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For more than 60 years it has been known that profiles from the Minnesota Multiphasic Personality Inventory (MMPI), obtained from medical patients, are elevated when scores are plotted using general population norms. These elevations have been most apparent on the neurotic triad (NTd), the first 3 clinical scales on the MMPI profile. More than 45 years have passed since a nonreferred, normative sample of MMPIs was established from 50,000 consecutive medical outpatients. We present comparable but contemporary normative data for the revised MMPI (MMPI-2) based on a nonreferred sample of 1,243 family medicine outpatients (590 women; 653 men). As true for the original MMPI, contemporary medical outpatients have profiles that are significantly different, clinically and statistically, from the general population norms for the MMPI-2. This is particularly evident in elevations on the NTd. New normative tables of uniform medical T (UMT) scores were developed following the procedures used to create the uniform T scores for the MMPI-2. Measures of internal consistency are reported; test-retest reliability was established over a mean of 3.7 weeks, and results characterizing the stability of the validity and clinical scales are presented.

Patients with medical or social problems related to alcohol abuse or alcohol dependence frequently are seen in the health care delivery system. Direct and indirect screening methods are available, but contemporary data describing their combined effectiveness have not been reported. We determined the sensitivity of (a) an empirically derived, item-weighted, relatively "indirect" screening measure for alcohol misuse (the Common, Alcohol, Logistic [CAL] scale for the MMPI), (b) a "direct" approach to screening for alcohol misuse (the Self-Administered Alcohol Screening Test [SAAST]), and (c) their combined application. We obtained the responses to both measures from an archival sample of 361 medical patients (89 women, 272 men) who had been diagnosed with alcohol dependence by DSM-III-R criteria. The CAL scale and the SAAST both demonstrated high sensitivity. However, results favored the simultaneous use of a direct-in this study, the SAAST-and an indirect-in this study, the CAL scale-screening procedure.

Objective: To examine explanatory style (how people explain life events) as a risk factor for early death, using scores from the Optimism-Pessimism scale of the Minnesota Multiphasic Personality Inventory (MMPI)., Subjects and Methods: A total of 839 patients completed the MMPI between 1962 and 1965 as self-referred general medical patients. Thirty years later, the vital status of each of these patients was ascertained., Results: Of the 839 patients, 124 were classified as optimistic, 518 as mixed, and 197 as pessimistic. Follow-up was available for 723 patients. Among these, a 10-point T-score increase on the Optimism-Pessimism scale (e.g., more pessimistic) was associated with a 19% increase in the risk of mortality., Conclusion: A pessimistic explanatory style, as measured by the Optimism-Pessimism scale of the MMPI, is significantly associated with mortality.

Regression equations are presented for converting the non-K-corrected raw scores on the Minnesota Multiphasic Personality Inventory (MMPI) basic scales to an estimated optimism-pessimism score. This score describes an individual's explanatory style on a continuum from optimistic to pessimistic. These equations will enable clinicians and researchers to estimate an optimism-pessimism score if the MMPI item responses are not accessible or if computer scoring facilities for individual items are unavailable.

This article reports adolescent norms for the Optimism-Pessimism (PSM) scale of the Minnesota Multiphasic Personality Inventory (MMPI). The PSM scale measures explanatory style on a continuum from optimistic to pessimistic by using 298 MMPI items. It is based on Seligman's theory of explanatory style and was constructed by applying the Content Analysis of Verbatim Explanations (CAVE) technique to the MMPI item pool. The normative equations are based on a random sample of 624 normal boys and 691 normal girls ages 13 through 17 years. Reliability estimates of .94 demonstrate that the PSM scale can accurately assess explanatory style in adolescents. These norms may identify a personality factor associated with poorer physical and mental health and lower levels of achievement.

The Revised Optimism-Pessimism (PSM-R) scale was developed for use with either the MMPI-2 or the MMPI. The scale measures explanatory style on a continuum from optimistic to pessimistic by using 263 MMPI items of the original 298-item Optimism-Pessimism (PSM) scale. These 263 items are common to both the MMPI-2 and MMPI. PSM-R norms are based on a random sample of 1,408 normal adults who also were used for developing norms for the original PSM scale. Reliability estimates (.93 for men; .94 for women) indicate that the PSM-R scale is as accurate as the original PSM scale.

