et al. adolescent norms to a psychiatric adolescent sample. They found that the adult norms classified sub- stantially more adolescents as psychotic than the adolescents' norms. Although these studies have emphasized the importance of age-appropriate norms, other investigations have stressed the need for current norms. In a study of the effects of cultural change on the MMPI for adolescents, Schubert and Wagner (1975) detected significant shifts in the response patterns of groups of adolescents of different eras. From their findings, they suggested that a periodic MMPl norm revision was needed.

The Marks et al. norms are not without limitations. The sample includes all adoles- cent profiles regardless of L, F, or K scale elevations. Although the number of invalid profiles is probably small, such profiles can nonetheless affect the normative information. The norms are based on a normal adolescent population which may also affect their

'The authors wish to thank James L. Hedlund for providing the MMPl protocols used in this study. lReprint requests should be sent to Dr. Louis LaBeck, Psych Systems, 600 Reistertown Road, Baltimore.

Maryland 2 1208.

696

MMPI Content Norms 697

TABLE I

Names and Abbreviations for MMPI Special Scales

SOC B O R G H EA Nd UI PSY A H Y P ALC P H O MOR Pd REG DEN DIS INT P R O O r Sf DBT Dfk REL EC-5M EC-5F E R - 0 Es Im FEM T DEP D HOS R Ca Lb FA M AUT I

SP

CP

EM P

Social adjustment (Wiggins, 1966)

Body symptoms (TSC-11; Tryon. Stein. & Chu, 1968)

Organic symptoms (Wiggins. 1966)

Poor health (Wiggins, 1966)

Neurodermatitis (Allerhand. Gough, & Grais, 1950)

Ulcer personality (Scodel. 1953)

Psychoticism (Wiggins. 1966)

Autism (TSC-VI; Tryon, Stein. & Chu, 1968)

Hypomania (Wiggins. 1966)

Alcoholism (MacAndrew, 1965)

Phobias (Wiggins, 1966)

Poor morale (Wiggins, 1966)

Primitive defense (Haan. 1965)

Regression ( Haan, 1965)

Denial (Haan, 1965)

Displacement (Haan. 1965)

Intellectualizing (Haan, 1965)

Projection (Haan. 1965)

Originality (Gough, 1957)

Self-sufficiency (Wolff, 1955)

Doubt (Haan, 1965)

Desire for Kenoota (righteousness) (MacDougald, 1970)

Religious fundamentalism (Wiggins. 1966)

Ego control (males) (Block, 1965)

Ego control (females) (Block, 1965)

Ego resiliency (Block, 1965)

Lgo strength (Barron, 1953)

Impulsivity (Gough, 1957)

Feminine interests (Wiggins. 1966)

Tension (TSC-VII; Tryon, Stein, & Chu. 1968)

Depression (Wiggins, 1966)

Depression (TSC-IV; Tryon, Stein, & Chu, Manifest hostility (Wiggins. 1966)

Resentment (TSC-V; Tryon. Stein, & Chu, Caudality (Williams, 1952)

Low back pain (functional) (Hanvik. 1949)

Family problems (Wiggins, 1966)

4uthority conflict (Wiggins, 1966)

968)

968)

Socidl introversion (TSC-1. Tryon. Stein. & Chu. 1968)

Social participation (Gough, 1952)

tmpathy (Hogan, 1969)

Competitor (Booth, 1958)

698 Journal of Clinical Psychology, September, 1983. Vol. 39, No. 5

TABLE I (conrinuedt

Names and Abbreviarions jor MMPI Special Scales

CYN S WA Ha Headache proneness (Archibald, 1955) Sd-A Sd- R

Cynicism (Harrison & Kass, 1967) Suspicion (TSC-Ill; Tryon, Stein, & Chu, 1968) Work attitude (Tydlaska & Mengel, 1953)

Social desirability (A scale) (Wiggins & Rumrill, 1959) Social desirability (R scale) (Wiggins & Rumrill, 1959)

utility for psychiatric groups of adolescents. Finally, the Marks et al. norms include in- formation for only the validity and standard clinical scales. For the mental health prac- titioner who uses special scales in the psychological assessment of the adolescent, these norms are only partially helpful.

The purpose of this paper is to report a set of adolescent MMPI norms, based on a mixed psychiatric sample. These norms augment Marks et al.’s work in that they in- clude, in addition to the validity and clinical scales, 48 content scales. Table I lists the content scale for which content normative data are provided. I t is hoped that the ex- panded normative data will be useful in the interpretation of MMPI protocols of adolescents. I t is also expected that this information will aid clinical decision-making and treatment planning of adolescent psychiatric patients.

