Millon Clinical Multiaxial

Inventory-III (MCMI-III)
Allison C. Aosved, PhD

Objectives

Participants will be provided with an

overview of the MCMI-III
Participants will be familiar with
interpretation guidelines for the MCMIIII
Participants will have the opportunity
to practice interpretation of the MCMIIII

Objective 1
MCMI-III Overview

Personality Models &

Theories

Models to describe personality prototypes

Behavioral: observable behavior
Phenomenological: cognitive styles, object

representations, self-image
Intrapsychic: regulatory mechanisms
Biophysical: impact of mood and temperament
Sociocultural: impact of interpersonal
relationships

Millons theory draws on evolutionary

theory to explain personality

Theoretical Underpinnings

Theodore Millons bioevolutionary theory

Personality exists on a continuum that is a combination of

3 polarities:
Survival aims survival/pleasure
Adaptive modes changing/reacting to environment
Replication strategies reinforcement/nurturing

Similar to DSM but not an exact match

DSM disorders
Additional disorders (aggressive/sadistic, self-defeating)

Medical illness analogy

Axis I = fever and cough
Axis II = immune system
Axis III & IV = medical & psychosocial factors

Test Construction &

Development
Test construction deductive or rational
Sequential validation strategy, 3 phases

Theoretical-substantive: items are evaluated on

how well their content conforms to the theory

from which they were derived (e.g., DSM &
Millons)
Internal-structural validation: evaluated internal
structure of the measure
External-criterion validation: evaluated measure
externally

Item assignment and weighting

Brief History of the MCMI

MCMI was originally published in 1977

Theodore Millon was active with DSM-III
Axis II criteria work group
MCMI-II was published in 1987 (same year
as DSM-III-R published adjusted criteria)
MCMI-III was published in 1994 (with
introduction of DSM-IV)
MCMI-III is the 3rd most frequently used
psychological test

MCMI-II vs. MCMI-III

90 items were revised or replaced

Additional scales
Noteworthy responses added
Axis I scales were improved
Item weighting scheme was changed
Fewer items per scale
New validity scale
Grossman Facet scales
New norms

Rationale for MCMI-III

Make an inventory useful for

diagnosing DSM disorders
Assist with distinguishing between:
Persistent, life long characteristics (Axis II)
Current symptom states (Axis I)

Ability to reflect severity of pathology

Designed for computer scoring and
analysis
Base rate (BR) scores

Base Rates (BR)

MCMI-III uses BR instead of T or Z scores

Millon posits that these better reflect the skewed

distributions of personality disorders

General interpretation guidelines for a BR

BR 35 = normal population (non-clinical)
BR 60 = standard for clinical population (this was set

by Millon)
BR of 75-84 = some characteristics are present
BR 85 and higher = most characteristics of a disorder
are present
Note: BR under 75 are not considered clinically
significant and are not to be interpreted

MCMI-III Final Form

Five validity scales

Eleven clinical personality patterns
(Axis II)
Three scales of severe personality
pathology (Axis II)
Seven clinical syndromes (Axis I)
Three severe clinical syndromes (Axis I)

MCMI-III Norms

MCMI-II Norms (1992)

General norms (998 adults seeking therapy in

inpatient and outpatient settings)

Correctional norms (1,676 incarcerated adults)

MCMI-III New Norms (2008)

Demographics:
Sex: 397 (52.8%) women, 355 (47.2%) men
Race/ethnicity: 83 (11%) African American, 4 (0.5%)
Native American, 11 (1.5%) Asian American, 70
(7.6%) Hispanic/Latino, 571 (76%) Caucasian, 12
(1.6%) Other
Ages: 18-79

Strengths

Theoretically based
Strongly corresponds with DSM-IV
Assess both Axis I and Axis II
Brief measure
Strong norms
Psychometrically sound
Resources for interpretation

Limitations

Clinical population
May indicate pathology when there is none
Heavy item overlap
Requires computer scoring
Unconventional approach to norms (i.e., BR)
Validity scales
May be more reflective of theory than DSM
Not all DSM diagnoses are well represented

Administration

Designed for individuals with a

suspected mental health disorder
Appropriate for age 18 and older
Requires a 6th grade reading level
175 True or False items
Can be administered in group or
individual setting
Typically requires 25-30 minutes

