The Utility of MMPI-2-RF Substantive Scales in Prediction of Negative Treatment Outcomes in a Community Mental Health Center

Abstract

This study examined the utility of the Minnesota Multiphasic Personality Inventory–2–Restructured Form (MMPI-2-RF) substantive scales in the prediction of premature termination and therapy no-shows while controlling for other relevant predictors in a university-based community mental health center, a sample at high risk of both premature termination and no-show appointments. Participants included 457 individuals seeking services from a university-based psychology clinic. Results indicated that Juvenile Conduct Problems (JCP) predicted premature termination and Behavioral/Externalizing Dysfunction and JCP predicted number of no-shows, when accounting for initial severity of illness, personality disorder diagnosis, therapist experience, and other related MMPI-2-RF scales. The MMPI-2-RF Aesthetic-Literary Interests scale also predicted number of no-shows. Recommendations for applying these findings in clinical practice are discussed.

Keywords

personality assessment MMPI-2-RF outpatients termination therapy no-shows

Get full access to this article

View all access options for this article.

References

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., Text Rev.). Washington, DC: American Psychiatric Association.

Arbisi

P. A.

Rusch

Polusny

M. A.

Thuras

Erbes

C. R.

(2013). Does cynicism play a role in failure to obtain needed care? Mental health service utilization among returning U.S. National Guard soldiers. Psychological Assessment, 29(3), 991-996. doi:10.1037/a0032225.

Ben-Porath

Y. S.

(2012). Interpreting the MMPI-2-RF. Minneapolis: University of Minnesota Press.

Ben-Porath

Tellegen

(2008). MMPI-2-RF (Minnesota Multiphasic Personality Inventory-2 Restructured Form): Manual for administration, scoring, and interpretation. Minneapolis: University of Minnesota Press.

Berrigan

L. P.

Garfield

S. L.

(1981). Relationship of missed psychotherapy appointments to premature termination and social class. British Journal of Clinical Psychology, 20, 239-242. doi:10.1111/j.2044-8260.1981.tb00524.x

Callahan

J. L.

Aubuchon-Endsley

Borja

S. E.

Swift

J. K.

(2009). Pretreatment expectancies and premature termination in a training clinic environment. Training and Education in Professional Psychology, 3, 111-119. doi:10.1037/a0012901

Camara

W. J.

Nathan

J. S.

Puente

A. E.

(2000). Psychological test usage: Implications in professional psychology. Professional Psychology: Research and Practice, 31, 141-154. doi:10.1037/0735-7028.31.2.141

Chisholm

S. M.

Crowther

J. H.

Ben-Porath

Y. S.

(1997). Selected MMPI-2 scales’ ability to predict premature termination and outcome from psychotherapy. Journal of Personality Assessment, 69, 127-144. doi:10.1207/s15327752jpa6901_7

Conduit

Byrne

Court

Stefanovic

(2004). Non-attendance at a university-based psychology clinic: Telephone appointment reminders versus no reminders. Australian Psychologist, 39, 68-75. doi:10.1080/00050060410001660362

10.

Coodin

Staley

Cortens

Desrochers

McLandress

(2004). Patient factors associated with missed appointments in persons with schizophrenia. Canadian Journal of Psychiatry, 49, 145-148.

11.

Craig

R. J.

(1984). Can personality tests predict treatment dropouts? International Journal of Addictions, 19, 665-674.

12.

de Haan

A. M.

Boon

A. E.

de Jong

J. T. V. M.

Hoeve

Vermeiren

R. R. J. M.

(2013). A meta-analytic review on treatment dropout in child and adolescent outpatient mental health care. Clinical Psychology Review, 33, 698-711. doi:10.1016/j.cpr.2013.04.005

13.

Fenger

Mortensen

E. L.

Poulsen

Lau

(2011). No-shows, drop-outs and completers in psychotherapeutic treatment: Demographic and clinical predictors in a large sample of non-psychotic patients. Nordic Journal of Psychiatry, 65, 183-191. doi:10.3109/08039488.2010.515687

14.