METHOD Subjects and Materials

A large data base of 20,000 adult and adolescent inpatients and outpatients who had completed the MMPI was obtained from the Missouri Department of Mental Health. From this data base, a total sample of 1022 valid adolescent MMPI protocols, ranging from 13 to I8 years of age, was drawn. Three hundred and fifty-eight females (35%) and 664 (65%) males comprised the sample. I n this study, the criteria for a valid protocol were a F - K < = 15 and less than 51 missing items. These criteria were adopted to avoid ambiguities that can occur when both valid and invalid protocols are used to generate normative information.

RESULTS Tables 2 and 3 contain the raw mean scores and standard deviations without K-

corrections for male and female adolescents on the validity and clinical scales following the approach of Marks et al. For the present study the normative data are broken down into 5 age categories (13-14, 15, 16, 17, and 18). It is apparent by inspection of these tables that the raw mean scores and standard deviations for the validity and clinical scales in the present study are higher than those reported by Marks et al. This is an ex- pected finding since the norms were derived from a psychiatric sample.

Tables 4 and 5 consist of the raw mean scores and standard deviations for male and female adolescents on the 48 most widely used content scales. The content scales cover a broad range of areas that are useful in describing the individual’s personality and level of psychopathology .

Many MMPI researchers agree that the content scale adds meaningful information to the test interpretation. Diagnostically, this means that the application of content scales can lead to the formulation of detailed hypotheses, to increased accuracy in clinical decision-making, and to more precise treatment planning.

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M M P I Contenr Norms 707

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708 Journal of Clinical Psychology. September, 1983, Vol. 39, No. 5

There are some restrictions to the application of the present norms. The norms for the 13- 14 and I5 year old groups are based on relatively small samples. The small sample size for these two age groupings for both male and female adolescents makes the raw mean scores and standard deviations much more susceptible to extreme scores. Another limitation is that the adolescent sample was drawn from a single midwestern state. The fact that regional representation is not a feature of the sample needs to be considered when applying these norms. A final caveat is that the normative sample was comprised of white male and female adolescents. The use of these norms with nonwhite adolescents should be weighed carefully to avoid discrepancies and distortions.

The norm tables presented in this study are designed to complement existing adoles- cent norms. They represent an additional benchmark for examining the personality and assessing psychopathology among adolescents. It is further hoped that these norms, devised from a large mixed psychiatric sample, will facilitate the use of the content scales with adolescent patients.

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BLOCK, J. The chollenge of response sets: Unconfounding meoning. acquiescence. and social desirobility in

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DAVIS. W. E. Age and the discriminative "power" of the MMPl with schizophrenic and nonschizophrenic

DAVIS, W. E.. MOZDZIERZ, G. J.. & MACCHITELLI, F. J. Loss ofdiscrimination "power" of the MMPl with

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M M P I Content Norms 709

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SCHUBERT, D. S. P.. & WAGNER, M. E. A subcultural change of MMPI norms in the 1960s due to adolescent

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WIGGINS, J . S.. & RUMRILL. C. Social desirability in the MMPI and Welsh's factor scales A and R. Journal

WILLIAMS. H. I The development of a caudality scale for the MMPI. Journul oJ Clinical P.ryrhology, 1952.

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A COMPARISON OF SELF-DEVALUATION AND SOMATIC SUGGESTION CONTENT IN DEPRESSIVE MOOD MANIPULATION

A R N O L D SMALL'

George Muson L niversrii and Famil, C'ounyeling Cenrer

THEODORE GESSNER A N D KATHRYN WILLIAMS

George Mpron L'niversii)

The Velten Mood Induction Procedure (VMIP), often used to manipulate depressive mood, has its effectiveness attributed to the self-devaluative con- tent of its statements; this finding supports cognitive theories of depression. Recent research has suggested that somatic content is more important than self-devaluation content in producing depressive mood variations. To study this using the VMIP, a neutral condition and two modified depression con- ditions were used: Somatic and self-devaluation (N = 302). The results in- dicate that self-devaluative statements resulted in significantly more depressed affect than neutral Ss, but no more than somatic statements; this latter group, however, did not differ from neutral Ss. The results of the previous research indicating the importance of the somatic suggestion manipulations as having more influence than negative self-evaluative statements is questioned.

The Velten mood induction procedure (VMIP) (Velten, 1968) has become a popular method for producing mood changes of elation and depression. Of particular interest has been the effectiveness of this method for the manipulation of depressed mood. The

'Reprint requests fo Arnold Small. Family Counseling Center, I 1706 Bowman Green Dribe. Keaion. Virginia 22090