The Common Alcohol Logistic-Revised (CAL-R) scale was developed for use with MMPI or MMPI-2 with medical patients. It was derived from the Common Alcohol Logistic (CAL) scale and developed by (1) dropping the six CAL items deleted from the MMPI during construction of the MMPI-2 and recomputing item weights (using logistic regression); (2) calculating norms; and (3) repeating the validation procedure used in developing CAL. We used the same criterion group (1,221 alcoholics) and same contrast sample (7,621 nonalcoholic medical patients) used for CAL. Comparison of receiver operating characteristic curves, positive predictive value, and negative predictive value for CAL and CAL-R indicates that the latter has the same favorable ability to screen medical patients for alcoholism as the former.

Eleven personality disorder scales for the MMPI, as described in DSM-III, were derived by Morey and his colleagues from the original MMPI item pool through a combination of rational and empirical strategies. These new scales have enjoyed popularity among clinicians. Normative tables for each of these scales, with and without overlapping items, were constructed from MMPI responses from a large contemporary normal reference sample of adults and adolescents without any physical or mental handicaps who were selected randomly from a three-state area in the Midwest. Some items from the Morey Personality Disorder scales were deleted during development of the MMPI-2; separate normative tables have been prepared for the scales so affected, which allows clinicians who are using the MMPI-2 to continue to use these slightly modified scales.

Research based on Seligman's model indicates that a pessimistic explanatory style predicts increased frequency of depression, poorer physical health, and lower levels of achievement. The data show that persons who have a pessimistic outlook on life are more frequent users of the medical and mental health care delivery systems. This paper describes the development of a bipolar MMPI Optimism-Pessimism (PSM) scale that is based on the results of a technique--Content Analysis of Verbatim Explanation (CAVE)--applied to the MMPI. Reliability and validity indices show that the PSM scale is highly accurate and consistent with Seligman's theory. Identification of the patient's explanatory style may lead to improved management because intervention measures can be directed more accurately according to the patient's personality style. The new scale also will allow researchers to use existing MMPI data to explore relationships between explanatory style and various outcome variables and behavioral correlates.

Three prospective studies from the early 1980s found that high scores on the Hostility (Ho) Scale of the Minnesota Multiphasic Personality Inventory (MMPI) were associated with an increased incidence of coronary heart disease (CHD) and mortality from CHD and other causes. In the current study, the association between the Ho score and subsequent health status was examined in a 20-year follow-up of 620 general medical patients who completed the MMPI between 1962 and 1965. Univariately, the Ho score from the MMPI was a significant factor for predicting the development of CHD, CHD-related mortality, and total mortality. When two simple risk factors for CHD--age and sex--were also considered, however, the MMPI Ho score was no longer a significant predictive factor.

Statistically significant and clinically relevant age-related changes in MMPI response patterns have long been known to clinicians. Graphic representations of mean scores that cover an 85-year age span, separately by sex, for each of the 13 basic MMPI validity and clinical scales support the use of adolescent norms and indicate that clinicians should give greater acknowledgement to age-related MMPI changes in adults and their interpretation, particularly among geriatric patients.

We developed a MMPI alcoholism scale based on adult medical patient samples. Our criterion group consisted of 736 inpatients (525 males; 211 females) diagnosed as having alcoholism according to DSM-III criteria. Three contrast samples that totaled 13,120 individuals were used for control purposes. MMPI items were chosen by means of logistic regression. The 33 items yielded by this procedure formed a provisional scale (CAL, for common alcoholism logistic) that worked equally well for males and females. With new cross-validation samples, with sensitivity (proportion of alcoholics correctly identified) set at 90%, the specificity (proportion of nonalcoholics correctly identified) ranged from 90% to 96% for selected contrast samples. We conclude that this scale shows promise as a screening device in similar populations.

Current adolescent norms for the MMPI are based on data obtained 25 to 45 years ago, from samples established in 1947 to 1957 and 1964 to 1965 (Marks & Briggs, 1967). Recently, MMPIs from 1,315 normal adolescent females and males, aged 13 through 17 years, were gathered from a three-state midwest area. There were significant differences between contemporary adolescent MMPI response patterns and those obtained from the earlier adolescent samples. This article presents new K-corrected normalized T-score conversion tables to encourage research that compares the relative efficacy of profiles calculated with and without K correction.