First

M. B.

Gibbon

Spitzer

R. L.

Williams

J. B.

Smith Benjamin

(1997). Structured clinical interview for DSM-IV axis II personality disorders (SCID-II). Washington, DC: American Psychiatric Association.

15.

Graham

J. R.

(2012). MMPI-2: Assessing personality and psychopathology (5th ed.). New York, NY: Oxford University Press.

16.

Gudjonsson

G. H.

Hannesdottir

Agustsson

Sigurdsson

J. F.

Gudmundsdottir

Þordardottir

Þ.

… Petursson

(2004). Personality predictors of the failure of alcoholics to come for follow-up assessment. Personality and Individual Differences, 37, 805-813. doi:10.1016/j.paid.2003.11.006

17.

Harkness

A. R.

Lilienfeld

S. O.

(1997). Individual differences science for treatment planning: Personality traits. Psychological Assessment, 9, 349-360. doi:10.1037/1040-3590.9.4.349

18.

Harkness

A. R.

McNulty

J. L.

Ben-Porath

Y. S.

(1995). The Personality Psychopathology Five (PSY-5): Constructs and MMPI-2 scales. Psychological Assessment, 7, 104-114. doi:10.1037/1040-3590.7.1.104

19.

Hilsenroth

M. J.

Handler

Toman

K. M.

Padawer

J. R.

(1995). Rorschach and MMPI-2 indices of early psychotherapy termination. Journal of Consulting and Clinical Psychology, 63, 956-965.

20.

Kazdin

A. E.

Mazurick

J. L.

Bass

(1993). Risk for attrition in treatment of antisocial children and families. Journal of Clinical Child Psychology, 22, 2-16. doi:10.1207/s15374424jccp2201_1

21.

Killaspy

(2000). Prospective controlled study of psychiatric out-patient non-attendance: Characteristics and outcome. British Journal of Psychiatry, 176, 160-165. doi:10.1192/bjp.176.2.160

22.

Klein

E. B.

Stone

W. N.

Hicks

M. W.

Pritchard

I. L.

(2003). Understanding dropouts. Journal of Mental Health Counseling, 25, 89-100.

23.

Knox

Adrians

Everson

Hess

Hill

Crook-Lyon

(2011). Clients’ perspectives on therapy termination. Psychotherapy Research, 21, 154-167. doi:10.1080/10503307.2010.534509

24.

Kokotovic

A. M.

Tracey

T. J.

(1987). Premature termination at a university counseling center. Journal of Counseling Psychology, 34, 80-82. doi:10.1037/0022-0167.34.1.80

25.

Kruse

G. R.

Rohland

B. M.

(2002). Factors associated with missed first appointments at a psychiatric clinic. Psychiatric Services, 53, 1173-1176. doi:10.1176/appi.ps.53.9.1173

26.

Lefforge

N. L.

Donohue

Strada

M. J.

(2007). Improving session attendance in mental health and substance abuse settings: A review of controlled studies. Behavior Therapy, 38, 1-22. doi:10.1016/j.beth.2006.02.009

27.

Marlowe

D. B.

Kirby

K. C.

Festinger

D. S.

Husband

S. D.

Platt

J. J.

(1997). Impact of comorbid personality disorders and personality disorder symptoms on outcomes of behavioral treatment for cocaine dependence. Journal of Nervous and Mental Disease, 185, 483-490.

28.

Mattson

Powers

Halfaker

Akeson

Ben-Porath

(2012). Predicting drug court treatment completion using the MMPI-2-RF. Psychological Assessment, 24, 937-943. doi:10.1037/a0028267

29.

McMurran

Huband

Overton

(2010). Non-completion of personality disorder treatments: A systematic review of correlates, consequences, and interventions. Clinical Psychology Review, 30, 277-287. doi:10.1016/j.cpr.2009.12.002

30.

Meyer

G. J.

Finn

S. E.

Eyde

L. D.

Kay

G. G.

Moreland

K. L.

Dies

R. R.

. . .Reed

G. M.

(2001). Psychological testing and psychological assessment: A review of evidence and issues. American Psychologist, 56, 128-165. doi:10.1037//OOO3-O66X.56.2.128

31.

