Clinical Assessment of Child and Adolescent Personality and ...

128 CHAPTER 6 SELF-REPORT INVENTORIESInterpretationThe MMPI-A manual and subsequentliterature (e.g., Archer, Krishnamurthy,& Stredny, 2007) supplies several aids tointerpretation. Considerable psychometricinformation is available, including reliabilityand factor-analytic validity information.The potential import of reliability informationfor interpretation was outlined earlier.Similarly, factor-analytic data can help cliniciansunderstand MMPI-A results.If an adolescent obtains high score elevationson all of the clinical scales save Si andMf, for example, then the client is producinga high factor 1 score. This client, consistentwith the factor-analytic research, isshowing a high level of general anxiety ordistress. This result may not be of particularimport for differential diagnosis, but itis a sensible and predictable finding in lightof factor-analytic results.Furthermore, the MMPI-A, as with itsadult counterpart, includes Harris-Lingoesscales which are subscales that may helpthe clinician determine what types of itemsled to a clinical scale elevation. For example,The Depression (D) scale includes fiveHarris-Lingoes subscales (i.e., SubjectiveDepression, Psychomotor Retardation,Physical Malfunctioning, Mental Dullnessand Brooding).The previous description of scale itemcontent can also be most useful for understandingscale elevations. The MMPI-Amanual (Butcher et al., 1992) also providesa list of items and their scale membership(Table E-1), which can be useful for scaleinterpretation.Some questions to ask oneself wheninterpreting the MMPI-A could include:llHow does an adolescent get a high scoreon this scale? What are the behaviors,perceptions, and feelings assessed by thisscale (i.e., the item content)?How reliable are the scales that I wish tointerpret as being of some clinical value inthis case?lllllIs there a content scale analogue that ismore reliable and potentially more valid(e.g., D versus A-dep) than the clinicalscale?What does the pattern of scale elevationssuggest in terms of factor-analyticresearch?How is this scale reflective of nontestbasedclinical symptomatology?Does external validity evidence exist(e.g., differential validity studies) to supportor refute my interpretation of thisscale?Has the validity study been independentlyreplicated?Interpretation of the MMPI is also supportedby practical and thorough bookson the topic (e.g., Archer, 1997) as well asnumerous work-shops and other continuingprofessional development opportunities.The MMPI-A literature, while notnearly as extensive as that of the MMPI-2,is expansive. A specific example of this rangeof resources is a guide devoted singularlyto the use of the MMPI system in forensicwork (Pope, Butcher, & Seelen, 2000).A sample case (Box 6.4) on the followingpage illustrates briefly how MMPI-A scaleelevations can be used in conjunction withother assessment information to aid diagnosticdecisions and in determining the primarytarget(s) of intervention.Strengths and WeaknessesThe MMPI-A’s long history is simultaneouslyits greatest asset and liability.On the one hand, the volumes of MMPIresearch guide practice. In direct contrast,the original clinical scales are incongruentwith modern research on child and adolescentpsychopathology and test developmentmethods. The continually expandingresearch base and new scale developmentensures that the MMPI will enjoy continuedpopularity and utility. It is, after all, aunique self-report measure.