MacAndrew (1965) constructed the MacAndrew Alcoholism Scale (MAC) using adult male alcoholic outpatients and male psychiatric outpatients. Later, he developed the Substance Abuse Proclivity Scale (SAP; MacAndrew, 1986), specifically for screening younger males, using adolescent and young adult substance misusing and nonmisusing males 16 to 22 years of age. Because clinicians frequently apply the MAC to adolescents, we compared the efficacy of the MAC and the SAP scales using a sample of 436 young males between the ages of 13 and 25, who were hospitalized because of substance abuse, and 770 normal young males between the ages of 13 and 25. Results suggest that clinicians should use these scales with great caution.

Recent work with the F-K index of the MMPI has reaffirmed its usefulness for identifying dissimulation. However, the potential usefulness of any index of malingering is dependent on its frequency of occurrence in the normal population. This article presents normative tables for the F-K index based on a contemporary normative sample of 335 normal women and 304 normal men.

In 1937, research was initiated to develop a questionnaire that would aid physicians in evaluating the psychologic functioning of patients. The questionnaire quickly proved to be useful and became, as the Minnesota Multiphasic Personality Inventory (MMPI), the most widely used and thoroughly researched objective personality-assessment instrument. In 1959, the first computerized scoring and interpretative system for the MMPI was developed at the Mayo Clinic. During the 50 years that the MMPI has been used, however, our society has changed considerably. Therefore, a new normal contemporary reference sample of adults was obtained by Mayo Clinic investigators in 1983. Significant changes in response patterns were observed in comparison with the original norms, and new tables, based on normalized T scores rather than the linear transformation procedures of the past, were developed; these were incorporated into the Mayo Clinic MMPI scoring and interpretative system in 1984. Subsequently, a companion study of contemporary normal adolescents (691 girls and 624 boys) also showed significant changes in response patterns in comparison with the original norms. In addition, MMPI profiles from contemporary normal adolescents continue to differ from those of contemporary normal adults, similar to the differences noted between these two groups in the past. Data from these contemporary normal adolescents were used to develop new adolescent norms, which were incorporated into the Mayo Clinic scoring and interpretative system for the MMPI in January 1988.

The Minnesota Multiphasic Personality Inventory (MMPI) was scored for the MacAndrew (MAC) Scale in a series of samples totaling 14,789 subjects. These samples included 1077 substance-dependent patients (739 men), 7090 selected medical outpatients (2853 men), 5000 unselected medical outpatients (2500 men), 214 psychiatric inpatients (92 men) and 1408 contemporary normal (646 men). Overall, the MAC Scale correctly classified only 70.7% of the men and 37.9% of the women alcoholics. However, when samples of men and women alcoholics were broken down into four age groups, the MAC Scale correctly identified 90% of men alcoholics in the 18- to 24-year age group but only 41% of women alcoholics in the same age group. In addition, the predicted rate of alcoholism in the samples that were not substance-dependent, using the MAC Scale, was approximately 1.5 to 4 times the estimated lifetime prevalence rate (this was also true in the 18- to 24-year age group). MMPI item 215 ("I have used alcohol excessively") correctly identified 95% of the men and 94% of the women alcoholics. It was concluded that, except for men less than 24 years old, the MAC Scale is not an appropriate screening test for substance dependence in a predominantly middle-class medical population.

MMPI responses obtained from a large random sample of midwestern adults who were 18 through 99 years old and had no physically or mentally handicapping condition yielded a pattern significantly different from the pattern of the original norms. From these data, two new kinds of normative tables have been developed: Norms that reflect, for each sex, the response pattern of the general adult population, and a set of tables, separate for each sex, that allow comparisons to be based on age. In addition, the traditional scoring procedures based on a linear transformation that maintains any underlying skewness of the raw score distribution has been replaced by procedures that yield normalized T scores. The changes that are apparent at the item and scale level are also evident in the frequency with which certain 1- and 2-point codes occur in normal and clinical samples. These changes are apt to make our interpretive statements more meaningful because they are based on contemporary norms.