Administration in VA MHA

Administration in VA MHA

Administration in VA MHA

Administration in VA MHA

Objective 2
General MCMI-III
Interpretive Guidelines

General Interpretative
Guidelines

Consider the context of the testing (e.g., how this might impact
approach to test taking)
Examine validity indices
Review critical items
Examine severe personality disorders
Examine clinical personality patterns
Grossman Facet scales
Examine severe clinical syndromes
Examine clinical syndromes
Consider other data (e.g., background, hx, records review, other test
data, etc.)
Establish diagnosis
Generate treatment recommendations
Write report
Provide Feedback

Interpretation Validity
Indices

Omitted items do not interpret if more than 10 items were omitted

Inconsistency Index (W): 44 pairs
Validity Index (V): 3 items of an improbable nature
No BR
True response to 1 of these items = questionable profile; True response to 2 of these

items = invalid (do not interpret)

Disclosure (X): Self-revealing vs. defensive

No BR
Degree of deviation from midrange of an adjusted composite raw score total for the 11

personality scales
If raw score is below 34 = invalid
If raw score is above 178 = invalid

Desirability (Y): favorable light

21 item scale
BR, if BR is greater than 74 = faking good

Debasement (Z): negative light

33 item scale
BR, if BR is 85 = cry for help or faking bad

Interpretation Severe
Personality

Severe Personality Disorder Scales

Schizotypal (S)
Borderline (C)
Paranoid (P)

Should be interpreted first (prior to clinical personality

patterns)
Interpret 3 highest personality elevations
Base rate interpretations:

BR 35 = normal population (non-clinical)

BR 60 = standard for clinical population (this was set by Millon)
BR of 75-84 = some characteristics are present
BR 85 and higher = most characteristics of a disorder are present
Note: BR under 75 are not considered clinically significant and are
not to be interpreted

Interpretation Clinical
Personality

Clinical Personality Disorder Scales

Schizoid (1)
Avoidant (2a)
Depressive (2b)
Dependent (3)
Histrionic (4)
Narcissistic (5)
Antisocial (6a)
Aggressive-sadistic (6b)
Compulsive (7)
Passive-aggressive (8a)
Self-defeating (8b)

Should be interpreted after severe personality disorder scales

Interpret 3 highest personality elevations
Guidelines for BR interpretation remain the same

Interpretation Severe
Clinical Syndromes

Severe Clinical Syndrome Scales

Thought disorder (SS)
Major depression (CC)
Delusional disorder (PP)

Should be interpreted first (prior to

clinical syndromes)
BR interpretation guidelines remain the
same

Interpretation Clinical
Syndromes

Clinical Syndrome Scales

Anxiety disorder (A)

Somataform disorder (H)
Bipolar: Manic disorder (N)
Dysthymic disorder (D)
Alcohol dependence (B)
Drug dependence (T)
Posttraumatic stress disorder (R)

Should be interpreted after severe clinical

syndrome scales
Guidelines for BR interpretation remain the same

Objective 3
Practice Interpretation

Practice: Case

Patient fictitious and created for the purpose of practice

interpretation
Female, 53 years old, Caucasian
Married with 2 college age children
Family hx: no hx of bipolar or psychosis, paternal depression and alcohol

abuse, maternal depression

Successful 20+ year military career, 2 deployments to OIF (combat trauma
exposure)
Childhood sexual abuse by an uncle
Retired from Army 2 years ago
One psychiatric hospitalization (4 months ago)
Civilian career in health care administration
Is not applying for or interested in service connection
Has a diagnosis of breast cancer
New to outpatient mental health treatment requesting help with managing
anxiety related to work, previous trauma, and recent cancer diagnosis

Practice: Profile

Consider the context of the testing (e.g., how this might

impact approach to test taking)
Examine validity indices
Review critical items
Examine severe personality disorders
Examine clinical personality patterns
Grossman Facet scales
Examine severe clinical syndromes
Examine clinical syndromes
Consider other data (e.g., background, hx, records review,
other test data, etc.)
Establish diagnosis
Generate treatment recommendations

References
Resources & References

References

Craig, R. (1999). Interpreting Personality Tests: A

Clinical Manual for the MMPI-2, MCMI-III, CPI-R,
and 16PF. New York: Wiley.
Groth-Marnat, G. (2003). The Handbook of
Psychological Assessment. New York: John Wiley &
Sons. (Directed Reading)
Millon, T. (Ed). (1996). The Millon Inventories. New
York: Guilford.
Millon, T., Millon, C., Davis, R., & Grossman, S.
(2010). MCMI-III: Independent study training
program for the Millon Clinical Multiaxial Inventory
(MCMI-III) test. Pearson.