Minnix

J. A.

Reitzel

L. R.

Repper

K. A.

Burns

A. B.

Williams

Lima

E. N.

. . .Joiner

T. E.

(2005). Total number of MMPI-2 clinical scale elevations predicts premature termination after controlling for intake symptom severity and personality disorder diagnosis. Personality and Individual Differences, 38, 1745-1755. doi:10.1016/j.paid.2004.11.006

32.

Ogrodniczuk

J. S.

Joyce

A. S.

Piper

W. E.

(2005). Strategies for reducing patient-initiated premature termination of psychotherapy. Harvard Review of Psychiatry, 13(2), 57-70. doi:10.1080/10673220590956429

33.

Pekarik

(1985). Coping with dropouts. Professional Psychology: Research and Practice, 16, 114-123. doi:10.1037/0735-7028.16.1.114

34.

Pekarik

(1992). Posttreatment adjustment of clients who drop out early vs. late in treatment. Journal of Clinical Psychology, 48, 379-387. doi:10.1002/1097-4679(199205)48:3<379::AID-JCLP2270480317>3.0.CO;2-P

35.

Piselli

Halgin

R. P.

MacEwan

G. H.

(2011). What went wrong? Therapists’ reflections on their role in premature termination. Psychotherapy Research, 21, 400-415. doi:10.1080/10503307.2011.573819

36.

Reardon

M. L.

Cukrowicz

K. C.

Reeves

M. D.

Joiner

T. E.

(2002). Duration and regularity of therapy attendance as predictors of treatment outcome in an adult outpatient population. Psychotherapy Research, 12(3), 273-285. doi:10.1080/713664390

37.

Reda

Rowett

Makhoul

(2001). Prompts to encourage appointment attendance for people with serious mental illness. Cochrane Database of Systematic Reviews, (2), CD002085. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD002085/pdf

38.

Sellbom

Ben-Porath

Y. S.

Baum

L. J.

Erez

Gregory

(2008). Predictive validity of the MMPI-2 Restructured Clinical (RC) Scales in a batterers’ intervention program. Journal of Personality Assessment, 90, 129-135. doi:10.1080/00223890701845153

39.

Sharp

D. J.

Hamilton

(2001). Non-attendance at general practices and outpatient clinics. British Medical Journal, 323(7321), 1081-1082. doi:10.1136/bmj.323.7321.1081

40.

Swartz

H. A.

Zuckoff

Grote

N. K.

Spielvogle

H. N.

Bledsoe

S. E.

Shear

M. K.

Frank

(2007). Engaging depressed patients in psychotherapy: Integrating techniques from motivational interviewing and ethnographic interviewing to improve treatment participation. Professional Psychology: Research and Practice, 38, 430-439. doi:10.1037/0735-7028.38.4.430

41.

Swift

J. K.

Greenberg

R. P.

(2012). Premature discontinuation in adult psychotherapy: A meta-analysis. Journal of Consulting and Clinical Psychology, 80, 547-559. doi:10.1037/a0028226

42.

Tellegen

Ben-Porath

(2008). Minnesota Multiphasic Personality Inventory-2-Restructured Form: Technical manual. Minneapolis: University of Minnesota Press.

43.

Tellegen

Ben-Porath

McNulty

J. L.

Arbisi

Graham

J. R.

Kaemmer

(2003). MMPI-2 Restructured Clinical (RC) scales: Development, validation, and interpretation. Form: Technical manual. Minneapolis: University of Minnesota Press.

44.

Van Der Heijden

P. T.

Egger

J. I. M.

Derksen

J. J. L.

(2010). Comparability of scores on the MMPI-2-RF scales generated with the MMPI-2 and MMPI-2-RF booklets. Journal of Personality Assessment, 92(3), 254-259. doi:10.1080/00223891003670208

45.

Walters

G. D.

Solomon

G. S.

Walden

V. R.

(1982). Use of the MMPI in predicting psychotherapeutic persistence in groups of male and female outpatients. Journal of Clinical Psychology, 38, 80-83. doi:10.1002/1097-4679(198201)38:1<80::AID-JCLP2-270380110>3.0.CO;2-D