Twenty-five years of experience with the Mayo Clinic computerized system for the Minnesota Multiphasic Personality Inventory (MMPI) have accrued since Swenson , Rome, and their colleagues proposed this innovation in 1959. Although it is the most respected, widely used, and thoroughly researched objective personality-assessment instrument that has been developed to date, the MMPI is aging. Work on the MMPI began in 1937, and the original normative base was established in the late 1930s and early 1940s . To develop new norms, we selected a random sample of 1,408 subjects, not under care for any physically or mentally handicapping condition and ranging in age from 18 through 99 years, from parts of Iowa, Wisconsin, and Minnesota in a 50-mile radius surrounding Rochester, Minnesota. MMPI responses obtained from this sample were used to develop normalized T-score tables for specific age ranges, and for adults in general, for the 13 basic scales of the MMPI.

Welsh developed scales A (anxiety/maladjustment) and R (repression/control) as measures of two of the underlying dimensions of the MMPI. They are among the most frequently used of the supplemental scales for the MMPI. However, there have been significant changes in MMPI response patterns when profiles from contemporary normal people are compared with the original Minnesota normal sample from which the original MMPI norms were derived more than 40 years ago. Comparable changes are also apparent on scales A and R. New norms based on a large sample (N = 1,408) of contemporary normal people are presented for clinicians and researchers who use scales A and R.

Content scales for the MMPI continue to hold considerable interest for clinicians. On the basis of a critique of prior research in this area, a new set of content-homogeneous subscales, the Augmented Purdue Subscales (APS), were developed for the basic MMPI scales. Norms for the APS then were derived from the MMPI response patterns of a large, randomly selected sample of contemporary normal persons.

The original standardization of the MMPI was completed approximately 40 years ago. These norms were refined in 1957, but no attempt has been made to develop new standards. Therefore, a contemporary random sample of 1,408 persons living in the midwestern states who were similar to the original sample in area of residence and in the absence of significant medical problems were asked to complete the MMPI. The resulting MMPI data by age and sex are presented. In general, responses from this contemporary sample yielded higher mean scores than appeared in the original standardization group. These data suggest a somewhat more conservative approach to profile interpretation, with more careful consideration of the impact of age and sex on profile configurations.

The Wiggins Content Scales (WCS) continue to be popular among clinicians. However, MMPI profile patterns across the basic scales have shown significant changes since the inception of the MMPI in 1937. Therefore, the possibility of similar changes on the WCS was investigated. Significant differences between the old norms and a large, randomly selected contemporary normal sample (N = 1,408) were found on 9 of the WCS for women and on 5 for men. New normative tables are presented as an aid for clinicians who use the WCS.

Seven alcoholism scales for the MMPI were evaluated for effectiveness in screening medical patients. Sensitivity and specificity were assessed by use of five contrast samples: (1) 736 inpatients from an alcohol and drug dependence unit; (2) 4,923 unselected medical outpatients; (3) 7,044 selected medical outpatients; (4) 214 psychiatric inpatients; and (5) 1,408 contemporary normal persons. None of these scales can be recommended for use in screening medical patients. However, endorsement of MMPI item 215 should lead to further evaluation because classification was more accurate with this single item than with any of the scales evaluated.

Although it is more than 30 years old, Es remains one of the most frequently scored of the MMPI supplemental scales. However, there have been significant changes in MMPI response patterns among adults since the Es scale was first developed. New normative tables for the Es scale based on a contemporary census-matched sample of normal adults are presented along with figures that illustrate changes associated with age and sex.

Although the MacAndrew scale (MAC) is the most widely used of the MMPI alcoholism screening scales, evidence to support its continued use is equivocal, and recent data raise serious questions about its efficacy in the screening of medical patients. In comparison, the Institutionalized Chronic Alcoholic Scale (ICAS), an 8-item scale, has an equivalent correct classification rate among male alcoholics and is significantly better than the MAC scale at identifying female alcoholics. Furthermore, misclassification rates among medical patients and normal persons are substantially lower for the ICAS than for the MAC scale, although the ICAS overidentifies potential alcoholism among normal women and female medical patients. However, reliability coefficients across the criterion and contrast samples are disappointingly low, and the use of the ICAS cannot be defended on that basis.